Digital contrast subtraction radiography for proximal caries diagnosis

International Nuclear Information System (INIS)

Kang, Byung Cheol; Yoon, Suk Ja

2002-01-01

To determine whether subtraction images utilizing contrast media can improve the diagnostic performance of proximal caries diagnosis compared to conventional periapical radiographic images. Thirty-six teeth with 57 proximal surfaces were radiographied using a size no.2 RVG-ui sensor (Trophy Radiology, Marne-la-Vallee, France). The teeth immersed in water-soluble contrast media and subtraction images were taken. Each tooth was then sectioned for histologic examination. The digital radiographic images and subtraction images were examined and interpreted by three dentists for proximal caries. The results of the proximal caries diagnosis were then verified with the results of the histologic examination. The proximal caries sensitivity using digital subtraction radiography was significantly higher than simply examining a single digital radiograph. The sensitivity of the proximal dentinal carious lesion when analyzed with the subtraction radiograph and the radiograph together was higher than with the subtraction radiograph or the radiograph alone. The use of subtraction radiography with contrast media may be useful for detecting proximal dentinal carious lesions.

Odontoblast layer structure alteration as a response to carious lesions

Directory of Open Access Journals (Sweden)

Tetiana Haniastuti

2011-09-01

Full Text Available Background: Dental caries is a bacterial disease affecting the hard tissue of the teeth as well as the pulp. The human dental pulp consists of odontoblast which are organized as a densely packed cell layer. Odontoblasts is located at the periphery of the pulp; therefore, they are the first cells encountered by cariogenic bacteria and their products that are represented in the carious lesion. Purpose: This study aimed to elucidate the effect of cariogenic bacteria to odontoblasts of human teeth. Methods: Five intact third molars and 15 third molars with occlusal caries at various stages of decay were extracted because of orthodontic or therapeutic reasons. The tooth specimens were fixed, decalcified with 10% EDTA solution (pH 7.4, and embedded in paraffin. Serial sections of 5 μm thickness were cut and stained with haematoxylin eosin and Gram’s, in addition to nestin immunohistochemistry. The specimens were then examined under light microscopy. Results: In normal teeth, odontoblast layer were aligned along the pulp chamber showing normal morphology of the cells. Slight disorganization of odontoblast layer was seen in the cases of carious lesions confined to enamel. In the cases of carious lesions confined to dentin, odontoblast layer was not observed in the areas subjacent to the lesions, only single cells showing flattened cell morphology were found. Odontoblasts beneath the lesion suffered severe damage and diminished nestin immunoreaction were observed in all cases of carious lesions with pulp exposure. Conclusion: Cariogenic bacteria invasion may damage the odontoblasts by affecting the morphology and vitality of the cells. The severity of the damage of the odontoblasts may increase as the bacterial invasion progresses toward the pulp.Latar belakang: Karies merupakan penyakit yang disebabkan oleh bakteri, yang dapat memengaruhi jaringan keras gigi maupun pulpa. Pada pulpa gigi manusia terdapat sel odontoblas yang tersusun atas lapisan sel

Nd:YAG Lasers Treating of Carious Lesion and Root Canal In Vitro

Directory of Open Access Journals (Sweden)

Danqing Xia

2012-01-01

Full Text Available Dental caries is a transmissible bacterial disease process, with cavities at the end, and caused by acids from bacterial metabolism. The essence of dental treatment is to clean and disinfect bacterial contamination from the tooth. In this work, we tried to demonstrate the cleaning and disinfecting effects of Nd:YAG laser irradiation on dental carious lesion and root canal in vitro. Acousto-optic Q-switched quasicontinuous and Cr3+:YAG crystal Q-switched pulse Nd:YAG lasers were employed to treat caries lesion and the root canal, respectively. Results showed that acousto-optic Q-switched quasicontinuous Nd:YAG laser irradiation and Cr3+:YAG crystal Q-switched pulse Nd:YAG laser irradiation could rapidly clean decayed material and bacterial contamination from dental carious lesion and the narrow tail end of root canal with minimally invasive in vitro, respectively. It was concluded that acousto-optic Q-switched quasicontinuous laser irradiation may be a rapid and effective alternative caries treatment, and Cr3+:YAG crystal Q-switched pulse Nd:YAG laser irradiation may be an effective method for canal cleaning and disinfecting during root canal therapy.

Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions.

Science.gov (United States)

Gilbert, Kenneth; Joseph, Raphael; Vo, Alex; Patel, Trusha; Chaudhry, Samiya; Nguyen, Uyen; Trevor, Amy; Robinson, Erica; Campbell, Margaret; McLennan, John; Houran, Farielle; Wong, Tristan; Flann, Kendra; Wages, Melissa; Palmer, Elizabeth A; Peterson, John; Engle, John; Maier, Tom; Machida, Curtis A

2014-01-01

Mutans streptococci (MS) are one of the major microbiological determinants of dental caries. The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC), and assess if cariogenic MS and non-cariogenic streptococci might independently exist as primary bacterial strains on distinct sites within the dentition of individual children. Dental plaque from children (N=20; aged 3-6) with S-ECC was collected from carious lesions (CLs), white spot lesions (WSLs) and non-carious enamel surfaces. Streptococcal isolates (N=10-20) from each site were subjected to polymerase chain reaction (PCR) to identify MS, and arbitrarily primed-PCR for assignment of genetic strains. Primary strains were identified as ≥50% of the total isolates surveyed at any site. In several cases, strains were characterized for acidurity using ATP-driven bioluminescence and subjected to PCR-determination of potential MS virulence products. Identification of non-MS was determined by 16S rRNA gene sequencing. Sixty-four independent MS or non-MS streptococcal strains were identified. All children contained 1-6 strains. In many patients (N=11), single primary MS strains were identified throughout the dentition. In other patients (N=4), primary MS strains were identified within CLs that were distinct from primary strains found on enamel. Streptococcus gordonii strains were identified as primary strains on enamel or WSLs in four children, and in general were less aciduric than MS strains. Many children with S-ECC contained only a single primary MS strain that was present in both carious and non-carious sites. In some cases, MS and non-cariogenic S. gordonii strains were found to independently exist as dominant strains at different locations within the dentition of individual children, and the aciduric potential of these strains may influence susceptibility in the

Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions

Directory of Open Access Journals (Sweden)

Kenneth Gilbert

2014-10-01

Full Text Available Background and objectives: Mutans streptococci (MS are one of the major microbiological determinants of dental caries. The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC, and assess if cariogenic MS and non-cariogenic streptococci might independently exist as primary bacterial strains on distinct sites within the dentition of individual children. Design: Dental plaque from children (N=20; aged 3–6 with S-ECC was collected from carious lesions (CLs, white spot lesions (WSLs and non-carious enamel surfaces. Streptococcal isolates (N=10–20 from each site were subjected to polymerase chain reaction (PCR to identify MS, and arbitrarily primed-PCR for assignment of genetic strains. Primary strains were identified as ≥50% of the total isolates surveyed at any site. In several cases, strains were characterized for acidurity using ATP-driven bioluminescence and subjected to PCR-determination of potential MS virulence products. Identification of non-MS was determined by 16S rRNA gene sequencing. Results: Sixty-four independent MS or non-MS streptococcal strains were identified. All children contained 1–6 strains. In many patients (N=11, single primary MS strains were identified throughout the dentition. In other patients (N=4, primary MS strains were identified within CLs that were distinct from primary strains found on enamel. Streptococcus gordonii strains were identified as primary strains on enamel or WSLs in four children, and in general were less aciduric than MS strains. Conclusions: Many children with S-ECC contained only a single primary MS strain that was present in both carious and non-carious sites. In some cases, MS and non-cariogenic S. gordonii strains were found to independently exist as dominant strains at different locations within the dentition of individual children, and

The Comparison of Dentine Thickness Under Proximal Caries Between Bitewing Radiographs and Tooth Structure

Directory of Open Access Journals (Sweden)

Khosravi K

2001-05-01

Full Text Available Carious lesions are usually found by dentists, using bitewing radiographs, and according to the depth of the lesions, the treatment plan is designed. At the present, this technique is the most accepted one and is used generally. But it is not a perfect technique and there are some errors in determining of depth of proximal carious lesions. These errors are mainly related to the use of new high-speed films with broad density and lower voltages. In this study, dentin thickness under proximal caries in bitewing radiography was compared with its real thickness, in tooth structure. Twenty-four teeth samples with proximal caries were used. Before and after removal of carious lesions bitewing radiographs were taken and then each tooth was sectioned occlusogingivally and the thickness of dentine under proximal caries and on bitewing radiographs were measured under microscope with 0.01 mm accuracy. Mean value of dentine thickness in tooth structure was 41% of its mean thickness in bitewing radiographs, showing 59% difference (reduction. Therefore, more care should be taken in using standard technique and interpreting of bitewing radiographs by clinicians. Clinical examinations also should be performed in ideal conditions, and patients should be clinically and radiographically examined every six months.

NON - OPERATIVE TREATMENT OF NON - CAVITATED APPROXIMAL CARIOUS LESIONS OF PERMANENT CHIDREN’S TEETH.

Directory of Open Access Journals (Sweden)

Rossiza I. Kabakchieva

2014-10-01

Full Text Available Aim: To apply and follow up in clinical conditions the success rate of microinvasive technique of infiltration with low viscosity resin ICON® (DMG of non cavitated approximal caries lesions of permanent children's teeth for a period of one year. Material and methods: The study included 18 children aged 7-16 years. They were divided into two groups - children with medium and high caries risk. The survey include 20 teeth with approximal non-cavitated enamel lesions up to the outer third of dentin (E1, E2, D1 – according to the manufacturer’s instructions of ICON®. The size of the lesions was determined using bitewing radiographs and the activity - by Papilla Bleeding Index. The clinical application of the infiltr+ant (ICON® Caries Infiltrant Proximal, DMG was conducted according to the manufacturer's instructions. Bitewing radiographs were made at 6 and 12 months after infiltration in order to evaluate the success of the method. A test of the difference between two relative proportions and alternative test for analysis of the results were used. Results: Our study confirm the hypothesis that this method of infiltration is equally successful for permanent teeth in patients with moderate caries risk as well as those at high caries risk. Conclusion: This study is the first survey regarding the success of the application of ICON® for treatment of non-cavitated approximal carious lesions in permanent dentition of children in the country. Research in this direction should continue in order to increase the conviction that caries can be controlled and arrested in its earliest stages.

Assessment of cavitation in artificial approximal dental lesions with near-IR imaging

Science.gov (United States)

Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

2017-02-01

Bitewing radiography is still considered state-of-the-art diagnostic technology for assessing cavitation within approximal carious dental lesions, even though radiographs cannot resolve cavitated surfaces but instead are used to measure lesion depth in order to predict cavitation. Clinicians need new technologies capable of determining whether approximal carious lesions have become cavitated because not all lesions progress to cavitation. Assessing lesion cavitation from near-infrared (NIR) imaging methods holds great potential due to the high transparency of enamel in the NIR region from λ=1300-1700-nm, which allows direct visualization and quantified measurements of enamel demineralization. The objective of this study was to measure the change in lesion appearance between non-cavitated and cavitated lesions in artificially generated lesions using NIR imaging modalities (two-dimensional) at λ=1300-nm and λ=1450-nm and cross-polarization optical coherence tomography (CP-OCT) (thee-dimensional) λ=1300-nm. Extracted human posterior teeth with sound proximal surfaces were chosen for this study and imaged before and after artificial lesions were made. A high speed dental hand piece was used to create artificial cavitated proximal lesions in sound samples and imaged. The cavitated artificial lesions were then filled with hydroxyapatite powder to simulate non-cavitated proximal lesions.

Detection of questionable occlusal carious lesions using an electrical bioimpedance method with fractional electrical model

Energy Technology Data Exchange (ETDEWEB)

Morais, A. P. [Biomedical Engineering Program, COPPE, Rio de Janeiro (Brazil); Salgado de Oliveira University, Marechal Deodoro Street, 217 – Centro, Niterói, Rio de Janeiro (Brazil); Pino, A. V. [Biomedical Engineering Program, COPPE, Rio de Janeiro (Brazil); Souza, M. N. [Biomedical Engineering Program, COPPE, Rio de Janeiro (Brazil); Electronics Department at Polytechnic School, Federal University of Rio de Janeiro, Centro de Tecnologia Bloco H sala 217, Ilha do Fundão, Rio de Janeiro (Brazil)

2016-08-15

This in vitro study evaluated the diagnostic performance of an alternative electric bioimpedance spectroscopy technique (BIS-STEP) detect questionable occlusal carious lesions. Six specialists carried out the visual (V), radiography (R), and combined (VR) exams of 57 sound or non-cavitated occlusal carious lesion teeth classifying the occlusal surfaces in sound surface (H), enamel caries (EC), and dentinal caries (DC). Measurements were based on the current response to a step voltage excitation (BIS-STEP). A fractional electrical model was used to predict the current response in the time domain and to estimate the model parameters: Rs and Rp (resistive parameters), and C and α (fractional parameters). Histological analysis showed caries prevalence of 33.3% being 15.8% hidden caries. Combined examination obtained the best traditional diagnostic results with specificity = 59.0%, sensitivity = 70.9%, and accuracy = 60.8%. There were statistically significant differences in bioimpedance parameters between the H and EC groups (p = 0.016) and between the H and DC groups (Rs, p = 0.006; Rp, p = 0.022, and α, p = 0.041). Using a suitable threshold for the Rs, we obtained specificity = 60.7%, sensitivity = 77.9%, accuracy = 73.2%, and 100% of detection for deep lesions. It can be concluded that BIS-STEP method could be an important tool to improve the detection and management of occlusal non-cavitated primary caries and pigmented sites.

Detection of questionable occlusal carious lesions using an electrical bioimpedance method with fractional electrical model

International Nuclear Information System (INIS)

Morais, A. P.; Pino, A. V.; Souza, M. N.

2016-01-01

This in vitro study evaluated the diagnostic performance of an alternative electric bioimpedance spectroscopy technique (BIS-STEP) detect questionable occlusal carious lesions. Six specialists carried out the visual (V), radiography (R), and combined (VR) exams of 57 sound or non-cavitated occlusal carious lesion teeth classifying the occlusal surfaces in sound surface (H), enamel caries (EC), and dentinal caries (DC). Measurements were based on the current response to a step voltage excitation (BIS-STEP). A fractional electrical model was used to predict the current response in the time domain and to estimate the model parameters: Rs and Rp (resistive parameters), and C and α (fractional parameters). Histological analysis showed caries prevalence of 33.3% being 15.8% hidden caries. Combined examination obtained the best traditional diagnostic results with specificity = 59.0%, sensitivity = 70.9%, and accuracy = 60.8%. There were statistically significant differences in bioimpedance parameters between the H and EC groups (p = 0.016) and between the H and DC groups (Rs, p = 0.006; Rp, p = 0.022, and α, p = 0.041). Using a suitable threshold for the Rs, we obtained specificity = 60.7%, sensitivity = 77.9%, accuracy = 73.2%, and 100% of detection for deep lesions. It can be concluded that BIS-STEP method could be an important tool to improve the detection and management of occlusal non-cavitated primary caries and pigmented sites.

Assessment of non-cavitated and cavitated carious lesions among 12- to 15-year-old government and private school children in Pune, Maharashtra, India.

Science.gov (United States)

Machale, Priyanka S; Hegde-Shetiya, Sahana; Shirahatti, Ravi; Agarwal, Deept

2014-01-01

The present cross-sectional study was conducted to assess and compare the mean number of non-cavitated (initial lesions, IL) and cavitated carious lesions (WHO criteria) per child in the permanent dentition and to correlate it with the plaque index among 12- to 15-year-old government and private school children. 481 schoolchildren aged 12-15 years were selected randomly by multistage random sampling from two government and two private schools. Demographic details were collected at the time of examination. Baseline plaque scores were recorded using the Silness and Löe plaque index. Immediately after brushing and drying the teeth, cavitated lesions were recorded based on WHO recommendations and non-cavitated lesions were recorded using the IL criteria of Nyvad et al and Fyffe et al. The mean number of surfaces with cavitated and non-cavitated lesions for government school children was 2.13 ± 2.98 and 3.21 ± 2.97, respectively, and 1.24 ± 1.86 and 3.08 ± 2.33 for private school children, respectively. WHO + IL surfaces among private school children were 4.33 ± 3.48 and in government school children 5.35 ± 4.45. There was a positive correlation of plaque score with IL (r = 0.63) and WHO+IL (r = 0.73). Non-cavitated lesions are about twice as common as cavitated carious lesions in school children. Government school children had a higher number of cavitated and non-cavitated carious lesions when compared with private school children.

Do the levels of selected metals differ significantly between the roots of carious and non-carious teeth?

International Nuclear Information System (INIS)

Malara, Piotr; Kwapulinski, Jerzy; Malara, Beata

2006-01-01

Since the metals deposited in teeth during formation and mineralization processes are to a large extent retained, human teeth receive a considerable attention as the indicators of the heavy metal exposure. The use of permanent teeth is limited because the extraction of healthy permanent teeth just for this purpose is hardly acceptable. As the issue of the loss of elements from a carious lesion in the coronal part of a tooth remains controversial, the valuable material could only be the root of carious and fractured permanent teeth. However, to ensure the validity of the results, it should be ascertained that the levels of certain toxic and essential elements do not differ significantly between the roots of non-carious and carious teeth, and therefore this is the aim of this project. The levels of cadmium, chromium, copper, iron, manganese, lead, zinc, potassium, sodium, calcium and magnesium were determined in the roots of 344 permanent teeth (189 carious and 155 caries-free teeth) from the residents of Ruda Slaska, Poland, aged 18 to 34. No statistically significant difference between the concentration of these metals in the roots of non-carious and carious teeth was found. This finding applies to both the general population and after the grouping by donor's gender and tooth type. The concentration of lead, iron, calcium and manganese in the roots of non-carious and carious teeth exhibited dependence upon tooth type, as well as the concentration of potassium in the roots of carious teeth. Since the mineral composition of the roots of permanent teeth is similar for the non-carious, as well as the carious teeth, they can be indiscriminately selected for the tests required by a research project, as they will produce the comparable results. However, in the case of lead, iron, calcium, potassium and manganese, the comparison should be made after grouping by tooth type

Influence of the cavity-size on the survival rate of proximal ART restorations in primary molars

NARCIS (Netherlands)

Kemoli, A.M.; van Amerongen, W.E.

2009-01-01

Aim.  To evaluate the influence of the size of proximal cavities on the survival rate of the atraumatic restorative treatment (ART) restorations. Design.  A total of 804 children, aged 6-8 years, from a low socio-economic community, with an ART restorable proximal carious lesion in their primary

Antimicrobial photodynamic therapy as an adjunct for treatment of deep carious lesions-A systematic review.

Science.gov (United States)

Cieplik, Fabian; Buchalla, Wolfgang; Hellwig, Elmar; Al-Ahmad, Ali; Hiller, Karl-Anton; Maisch, Tim; Karygianni, Lamprini

2017-06-01

For deep carious lesions, a more conservative treatment modality ("selective caries removal") has been proposed, where only the heavily contaminated dentine is removed. In this regard, effective adjuncts for cavity disinfection such as the antimicrobial photodynamic therapy (aPDT) can be valuable clinically prior to definitive restoration. Therefore, the aim of this study was to systematically assess clinical studies on the effectiveness of aPDT as a supplementary tool in the treatment of deep caries lesions. Searches were performed in four databases (PubMed, EMBASE, ISI Web of Science, ClinicalTrials.gov) from 1st January, 2011 until 21st June, 2016 for search terms relevant to the observed parameters, pathological condition, intervention and anatomic entity. The pooled information was evaluated according to PRISMA guidelines. At first, 1651 articles were recovered, of which 1249 full-text articles were evaluated, 270 articles thereof were reviewed for eligibility and finally 6 articles met all inclusion criteria. The aPDT protocols involved Methylene Blue, Toluidine Blue and aluminium-chloride-phthalocyanine as photosensitizers and diode lasers, light-emitting diodes and halogen light-sources. The data from five reports, utilizing both culture-dependent and -independent methods, disclosed significant reduction of cariogenic bacterial load after mechanical caries removal with adjunct aPDT. As these studies exhibit some methodological limitations, e.g. lack of positive controls, this systematic review can support the application of aPDT to a limited extent only in terms of reducing the microbial load in deep carious lesions before restorative treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

Infiltrating/sealing proximal caries lesions

DEFF Research Database (Denmark)

Martignon, S; Ekstrand, K R; Gomez, J

2012-01-01

This randomized split-mouth controlled clinical trial aimed at assessing the therapeutic effects of infiltration vs. sealing for controlling caries progression on proximal surfaces. Out of 90 adult students/patients assessed at university clinics and agreeing to participate, 39, each with 3...... differences in lesion progression between infiltration and placebo (P = 0.0012) and between sealing and placebo (P = 0.0269). The study showed that infiltration and sealing are significantly better than placebo treatment for controlling caries progression on proximal lesions. No significant difference...

The presence of non-carious lesions in children

Directory of Open Access Journals (Sweden)

Demko-Rihter Ivana

2015-01-01

Full Text Available Introduction. A non-carious lesion (NCL is the loss of hard dental tissue on the neck, tuberculum and incisal edges of the teeth. Interest in clinical presence and in unclear etiology of these lesions allows for their future prevention and treatment. Objective. The aim of the study was to determine presence and clinical characteristics of NCLs and dentine hypersensitivity (DH, as well as their possible risk factors in children, in the population of the city of Novi Sad. Methods. A total of 55 subjects were included in the present study, aged between three and 18 years. Each subject completed a structured questionnaire related to the etiological factors, and all teeth of each subject were examined by two independent clinical dentists to determine NCLs and DH. In the case of small children, their parents or guardians filled out the questionnaire. Teeth with NCLs and DH were diagnosed according to the Basic Erosive Wear Examination (BEWE index and by a blast of air according to Schiff and Hypersensitivity Index. The review was carried out by inspection and probing. Results. The data were analyzed by clinical examination and comparison of the answers to the questionnaires. We observed an increased presence of non-caries lesions on primary teeth, compared to permanent teeth, with a statistically significant difference (χ2=3.86, df=1, p=0.04. The changes were observed in 82 teeth, and were most frequent on the canine deciduous teeth (65% and canine permanent teeth (51%. BEWE index was 10-11% to 92-100% in permanent, and 51-57% in deciduous teeth. Majority of patients with primary teeth (89.36% did not respond to air stimulus, while most patients with permanent teeth (74.29% did not react to Schiff Index. In the estimate of sensitivity, the respondents reported hypersensitivity on 6.38% of the deciduous teeth and 22.86% of the permanent teeth. Comparison of etiology factors did not reveal a direct link with the appearance of NCLs. Conclusion. Research

Bond strength to dentin with artificial carious lesions: influence of caries detecting dye.

Science.gov (United States)

Palma, R G; Turbino, M L; Matson, E; Powers, J M

1998-06-01

To evaluate the influence of dyes for caries detection on tensile bond strength of adhesive materials to artificial carious dentin. Buccal and lingual enamel of human molars were removed leaving intact dentin surfaces. The entire surface of each specimen was covered with nail varnish, keeping a window area of 4 x 4 mm. Artificial carious lesions were induced with acidified gel. Three dyes (0.5% basic fuchsin; Caries Finder and Cari-D-Tect) were used according to manufacturers' recommendations. Specimens were etched with 35% phosphoric acid for 20 s, washed and dried, leaving a wet dentin surface. The adhesive system (Prime & Bond 2.0) was applied in two layers and light-cured. Restorative materials (TPH Spectrum, Dyract, Advance) were bonded using a 3-mm diameter inverted-cone mold. Control groups were made without dye. Eight samples were tested for each group. After 24 hrs of storage in distilled water, the samples were debonded using a testing machine at 0.5 mm/min crosshead speed. ANOVA and Tukey-Kramer test showed that TPH Spectrum (0.73 MPa) and Dyract (0.74 MPa) had similar bond strengths, and both were higher than Advance (0.0 MPa), which was statistically different (P strength for any tested materials.

Comparing natural and artificial carious lesions in human crowns by means of conventional hard x-ray micro-tomography and two-dimensional x-ray scattering with synchrotron radiation

Science.gov (United States)

Botta, Lea Maria; White, Shane N.; Deyhle, Hans; Dziadowiec, Iwona; Schulz, Georg; Thalmann, Peter; Müller, Bert

2016-10-01

Dental caries, one of the most prevalent infectious bacterial diseases in the world, is caused by specific types of acid-producing bacteria. Caries is a disease continuum resulting from the earliest loss of ions from apatite crystals through gross cavitation. Enamel dissolution starts when the pH-value drops below 5.5. Neutralizing the pH-value in the oral cavity opposes the process of demineralization, and so caries lesions occur in a dynamic cyclic de-mineralizing/remineralizing environment. Unfortunately, biomimetic regeneration of cavitated enamel is not yet possible, although remineralization of small carious lesions occurs under optimal conditions. Therefore, the development of methods that can regenerate carious lesions, and subsequently recover and retain teeth, is highly desirable. For the present proceedings we analyzed one naturally occurring sub-surface and one artificially produced lesion. For the characterization of artificial and natural lesions micro computed tomography is the method of choice when looking to determine three-dimensional mineral distribution and to quantify the degree of mineralization. In this pilot study we elucidate that the de-mineralized enamel in natural and artificially induced lesions shows comparable X-ray attenuation behavior, thereby implying that the study protocol employed herein seems to be appropriate. Once we know that the lesions are comparable, a series of well-reproducible in vitro experiments on enamel regeneration could be performed. In order to quantify further lesion morphology, the anisotropy of the enamel's nanostructure can be characterized by using spatially resolved, small-angle X-ray scattering. We wanted to demonstrate that the artificially induced defect fittingly resembles the natural carious lesion.

Should cavitation in proximal surfaces be reported in cone beam computed tomography examination

DEFF Research Database (Denmark)

Sansare, K.; Singh, D.; Sontakke, S.

2014-01-01

proximal surfaces without restorations in permanent teeth were examined. Patients suspected to have carious lesions after a visual clinical and a bitewing examination participated in a CBCT examination (Kodak 9000 3D, 5 × 3.7 cm field of view, voxel size 0.07 mm). Ethical approval and informed consent were...

Stress Analysis of Occlusal Forces in Canine Teeth and Their Role in the Development of Non-Carious Cervical Lesions: Abfraction

Directory of Open Access Journals (Sweden)

Shihab A. Romeed

2012-01-01

Full Text Available Non-carious cervical tooth lesions for many decades were attributed to the effects of abrasion and erosion mainly through toothbrush trauma, abrasive toothpaste, and erosive acids. However, though the above may be involved, more recently a biomechanical theory for the formation of these lesions has arisen, and the term abfraction was coined. The aim of this study was to investigate the biomechanics of abfraction lesions in upper canine teeth under axial and lateral loading conditions using a three-dimensional finite element analysis. An extracted human upper canine tooth was scanned by μCT machine (Skyscan, Belgium. These μCT scans were segmented, reconstructed, and meshed using ScanIP (Simpleware, Exeter, UK to create a three-dimensional finite element model. A 100 N load was applied axially at the incisal edge and laterally at 45° midpalatally to the long axis of the canine tooth. Separately, 200 N axial and non-axial loads were applied simultaneously to the tooth. It was found that stresses were concentrated at the CEJ in all scenarios. Lateral loading produced maximum stresses greater than axial loading, and pulp tissues, however, experienced minimum levels of stresses. This study has contributed towards the understanding of the aetiology of non-carious cervical lesions which is a key in their clinical management.

Distribution of class ii major histocompatibility complex antigenexpressing cells in human dental pulp with carious lesions

Directory of Open Access Journals (Sweden)

Tetiana Haniastuti

2012-09-01

Full Text Available Background: Dental caries is a bacterial infection which causes destruction of the hard tissues of the tooth. Exposure of the dentin to the oral environment as a result of caries inevitably results in a cellular response in the pulp. The major histocompatibility complex (MHC is a group of genes that code for cell-surface histocompatibility antigens. Cells expressing class II MHC molecules participate in the initial recognition and the processing of antigenic substances to serve as antigen-presenting cells. Purpose: The aim of the study was to elucidate the alteration in the distribution of class II MHC antigen-expressing cells in human dental pulp as carious lesions progressed toward the pulp. Methods: Fifteen third molars with caries at the occlusal site at various stages of decay and 5 intact third molars were extracted and used in this study. Before decalcifying with 10% EDTA solution (pH 7.4, all the samples were observed by micro-computed tomography to confirm the lesion condition three-dimensionally. The specimens were then processed for cryosection and immunohistochemistry using an anti-MHC class II monoclonal antibody. Results: Class II MHC antigen-expressing cells were found both in normal and carious specimens. In normal tooth, the class II MHC-immunopositive cells were observed mainly at the periphery of the pulp tissue. In teeth with caries, class II MHC-immunopositive cells were located predominantly subjacent to the carious lesions. As the caries progressed, the number of class II MHC antigen-expressing cells was increased. Conclusion: The depth of carious lesions affects the distribution of class II MHC antigen-expressing cells in the dental pulp.Latar belakang: Karies merupakan penyakit infeksi bakteri yang mengakibatkan destruksi jaringan keras gigi. Dentin yang terbuka akibat karies akan menginduksi respon imun seluler pada pulpa. Kompleks histokompatibilitas utama (MHC merupakan sekumpulan gen yang mengkode histokompatibilitas

Performance of Universal Adhesive in Primary Molars After Selective Removal of Carious Tissue: An 18-Month Randomized Clinical Trial.

Science.gov (United States)

Lenzi, Tathiane Larissa; Pires, Carine Weber; Soares, Fabio Zovico Maxnuck; Raggio, Daniela Prócida; Ardenghi, Thiago Machado; de Oliveira Rocha, Rachel

2017-09-15

To evaluate the 18-month clinical performance of a universal adhesive, applied under different adhesion strategies, after selective carious tissue removal in primary molars. Forty-four subjects (five to 10 years old) contributed with 90 primary molars presenting moderately deep dentin carious lesions on occlusal or occluso-proximal surfaces, which were randomly assigned following either self-etch or etch-and-rinse protocol of Scotchbond Universal Adhesive (3M ESPE). Resin composite was incrementally inserted for all restorations. Restorations were evaluated at one, six, 12, and 18 months using the modified United States Public Health Service criteria. Survival estimates for restorations' longevity were evaluated using the Kaplan-Meier method. Multivariate Cox regression analysis with shared frailty to assess the factors associated with failures (Padhesion strategy did not influence the restorations' longevity (P=0.06; 72.2 percent and 89.7 percent with etch-and-rinse and self-etch mode, respectively). Self-etch and etch-and-rinse strategies did not influence the clinical behavior of universal adhesive used in primary molars after selective carious tissue removal; although there was a tendency for better outcome of the self-etch strategy.

Clinical evaluation of Carisolv in the chemico-mechanical removal of carious dentin.

Science.gov (United States)

Munshi, A K; Hegde, A M; Shetty, P K

2001-01-01

The Chemo-mechanical caries removal technique involves the application of chemical agents, to cause a selective softening of the carious dentine and facilitate removal by gentle excavation. Carisolv is one such new chemical agent used in this minimal invasive technique of carious dentine removal. The present study was, therefore, undertaken to evaluate the efficacy of Carisolv in the chemo-mechanical removal of carious dentine, the time taken for caries removal, the perception of the treatment by the patient, and to evaluate the restorations, radiographically. Accordingly, fifty primary and permanent molars with dentinal carious lesions were excavated using this technique of caries removal. The chemo-mechanical caries removal technique using Carisolv proved to be an effective atraumatic treatment modality with potential interest for use in clinical pediatric dentistry.

In Vivo Remineralization of Artificial Carious Lesions using Calcifying Solution and Fluoride Solution

Directory of Open Access Journals (Sweden)

Els Sunarsih Budipramana

2015-10-01

Full Text Available The remineralization potential of fluoride and calcifying solution was studiedas in situ model. Matched enamel discs of artifically demineralized human enamel were attached to an acrylic mandibular removable appliance of 6 adult volunteers who rinsed their mouth with a solution containing either 50 ppm F-, 200 ppm F- in amine fluoride, calcifying solution (formula BR21 or placebo as a control. The volunteers were asked to rinse 3 times a day for 3 minutes with 15 ml of the solution for 6 days (18 times. On the 7th day enamel discs were taken out from the partial denture. Three kinds of measurements were done: enamel permeability testing, depth lesion testing and fluoride retention testing. New demineralized enamel discs were attached to the partial dentures and the volunteers were asked to start rinsing with other solutions using the same protocols. The purpose of this study was to answer the question why the calcifying solutions were no more used as a remineralizing solution. The data ws analyzed using SPSS/PC for two factors Anova and one way Anova for enamel permeability and Kruskal Wallis for studying enamel depth lesion and fluoride retention. There was no significant difference after rinsing with calcifying solution and placebo in enamel permeability, depth lesions, and fluoride retention when compared to fluoride solution. To get a better result in remineralizing carious teeth fluoride contents in solution must be higher than 50 ppm F-.

Correlation of Streptococcus mutans and Streptococcus sanguinis colonization and ex vivo hydrogen peroxide production in carious lesion-free and high caries adults.

Science.gov (United States)

Giacaman, Rodrigo A; Torres, Sebastián; Gómez, Yenifer; Muñoz-Sandoval, Cecilia; Kreth, Jens

2015-01-01

This study was conducted to estimate oral colonization by Streptococcus mutans and Streptococcus sanguinis in adults with high and without any caries experience. Furthermore, differences in the amount of hydrogen peroxide (H2O2) produced by S. sanguinis isolated from both groups were assessed. Forty adults were divided into: (i) carious lesion-free, without any carious lesion, assessed by the International Caries Detection and Assessment System (ICDAS), or restoration, (CF) and (ii) high caries experience (HC). Saliva samples were collected and seeded on respective agar-plates for enumeration of total streptococci, S. mutans and S. sanguinis (CFU/mL) and compared between groups. Additionally, S. sanguinis colonies obtained from both groups were inoculated on Prussian blue agar for H2O2 detection. Production of H2O2 was quantified and compared between the two groups. S. sanguinis counts were significantly higher in CF than HC individuals (pmutans showed significantly higher levels in HC than CF subjects (pmutans in saliva of adults without caries experience. In those people, S. sanguinis produces more H2O2ex vivo. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Role of Light-Induced Fluorescence in the Treatment of Smooth Surface Carious Lesions with Icon Infiltration and the Results After 1 Year

Directory of Open Access Journals (Sweden)

Kabaktchieva R.

2014-12-01

Full Text Available Caries infiltration is a novel technique that brings out immediate esthetic improvement in the opacity of the white spot lesions. Light-induced fluorescence method is a modern caries diagnostic method. In this study SoproLife camera (Acteon, France was applied for diagnosing and follow-up of the results. The aims of this in vivo study are to test the role of light-induced fluorescence method (SoploLife camera in the diagnosis of non-cavitated smooth surfaces carious lesions (ICDAS codes 1 and 2 of primary and permanent teeth and in the follow-up period immediately after application, 6 months and 1 year after applying ICON material (DMG. Teeth: n = 90; primary teeth: 6 kids; n = 40 teeth; permanent teeth: 6 patients; n = 50 teeth. Visual examination by ICDAS without probe, dry for 10 s with 3-in-1 syringe using lightening; SoproLife camera (450 nm, digital photos. LIF method applied with SoproLife camera (Diagnostic mode with day light and blue light is more accurate than visual examination only when applied for single tooth diagnose. Moreover, LIF method for single tooth is more accurate in following up the effect of non-operative treatment of smooth surfaces lesions than using digital images. ICON is a material that stops the progression of non-cavitated smooth surfaces carious lesions in both primary and permanent teeth and make the aesthetic result better up to 1 year following the procedure.

Efficacy of 1.23% APF gel applications on incipient carious lesions: a double-blind randomized clinical trial

Directory of Open Access Journals (Sweden)

Maria Laura Menezes Bonow

2013-06-01

Full Text Available The aim of this double-blind randomized clinical trial was to evaluate the efficacy of 1.23% APF gel application on the arrest of active incipient carious lesions in children. Sixty 7- to 12-year-old children, with active incipient lesions were included in the study. Children were divided randomly into 2 groups: 1.23% APF gel and placebo gel applications. Each group received 8 weekly applications of treatment. The lesions were re-evaluated at the 4th and 8th appointments. Poisson regression analysis was used to estimate relative risks of the presence of active white spot lesions. Groups showed similar results (PR = 1.67; CI 95% 0.69–3.98. The persistence of at least 1 active lesion was associated with a higher number of lesions in the baseline (PR = 2.67; CI 95% 1.19–6.03, but not with sugar intake (PR = 1.06; CI 95% 0.56–2.86 and previous exposure to fluoride dentifrice (PR = 1.26; CI 95% 0.49–2.29. The trial demonstrates the equivalence of the treatments. The use of the APF gel showed no additional benefits in this sample of children exposed to fluoridated water and dentifrice. The professional dental plaque removal in both groups may also account for the resulting equivalence of the treatments.

Wireless capsule endoscopy and proximal small bowel lesions in Crohn’s disease

Science.gov (United States)

Petruzziello, Carmelina; Onali, Sara; Calabrese, Emma; Zorzi, Francesca; Ascolani, Marta; Condino, Giovanna; Lolli, Elisabetta; Naccarato, Paola; Pallone, Francesco; Biancone, Livia

2010-01-01

AIM: To investigate the prevalence of proximal small bowel (SB) lesions detected by wireless capsule endoscopy (WCE) in Crohn’s disease (CD). METHODS: WCE was performed in 64 patients: 32 with CD of the distal ileum, and 32 controls with iron-deficiency anemia (IDA) or diarrhea. WCE was performed using the Given SB-WCE, followed by small intestine contrast ultrasonography (SICUS). Findings compatible with CD by using WCE included erosions, aphthoid or deep ulcers, and strictures/stenosis. RESULTS: WCE detected proximal SB lesions in 16/32 (50%) patients (14 aphthoid ulcers, 2 deep ulcers, one stricture), which appeared not to be related to clinical parameters [epigastric pain, age, smoking, non-steroidal anti-inflammatory drugs (NSAIDs), IDA]. Among patients with proximal SB lesions, 6 (37%) were smokers, 3 (19%) NSAID users, 3 (19%) had epigastric pain and 4 (25%) had IDA. SICUS detected proximal SB lesions in 3/32 patients (19%) also showing lesions with WCE. No correlations were observed between proximal SB lesions assessed by WCE or by SICUS (χ2 = 1.5, P = 0.2). CONCLUSION: The use of WCE allows the detection of previously unknown upper SB lesions in a high proportion of patients with a previous diagnosis of CD involving the distal ileum. PMID:20614486

Estimation of Remnant Dentin Thickness under Proximal Caries Using Digital Bitewing Radiography: An In-Vitro Study

Directory of Open Access Journals (Sweden)

Masoomeh Afsa

2015-12-01

Full Text Available Objectives: In restorative dentistry, it is essential to estimate the amount of remnant tooth structure after caries removal to make the best treatment plan. The present study was aimed to determine whether there is a correlation between the real thickness of remnant dentin under carious lesion and the radiographical measurement from photostimulable phosphor plates (PSPs. Methods: a whole number of 68 unrestored permanent human molar and premolar teeth with 82 proximal carious surfaces were mounted in an artificial arch. Digital bitewing radiographs with PSPs were taken, carious lesions were removed and radiographic imaging was repeated. Teeth were sectioned mesiodistally in two parts and thickness of remnant tooth structure to pulp was measured. Measurements of remnant dentin under caries from radiographic images and teeth structures were compared. Result: The mean measurements of remnant dentin on primary radiographs were statistically different from the measurements on teeth structures. The mean thickness of remnant dentin on tooth structure was around 30% less than what measured on radiographic image. Conclusion: The real thickness of remnant dentin under caries is about 70% of its thickness measured on digital bitewing radiographs prepared by PSPs as image receptor.

Effect of enamel organic matrix on the potential of Galla chinensis to promote the remineralization of initial enamel carious lesions in vitro

Energy Technology Data Exchange (ETDEWEB)

Zhang Linglin; Zou Ling; Li Jiyao; Hao Yuqing; Xiao Liying; Zhou Xuedong; Li Wei, E-mail: leewei2000@sina.co, E-mail: zhll_sc@yahoo.c [State Key Laboratory of Oral Diseases, West China College of Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu (China)

2009-06-15

Galla chinensis, a natural traditional Chinese medicine with main composition of tannic acid and gallic acid, is formed when the Chinese sumac aphid Baker (Melaphis chinensis bell) parasitizes the levels of Rhus chinensis Mill. Galla chinensis has shown the potential to enhance the remineralization of initial enamel carious lesion, but the mechanism is still unknown. This study was to investigate whether the enamel organic matrix plays a significant role in the potential of Galla chinensis to promote the remineralization of initial enamel caries. Bovine sound enamel blocks and non-organic enamel blocks were demineralized and exposed to a 12 day pH cycling. During the pH cycling, 30 specimens with the enamel organic matrix were randomly divided into three groups, and treated with 1 g L{sup -1} NaF (group A), 4 g L{sup -1} Galla chinensis extract (group B1) or double deionized water (group C1). Twenty specimens without the enamel organic matrix were randomly divided into two groups, and treated with 4 g L{sup -1} Galla chinensis extract (group B2) or double deionized water (group C2). The integrated mineral loss and lesion depth of all the specimens were analysed by transverse microradiography. The integrated mineral loss and lesion depth of group B1 were less than those of groups B2, C1 and C2, and there were no statistical differences among groups B2, C1 and C2. In conclusion, Galla chinensis can enhance the remineralization of initial enamel carious lesion, and the enamel organic matrix plays a significant role in this potential of Galla chinensis.

Macroscopic and radiographic examination of proximal root surface caries

International Nuclear Information System (INIS)

Nordenram, G.; Bergvist, A.; Johnson, G.; Henriksen, C.O.; Anneroth, G.

1988-01-01

The purpose of the study was to compare macroscopic and radiographic examination of proximal root surface caries of extracted teeth from patients aged 65-95 years. Although the study conditions for macroscopic and radiographic diagnosis favored more sensitive evaluations than routine clinical conditions, there was a 24% disagreement in diagnosis. This finding indicates that under routine clinical conditions it is difficult to register with certainty all superficial root carious lesions. Even in the absence of clinically detectable root surface caries, preventive measures should be considered for elderly people with exposed root surfaces

Carious lesions and maize consumption among the Prehispanic Maya: an analysis of a coastal community in northern Yucatan.

Science.gov (United States)

Cucina, Andrea; Cantillo, Cristina Perera; Sosa, Thelma Sierra; Tiesler, Vera

2011-08-01

Patterns of carious lesions were analyzed in the Classic period coastal Maya population of Xcambó, a salt production and administration center in northern Yucatan. To this end, the study investigated caries in the permanent dentitions of 163 adult skeletons, 23 from the Early Classic (AD 250-550) and 140 from the Late Classic period (AD 550-750), equally distributed between sexes. The archaeological and bioarchaeological evidence indicates a wealthy and socially homogeneous population dedicated to salt production and administration in the Early Classic that switched to pure administrative functions in the Late Classic. The results indicate an increase in caries from 7.4% and 21.2% (males and females respectively) from the Early Classic to 14.0% in males and 27.4% in females from the Late Classic period. The rate of caries in the Early and in the Late Classic phases of continuous occupation is not consistent with a simple interpretation of a heavier reliance on maize during the latter phase, characterized by a sedentary lifestyle, particularly for the male segment of the society now dedicated completely to the administration of the salt mines. Rather, the increase in caries rates in both sexes is best explained within a broader context of overall food habits, new cariogenic foods for both sexes, and the changes in lifestyle imposed by the increased socioeconomic role of the site. Our conclusions stress the limitations imposed by interpreting carious lesions solely in terms of single dietary components, such as maize consumption, without taking into account broader aspects of cultural and socioeconomic relevance. Copyright © 2011 Wiley-Liss, Inc.

Effect of gallic acid on the wear behavior of early carious enamel

International Nuclear Information System (INIS)

Gao, S S; Huang, S B; Yu, H Y; Qian, L M

2009-01-01

The purpose of this research was to investigate the wear behavior of early carious enamel remineralized with gallic acid. Forty natural human premolar specimens with early caries lesions were prepared. A remineralization pH-cycling treatment agent of 4000 ppm gallic acid was used for 12 days to treat the early lesions. The changes in microhardness were monitored. Nanoscratch tests were used to evaluate wear resistance. The experimental data were analyzed by using a t-test. The widths of traces were measured by an AMBIOS XP-2 stylus profilometer. After remineralization, all samples re-hardened significantly. The coefficients of friction became higher, and the widths of scratches were larger than they were before remineralization. Gallic acid significantly improved the early carious enamel's hardness. The wear damage of the samples treated with gallic acid was more severe than that of the control group. There were more obvious cracks and delaminations on the traces of the treated group. Compared with the control group, the enamel remineralized with gallic acid had inferior wear resistance. After remineralization, the dominant damage mechanisms of early carious enamel had changed from plastic deformation and adhesive wear to a combination of brittle cracks and delamination of enamel.

Diagnostic yield of ink-jet prints from digital radiographs for the assessment of approximal carious lesions: ROC-analysis

International Nuclear Information System (INIS)

Schulze, Ralf K.W.; Grimm, Stefanie; Schulze, Dirk; Voss, Kai; Keller, Hans-Peter; Wedel, Matthias

2011-01-01

Aims: To investigate the diagnostic quality of different quality, individually calibrated ink-jet printers for the very challenging dental radiographic task of approximal carious lesion detection. Materials and methods: A test-pattern evaluating resolution, contrast and homogeneity of the ink-jet prints was developed. 50 standardized dental radiographs each showing two neighbouring teeth in natural contact were printed on glossy paper with calibrated, randomly selected ink-jet printers (Canon S520 and iP4500, Epson Stylus Photo R2400). Printing size equalled the viewing size on a 17'' cathode-ray-tube monitor daily quality-tested according to German regulations. The true caries status was determined from serial sectioning and microscopic evaluation. 16 experienced observers evaluated the radiographs on a five-point confidence scale on all prints plus the viewing monitor with respect to the visibility of a carious lesion. A non-parametric Receiver-Operating Characteristics (ROC-) analysis was performed explicitly designed for the evaluation of readings stemming from identical samples but different modality. Significant differences are expressed by a critical ratio z exceeding ±2. Diagnostic accuracy was determined by the area (Az) underneath the ROC-curves. Results: Average Az-values ranged between 0.62 (S520 and R2400) and 0.64 (monitor, iP4500), with no significant difference between modalities (P = 0.172). Neither significant (range mean z: -0.40 (S520) and -0.11 (iP4500)) nor clinically relevant differences were found between printers and viewing monitor. Conclusions: Our results for a challenging task in dental radiography indicate that calibrated, off-the-shelf ink-jet printers are able to reproduce (dental) radiographs at quality levels sufficient for radiographic diagnosis in a typical dental working environment.

Diagnostic yield of ink-jet prints from digital radiographs for the assessment of approximal carious lesions: ROC-analysis

Energy Technology Data Exchange (ETDEWEB)

Schulze, Ralf K.W., E-mail: rschulze@mail.uni-mainz.de [Poliklinik fuer Zahnaerztliche Chirurgie, University Medical Center of the Johannes Gutenberg-University, Augustusplatz 2, D-55131 Mainz (Germany); Grimm, Stefanie, E-mail: StefanieGrimm@gmx.de [Poliklinik fuer Zahnaerztliche Chirurgie, University Medical Center of the Johannes Gutenberg-University, Augustusplatz 2, D-55131 Mainz (Germany); Schulze, Dirk, E-mail: dirk.schulze@uniklinik-freiburg.de [Klinik fuer Mund,- Kiefer- und Gesichtschirurgie, Sektion Roentgen, Universitaetsklinikum Freiburg, Hugstetterstr. 55, D-79106 Freiburg (Germany); Voss, Kai, E-mail: zahnarzt@drvoss.eu [Zahnaerztekammer Schleswig-Holstein, Vorstand fuer Praxisfuehrung, Westring 496, D- 24106 Kiel (Germany); Keller, Hans-Peter, E-mail: hans-peter.keller@din.de [NA Dental (NADENT) im DIN, Alexander-Wellendorff-Str. 2, D-75172 Pforzheim (Germany); Wedel, Matthias, E-mail: matthias.wedel@siemens.com [Siemens AG, Medical Solutions, Postfach 32 60, D-91050 Erlangen (Germany)

2011-08-15

Aims: To investigate the diagnostic quality of different quality, individually calibrated ink-jet printers for the very challenging dental radiographic task of approximal carious lesion detection. Materials and methods: A test-pattern evaluating resolution, contrast and homogeneity of the ink-jet prints was developed. 50 standardized dental radiographs each showing two neighbouring teeth in natural contact were printed on glossy paper with calibrated, randomly selected ink-jet printers (Canon S520 and iP4500, Epson Stylus Photo R2400). Printing size equalled the viewing size on a 17'' cathode-ray-tube monitor daily quality-tested according to German regulations. The true caries status was determined from serial sectioning and microscopic evaluation. 16 experienced observers evaluated the radiographs on a five-point confidence scale on all prints plus the viewing monitor with respect to the visibility of a carious lesion. A non-parametric Receiver-Operating Characteristics (ROC-) analysis was performed explicitly designed for the evaluation of readings stemming from identical samples but different modality. Significant differences are expressed by a critical ratio z exceeding {+-}2. Diagnostic accuracy was determined by the area (Az) underneath the ROC-curves. Results: Average Az-values ranged between 0.62 (S520 and R2400) and 0.64 (monitor, iP4500), with no significant difference between modalities (P = 0.172). Neither significant (range mean z: -0.40 (S520) and -0.11 (iP4500)) nor clinically relevant differences were found between printers and viewing monitor. Conclusions: Our results for a challenging task in dental radiography indicate that calibrated, off-the-shelf ink-jet printers are able to reproduce (dental) radiographs at quality levels sufficient for radiographic diagnosis in a typical dental working environment.

Two-year clinical evaluation of three adhesive systems in non-carious cervical lesions

Directory of Open Access Journals (Sweden)

Evrim Eliguzeloglu Dalkilic

2012-04-01

Full Text Available OBJECTIVES: Adhesive systems are continuously being introduced to Dentistry, unfortunately often without sufficient clinical validation. The aim of this study was to evaluate the clinical performance of cervical restorations done with three different adhesive systems. MATERIAL AND METHODS: 158 non-carious cervical lesions of 23 patients were restored with a nanofilled composite resin (Filtek Supreme, 3M/ESPE combined with Single Bond (3M/ESPE, group SI, Clearfil SE (Kuraray Medical Inc., group CL and Xeno III (De Trey Dentsply, group XE. In groups SI-B, CL-B and XE-B, the outer surface of the sclerotic dentin was removed by roughening with a diamond bur before application of the respective adhesive systems. In groups CL-BP and XE-BP, after removal of the outer surface of the sclerotic dentin with the bur, the remaining dentin was etched with 37% phosphoric acid and the self-etch adhesive systems Clearfil SE and Xeno III were applied, respectively. Lesions were evaluated at baseline, and restorations after 3 months, 1 year and 2 years using modified USPHS criteria. RESULTS: After 2 years, no significant difference was found between the retention rates of the groups (p >0.05. Although groups CL and SI showed significantly better marginal adaptation than group XE (p0.05. After 2 years no significant difference was observed among the marginal staining results of all groups (p>0.05. CONCLUSION: Although all adhesive systems showed similar retention rates, Clearfil SE and Single Bond showed better marginal adaptation than Xeno III after 2 years of follow-up.

Effect of gallic acid on the wear behavior of early carious enamel

Energy Technology Data Exchange (ETDEWEB)

Gao, S S; Huang, S B; Yu, H Y [State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041 (China); Qian, L M, E-mail: yhyang6812@scu.edu.c [Tribology Research Institute, National Traction Power Laboratory, Southwest Jiaotong University, Chengdu 610031 (China)

2009-06-15

The purpose of this research was to investigate the wear behavior of early carious enamel remineralized with gallic acid. Forty natural human premolar specimens with early caries lesions were prepared. A remineralization pH-cycling treatment agent of 4000 ppm gallic acid was used for 12 days to treat the early lesions. The changes in microhardness were monitored. Nanoscratch tests were used to evaluate wear resistance. The experimental data were analyzed by using a t-test. The widths of traces were measured by an AMBIOS XP-2 stylus profilometer. After remineralization, all samples re-hardened significantly. The coefficients of friction became higher, and the widths of scratches were larger than they were before remineralization. Gallic acid significantly improved the early carious enamel's hardness. The wear damage of the samples treated with gallic acid was more severe than that of the control group. There were more obvious cracks and delaminations on the traces of the treated group. Compared with the control group, the enamel remineralized with gallic acid had inferior wear resistance. After remineralization, the dominant damage mechanisms of early carious enamel had changed from plastic deformation and adhesive wear to a combination of brittle cracks and delamination of enamel.

In vitro evaluation of fluoride products in the development of carious lesions in deciduous teeth.

Science.gov (United States)

Santos, Lucineide de Melo; Reis, José Ivo Limeira dos; Medeiros, Maria Perolina de; Ramos, Sheyla Moreira; Araújo, Juliane Mendes de

2009-01-01

The purpose of this study was to evaluate the effect of the application of fluoride products on the development of enamel caries in deciduous teeth. A total of 108 deciduous teeth were chosen for the study. Acid-resistant varnish was applied on the teeth, leaving only one area of 5 mm x 1 mm of dental enamel exposed. The teeth were allocated randomly to one of the following groups: 1) control - toothpaste without fluoride; 2) 1.23% fluoride gel; 3) Duraflur fluoride varnish; 4) Duraphat fluoride varnish; 5) Fluorniz fluoride varnish; 6) Fluorphat fluoride varnish; 7) varnish with Duofluorid; 8) 12% silver fluoride diamine (Cariestop); 9) children's fluoride toothpaste (500 ppm). The tested products were applied on the teeth according to the manufacturer's recommendations and the teeth were stored in a moist environment for 24 hours. Each group of teeth was then subjected to a pH cycling model for 14 days, after which the teeth were cut through the center for an analysis of the depth of the carious lesion by polarized light microscopy. Comparisons were made between the treatments and the control group. The mean lesion depth values were 318 microm +/- 39 (control), 213 microm +/- 27 (fluoride gel), 203 microm +/- 34 (Duraflur), 133 microm +/- 25 (Duraphat), 207 microm +/- 27 (Fluor-niz), 212 microm +/- 27 (Fluorphat), 210 +/- 28 (Duofluorid), 146 +/- 31 (Cariestop) and 228 +/- 24 (fluoride toothpaste). None of the products used here was able to completely prevent the formation of lesions. The highest cariostatic effect was achieved by fluoride varnish Duraphat and the lowest by the fluoride toothpaste.

Relationship between mineral distributions in dentine lesions and subsequent remineralization in vitro

NARCIS (Netherlands)

Kawasaki, K; Ruben, J; Tsuda, H; Huysmans, MCDNJM; Takagi, O

2000-01-01

Though the mineral distribution of the dentine carious lesion varies largely from tooth to tooth and from patient to patient, there are two main distribution profiles that characterize natural carious lesions in dentine. These profiles include softened and subsurface lesion types. The mineral

In vitro evaluation of fluoride products in the development of carious lesions in deciduous teeth

Directory of Open Access Journals (Sweden)

Lucineide de Melo Santos

2009-09-01

Full Text Available The purpose of this study was to evaluate the effect of the application of fluoride products on the development of enamel caries in deciduous teeth. A total of 108 deciduous teeth were chosen for the study. Acid-resistant varnish was applied on the teeth, leaving only one area of 5 mm x 1 mm of dental enamel exposed. The teeth were allocated randomly to one of the following groups: 1 control - toothpaste without fluoride; 2 1.23% fluoride gel; 3 Duraflur fluoride varnish; 4 Duraphat fluoride varnish; 5 Fluorniz fluoride varnish; 6 Fluorphat fluoride varnish; 7 varnish with Duofluorid; 8 12% silver fluoride diamine (Cariestop; 9 children's fluoride toothpaste (500 ppm. The tested products were applied on the teeth according to the manufacturer's recommendations and the teeth were stored in a moist environment for 24 hours. Each group of teeth was then subjected to a pH cycling model for 14 days, after which the teeth were cut through the center for an analysis of the depth of the carious lesion by polarized light microscopy. Comparisons were made between the treatments and the control group. The mean lesion depth values were 318 μm ± 39 (control, 213 μm ± 27 (fluoride gel, 203 μm ± 34 (Duraflur, 133 μm ± 25 (Duraphat, 207 μm ± 27 (Fluor-niz, 212 μm ± 27 (Fluorphat, 210 ± 28 (Duofluorid, 146 ± 31 (Cariestop and 228 ± 24 (fluoride toothpaste. None of the products used here was able to completely prevent the formation of lesions. The highest cariostatic effect was achieved by fluoride varnish Duraphat and the lowest by the fluoride toothpaste.

Detection of intaoral lesions using a fluorescence camera

Science.gov (United States)

Thoms, Michael

2006-02-01

Optical methods for the detection of carious lesions, calculus and plaque have the advantage of being minimally invasive. The use of endogeneous fluorescence markers like porphyrins could simplify the application of fluorescence techniques in the dental practice. It is known that porphyrins are produced by some of the bacterial species that are present in the oral cavity. Since porphyrins have an excitation band at about 400nm they have the potential to be used as fluorescent markers of locations in the oral cavity where the production of bacteria is out of the limits of healthy regions. Further, modern and efficient GaN-based semiconductor diodes emit light in this spectral range and thus make the implementation of fluorescence sensors with excitation at this wavelength easy. Carious lesions, calculus and plaque have been measured using a self build fluorescence camera using GaN-diodes for illumination at 405nm. Further, emission spectra under this excitation were recorded. For the latter purpose freshly extracted teeth were used. It has been found that already in the case of an initial carious lesion red porphyrin-fluorescence is emitted whereas it is absent in healthy enamel. In already brown coloured carious lesions the emission bands of porphyrin are present but the observed overall fluorescence intensity is lower, probably due to the absorption of the fluorescence by the carious defect itself. In dental calculus, dental plaque and subgingival concrements porphyrin originated luminescence was found as well. Since in these cases the emission spectra differ slightly it can be concluded that they originate from different types of porphyrins and thus also from different bacteria. These results show that this fluorescence technique can be a promising method to diagnose carious lesions, calculus and plaque.

Secondary mineralization in carious lesions of human dentin. Electron-probe, electron microscope, and electron diffraction studies

Energy Technology Data Exchange (ETDEWEB)

Ogiwara, H [Tokyo Dental Coll. (Japan)

1975-02-01

Dentinal carious lesions having a remineralized surface layer were studied by means electron-probe microanalysis, electron microscopy, electron diffraction. As the results of electron-probe study, F, Mg, and Na were found to be distributed mainly in the remineralized surface layer and S in the decalcified region where decreases in Ca, P, and Mg concentration were usually observed. The decrease in Mg concentration always started earlier than that of Ca and P concentration. Electron microscope and electron diffraction studies revealed that apatic crystals in the remineralized surface layer were much larger than those in the intact dentin. Although they were less conspicuous, crystals in the decalcified region also were larger than those in the intact region. Dentinal tubules, occluded by many crystals, were frequently seen during the observations. Crystals in the tubules varied in morphology, showing granular, needle, rhomboid, and tabular shapes. By means of electron diffraction, the granular- or needle-shaped crystals were identified as apatite and the rhomboid-shaped crystals as whitlockite. Some of the tabular-shaped crystals appeared to be cotacalcium phosphate.

Tumoral calcinosis-like lesion of the proximal linea aspera

International Nuclear Information System (INIS)

Seeger, L.L.; Butler, D.L.; Eckardt, J.J.; Layfield, L.; Adams, J.S.

1990-01-01

Tumoral calcinosis is presently a poorly defined disease. In its classic form, it consists of multiple large foci of benign mineralization in the soft tissue adjacent to bone near large joints. Patients are generally of African descent and are adolescents or young adults at presentation. Both metabolic and traumatic etiologies have been proposed. We report six adult Caucasian patients with lesions that pathologically resembled tumoral calcinosis. All lesions were small (less than 3x3 cm) and were located along the proximal linea aspera lof the femur. All patients presented with pain. Because of the atypical patient population and the unusual size and location of the lesions, we refer to this process as a 'tumoral calcinosis-like lesion'. A typical radiographic appearance and location, together with appropriate clinical history, can strongly suggest this diagnosis. (orig.)

Effectiveness of fluoride sealant in the prevention of carious lesions around orthodontic brackets: an OCT evaluation

Science.gov (United States)

Pithon, Matheus Melo; Santos, Mariana de Jesus; de Souza, Camilla Andrade; Leão, Jorge César Borges; Braz, Ana Karla Souza; de Araujo, Renato Evangelista; Tanaka, Orlando Motohiro; Oliveira, Dauro Douglas

2015-01-01

Abstract Objective: This article aimed to evaluate in vitro the efficiency of Pro Seal fluoride sealant application in the prevention of white spot lesions around orthodontic brackets. Material and Methods: Brackets were bonded to the buccal surface of bovine incisors, and five groups were formed (n = 15) according to the exposure of teeth to oral hygiene substances and the application of enamel sealant: G1 (control), only brushing was performed with 1.450 ppm fluoride; G2 (control) brushing associated with the use of mouthwash with 225 ppm fluoride; G3, only Pro Seal sealant application was performed with 1.000 ppm fluoride; G4 Pro Seal associated with brushing; G5 Pro Seal associated with brushing and mouthwash. Experimental groups alternated between pH cycling and the procedures described. All specimens were kept at a temperature of 37 °C throughout the entire experiment. Both brushing and immersion in solutions were performed within a time interval of one minute, followed by washing in deionized water three times a day for 28 days. Afterwards, an evaluation by Optical Coherence Tomography (OCT) of the spectral type was performed. In each group, a scanning exam of the white spot lesion area (around the sites where brackets were bonded) and depth measurement of carious lesions were performed. Analysis of variance (ANOVA) was applied to determine whether there were significant differences among groups. For post hoc analysis, Tukey test was used. Results: There was statistically significant difference between groups 1 and 2 (p = 0.003), 1 and 3 (p = 0.008), 1 and 4 (p = 0.000) and 1 and 5 (p = 0.000). The group in which only brushing was performed (Group 1) showed deeper enamel lesion. Conclusion: Pro Seal sealant alone or combined with brushing and/or brushing and the use of a mouthwash with fluoride was more effective in protecting enamel, in comparison to brushing alone. PMID:26691968

The prevalence and severity of non-carious cervical lesions in a group of patients attending a university hospital in Trinidad.

Science.gov (United States)

Smith, W A J; Marchan, S; Rafeek, R N

2008-02-01

Non-carious cervical lesions (NCCLs) are often encountered in clinical practice and their aetiology attributed to toothbrush abrasion, erosion and tooth flexure. This paper aims to determine the prevalence and severity of NCCLs in a sample of patients attending a university clinic in Trinidad and to investigate the relationship with medical and dental histories, oral hygiene practices, dietary habits and occlusion. Data were collected via a questionnaire and clinical examination. Odds ratios were used to determine the association of the presence of lesions and the factors examined. One hundred and fifty-six patients with a mean age of 40.6 years were examined of whom 62.2% had one or more NCCLs. Forty five per cent of the lesions were sensitive to compressed air. Younger age groups had a significantly lower correlation with the presence of NCCLs than older age groups. Other significant factors included patients who reported heartburn, gastric reflux, headaches, bruxism, sensitive teeth and swimming or had a history of broken restorations in the last year. There was also significant correlation of NCCLs in patients who brushed more than once a day or used a medium or hard toothbrush. Patients with vegetarian diets and those who reported consuming citrus fruits, soft drinks, alcohol, yoghurt and vitamin C drinks were associated with the presence of lesions. Significant associations were also found in patients with group function, faceting, clicking joints or those who wore occlusal splints.

Caries status and proximal lesion behaviour during a 6-year period in young adult Danes: an epidemiological investigation

DEFF Research Database (Denmark)

Martignon, Stefania; Chavarría, Nathaly; Ekstrand, Kim

2009-01-01

Studies have indicated that many initial proximal caries lesions progress and are eventually restored even if the patients have been under comprehensive preventive programmes. The objectives of the study were (1) to describe the 1996-year baseline caries status of male Danish conscripts and (2......) to assess their early proximal lesions 6-year behaviour. In 1996, all 20-year-old conscripts at Central Barrack Birkerød (n = 115) went through an oral examination, including visual surface-level fillings' recording and a radiographic examination with bitewing radiographs that assessed the proximal......-surface caries and restoration patterns. After 6 years, the behaviour of proximal lesions was studied in 73 of these subjects, and oral health habits were assessed through a questionnaire. Mean number of filled surfaces was 7.5, of which 23% were posterior proximal. Radiographically, the mean number of proximal...

Effectiveness of probiotics in the prevention of carious lesions during treatment with fixed orthodontic appliances.

Directory of Open Access Journals (Sweden)

Paula Contreras

2017-07-01

Full Text Available The difficulty experienced by patients with fixed orthodontic appliances in maintaining adequate oral hygiene poses a risk for dental caries. The use of probiotics has been proposed as a means of prevention. The following systematic review aims to determine the effectiveness of probiotics in the prevention of dental caries during treatment with fixed orthodontic appliances. This review was carried out according to the PRISMA guidelines. A comprehensive electronic search was conducted in the Cochrane Library, EMBASE, PubMed and Google Scholar Beta databases. The inclusion criteria included randomized controlled clinical trials involving the use of probiotics, caries and patients under fixed orthodontic treatment. The methodological quality of the articles was evaluated according to risk of bias. Of the five included studies, three reported significant differences compared to the control group. Of the others, one article reported significant decrease in the final count of microorganisms compared to the beginning of treatment. Only one study reported no differences of any kind. It was estimated that the eligible studies were of moderate methodological quality and had an unclear risk of bias, without affecting key domains for the research. It is concluded that the daily consumption of probiotics can be effective in the prevention of carious lesions in patients under fixed orthodontic treatment. However, this should be interpreted with caution and corroborated by clinical trials of better methodological quality.

External and internal resin infiltration of natural proximal subsurface caries lesions: A valuable enhancement of the internal tunnel restoration.

Science.gov (United States)

Kielbassa, Andrej M; Ulrich, Ina; Werth, Vanessa D; Schüller, Christoph; Frank, Wilhelm; Schmidl, Rita

2017-01-01

The aim of this ex-vivo study was to evaluate both the external and the internal penetration ability of a resin infiltrant into natural proximal and macroscopically intact white spot lesions, and to merge this approach with the internal tunnel preparation concept. 20 premolars and 20 molars with proximal subsurface lesions (ICDAS, code 2) and respective radiographic lesion depths extending into the middle third of dentin (D2 lesions) were selected and divided into two groups. Treatment needs were confirmed using digital imaging fiber-optic transillumination and laser fluorescence. Deproteinization (NaOCl; 2%) followed, and lesions of Group 1 (control; n = 20) were etched (HCl; 15%) and externally infiltrated (Icon). Accordingly, the specimens of Group 2 (n = 20) were treated with the resin infiltrant from external; then, internal Class I tunnels were prepared, lesions were internally infiltrated (Icon), and the occlusal cavities were restored (G-ænial Flo X) after etching (H3PO4 gel; 40%). Teeth were cut perpendicular to the proximal lesion surfaces, and percentage infiltrations were analyzed using confocal laser microscopy and a dedicated image manipulation program (GIMP). Regarding the external infiltration, no differences between both groups were detected (P = .114; Mann-Whitney). Additional internal application of the resin infiltrant significantly increased the percentage amount of enamel lesion infiltration (P External and internal infiltration seem to complement the internal tunnel approach, thus remediating the drawbacks of the latter by occluding and stabilizing the porous areas of the proximal caries lesion, and preserving both the marginal ridge and the proximal contact area.

Evidence for the occurrence of gingival recession and non-carious cervical lesions as a consequence of traumatic toothbrushing.

Science.gov (United States)

Heasman, Peter A; Holliday, Richard; Bryant, Andrew; Preshaw, Philip M

2015-04-01

To identify the best available evidence for the effect of toothbrushing on the initiation and progression of gingival recession and non-carious cervical lesions (NCCLs). A protocol was developed for the questions: Does traumatic toothbrushing, compared to normal toothbrushing, lead to an increased prevalence of non-inflammatory gingival recession? [FQ1] and NCCLs? [FQ2]. The search covered four electronic databases. Bibliographies of review articles, relevant texts, World and European Workshops were screened. Hand searches were performed of the Journals of Clinical Periodontology, Periodontology, Periodontal Research and IADR abstracts. A meta-analysis included 159 subjects and showed that subjects who used MTBs (manual toothbrush) had greater gingival recession after 12 months when compared with those using PTBs (powered toothbrush). Thirteen cross-sectional studies identified the most frequent toothbrushing factors associated with gingival recession as being toothbrushing frequency, a horizontal or scrub toothbrushing method, bristle hardness, toothbrushing duration and the frequency of changing a toothbrush. The principal toothbrushing factors associated with NCCLs were toothbrushing method and frequency. The data to support or refute the association between toothbrushing and gingival recession and NCCLs remain largely inconclusive. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Distribution of the amelogenin protein in developing, injured and carious human teeth

Directory of Open Access Journals (Sweden)

Thimios eMitsiadis

2014-12-01

Full Text Available Amelogenin is the major enamel matrix protein with key roles in amelogenesis. Although for many decades amelogenin was considered to be exclusively expressed by ameloblasts, more recent studies have shown that amelogenin is also expressed in other dental and no-dental cells. However, amelogenin expression in human tissues remains unclear. Here, we show that amelogenin protein is not only expressed during human embryonic development but also in pathological conditions such as carious lesions and injuries after dental cavity preparation. In developing embryonic teeth, amelogenin stage-specific expression is found in all dental epithelia cell populations but with different instensities. In the different layers of enamel matrix, waves of positive versus negative immunostaining for amelogenin are detected suggesting that the secretion of amelogenin protein is orchestreted by a biological clock. Amelogenin is also expressed transiently in differentiating odontoblasts during predentin formation, but was absent in mature functional odontoblasts. In intact adult teeth, amelogenin was not present in dental pulp, odontoblasts, and dentin. However, in injured and carious adult human teeth amelogenin is strongly re-expressed in newly differentiated odontoblasts and is distributed in the dentinal tubuli under the lesion site. In an in vitro culture system, amelogenin is expressed preferentially in human dental pulp cells that start differentiating into odontoblast-like cells and form mineralization nodules. These data suggest that amelogenin plays important roles not only during cytodifferentiation, but also during tooth repair processes in humans.

Proximal surface caries detection with direct-exposure and rare earth screen/film imaging

International Nuclear Information System (INIS)

Lundeen, R.C.; McDavid, W.D.; Barnwell, G.M.

1988-01-01

This laboratory study compared five imaging systems for their diagnostic accuracy in detection of proximal surface dental caries. Ten viewers provided data on radiographic detectability of carious lesions. The diagnostic accuracy of each system was determined with receiver operating characteristic (ROC) curves by comparing viewer data with the true state of the teeth as determined microscopically. D-speed film marginally outperformed the other four systems, but the three screen/film systems matched the diagnostic accuracy of E-speed film. Radiation reductions between 62% and 92% were achieved with the screen/film systems when compared to the two conventional dental films. The feasibility of designing a screen/film bite-wing cassette was shown, but the poor diagnostic accuracy of the present bite-wing system indicated a need for a new technology in caries detection

A 7-year randomized prospective study of a one-step self-etching adhesive in non-carious cervical lesions. The effect of curing modes and restorative material

DEFF Research Database (Denmark)

van Dijken, Jan W V; Pallesen, Ulla

2012-01-01

Objective: The aim of this study was to evaluate the clinical retention of a one-step self-etching adhesive system (Xeno III) in Class V non-carious cervical lesions and the effect of restorative material and curing techniques on longevity of the restorations. Material and methods: A total of 139...... be evaluated. No post-operative sensitivity was reported by the participants. Overall relative cumulative loss rate frequencies for the adhesive system at 6, 18 and 7 years, independent of curing technique and restorative material, were 0.8%, 6.9% and 23.0%, respectively. The self-etching adhesive fulfilled...... secondary caries was observed. Significance: The single-step self-etching adhesive showed acceptable clinical long-time retention rates to dentin surfaces independent of restorative material and curing technique used....

Environmental lead pollution and its possible influence on tooth loss and hard dental tissue lesions

Directory of Open Access Journals (Sweden)

Cenić-Milošević Desanka

2013-01-01

Full Text Available Bacground/Aim. Environmental lead (Pb pollution is a global problem. Hard dental tissue is capable of accumulating lead and other hard metals from the environment. The aim of this study was to investigate any correlation between the concentration of lead in teeth extracted from inhabitants of Pančevo and Belgrade, Serbia, belonging to different age groups and occurrence of tooth loss, caries and non-carious lesions. Methods. A total of 160 volunteers were chosen consecutively from Pančevo (the experimental group and Belgrade (the control group and divided into 5 age subgroups of 32 subjects each. Clinical examination consisted of caries and hard dental tissue diagnostics. The Decayed Missing Filled Teeth (DMFT Index and Significant Caries Index were calculated. Extracted teeth were freed of any organic residue by UV digestion and subjected to voltammetric analysis for the content of lead. Results. The average DMFT scores in Pančevo (20.41 were higher than in Belgrade (16.52; in the patients aged 31-40 and 41-50 years the difference was significant (p < 0.05 and highly significant in the patients aged 51-60 (23.69 vs 18.5, p < 0.01. Non-carious lesions were diagnosed in 71 (44% patients from Pančevo and 39 (24% patients from Belgrade. The concentrations of Pb in extracted teeth in all the groups from Pančevo were statistically significantly (p < 0.05 higher than in all the groups from Belgrade. In the patients from Pančevo correlations between Pb concentration in extracted teeth and the number of extracted teeth, the number of carious lesions and the number of non-carious lesions showed a statistical significance (p < 0.001, p < 0.01 and p < 0.001, respectively. Conclusion. According to correlations between lead concentration and the number of extracted teeth, number of carious lesions and non-carious lesions found in the patients living in Pančevo, one possible cause of tooth loss and hard dental tissue damage could be a long

Radiographic assessment of proximal caries: A comparison between film-based and dexis digital imaging systems

Directory of Open Access Journals (Sweden)

Anupama N Kalappanavar

2011-01-01

Full Text Available This study compared Kodak Ektaspeed film and Dexis digital imaging systems for their diagnostic accuracy in detection of proximal canes in 210 proximal surfaces from 105 extracted human teeth (20 premolars and 85 molars, 129 of which were carious. Ground teeth were evaluated histologically. The images were assessed by an observer. ANOVA revealed that groups differ in scoring patterns with f-value of 26.72 and p < 0.01. The mean caries score by histologic assessment was significantly (p < 0.01 more when compared with the scores obtained by conventional and Dexis digital radiographic methods. The mean score for conventional radiographic method was slightly more than Dexis digital radiographic method, but the difference was statistically insignificant (p < 0.05. Both the radiographic methods were less accurate in detecting proximal canes confined to enamel, but as the lesion depth was increased to dentin, the rate of caries detection increased dramatically. It was concluded that both conventional and Dexis digital radiographic methods under estimated canes depth when compared with histologic method. Lastly, conventional film radiographs and Dexis digital radiographs did not perform significantly different from each other in the detection of canes.

Systematic review of noninvasive treatments to arrest dentin non-cavitated caries lesions

Science.gov (United States)

de Assunção, Isauremi Vieira; da Costa, Giovanna de Fátima Alves; Borges, Boniek Castillo Dutra

2014-01-01

AIM: To systematically review the literature on the efficacy of noninvasive methods of arresting the progression of non-cavitated occlusal carious lesions in dentin. METHODS: The Medline/PubMed, LILACS, SciELO and Scopus databases were searched to identify relevant publications through to November 2013. Only clinical trials evaluating the ability of noninvasive methods to arrest the progression of occlusal non-cavitated carious lesions in dentin were included. Screening, data extraction and quality assessment were conducted independently and in duplicate. RESULTS: Of 167 citations identified, nine full text articles were screened and five were included in the analysis. All papers reported on occlusal fissure sealing using a self-curing glass ionomer (n = 1) or resin-based (n = 4) sealant. Only the use of resin-based sealant to obliterate occlusal fissures arrested the progression of non-cavitated occlusal carious lesions in dentin. CONCLUSION: Occlusal fissure sealing with a resin-based sealant may arrest the progression of non-cavitated occlusal dentinal caries. Further clinical trials with longer follow-up times should be performed to increase scientific evidence. PMID:24868513

Description of osteomyelitis lesions associated with Actinomyces pyogenes infection in the proximal tibia of adult male turkeys.

Science.gov (United States)

Brinton, M K; Schellberg, L C; Johnson, J B; Frank, R K; Halvorson, D A; Newman, J A

1993-01-01

Actinomyces pyogenes was isolated from osteomyelitis lesions from the proximal tibia of mature tom turkeys. Gram-stained impression smears of the lesions resulted in bacteria that appeared as club-shaped, gram-positive pleomorphic rods. The bacteria grew better in a reduced-oxygen environment. The lesions were well demarcated and cavernous, ranging from purulent to caseous in consistency.

Autoradiographic pattern of the in vitro uptake of proline by the coronal areas of intact and carious human teeth

Energy Technology Data Exchange (ETDEWEB)

Karjalainen, S; Soederling, E [Turku Univ. (Finland)

1979-01-01

The biosynthesis of collagen in teeth was studied by following the uptake of proline in vitro. Whole crowns of human teeth were incubated for 6 h with (/sup 14/C)- or (/sup 3/H)-proline. Autoradiographs were prepared from sections of intact teeth and teeth with carious lesions of varying depths and location. The number of silver grains per cm/sup 2/ in the predentine, odontoblast layer and pulp were counted in selected fields magnified x 430 representing the deepest parts of the carious lesions. No differences in the labelling pattern were observed between the intact teeth incubated freshly after extraction and those preserved in liquid nitrogen. The densest labelling of intact teeth was seen in the predentine and odontoblast layer. The alterations under initial dentine caries appeared as increased labelling of the predentine and decreased labelling of the odontoblast layer; no alterations were observed in the underlying pulp. In advanced lesions, the predentine labelling decreased and that in the odontoblast layer and pulp increased. In the initial stages, caries seem to activate collagen synthesis in a relatively restricted area of the underlying structures, but in advanced stages, caries seem to increase the odontoblastic cellular polypeptide chain formation but prevent further maturation of the collagen.

Comparison of the clinical examination with the panoramic radiography in the diagnosis of dental caries

Energy Technology Data Exchange (ETDEWEB)

Choi, Hang Moon [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1999-02-15

The objective of this study was to compare clinical examination of of dental caries and secondary caries with panoramic examination, and to examine bone lesions and dental anomaly of unerupted state. In this study, clinical records and panoramic radiographs were available for 89 first grade students in elementary school. Dental caries of occlusal surfaces, proximal surfaces, and buccolingual surfaces were examined. Secondary caries was examined too. In addition, the central lesion and dental anomaly of unerupted state were examined in panoramic radiographs. The obtained results were as followed :1. Carious detectability of clinical examination in occlusal and buccolingual surface was higher than that of panoramic examination, but it is statistically insignificant (p>0.05). In proximal surface, carious detectability of panoramic examination was higher than that of clinical examination, and it is statistically significant (p<0.01). 2. In contrast to clinical examination only, when the two examination methods were combined, there was additional detection of dental caries (26.7% in occlusal surface, 48.2% in proximal surface, 33.3% in buccolingual surface, and 38.3% totally). 3. In detection of secondary caries, panoramic examination had lower ability than clinical examination in all three surfaces, but in case that both methods were combined, totally 36.0% extra carious lesions were detected. 4. In panoramic examination, detectability of secondary caries in upper teeth is lower than lower teeth. 5. In panoramic examination, it was possible to detect the central lesions and dental anomalies of unerupted state which cannot be detected in clinical examination. It is useful to combine the panoramic examination with clinical examination in order to increase carious detectability and to evaluate the central lesions and dental anomalies of unerupted state.

Comparison of the clinical examination with the panoramic radiography in the diagnosis of dental caries

International Nuclear Information System (INIS)

Choi, Hang Moon

1999-01-01

The objective of this study was to compare clinical examination of of dental caries and secondary caries with panoramic examination, and to examine bone lesions and dental anomaly of unerupted state. In this study, clinical records and panoramic radiographs were available for 89 first grade students in elementary school. Dental caries of occlusal surfaces, proximal surfaces, and buccolingual surfaces were examined. Secondary caries was examined too. In addition, the central lesion and dental anomaly of unerupted state were examined in panoramic radiographs. The obtained results were as followed :1. Carious detectability of clinical examination in occlusal and buccolingual surface was higher than that of panoramic examination, but it is statistically insignificant (p>0.05). In proximal surface, carious detectability of panoramic examination was higher than that of clinical examination, and it is statistically significant (p<0.01). 2. In contrast to clinical examination only, when the two examination methods were combined, there was additional detection of dental caries (26.7% in occlusal surface, 48.2% in proximal surface, 33.3% in buccolingual surface, and 38.3% totally). 3. In detection of secondary caries, panoramic examination had lower ability than clinical examination in all three surfaces, but in case that both methods were combined, totally 36.0% extra carious lesions were detected. 4. In panoramic examination, detectability of secondary caries in upper teeth is lower than lower teeth. 5. In panoramic examination, it was possible to detect the central lesions and dental anomalies of unerupted state which cannot be detected in clinical examination. It is useful to combine the panoramic examination with clinical examination in order to increase carious detectability and to evaluate the central lesions and dental anomalies of unerupted state.

[Accuracy of computer aided measurement for detecting dental proximal caries lesions in images of cone-beam computed tomography].

Science.gov (United States)

Zhang, Z L; Li, J P; Li, G; Ma, X C

2017-02-09

Objective: To establish and validate a computer program used to aid the detection of dental proximal caries in the images cone beam computed tomography (CBCT) images. Methods: According to the characteristics of caries lesions in X-ray images, a computer aided detection program for proximal caries was established with Matlab and Visual C++. The whole process for caries lesion detection included image import and preprocessing, measuring average gray value of air area, choosing region of interest and calculating gray value, defining the caries areas. The program was used to examine 90 proximal surfaces from 45 extracted human teeth collected from Peking University School and Hospital of Stomatology. The teeth were then scanned with a CBCT scanner (Promax 3D). The proximal surfaces of the teeth were respectively detected by caries detection program and scored by human observer for the extent of lesions with 6-level-scale. With histologic examination serving as the reference standard, the caries detection program and the human observer performances were assessed with receiver operating characteristic (ROC) curves. Student t -test was used to analyze the areas under the ROC curves (AUC) for the differences between caries detection program and human observer. Spearman correlation coefficient was used to analyze the detection accuracy of caries depth. Results: For the diagnosis of proximal caries in CBCT images, the AUC values of human observers and caries detection program were 0.632 and 0.703, respectively. There was a statistically significant difference between the AUC values ( P= 0.023). The correlation between program performance and gold standard (correlation coefficient r (s)=0.525) was higher than that of observer performance and gold standard ( r (s)=0.457) and there was a statistically significant difference between the correlation coefficients ( P= 0.000). Conclusions: The program that automatically detects dental proximal caries lesions could improve the

OCT investigation of dental lesions

Science.gov (United States)

Osiac, Eugen; Popescu, Sanda Mihaela; Scrieciu, Monica; Mercuţ, Rǎzvan; Mercuţ, Veronica; Vǎtu, Mihaela

2018-03-01

There are several important non carious lesions affecting the tooth structure, lesions which may be classified into four clinical forms of dental wear: abfraction, erosion, attrition and abrasion, and different types of root resorption. Search for new, non-invasive and fast methods able to detect and describe such injuries is of utmost importance. Optical coherence tomography (OCT) proved itself as an appropriate investigation method for several medical fields including ophthalmology, dermatology, cardiology etc. Our study reveals OCT preliminary investigations as a promising tool for detecting and evaluating of the mentioned lesions.

The autoradiographic pattern of the in vitro uptake of proline by the coronal areas of intact and carious human teeth

International Nuclear Information System (INIS)

Karjalainen, S.; Soederling, E.

1979-01-01

The biosynthesis of collagen in teeth was studied by following the uptake of proline in vitro. Whole crowns of human teeth were incubated for 6 h with ( 14 C)- or ( 3 H)-proline. Autoradiographs were prepared from sections of intact teeth and teeth with carious lesions of varying depths and location. The number of silver grains per cm 2 in the predentine, odontoblast layer and pulp were counted in selected fields magnified x 430 representing the deepest parts of the carious lesions. No differences in the labelling pattern were observed between the intact teeth incubated freshly after extraction and those preserved in liquid nitrogen. The densest labelling of intact teeth was seen in the predentine and odontoblast layer. The alterations under initial dentine caries appeared as increased labelling of the predentine and decreased labelling of the odontoblast layer; no alterations were observed in the underlying pulp. In advanced lesions, the predentine labelling decreased and that in the odontoblast layer and pulp increased. In the initial stages, caries seem to activate collagen synthesis in a relatively restricted area of the underlying structures, but in advanced stages, caries seem to increase the odontoblastic cellular polypeptide chain formation but prevent further maturation of the collagen. (author)

A Study on the Diagnostic Detection Ability of the Artificial Proximal Caries by Digora

International Nuclear Information System (INIS)

Oh, Kyung Ran; Choi, Eui Hwan; Kim, Jae Duck

1998-01-01

Digora system is an intraoral indirect digital radiography system utilizing storage phosphor image plate. It has wide dynamic range which allows it to decrease the patient's exposure time and may increase diagnostic ability through image processing (such as edge enhancement, grey scale conversion, brightness change, and contrast enhancement). And also, it can transmit and storage image information. The purpose of this study was to evaluate the diagnostic ability of artificial proximal caries between Conventional radiograph and Digora images (unenhanced image, brightness and contrast controlled image, and edge enhanced image). ROC (Receiver Operating Characteristic) analysis, paired t-tests, and F-tests were done for the statistical evaluation of detectability. The following results were acquired: 1. In Grade I lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.953, 0.933, 0.965, 0.978 (p>0.05). 2. In Grade II lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.969, 0.964, 0.988, 0.994. Among theses areas, there was just statistical significance between Diagnostic abilities of Digora edge enhanced image and Conventional radiograph (p<0.05). 3. In the Interobserver variability, the ROC curve areas of Digora edge enhanced image was lowerest in these areas, regardless of the Carious lesion depths. In conclusion, intraoral indirect digital system, Digora system, has the potential possibility as an alternative of Conventional radiograph in the diagnosis of proximal caries.

Accuracy of digital subtraction radiography in combination with a contrast media in assessment of proximal caries depth

Directory of Open Access Journals (Sweden)

Farzad Esmaeili

2008-07-01

Full Text Available Background and aims. Radiography is used to diagnose the demineralization process and carious lesions; however, conventional radiography and direct digital images do not show these lesions when the amount of demineralization is less than 40%. Digital subtraction radiography has recently been used to improve the diagnostic quality of these lesions. The purpose of this study was to compare the caries depth estimated by digital subtraction radiography in combination with barium sulfate in diagnosing proximal dental caries with histopathologic evaluation. Materials and methods. In this study 30 molars and premolars (24 demineralized lesions with cavity, 8 without cavity were studied. Direct digital images were taken (kVp: 68, mA: 8; t: 0.12 for premolars and t: 0.16 for molars whereas the position of X-ray tube and CCD receptor and teeth was fixed. To prepare the second images 135 gr/L barium sulfate was used. The images obtained with the same exposure and geometry and then subtracted. The depth of the lesions in direct digital and subtracted images were assessed and compared with the depth measured in histopathologic assessments. Results. The mean depths (± SD of the lesions were 1.80 ± 0.77 mm in direct digital radiography, 2.32 ± 0.76 mm in subtracted images after barium sulfate treatment, and 2.51 ± 0.43 mm in histopathologic sections. The statistical difference between direct digital radiography and the other methods was significant (P < 0.05. However, the differences were not statistically significant between subtracted images and histopathologic sections. The average intra-class correlation coefficient was 0.7241 (CI: 95%. Conclusion. The present study has demonstrated that digital subtraction radiography images have the potential to measure the depth of proximal caries with no significant difference with histopathologic evaluation.

Impact of inhalation therapy on the incidence of carious lesions in patients with asthma and COPD

Directory of Open Access Journals (Sweden)

Branislava Velicki Bozejac

Full Text Available Abstract Objective: The aim of this study was to investigate the incidence of carious lesions, the amount of salivary flow rate and pH value in patients with asthma and chronic obstructive pulmonary diseases (COPD, using inhalation therapy. The obtained results were compared with the results of adult healthy subjects, forming a control group. Material and Methods: The study included 80 participants aging between 18 and 65 years. The experimental group (EG was comprised of 40 participants, previously diagnosed with asthma or COPD undergoing inhalation therapy for more than five years. The control group (CG, comprised of 40 participants, mirrored the same age and gender status of the EG. Dental status was determined by decayed, missing, and filled teeth (DMFT index. Quantity and pH value of saliva were determined in the laboratory. Results: In the EG, the mean value of the salivary flow rate and pH value were statistically significantly lower than in the CG (p<0.001. Patients in the EG had a higher value of DMFT index when compared with the CG, although the difference was not statistically significant (p=0.199. Mean number of decayed teeth, as well as missing teeth, in the EG was statistically significantly higher than in the CG (p<0.001. Mean number of filled teeth in the EG was statistically significantly lower than in the CG (p<0.001. Conclusion: It was found that patients undergoing inhalation therapy face increasing risk of dental caries due to the lower salivary flow rate and pH value along with the inhalation therapy. They should receive intensive preventive care, including oral hygiene instruction and dietary advice.

Characteristics, Detection Methods and Treatment of Questionable Occlusal Carious Lesions

DEFF Research Database (Denmark)

Makhija, S.K.; Gilbert, G.H.; Funkhouser, E.

2014-01-01

. The objective of this report has been to quantify the characteristics of these common lesions, the diagnostic aids used and the treatment of QOC. A total of 82 dentist and hygienist practitioner-investigators from the USA and Denmark in the National Dental Practice-Based Research Network participated. When...... consenting patients presented with a QOC, information was recorded about the patient, tooth, lesion and treatments. A total of 2,603 QOC from 1,732 patients were analyzed. The lesions were usually associated with a fissure, on molars, and varied from yellow to black in color. Half presented with a chalky...... luster and had a rough surface when examined with an explorer. There was an association between color and luster: 10% were chalky-light, 47% were shiny-dark and 42% were mixtures. A higher proportion of chalky than of shiny lesions were light (22 vs. 9%; p color were less common...

To fill or not to fill: a qualitative cross-country study on dentists' decisions in managing non-cavitated proximal caries lesions.

Science.gov (United States)

Schwendicke, F; Foster Page, L A; Smith, L A; Fontana, M; Thomson, W M; Baker, S R

2018-04-06

This study aimed to identify barriers and enablers for dentists managing non-cavitated proximal caries lesions using non- or micro-invasive (NI/MI) approaches rather than invasive and restorative methods in New Zealand, Germany and the USA. Semi-structured interviews were conducted, focusing on non-cavitated proximal caries lesions (radiographically confined to enamel or the outer dentine). Twelve dentists from New Zealand, 12 from Germany and 20 from the state of Michigan (USA) were interviewed. Convenience and snowball sampling were used for participant recruitment. A diverse sample of dentists was recruited. Interviews were conducted by telephone, using an interview schedule based on the Theoretical Domains Framework (TDF). The following barriers to managing lesions non- or micro-invasively were identified: patients' lacking adherence to oral hygiene instructions or high-caries risk, financial pressures and a lack of reimbursement for NI/MI, unsupportive colleagues and practice leaders, not undertaking professional development and basing treatment on what had been learned during training, and a sense of anticipated regret (anxiety about not restoring a proximal lesion in its early stages before it progressed). The following enablers were identified: the professional belief that remineralisation can occur in early non-cavitated proximal lesions and that these lesions can be arrested, the understanding that placing restorations weakens the tooth and inflicts a cycle of re-restoration, having up-to-date information and supportive colleagues and work environments, working as part of a team of competent and skilled dental practitioners who perform NI/MI (such as cleaning or scaling), having the necessary resources, undertaking ongoing professional development and continued education, maintaining membership of professional groups and a sense of professional and personal satisfaction from working in the patient's best interest. Financial aspects were more commonly

Quantitative Microbiological Study of Human Carious Dentine by Culture and Real-Time PCR: Association of Anaerobes with Histopathological Changes in Chronic Pulpitis

Science.gov (United States)

Martin, F. Elizabeth; Nadkarni, Mangala A.; Jacques, Nicholas A.; Hunter, Neil

2002-01-01

The bacteria found in carious dentine were correlated with the tissue response of the dental pulps of 65 teeth extracted from patients with advanced caries and pulpitis. Standardized homogenates of carious dentine were plated onto selective and nonselective media under anaerobic and microaerophilic conditions. In addition, real-time PCR was used to quantify the recovery of anaerobic bacteria. Primers and fluorogenic probes were designed to detect the total anaerobic microbial load, the genera Prevotella and Fusobacterium, and the species Prevotella melaninogenica, Porphyromonas endodontalis, Porphyromonas gingivalis, and Micromonas (formerly Peptostreptococcus) micros. The pulpal pathology was categorized according to the cellular response and degenerative changes. Analysis of cultured bacteria showed a predominance of gram-positive microorganisms, particularly lactobacilli. Gram-negative bacteria were also present in significant numbers with Prevotella spp., the most numerous anaerobic group cultured. Real-time PCR analysis indicated a greater microbial load than that determined by colony counting. The total number of anaerobes detected was 41-fold greater by real-time PCR than by colony counting, while the numbers of Prevotella and Fusobacterium spp. detected were 82- and 2.4-fold greater by real-time PCR than by colony counting, respectively. Real-time PCR also identified M. micros, P. endodontalis, and P. gingivalis in 71, 60, and 52% of carious samples, respectively. Correlation matrices of the real-time PCR data revealed significant positive associations between M. micros and P. endodontalis detection and inflammatory degeneration of pulpal tissues. These anaerobes have been strongly implicated in endodontic infections that occur as sequelae to carious pulpitis. Accordingly, the data suggest that the presence of high levels of these bacteria in carious lesions may be indicative of irreversible pulpal pathology. PMID:11980945

Association between the number of early carious lesions and diet in children with a high prevalence of caries.

Science.gov (United States)

Llena, C; Leyda, A; Forner, L; Garcet, S

2015-03-01

An investigation was conducted in a population of paediatric patients with a high risk of caries in order to assess the association between caries history (CH) and the number of early carious lesions (ECLs) and the frequency and timing of cariogenic food and beverage intake, sugar-containing medication, the frequency and efficacy of tooth brushing, and the use of topical fluorides. Study design: descriptive study. One hundred children aged 6-15 years with≥ ECL of a permanent tooth and not enrolled in any dental health educational or preventive programme were selected. For diagnosis it was used an explorer according to the ICDAS II criteria. The participants completed a closed-list questionnaire on the frequency and timing of cariogenic food intake. There was a nonsignificant tendency to present more ECLs and a greater CH among patients who consumed cariogenic foods and beverages. A significant relationship (pcariogenic beverages and the number of ECL or CH. Using the number of ECLs as dependent variable, regular fluoridated rinses (p=0.003), frequent sugar-containing medication (p=0.007), and cariogenic beverage consumption (p=0.024) were identified as explanatory parameters in the linear regression model. The Student t-test was used to compare ECL and CH with dietetic factors, fluoridated rinses, sugar- containing medicines, and the frequency and efficacy of tooth brushing. Linear regression analysis correlated the number of ECLs to the mentioned explanatory variables. The frequent consumption of sugary beverages and medications, and failure to regularly use fluoridated rinses, were positively correlated to an increased number of ECLs in patients with a high prevalence of caries.

Characterization of enamel caries lesions in rat molars using synchrotron X-ray microtomography

Energy Technology Data Exchange (ETDEWEB)

Free, R.D.; DeRocher, K.; Stock, S.R.; Keane, D.; Scott-Anne, K.; Bowen, W.H.; Joester, D. (Rochester); (NWU)

2017-08-18

Dental caries is a ubiquitous infectious disease with a nearly 100% lifetime prevalence. Rodent caries models are widely used to investigate the etiology, progression and potential prevention or treatment of the disease. To explore the suitability of these models for deeper investigations of intact surface zones during enamel caries, the structures of early-stage carious lesions in rats were characterized and compared with previous reports on white spot enamel lesions in humans. Synchrotron X-ray microcomputed tomography non-destructively mapped demineralization in carious rat molar specimens across a range of caries severity, identifying 52 lesions across the 30 teeth imaged. Of these lesions, 13 were shown to have intact surface zones. Depth profiles of fractional mineral density were qualitatively similar to lesions in human teeth. However, the thickness of the surface zone in the rat model ranges from 10 to 58 µm, and is therefore significantly thinner than in human enamel. These results indicate that a fraction of lesions in rat caries possess an intact surface zone and are qualitatively similar to human lesions at the micrometer scale. This suggests that rat caries models may be a suitable analog through which to investigate the structure of surface zone enamel and its role during dental caries.

Environmental lead pollution and its possible influence on tooth loss and hard dental tissue lesions.

Science.gov (United States)

Cenić-Milosević, Desanka; Mileusnić, Ivan; Kolak, Veljko; Pejanović, Djordje; Ristić, Tamara; Jakovljević, Ankica; Popović, Milica; Pesić, Dragana; Melih, Irena

2013-08-01

Environmental lead (Pb) pollution is a global problem. Hard dental tissue is capable of accumulating lead and other hard metals from the environment. The aim of this study was to investigate any correlation between the concentration of lead in teeth extracted from inhabitants of Pancevo and Belgrade, Serbia, belonging to different age groups and occurrence of tooth loss, caries and non-carious lesions. A total of 160 volunteers were chosen consecutively from Pancevo (the experimental group) and Belgrade (the control group) and divided into 5 age subgroups of 32 subjects each. Clinical examination consisted of caries and hard dental tissue diagnostics. The Decayed Missing Filled Teeth (DMFT) Index and Significant Caries Index were calculated. Extracted teeth were freed of any organic residue by UV digestion and subjected to voltammetric analysis for the content of lead. The average DMFT scores in Pancevo (20.41) were higher than in Belgrade (16.52); in the patients aged 31-40 and 41-50 years the difference was significant (p lead concentration and the number of extracted teeth, number of carious lesions and non-carious lesions found in the patients living in Pancevo, one possible cause of tooth loss and hard dental tissue damage could be a long-term environmental exposure to lead.

Abfraction lesions reviewed: current concepts

Directory of Open Access Journals (Sweden)

Adriana de Fátima Vasconcelos Pereira

2008-01-01

Full Text Available Non-carious cervical lesions are characterized by structural loss near the cementoenamel junction, without the presence of caries. Anumber of theories have arisen to explain the etiology of such lesions, although the real causes remain obscure, as is reflected by the contradictory terminology used in the literature. In addition to describing acidic and abrasive processes documented as etiological factors, attention is given to the role of mechanical stress from occlusal load, which is the most accepted theory for the development of abfraction lesions. Considering that tensile stress leads to the failure of restorations in the cervical region and that this is a fruitful area for future research, the present study has highlighted diagnosis, prognosis and the criteria for treatment.

Evaluation of proximal caries in images resulting from different modes of radiographic digitalization.

Science.gov (United States)

Xavier, C R G; Araujo-Pires, Ana Claudia; Poleti, M L; Rubira-Bullen, I R F; Ferreira, O; Capelozza, A L A

2011-09-01

The aim of this study was to evaluate the performances of observers in diagnosing proximal caries in digital images obtained from digital bitewing radiographs using two scanners and four digital cameras in Joint Photographic Experts Group (JPEG) and tagged image file format (TIFF) files, and comparing them with the original conventional radiographs. In total, 56 extracted teeth were radiographed with Kodak Insight film (Eastman Kodak, Rochester, NY) in a Kaycor Yoshida X-ray device (Kaycor X-707; Yoshida Dental Manufacturing Co., Tokyo, Japan) operating at 70 kV and 7 mA with an exposure time of 0.40 s. The radiographs were obtained and scanned by CanonScan D646U (Canon USA Inc., Newport News, VA) and Genius ColorPage HR7X (KYE Systems Corp. America, Doral, FL) scanners, and by Canon Powershot G2 (Canon USA Inc.), Canon RebelXT (Canon USA Inc.), Nikon Coolpix 8700 (Nikon Inc., Melville, NY), and Nikon D70s (Nikon Inc.) digital cameras in JPEG and TIFF formats. Three observers evaluated the images. The teeth were then observed under the microscope in polarized light for the verification of the presence and depth of the carious lesions. The probability of no diagnosis ranged from 1.34% (Insight film) to 52.83% (CanonScan/JPEG). The sensitivity ranged from 0.24 (Canon RebelXT/JPEG) to 0.53 (Insight film), the specificity ranged from 0.93 (Nikon Coolpix/JPEG, Canon Powershot/TIFF, Canon RebelXT/JPEG and TIFF) to 0.97 (CanonScan/TIFF and JPEG) and the accuracy ranged from 0.82 (Canon RebelXT/JPEG) to 0.91 (CanonScan/JPEG). The carious lesion diagnosis did not change in either of the file formats (JPEG and TIFF) in which the images were saved for any of the equipment used. Only the CanonScan scanner did not have adequate performance in radiography digitalization for caries diagnosis and it is not recommended for this purpose.

Microbiological analysis after complete or partial removal of carious dentin using two different techniques in primary teeth: A randomized clinical trial

Science.gov (United States)

Singhal, Deepak Kumar; Acharya, Shashidhar; Thakur, Arun Singh

2016-01-01

Background: The management of deep carious lesions can be done by various techniques but residual caries dilemma still persists and bacterial reduction in cavities treated by either partial or complete caries removal techniques is debatable. So the objective of the present randomized clinical trial was to compare microbial counts in cavities submitted to complete caries removal and partial caries removal using either hand instruments or burs before and after 3 weeks of restoration. Materials and Methods: Primary molars with acute carious lesions in inner half of dentine and vital pulp were randomly divided into three groups of 14 each: Group A: Partial caries removal using hand instruments atraumatic restorative treatment (ART) only; Group B: Partial caries removal using bur; Group C: Complete caries removal using bur and caries detector dye. Dentine sample obtained after caries removal and 3 weeks after restoration, were subjected to microbial culture and counting (colony-forming units [CFU]/mg of dentine) for total viable bacterial count, Streptococcus spp., mutans streptococci, Lactobacillus spp. Results: Three techniques of caries removal showed significant (P < 0.05) reduction in all microorganisms studied after 3 weeks of evaluation, but there was no statistically significant difference in percentage reduction of microbial count among three groups. Conclusion: Results suggest the use of partial caries removal in a single session as compared to complete caries removal as a part of treatment of deep lesions in deciduous teeth in order to reduce the risk of pulp exposure. Partial caries removal using ART can be preferred for community settings as public health procedure for caries management. PMID:26962313

Clinical comparative study between the use of lasers and conventional methods of diagnosis and treatment in deciduous teeth with presence of carious lesion

International Nuclear Information System (INIS)

Pulga, Fabiane Galvao

2001-01-01

The aim of this work was to evaluate the efficiency of deciduous tooth cavity preparation by the Er:YAG laser in comparison with the conventional burr rotary instrument. Besides, we have used the laser fluorescence technique (DIAGNOdent equipment) for diagnosis and compared it to the usual tactile and visual examination as well as X-ray diagnosis. For this purpose, 20 chronic occlusal carious deciduous molar teeth from children with the ages between 5 to 10 years old were selected. Selection was ma de according to visual inspection, X-ray periapical image and measures of the DIAGNOdent. For treatment the teeth were divided in two groups, 10 to be treated by the Er:YAG laser and 10 with conventional burr. For enamel, the laser energy used was in the interval from 200 to 300 mJ; for the dentine the range was from 100 mJ to 200 mJ. In both cases, the laser frequency was in the range from 2 to 4 Hz. The results have shown that the laser treatment was more accepted by the children than the conventional burro Clinical evaluation of the cavity preparation indicates that the Er:YAG laser treatment is recommend. The DIAGNOdent evaluation method was very effective for diagnosis of carious tissue for initial detection. After successful removal of the carious tissue, confirmed by visual inspection, the DIAGNOdent evaluation method was only effective for the treatment with conventional burro For evaluation of the tooth after cavity preparation with the Er:YAG laser, the measurements oscillate covering the full range of the equipment. Therefore, the use of the DIAGNOdent equipment is indicated only for initial caries diagnosis. (author)

Long-standing morel-lavallee lesion in the proximal thigh: ultrasound and MR findings with surgical and histopathological correlation

International Nuclear Information System (INIS)

Puig, J.; Pelaez, I.; Banos, J.; Balliu, E.; Maroto, A.; Pedraza, S.; Casas, M.

2006-01-01

A 65-year-old man presented with a soft mass in his proximal right thigh. Ultrasonography showed a well-defined anechoic lesion with slightly internal echoes. On MRI, the mass was hypointense and minimally hyperintense compared with muscle at T 1 and hyperintense at T 2 , with a hypointense peripheral rim on both sequences. No signal loss was observed on T 1 -weighted fat-suppression MRI. The clinical setting, imaging findings and histopathological features were consistent with a long-standing Morel-Lavallee lesion

Prevalencia de lesiones incipientes de caries dental en niños escolares Prevalence of incipient lesions of dental caries in school children

Directory of Open Access Journals (Sweden)

Nayda Nasco Hidalgo

2008-06-01

School in Plaza de la Revolución municipality from January to December 2006, and to identify in the studied group the frequency of children according to the number of incipient lesion, as well as the frequency of incipient lesions per tooth localization in the arcade and per dental surface. METHODS: an observational descriptive cross-sectional study was undertaken. The universe consisted of all the children aged 6-11 that fulfilled the inclusion criteria for a total of 236, who were examined in the open-air and with natural light by using the soft visual-tactile method. The teeth were cleaned with cotton and were dried with air to detect the presence of incipient carious lesions, which were indicated in a dentigram model in the place corresponding to the surface affected. RESULTS: it was found that 22.5 % of the school children examined presented these lesions. Of them, 60.1 % were females, 19.5 % of the total of children presented a lesion and just 3 % had 2 incipient lesions of dental caries; 79.2 % of them were observed in the posterior tooth. The smooth surfaces were the most affected with 45.3 %. CONCLUSIONS: Approximately the fourth part of the studied children presented incipient carious lesions. Females were the most affected. Of all the children with incipient lesions, the highest figure corresponded to those having a lesion. The posterior teeth were the most affected by incipient lesions. The smooth surfaces showed more incipient lesions than the occlusal and proximal

An in-vitro evaluation of Kodak Insight and Ektaspeed Plus film with a CMOS detector for natural proximal caries: ROC analysis.

Science.gov (United States)

Nair, M K; Nair, U P

2001-01-01

This study compared the diagnostic efficacy of Kodak Ektaspeed Plus film, Kodak Insight film, a newly introduced E/F-speed film, and Schick CMOS-APS digital sensor, with respect to caries detection in 92 proximal surfaces of extracted unrestored teeth, 51 of which were carious. Ground truth was evaluated histologically and the lesions classified as enamel or dentinal. Eight observers read the radiographs using a five-point confidence rating scale to record their diagnoses. Analyses using receiver operating characteristic curves revealed the areas under each curve that indicated the diagnostic accuracy (Ektaspeed Plus - 0.760, Insight - 0.778 and CMOS-APS sensor - 0.732). ANOVA revealed significant differences with respect to caries depth (p<0.031) and observers (p<0.0001). Weighted kappa analyses indicated moderate to substantial inter- and intra-observer agreement (0.42 and 0.66, respectively). The results suggest that none of the imaging modalities evaluated in this study differed in their diagnostic capabilities with respect to proximal decay detection and that the Insight film which was used with 20% less radiation exposure than Ektaspeed Plus film was as good as the other two sensors for this purpose.

Effect of the antimicrobial photodynamic therapy on microorganism reduction in deep caries lesions: a systematic review and meta-analysis

Science.gov (United States)

Ornellas, Pâmela Oliveira; Antunes, Leonardo Santos; Fontes, Karla Bianca Fernandes da Costa; Póvoa, Helvécio Cardoso Corrêa; Küchler, Erika Calvano; Iorio, Natalia Lopes Pontes; Antunes, Lívia Azeredo Alves

2016-09-01

This study aimed to perform a systematic review to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) in the reduction of microorganisms in deep carious lesions. An electronic search was conducted in Pubmed, Web of Science, Scopus, Lilacs, and Cochrane Library, followed by a manual search. The MeSH terms, MeSH synonyms, related terms, and free terms were used in the search. As eligibility criteria, only clinical studies were included. Initially, 227 articles were identified in the electronic search, and 152 studies remained after analysis and exclusion of the duplicated studies; 6 remained after application of the eligibility criteria; and 3 additional studies were found in the manual search. After access to the full articles, three were excluded, leaving six for evaluation by the criteria of the Cochrane Collaboration's tool for assessing risk of bias. Of these, five had some risk of punctuated bias. All results from the selected studies showed a significant reduction of microorganisms in deep carious lesions for both primary and permanent teeth. The meta-analysis demonstrated a significant reduction in microorganism counts in all analyses (p<0.00001). Based on these findings, there is scientific evidence emphasizing the effectiveness of aPDT in reducing microorganisms in deep carious lesions.

Structural and thermal behaviour of carious and sound powders of human tooth enamel and dentine

International Nuclear Information System (INIS)

Tiznado-Orozco, Gaby E; Garcia-Garcia, R; Reyes-Gasga, J

2009-01-01

Powder from carious human tooth enamel and dentine were structurally, chemically and thermally analysed and compared against those from sound (healthy) teeth. Structural and chemical analyses were performed using x-ray diffraction, energy-dispersive x-ray spectroscopy and transmission electron microscopy. Thermal analysis was carried out by thermogravimetric analysis, Fourier transform infrared spectroscopy and x-ray diffraction. Results demonstrate partially dissolved crystals of hydroxyapatite (HAP) with substitutions of Na, Mg, Cl and C, and a greater weight loss in carious dentine as compared with carious enamel. A greater amount of thermal decomposition is observed in carious dentine as compared with sound dentine, with major variations in the a-axis of the HAP unit cell than in the c-axis. Variations in shape and intensity of the OH - , CO 3 2- and PO 4 3- FTIR bands were also found.

Radiofrequency Energy and Electrode Proximity Influences Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation Lesion Size: An In Vitro Study with Clinical Correlation.

Science.gov (United States)

Staudt, Michael D; Maturu, Sarita; Miller, Jonathan P

2018-02-16

Radiofrequency thermocoagulation of epileptogenic foci via stereoelectroencephalography (SEEG) electrodes has been suggested as a treatment for medically intractable epilepsy, but reported outcomes have been suboptimal, possibly because lesions generated using conventional high-energy radiofrequency parameters are relatively small. To describe a technique of delivering low energy across separate SEEG electrodes in order to create large confluent radiofrequency lesions. The size and configuration of radiofrequency lesions using different radiofrequency intensity and interelectrode distance was assessed in egg whites. Magnetic resonance images (MRI) from 3 patients who had undergone radiofrequency lesion creation were evaluated to determine the contribution of lesion intensity and electrode separation on lesion size. Electroencephalography, MRI, and clinical data were assessed before and after lesion creation. Both in Vitro and in Vivo analysis revealed that less energy paradoxically produced larger lesions, with the largest possible lesions produced when radiofrequency power was applied for long duration at less than 3 W. Linear separation of electrodes also contributed to lesion size, with largest lesions produced when electrodes were separated by a linear distance of between 5 and 12 mm. Clinical lesions produced using these parameters were large and resulted in improvement in interictal and ictal activity. Radiofrequency lesions produced using low-energy delivery between SEEG electrodes in close proximity can produce a large lesion. These findings might have advantages for treatment of focal epilepsy.

Mixed periapical lesion: differential diagnosis of a case.

Science.gov (United States)

Krithika, C; Kota, S; Gopal, K S; Koteeswaran, D

2011-03-01

A radicular cyst associated with carious teeth is a very common odontogenic lesion in the oral cavity, but calcifications in residual radicular cysts are quite rare. We report one such case where a routine pre-implant radiographic assessment revealed a mixed periapical radiopaque radiolucent lesion in the right maxillary central incisor region. Histological and radiographic studies show that there is a slow increase in the mineralized deposits within the cyst lumen with time. This becomes prominent histochemically in cysts more than 8 years old and radiographically 6 years later, as seen in our case. In this paper we would like to highlight the importance of a residual radicular cyst with calcifications in the differential diagnosis of a mixed periapical radiopaque radiolucent lesion.

Dentine microhardness after different methods for detection and removal of carious dentine tissue

Directory of Open Access Journals (Sweden)

Fernanda Brandão Mollica

2012-08-01

Full Text Available There are several methods for identifying carious dentinal tissue aiming to avoid removal of healthy dentinal tissue. OBJECTIVES: The purpose of this study was to test different methods for the detection of carious dentinal tissue regarding the amount of carious tissue removed and the remaining dentin microhardness after caries removal. MATERIAL AND METHODS: The dentin surfaces of 20 bovine teeth were exposed and half of the surface was protected with nail polish. Cariogenic challenge was performed by immersion in a demineralizing solution for 14 days. After transverse cross-section of the crown, the specimens were divided into four groups (n=10, according to the method used to identify and remove the carious tissue: "Papacárie", Caries-detector dye, DIAGNOdent and Tactile method. After caries removal, the cross-sectional surface was included in acrylic resin and polished. In a microhardness tester, the removed dentin thickness and the Vickers microhardness of the following regions were evaluated: remaining dentin after caries removal and superficial and deep healthy dentin. RESULTS: ANOVA and Tukey's test (α=0.05 were performed, except for DIAGNOdent, which did not detect the presence of caries. Results for removed dentin thickness were: "Papacárie" (424.7±105.0; a, Caries-detector dye (370.5±78.3; ab, Tactile method (322.8±51.5; bc. Results for the remaining dentin microhardness were: "Papacárie" (42.2±10.5; bc, Caries-detector dye (44.6±11.8; abc, Tactile method (24.3±9.0; d. CONCLUSIONS: DIAGNOdent did not detect the presence of carious tissue; Tactile method and "Papacárie" resulted in the least and the most dentinal thickness removal, respectively; Tactile method differed significantly from "Papacárie" and Caries-detector dye in terms of the remaining dentin microhardness, and Tactile method was the one which presented the lowest microhardness values.

Chemical risk factors responsible for the formation of wedge-shaped lesions

Directory of Open Access Journals (Sweden)

Perić Dejan

2015-01-01

Full Text Available Introduction: Non-carious tooth substances loss pose a major health problem of a modern man. The literature often collectively describes all non-carious lesions and is therefore difficult to compare results obtained by different authors. Chemical factors are one of the predisposing factors responsible for the formation of wedge-shaped erosions. Aim: Examination of chemical risk factors as one of the predisposing causes responsible for the formation of wedge-shaped lesions. Method: We examined 62 patients with wedge-shaped erosions (mean age 45.52 ± 12.03 years, 58.1% of men and 60 patients without erosions in the control group (mean age 34.40 ± 9.28 years, 60% men . The entire examination was completed by using a questionnaire at the Dental Clinic of the University of Pristina - Kosovska Mitrovica. salivary pH was measured by the pH meter. Results: The results show that the wedge-shaped lesions often occur equally in both men and women. Considerably often it might appear in older people but can also occur in teenagers. Patients with wedge-shaped erosion have increased acidity of saliva, a heightened sense of acid in the mouth and consume a lot more carbonated drinks compared to patients without erosions. Conclusion: Wedge-shaped lesions are more common in people older than 40 years. Taking into account the results obtained in this study it can be concluded that the chemical risk factors truly fall within the predisposing factors that may be responsible for the creation of wedge-shaped erosions.

Molecular detection of bacteria associated to caries activity in dentinal lesions.

Science.gov (United States)

Neves, Beatriz Gonçalves; Stipp, Rafael Nóbrega; da Silva Bezerra, Daniela; de Figueiredo Guedes, Sarah Florindo; Rodrigues, Lidiany Karla Azevedo

2017-07-01

This study aimed at identifying and quantifying Actinomyces naeslundii, Bifidobacterium spp., Streptococcus mitis group, Lactobacillus acidophilus, Lactobacillus casei group, Streptococcus gordonii, and Streptococcus mutans in active and inactive carious dentine lesions of children with early childhood caries by using quantitative polymerase chain reaction. Fifty-six dentin lesion samples, classified as active (n = 39) or inactive (n = 17), were collected from children aged from 2 to 5 years old. Dentinal-cavitated lesions were evaluated by Nyvad criteria for the assessment of caries lesion activity. Relative quantification revealed that Bifidobacterium spp. and the L. casei group were significantly more abundant in active dentin lesions (p oral microbiota related to dentin caries activity status is relevant, this study provides insights to better understand the differences in the microbiotas between active and arrested dentin cavities.

Detection of white spot lesions by segmenting laser speckle images using computer vision methods.

Science.gov (United States)

Gavinho, Luciano G; Araujo, Sidnei A; Bussadori, Sandra K; Silva, João V P; Deana, Alessandro M

2018-05-05

This paper aims to develop a method for laser speckle image segmentation of tooth surfaces for diagnosis of early stages caries. The method, applied directly to a raw image obtained by digital photography, is based on the difference between the speckle pattern of a carious lesion tooth surface area and that of a sound area. Each image is divided into blocks which are identified in a working matrix by their χ 2 distance between block histograms of the analyzed image and the reference histograms previously obtained by K-means from healthy (h_Sound) and lesioned (h_Decay) areas, separately. If the χ 2 distance between a block histogram and h_Sound is greater than the distance to h_Decay, this block is marked as decayed. The experiments showed that the method can provide effective segmentation for initial lesions. We used 64 images to test the algorithm and we achieved 100% accuracy in segmentation. Differences between the speckle pattern of a sound tooth surface region and a carious region, even in the early stage, can be evidenced by the χ 2 distance between histograms. This method proves to be more effective for segmenting the laser speckle image, which enhances the contrast between sound and lesioned tissues. The results were obtained with low computational cost. The method has the potential for early diagnosis in a clinical environment, through the development of low-cost portable equipment.

Bizarre parosteal osteochondromatous proliferation of the proximal humerus: case report

Energy Technology Data Exchange (ETDEWEB)

Bush, J.B.; Meyer, Mark S. [Ochsner Clinic Foundation, Department of Orthopedics, New Orleans, LA (United States); Reith, John D. [University of Florida College of Medicine, Departments of Pathology, Immunology and Laboratory Medicine and Orthopaedics and Rehabilitation, Gainesville, Florida (United States)

2007-06-15

Bizarre parosteal osteochondromatous proliferation (BPOP), or Nora's lesion, is a rare lesion of bone occurring predominantly in the long bones of the hands and feet. It exists as a puzzling clinical entity of uncertain origins and high recurrence rates after surgical resection. To our knowledge, this clinical entity has not been reported in the proximal aspect of the humerus. An interesting report of a lesion occurring in the proximal humerus, which initially was misinterpreted as a parosteal osteosarcoma, is discussed outlining the clinical, radiographic and pathologic features of the BPOP lesion. (orig.)

Bizarre parosteal osteochondromatous proliferation of the proximal humerus: case report

International Nuclear Information System (INIS)

Bush, J.B.; Meyer, Mark S.; Reith, John D.

2007-01-01

Bizarre parosteal osteochondromatous proliferation (BPOP), or Nora's lesion, is a rare lesion of bone occurring predominantly in the long bones of the hands and feet. It exists as a puzzling clinical entity of uncertain origins and high recurrence rates after surgical resection. To our knowledge, this clinical entity has not been reported in the proximal aspect of the humerus. An interesting report of a lesion occurring in the proximal humerus, which initially was misinterpreted as a parosteal osteosarcoma, is discussed outlining the clinical, radiographic and pathologic features of the BPOP lesion. (orig.)

Risk of initial and moderate caries lesions in primary teeth to progress to dentine cavitation

DEFF Research Database (Denmark)

Guedes, Renata S; Piovesan, Chaiana; Floriano, Isabela

2016-01-01

AIM: To investigate the risk of sound surfaces, and initial and moderate caries lesions to progress to dentine cavitation in preschool children. DESIGN: A cohort study was designed with 639 children (12-59 months old) who had been examined by visual inspection during a survey in 2010. After 2 years......, 469 children were re-examined regarding the presence of dentine cavitations. The probability of progression was calculated for sound and carious (initial and moderate lesions) surfaces. Relative risk of progression and 95% confidence intervals for each condition compared with sound surfaces were...

Computer-aided proximal caries diagnosis: correlation with clinical examination and histology

International Nuclear Information System (INIS)

Kang, Byung Cheol; Scheetz, James P.; Aarman, Allan G.

2002-01-01

To evaluate the performance of the LOGICON Caries Detector using RVG-4 and RVG-ui sensors, by comparing results of each detector to the results of clinical and histological examinations. Pairs of extracted teeth were radiographed, and a total of 57 proximal surfaces, which included both carious and non-carious situations, were analyzed. The RVG-4 produced 8-bit images, while the RVG-ui unit produced 12-bit images, which were taken in the high sensitivity mode. The images produced by the LOGICON were evaluated by a trained observer using both automated and manual caries detection software modes. Ground sections of the teeth established the actual absence or existence of caries. LOGICON-aided caries detection and depth discrimination of the RVG-4 and RVG-ui sensors were equally inconsistent irrespective of whether the LOGICON software was set to the automated or manual mode. Sensitivity ranged from 50% to 57% for caries penetration of the enamel-dentin junction. Care needs to be taken when using LOGICON in conjunction with RVG images as an adjunct for treatment planning dental caries. Even when applied by a trained observer, substantial discrepancies exist between the results of the LOGICON software-guided evalutation using RVG images and histologic examination.

The effect of polymer burs on microbiological reduction of carious dentin in deciduous teeth: a systematic review

Directory of Open Access Journals (Sweden)

Daniela Silva Barroso de Oliviera

2016-10-01

Full Text Available Background. Polymer bur is a new technology that proposes to conserve the dentin that is capable of remineralization. Aim: To conduct a quantitative systematic review to evaluate the effect of polymer burs on the reduction of Streptococcus mutans and Lactobacillus after dentin carious excavation in deciduous teeth. Methods and Material: Two reviewers performed the database to identify the relevant clinical papers. Only papers in English that compared polymer burs with other caries removal techniques with the microbiological aspects as an outcome were included. Papers that evaluated only permanent teeth were excluded. Risk of bias was also assessed. Individual study effect sizes were calculated using Cohen’s d formula for the comparisons of microorganism reduction before and after carious excavation. Results: The search resulted in 12 non-duplicated papers. After the revision, only 2 were selected. The quantitative evaluation demonstrated that polymer bur reduces microorganism levels in carious dentin. The larger effect size observed was for Streptococcus mutans in the polymer bur technique (r=0.84; d=3.12, followed by Lactobacillus in the carbide bur technique (r=0.83; d=3.03. Conclusion: Polymer burs promoted a significant reduction of microorganism levels, mainly Streptococcus mutans in carious dentin.

Fluorine determination in human healthy and carious teeth using the PIGE technique

International Nuclear Information System (INIS)

Carvalho, M.L.; Karydas, A.G.; Casaca, C.; Zarkadas, Ch.; Paradellis, Th.; Kokkoris, M.; Nsouli, B.; Cunha, A.S.

2001-01-01

The purpose of this study is to determine and compare the fluorine concentration in human teeth from two different populations, living in the Portuguese quite isolated islands of Acores: S. Miguel and Terceira. Both populations have similar dietary habits, similar occupational activities, mostly rural, and the age of both populations is more or less the same, around 40 years. No chronic diseases were registered in any of the donors. The two groups are exposed to different levels of fluorine in drinking water. Terceira island has moderate fluorine concentration levels (1-2 μg g -1 ) while S. Miguel island is known for the high fluorine concentration levels in its water (>3 μg g -1 ), especially in one area known as Furnas. Thirty-three teeth, 17 healthy and 16 carious without restoration (14 incisors and canines, 7 premolars and 12 molars), were collected and analyzed for the determination of fluorine concentration in the dentine region, using the nuclear reaction 19 F(p,αγ) 16 O. The teeth were cross-sectioned along the vertical plane and polished, in order to obtain a smooth and plane surface of about 1 mm thickness. In this work an association between caries prevalence and fluorine content of drinking water is discussed and the variation of fluorine concentration among different types of teeth (canines and incisors, premolars, molars) and physical state (carious and non-carious) is examined

A quantitative light microscopic study of the odontoblast and subodontoblastic reactions to active and arrested enamel caries without cavitation

DEFF Research Database (Denmark)

Bjørndal, L.; Darvann, T.A.; Thylstrup, Anders

1998-01-01

Carious lesions, Computerized histomorphology, Dental pulp, Dentine, Enamel, Microradiography, Odontoblast......Carious lesions, Computerized histomorphology, Dental pulp, Dentine, Enamel, Microradiography, Odontoblast...

Neutrophil to lymphocyte ratio is associated with proximal/middle segment of the LAD lesions in patients with ST segment elevation infarction

Directory of Open Access Journals (Sweden)

Ozlem Arican Ozluk

2017-01-01

Full Text Available Introduction: Neutrophil to lymphocyte ratio (NLR was revaled to have a close relation with atherosclerotic cardiovascular disease. The relationship between NLR and culprit plaque localization has never been studied. Aim of the study : To evaluate the association between NLR and unstable plaque localization of left anterior descending artery (LAD in anterior miyocardial infarction patients. Material and methods : Patients admitted to our hospital with acute anterior STEMI were included. Fifhy-eight patients who have single-vessel disease at LAD and their hematological parameters were analyzed retrospectively. Proximal segment of LAD lesions were groupped as Group I and mid segment of the LAD lesion groupped as Group II. The groups were compared according to their NLR and other parameters. Results : Between group I (n = 41, mean age 52.5 ±12.7 and group II (n = 17, mean ages 52.0 ±10.8; NLR, were significantly higher in group I compared to the group II (6.9 ±5.6 vs. 3.3 ±2.0, p = 0.01. In group I, left ventricular ejection fraction (LVEF was significantly lower (p = 0.02. In correlation analyzes, NLR was positively correlated with CK MB (r = 0.32, p = 0.01 and negatively correlated with LVEF (r = –0.28, p = 0.03. Conclusions : The present study demonstrated that anterior myocardial infarction patients with high NLR had a greater possibility having proximal culprit lesion on the LAD. Therefore NLR can be used as a useful tool to culprit plaque localization in patients with acute miyocardial infarction patients.

Computed-tomographic and conventional linear-tomographic evaluation of tracheobronchial lesions for laser photoresection

International Nuclear Information System (INIS)

Pearlberg, J.L.; Sandler, M.A.; Kvale, P.; Beute, G.H.; Madrazo, B.L.

1985-01-01

Laser therapy is a new modality for treatment of airway lesions. The authors examined 18 patients prior to laser photoresection of tracheobronchial lesions. Thirteen had cancers involving the distal trachea, carina, and/or proximal bronchi; five had benign lesions of the middle or proximal trachea. Each patient was examined by conventional linear tomography (CLT) and computed tomography (CT). CT was valuable in patients who had lesions of the distal trachea, carina, and/or proximal bronchi. Its particular usefulness, and its advantage relative to CLT, consisted in its ability to delineate vascular structures adjacent to the planned area of photoresection. Neither CLT nor CT was helpful in evaluation of benign lesions of the proximal trachea

STUDY ON THE EFFECTS OF ACID ETCHING ON AFFECTED ENAMEL

Directory of Open Access Journals (Sweden)

Simona Stoleriu

2011-12-01

Full Text Available The purpose of the study was to establish and compare the effects of ortophosphoric and hydrochloric acids on the enamel affected by incipient carious lesions with different evolution. Materials and method. 20 teeth with acute and chronic non-cavitary carious lesions were considered for the study. The teeth were sectioned in two halves through the middle of the non-cavitary lesions. The halves of 5 white spot-type lesions and of 5 brown spot-type ones were analyzed as to their surface roughness, on an atomic force microscope (AFM. 5 halves with white spot-type lesions and 5 halves with brown spot-type ones were subjected to acid etching with 37% ortophosphoric acid (Scotchbond etchant gel, 3M ESPE, and an equal number of samples was subjected to the action of 15% hydrochloric acid (ICON-etch, DMG Dental Products Ltd for 2 min, then washed with water and analyzed by AFM. Results. The initial surface roughness of the enamel was higher in the white spot–type carious lesions, comparatively with the brown spot-type ones. For both types of carious non-cavitary lesions, acid etching with phosphoric and hydrochloric acid significantly increased the surface roughness of the enamel, comparatively with the status of the enamel surface prior to etching. The hydrochloric acid led to a surface roughness significantly higher than in the case of ortophosphoric acid, in both acute and chronic non-cavitary carious lesions. The roughness values obtained through etching with ortophosphoric and hydrochloric acid were higher in the white spot-type carious lesions, comparatively with the brown spot-type ones. Conclusions. Both the 37% ortophosphoric acid and the 15% hydrochloric acid determined a significantly higher surface roughness of the enamel affected by acute and chronic non-cavitary carious lesions. The surface condition of the brown spot-type carious lesions was less significantly modified, comparatively with that of the white spot-type lesions, by the

Laser and caries diagnosis: the state of the art and evaluation in vitro of the differences of the fluorescence between sound, carious and demineralized enamel

International Nuclear Information System (INIS)

Mendonca, Maria Angelica Lopes Chaves

2001-01-01

The aim of this study was to evaluate the methods for establishing dental caries diagnosis that make use of Laser light as source of illumination, establishing the 'state of the art'. Experimental observation of the differences among fluorescence of sound, demineralized and carious enamel by visible luminescent spectroscopy was also done. Six human teeth, extracted for clinical reasons were studied, and the results showed that the spectrum of carious enamel is different from the sound and demineralized ones. The differences are more evident relative to sond enamel and carious enamel, the same occurring between demineralized and carious enamel. The review of the literature aimed to make comparative considerations between QLF, LF and DELF; their effectiveness relative to traditional methods such as visual, visual with probe, radiography. It was verified that DELF was more sensitive, but could not discriminate between different degrees of mineral loss. QLF, compared to DIAGNOdent has the same sensitivity, but it is better for scientific purposes. The experimental part of the present study used on argon ion Laser to illuminated the teeth and signs of emission of fluorescence were captured by a PMT and then analyzed by a computer system with EG and G software. The results showed that the spectrum of carious enamel is different from the sound and demineralized. The differences are more evident in relation to sound and carious enamel, the same occurs between demineralized and carious enamel. (author)

Glass ionomer-silver cermet Class II tunnel-restorations for primary molars.

Science.gov (United States)

Croll, T P

1988-01-01

Tunnel preparations preserve the anatomical marginal ridge and minimize the loss of healthy tooth structure adjacent to the carious lesion. When the practitioner has developed proficiency in restoring class II carious lesions with tunnel restorations, less treatment time is required than with traditional class II preparations. The technique for restoring a primary first molar with a class II carious lesion, using a tunnel preparation and Ketac-Silver restorative material is described.

Predictors of antegrade flow at internal carotid artery during carotid artery stenting with proximal protection.

Science.gov (United States)

Harada, Kei; Kakumoto, Kosuke; Oshikata, Shogo; Fukuyama, Kozo

2018-06-01

Carotid artery stenting (CAS) with proximal occlusion effectively prevent distal cerebral embolism by flow arrest at internal carotid artery (ICA); however, the method can expose antegrade flow at ICA due to incomplete flow arrest. The aim of this study was to identify predictors of antegrade flow during CAS with proximal protection. We retrospectively analyzed clinical and angiographic data among 143 lesions treated with CAS with proximal protection by occluding the common carotid artery (CCA) and external carotid artery (ECA). Flow arrest or antegrade flow at ICA was confirmed by contrast injection during proximal protection. Antegrade flow at ICA was observed in 12 lesions (8.4%). Compared with lesions in which flow arrest of ICA was achieved, the diameter of the superior thyroid artery (STA) was significantly larger (2.4 ± 0.34 vs. 1.4 ± 0.68 mm, p protection should be combined with proximal protection for the lesions with antegrade flow to prevent distal migration of the carotid debris.

Endoscopic mucosal resection for proximal superficial lesions: efficacy and safety study in 59 consecutive resections Resección endoscópica mucosa de lesiones superficiales altas: estudio de su eficacia y seguridad en 59 resecciones consecutivas

Directory of Open Access Journals (Sweden)

Eduardo Albéniz-Arbizu

2012-09-01

Full Text Available Introduction: endoscopic mucosal resection is an accepted technique for the treatment of proximal gastrointestinal tract superficial lesions. Objectives: to evaluate the efficacy and safety of this procedure in the proximal gastrointestinal tract. Material and methods: forty one consecutive patients (23 males and 18 females, mean age of 61 ± 11.5 years were included in our study. Fifty nine resections were performed in these patients in 69 sessions. Lesions treated consisted of elevated lesions with high grade dysplasia in the context of Barrett's esophagus (group A, high grade dysplasia appearing in random biopsies taken during the follow-up of Barrett's esophagus (group B and superficial gastroduodenal lesions (group C. Snare resection after submucosal injection, band ligator-assisted or cap-assisted mucosal resection were the chosen techniques. Results: we resected 7 elevated lesions with high grade dysplasia in the context of Barrett's esophagus, 6 complete Barrett's esophagus with high grade dysplasia in 16 sequential sessions and 46 gastroduodenal superficial lesions (10 adenomas, 9 gastric superficial carcinomas, 18 carcinoid tumours and 9 lesions of different histological nature. Resections in the two first groups were complete in 100% of the cases, and in 97.9% of the cases in group C. Complications included 2 cases of limited deferred bleeding (groups A and B and another two cases of stenosis with little clinical relevance in Group B. Conclusions: a endoscopic mucosal resection is an efficient technique for the treatment of proximal gastrointestinal tract superficial lesions; b it is a safe procedure with a low percentage of complications, which can generally be managed endoscopically; and c in contrast with other ablative techniques, endoscopic mucosal resection offers the possibility of a pathologic analysis of the samples.Introducción: la resección endoscópica mucosa es una técnica aceptada en el tratamiento de lesiones

A Massive Chondroblastoma in the Proximal Humerus Simulating Malignant Bone Tumors

Directory of Open Access Journals (Sweden)

Ichiro Tonogai

2013-01-01

Full Text Available Chondroblastoma is a mostly benign bone neoplasm that typically affects the second decade of life and exhibits a lytic lesion in the epiphysis of long bones. We report an extreme case of massive, destructive chondroblastoma of the proximal humerus in a 9-year-old girl. It was difficult to differentiate using imaging information the lesion from malignant bone tumors such as osteosarcoma. Histopathological examination from biopsy proved chondroblastoma. The tumor was resected after preoperative transcatheter embolization. Reconstructive procedure for the proximal humerus was not performed due to the local destruction. The present case demonstrates clinical and radiological differentiations of the massive chondroblastoma from the other lesions and histopathological understandings for this lesion.

Vroegdiagnostiek van cariës

NARCIS (Netherlands)

van Strijp, A.J.P.

2010-01-01

Early detection of carious lesions enables the dental p rofessional to interfere in caries development. Visual inspection in combination with bitewing radiographs p erformed better than new quantitative methods in detecting early non-cavitated carious lesions. Once a lesion has been detected

Multiple Hereditary Osteochondromatosis: A Case Report

OpenAIRE

K???kesmen, ?i?dem; ?zen, Bu?ra; Ak?am, Mustafa

2007-01-01

Objectives Common carious lesions owing to vomiting are not widespread in children. In this case, we aimed to report an 11-years-old male patient with common carious lesions due to repeated vomitings, chewing and eating difficulty and retarded growth with Multiple Hereditary Osteochondromatosis (MHO). Case Report An 11-years-old boy was referred to Department of Pediatric Dentistry in Faculty of Dentistry because of eating difficulty owing to common carious lesions. It was seen that the patie...

Restorative treatment thresholds: factors influencing the treatment thresholds and modalities of general dentists in Kuwait.

Science.gov (United States)

Khalaf, Mai E; Alomari, Qasem D; Ngo, Hien; Doméjean, Sophie

2014-01-01

This study investigated the thresholds at which general dentists in Kuwait would restore approximal and occlusal carious lesions and examined the demographic characteristics of the dentists in relation to their decision making. The study population consisted of a random sample of 185 general dentists practicing in the Ministry of Health of Kuwait. A survey questionnaire was administered. The questionnaire presented different stages and locations of carious lesions; the participants were asked to identify the stage at which a restoration is required under different conditions, the preparation technique, and their choice of restorative material. For approximal carious lesions, 74 (40%) of the participants reported that they would restoratively intervene when the carious lesion reached the outer third of the dentin. A total of 91 (49.2%) reported the use of traditional class II restorations. For occlusal carious lesions, 128 (69.2%) said they would intervene when lesions reached the middle third of the dentin. 146 (78.9%) said they would remove the carious tissue only in their preparation. For both approximal and occlusal lesions, the participants preferred resin composite as the material for restoration. The respondents tended to delay restorative intervention until dentinal penetration of the caries. Resin restorative materials were used in conservatively prepared cavities. Participants chose a conservative approach for occlusal lesions but still believed in a traditional approach when it concerned approximal lesions. Experience, university dental education, and participation in continuous education courses were most significantly related to restorative treatment. © 2014 S. Karger AG, Basel.

Restoring proximal caries lesions conservatively with tunnel restorations.

Science.gov (United States)

Chu, Chun-Hung; Mei, May L; Cheung, Chloe; Nalliah, Romesh P

2013-07-30

The tunnel restoration has been suggested as a conservative alternative to the conventional box preparation for treating proximal caries. The main advantage of tunnel restoration over the conventional box or slot preparation includes being more conservative and increasing tooth integrity and strength by preserving the marginal ridge. However, tunnel restoration is technique-sensitive and can be particularly challenging for inexperienced restorative dentists. Recent advances in technology, such as the contemporary design of dental handpieces with advanced light-emitting diode (LED) and handheld comfort, offer operative dentists better vision, illumination, and maneuverability. The use of magnifying loupes also enhances the visibility of the preparation. The advent of digital radiographic imaging has improved dental imaging and reduced radiation. The new generation of restorative materials has improved mechanical properties. Tunnel restoration can be an option to restore proximal caries if the dentist performs proper case selection and pays attention to the details of the restorative procedures. This paper describes the clinical technique of tunnel restoration and reviews the studies of tunnel restorations.

Systemic calciphylaxis presenting as a painful, proximal myopathy.

OpenAIRE

Edelstein, C. L.; Wickham, M. K.; Kirby, P. A.

1992-01-01

A renal transplant patient who presented with a painful, proximal myopathy due to systemic calciphylaxis is described. The myopathy preceded the characteristic skin and soft tissue necrosis. Systemic calciphylaxis should be considered in a dialysis or a renal transplant patient presenting with a painful proximal myopathy even in the absence of necrotic skin lesions.

Proximal caries detection using digital subtraction radiography in the artificial caries activity model

Energy Technology Data Exchange (ETDEWEB)

Park, Jong Hoon; Lee, Gi Ja; Choi, Sam Jin; Park, Young Ho; Kim, Kyung Soo; Jin, Hyun Seok; Hong, Kyung Won; Oh, Berm Seok; Park, Hun Kuk [Department of Biomedical Engineering, School of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Choi, Yong Suk; Hwang, Eui Hwan [Department of Oral and Maxillofacial Radiology, Institute of Oral Biology, School of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

2009-03-15

The purpose of the experiment was to evaluating the diagnostic ability of dental caries detection using digital subtraction in the artificial caries activity model. Digital radiographs of five teeth with 8 proximal surfaces were obtained by CCD sensor (Kodak RVG 6100 using a size no.2). The digital radiographic images and subtraction images from artificial proximal caries were examined and interpreted. In this study, we proposed novel caries detection method which could diagnose the dental proximal caries from single digital radiographic image. In artificial caries activity model, the range of lesional depth was 572-1,374 {mu}m and the range of lesional area was 36.95-138.52 mm{sup 2}. The lesional depth and the area were significantly increased with demineralization time (p<0.001). Furthermore, the proximal caries detection using digital subtraction radiography showed high detection rate compared to the proximal caries examination using simple digital radiograph. The results demonstrated that the digital subtraction radiography from single radiographic image of artificial caries was highly efficient in the detection of dental caries compared to the data from simple digital radiograph.

Proximal caries detection using digital subtraction radiography in the artificial caries activity model

International Nuclear Information System (INIS)

Park, Jong Hoon; Lee, Gi Ja; Choi, Sam Jin; Park, Young Ho; Kim, Kyung Soo; Jin, Hyun Seok; Hong, Kyung Won; Oh, Berm Seok; Park, Hun Kuk; Choi, Yong Suk; Hwang, Eui Hwan

2009-01-01

The purpose of the experiment was to evaluating the diagnostic ability of dental caries detection using digital subtraction in the artificial caries activity model. Digital radiographs of five teeth with 8 proximal surfaces were obtained by CCD sensor (Kodak RVG 6100 using a size no.2). The digital radiographic images and subtraction images from artificial proximal caries were examined and interpreted. In this study, we proposed novel caries detection method which could diagnose the dental proximal caries from single digital radiographic image. In artificial caries activity model, the range of lesional depth was 572-1,374 μm and the range of lesional area was 36.95-138.52 mm 2 . The lesional depth and the area were significantly increased with demineralization time (p<0.001). Furthermore, the proximal caries detection using digital subtraction radiography showed high detection rate compared to the proximal caries examination using simple digital radiograph. The results demonstrated that the digital subtraction radiography from single radiographic image of artificial caries was highly efficient in the detection of dental caries compared to the data from simple digital radiograph.

Removal effects of the Nd:YAG laser and Carisolv on carious dentin.

Science.gov (United States)

Yamada, Y; Hossain, M; Kawanaka, T; Kinoshita, J; Matsumoto, K

2000-10-01

The purpose of this study was to investigate the removal effect of the Nd:YAG laser irradiation and Carisolv on carious dentin. Many previous studies have reported several simple and alternative techniques, such as lasers and chemicals, for caries removal. Carisolv was applied on the surface of 20 extracted human anterior and molar teeth for 1 min and then the Nd:YAG laser was irradiated with a continuous water spray for another 1 min. The energy densities were varied from 2 to 6W with a repetition rate of 20 pps. As caries removal progressed, the cavity was carefully assessed by DIAGNOdent. Each lesion was photographed before and after treatment, and the treated cavity was observed microscopically using a stereoscope and with scanning electron microscope (SEM). Thermal change at the time of laser irradiation was measured by thermovision. Our results revealed that application of Carisolv followed by Nd:YAG laser irradiation at 4-6W pulse energy effectively removed dentin caries. The total procedure was usually repeated once or twice for complete caries removal. From the SEM study, it was found that the cavity surface treated with the laser revealed various patterns of microirregularity, often accompanied by microfissure propagation. There was also no smear layer. It was revealed that Nd:YAG laser and Carisolv could provide an alternative technique for caries removal instead of the conventional mechanical drilling and cutting.

Comparison between RVG UI sensor and Kodak InSight film for detection of incipient proximal caries

International Nuclear Information System (INIS)

Matsuda, Yukiko; Hanazawa, Tomomi; Seki, Kenji; Araki, Kazuyuki; Okano, Tomohiro

2002-01-01

The purpose of this study was to compare the efficacy of the four combination modes of Trophy Radio Visio Graphy (RVG) UI sensor (Trex-Trophy Radiology Inc., Marne-la-Valee, France) and Kodak InSight film (Eastman Kodak Co., Rochester, NY) for detecting proximal dental caries. Thirty extracted human upper premolars were selected. Of 60 surfaces, 25 had carious lesions in the form of small cavities, and the rest showed no evidence of caries as verified by a micro computed tomogram (micro CT; XCT Research SA+, Stratec Medizintechnik GmbH, Pforzheim, Germany). All teeth were radiographed with the paralleling technique (60 kV, 40 cm focus-to-sensor distance). Four combination modes (high-resolution caries mode-HRC; high-sensitivity caries mode-HSC; high-resolution periodontal mode-HRP; and high-resolution endo mode-HRE) were used. Exposure was set at 0.12 sec for HRC, 0.08 sec for HSC, 0.16 sec for HRP, 0.12 sec for HRE, and 0.16 sec for the Kodak InSight film. The resulting images were evaluated by three oral radiologists. The same three observers evaluated the digital images, and were allowed to use the contrast and brightness controls in doing so. Possible differences in receiver operating characteristic (ROC) curve areas among image modalities were assessed by the Friedman test. The mean ROC curve areas were 0.66±0.11 for HRC, 0.78±0.02 for HSC, 0.76±0.04 for HRE, 0.77±0.04 for HRP, and 0.71±0.09 for the Kodak InSight film. There were no statistically significant differences between HRC, HSC, HRE, HRP and the Kodak InSight film in terms of proximal caries detection. The four modes of RVG UI system are each a viable alternative to intraoral film for the detection of incipient dental caries. (author)

Is it better to leave or restore carious deciduous molar teeth? A preliminary study.

Science.gov (United States)

Tickle, M; Milsom, K; Kennedy, A

1999-10-01

The objective of this study was to compare the extraction and exfoliation experience of filled and unfilled carious deciduous molar teeth. The study was carried out in 1997 in four general dental practices in south Cheshire, UK and involved a longitudinal retrospective review of case notes. A quota sample of 20 case notes of children from each practice was selected according to strict criteria. Subjects had to: Have had experience of approximal caries in one or more of the deciduous molar teeth. Have a date of birth between 1st January 1984 and 31st December 1985. Be a regular attender and in continuous contact with the practice. Data were collected on a common data abstraction form. Variables measured included: Base-line dmft. Site and number of filled teeth. Site and number of unfilled carious teeth. Number of courses of antibiotics. Site and number of pulp therapies. Site, number, method (local or general anaesthetic) of extractions. Reasons for extraction. All teeth not recorded as being extracted were assumed to have exfoliated. In addition, information was collected on the dentists' treatment philosophies. A series of group discussions revealed that the four dentists fitted into two groups according to treatment philosophies; two dentists shared a philosophy of minimal intervention, the other two shared the same views of treating more radically. There was no significant difference between the proportion of filled teeth and the proportion of carious unfilled teeth that were extracted (chi-square 0.05 P = 0.83). A logistic regression showed that for each course of antibiotics administered the odds of having an extraction was multiplied by 5.5 and children who were patients of the interventionist dentists were five times more likely to have an extraction than patients of non-interventionist dentists. Although the study was preliminary in nature no clear benefit could be found in filling deciduous molar teeth against leaving carious teeth unfilled, if avoidance

The Relationship Between Distal and Proximal Colonic Neoplasia : A Meta-Analysis

NARCIS (Netherlands)

Dodou, D.; De Winter, J.C.F.

2011-01-01

To investigate the association between proximal colonic neoplasia and distal lesions as a function of the lesion type. The extent to which health, demographic, and study characteristics moderate this association was also examined.

Myocardial Blood Flow and Flow Reserve in Proximal and Mid-to-Distal Lesions of Left Anterior Descending Artery Measured By N-13 Ammonia PET/CT

International Nuclear Information System (INIS)

Cho, Sanggeon; Kim, Ju Han; Cho, Jae Young; Kim, Hyeon Sik; Bom, Heeseung

2013-01-01

The purpose of this study is to compare the myocardial blood flow (MBF) and flow reserve (MFR) between proximal and mid-to-distal lesions of the left anterior descending artery (pLAD and mdLAD, respectively) using N-13 ammonia positron emission tomography/computed tomography (PET/CT). Subjects were 11 patients (six men and five women, mean age 64.5 years) with known coronary artery disease (CAD) involving LAD studied by N-13 ammonia PET/CT. They were divided into two groups by the location of stenotic lesions, i.e. pLAD versus mdLAD. Global and regional MBF and MFR were measured and compared. Characteristics of perfusion defects including the number of involved segments, basal area involvement, location, size, and shape were also compared between the two groups. The regional MFR in mid-anterior segment was significantly lower in pLAD group (1.80±0.35 vs 2.76±1.13 for pLAD and mdLAD groups, respectively, p=0.034), while global MFR was not different (2.10±1.10 vs 2.34±0.84). Both stress and rest MBF in LAD territories were not different in both groups. The size of the perfusion defects were significantly larger in pLAD group (44.0±11.5 % vs 21-1±15.8 %, p=0.041). Other characteristics such as location, basal area involvement, and shape were not significantly different between two groups. Conclusions The proximal lesion makes lower MFR in the mid-anterior segment and larger perfusion defect in the LAD territory but comparable MBF compared with mdLAD lesion

Hematoma of the proximal nail fold due to oximeter in a child

Directory of Open Access Journals (Sweden)

Patricia Chang

2014-01-01

Full Text Available Boy 4 years old, hospitalized due to hemorrhagic chickenpox and sepsis during his clinical examination besides hemorrhagic crust, vesicles and bullous he has also a cutaneous red lesion localized at the right proximal nail fold of the big toenail (Fig. 1, dermatoscopic view of the lesion (Fig. 2. The diagnosis of hematoma of the proximal nail fold due to oximeter was done. The proximal nail fold hematomas due to oximeter are uncommon dermatoses at this level that are caused for the pressure of the oximeter and it has been seeing in patient in Unit Intensive or Intermediate Unit Care since 2007.

Newly developed hardness testing system, "Cariotester": measurement principles and development of a program for measuring Knoop hardness of carious dentin.

Science.gov (United States)

Shimizu, Akihiko; Nakashima, Syozi; Nikaido, Toru; Sugawara, Toyotaro; Yamamoto, Takatsugu; Momoi, Yasuko

2013-01-01

We previously discovered that when a cone-shaped indenter coated with paint was pressed into an object, the paint disappeared in accordance with the depth of the indentation. Based on this fact, we developed the Cariotester, a portable system for measuring the Knoop hardness (KHN) of carious dentin. The Cariotester is composed of a handpiece with an indenter, a microscope, and a computer. In this system, the painted indenter is forced into the material with a 150-gf load, and the indentation depth (CT depth) is obtained from the paint disappearance. The CT depth by the Cariotester and the KHN by a microhardness tester were determined at 14 dentin regions. From the data, a program was created to convert the CT depth of the carious dentin into the KHN. As a result, if the CT depth is measured with this system, the KHN of carious dentin can be displayed in real time.

Full Pulpotomy with Biodentine in Symptomatic Young Permanent Teeth with Carious Exposure.

Science.gov (United States)

Taha, Nessrin A; Abdulkhader, Sakhaa Z

2018-04-19

This prospective study evaluated the outcome of Biodentine (Septodont, Saint Maur des Fosses, France) pulpotomy in young permanent teeth with carious exposure. Twenty permanent molar teeth in 14 patients with carious pulp exposure were treated with Biodentine pulpotomy. The age of the patients ranged from 9-17 years (12.3 ± 2.7 years). A preoperative pulpal and periapical diagnosis was established. After informed consent, the tooth was anesthetized, isolated via a dental dam, and disinfected with 5% sodium hypochlorite before caries excavation. Full pulpotomy was performed by amputating the exposed pulp to the level of the canal orifices, hemostasis was achieved via a cotton pellet moistened with 2.5% sodium hypochlorite, a 3-mm layer of Biodentine was placed as the pulpotomy agent, a Vitrebond liner (3M ESPE, St Paul, MN) was applied, and the tooth was subsequently restored. Postoperative periapical radiographs were taken after placement of the permanent restoration. Clinical and radiographic evaluation was completed after 6 months and 1 year postoperatively. Pain levels were scored preoperatively and 2 days after treatment. Statistical analysis was performed using the Fisher exact test. Clinical signs and symptoms suggestive of irreversible pulpitis were established in all teeth and symptomatic apical periodontitis in 14 of 20 (70%). Two days after treatment, all patients reported complete relief of pain. All teeth were clinically successful at 6 months and 1 year postoperatively. Radiographically, immature roots showed continued root development; dentin bridge formation was detected in 5 of 20 teeth. Seven of 7 teeth with preoperative periapical rarefaction showed signs of healing; 1 tooth had signs of internal root resorption at 1 year with an overall success rate of 95% (19/20). Young permanent teeth with carious exposure can be treated successfully with full pulpotomy using Biodentine, and clinical signs and symptoms of irreversible pulpitis are

Restoring proximal caries lesions conservatively with tunnel restorations

OpenAIRE

Chu, Chun-Hung; Cheung,; Nalliah,Romesh; Mei,May L

2013-01-01

Chun-Hung Chu1, May L Mei,1 Chloe Cheung,1 Romesh P Nalliah2 1Faculty of Dentistry, The University of Hong Kong, Hong Kong, People's Republic of China; 2Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA Abstract: The tunnel restoration has been suggested as a conservative alternative to the conventional box preparation for treating proximal caries. The main advantage of tunnel restoration over the conventional box or slo...

Dental Calculus Arrest of Dental Caries.

Science.gov (United States)

Keyes, Paul H; Rams, Thomas E

An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. These observations further document the potential protective effects of dental calculus mineralization against dental caries.

Dental Calculus Arrest of Dental Caries

Science.gov (United States)

Keyes, Paul H.; Rams, Thomas E.

2016-01-01

Background An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. Materials and methods A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Results Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. Conclusions These observations further document the potential protective effects of dental calculus mineralization against dental caries. PMID:27446993

Optical Assessment of Caries Lesion Structure and Activity

Science.gov (United States)

Lee, Robert Chulsung

technology will be employed for the detection and monitoring of early carious lesions without the use of ionizing radiation, thereby enabling conservative non-surgical intervention and the preservation of healthy tissue structure.

Restoring proximal caries lesions conservatively with tunnel restorations

Directory of Open Access Journals (Sweden)

Chu CH

2013-07-01

Full Text Available Chun-Hung Chu1, May L Mei,1 Chloe Cheung,1 Romesh P Nalliah2 1Faculty of Dentistry, The University of Hong Kong, Hong Kong, People's Republic of China; 2Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA Abstract: The tunnel restoration has been suggested as a conservative alternative to the conventional box preparation for treating proximal caries. The main advantage of tunnel restoration over the conventional box or slot preparation includes being more conservative and increasing tooth integrity and strength by preserving the marginal ridge. However, tunnel restoration is technique-sensitive and can be particularly challenging for inexperienced restorative dentists. Recent advances in technology, such as the contemporary design of dental handpieces with advanced light-emitting diode (LED and handheld comfort, offer operative dentists better vision, illumination, and maneuverability. The use of magnifying loupes also enhances the visibility of the preparation. The advent of digital radiographic imaging has improved dental imaging and reduced radiation. The new generation of restorative materials has improved mechanical properties. Tunnel restoration can be an option to restore proximal caries if the dentist performs proper case selection and pays attention to the details of the restorative procedures. This paper describes the clinical technique of tunnel restoration and reviews the studies of tunnel restorations. Keywords: operative, practice, tunnel preparation, composite, amalgam, glass ionomer

Pulp nerve fibers distribution of human carious teeth: An immunohistochemical study

Directory of Open Access Journals (Sweden)

Tetiana Haniastuti

2010-12-01

Full Text Available Background: Human dental pulp is richly innervated by trigeminal afferent axons that subserve nociceptive function. Accordingly, they respond to stimuli that induce injury to the pulp tissue. An injury to the nerve terminals and other tissue components in the pulp stimulate metabolic activation of the neurons in the trigeminal ganglion which result in morphological changes in the peripheral nerve terminals. Purpose: The aim of the study was to observe caries-related changes in the distribution of human pulpal nerve. Methods: Under informed consents, 15 third molars with caries at various stages of decay and 5 intact third molars were extracted because of orthodontic or therapeutic reasons. All samples were observed by micro-computed tomography to confirm the lesion condition 3-dimensionally, before decalcifying with 10% EDTA solution (pH 7.4. The specimens were then processed for immunohistochemistry using anti-protein gene products (PGP 9.5, a specific marker for the nerve fiber. Results: In normal intact teeth, PGP 9.5 immunoreactive nerve fibers were seen concentrated beneath the odontoblast cell layer. Nerve fibers exhibited an increased density along the pulp-dentin border corresponding to the carious lesions. Conclusion: Neural density increases throughout the pulp chamber with the progression of caries. The activity and pathogenicity of the lesion as well as caries depth, might influence the degree of neural sprouting.Latar belakang: Pulpa gigi manusia diinervasi oleh serabut saraf trigeminal yang berespon terhadap stimuli penyebab perlukaan dengan menimbulkan rasa sakit. Perlukaan pada akhiran saraf dan komponen lain dari pulpa akan menstimulasi aktivasi metabolik dari neuron pada ganglion trigeminal sehingga mengakibatkan perubahan morfologi pada akhiran saraf perifer. Tujuan: Penelitian ini bertujuan untuk mengamati perubahan distribusi saraf pada pulpa gigi manusia yang disebabkan oleh proses karies. Metode: Penelitian ini menggunakan

Subclinical ischemic events in patients undergoing carotid artery stent placement: comparison of proximal and distal protection techniques.

Science.gov (United States)

Aytac, Emrah; Gürkaş, Erdem; Akpinar, Cetin Kursad; Saleem, Muhammad A; Qureshi, Adnan I

2017-10-01

To determine the relative effectiveness of proximal and distal protection in prevention of cerebral ischemic events during carotid artery stent (CAS) placement using diffusion-weighted MRI (DW-MRI). We analyzed data from patients who had undergone DW-MRI before and within 24 hours of CAS for symptomatic internal carotid artery (ICA) stenosis (with last ischemic events within 3 months). The study was performed prospectively; patients were not randomized, and were treated either with a proximal balloon occlusion system (Mo.Ma; Invatec, Roncadelle, Italy) or filter-type distal protection device (Spider device; ev3, Plymouth, Minnesota, USA). Of the 45 patients (mean age±SD: 66.9±9.8 years; 73.3% were men) who underwent CAS, 19 had proximal protection and 26 distal protection. New ischemic lesions were detected in 26/45 patients on DW-MRI scans obtained within 24 hours after CAS. The proportion of patients with new lesions on DW-MRI at 24 hours was not different between the two groups (47.4% vs 65.4% for proximal and distal protection, respectively). The mean number of new ischemic lesions on post-CAS DW-MRI was non-significantly higher in patients who underwent CAS with distal protection (2.80±3.54 for proximal protection vs 4.96±5.11 for distal protection; p=0.12). The proportion of patients with new lesions >1 cm did not differ between the two groups (5.3% for proximal protection vs 11.5% for distal protection; p=0.62). There was no difference in the rates of ischemic stroke between patients who underwent CAS treatment using proximal and distal protection (5.3% vs 7.7%; p=1.000). We found a relatively high rate of new ischemic lesions in patients undergoing CAS with cerebral protection. There was no difference in the proportion of patients with new lesions between patients treated using distal protection and those treated using proximal protection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

Determining the Effect of Calculus, Hypocalcification, and Stain on Using Optical Coherence Tomography and Polarized Raman Spectroscopy for Detecting White Spot Lesions

Directory of Open Access Journals (Sweden)

Amanda Huminicki

2010-01-01

Full Text Available Optical coherence tomography (OCT and polarized Raman spectroscopy (PRS have been shown as useful methods for distinguishing sound enamel from carious lesions ex vivo. However, factors in the oral environment such as calculus, hypocalcification, and stain could lead to false-positive results. OCT and PRS were used to investigate extracted human teeth clinically examined for sound enamel, white spot lesion (WSL, calculus, hypocalcification, and stain to determine whether these factors would confound WSL detection with these optical methods. Results indicate that OCT allowed differentiating caries from sound enamel, hypocalcification, and stain, with calculus deposits recognizable on OCT images. ANOVA and post-hoc unequal N HSD analyses to compare the mean Raman depolarization ratios from the various groups showed that the mean values were statistically significant at P<.05, except for several comparison pairs. With the current PRS analysis method, the mean depolarization ratios of stained enamel and caries are not significantly different due to the sloping background in the stained enamel spectra. Overall, calculus and hypocalcification are not confounding factors affecting WSL detection using OCT and PRS. Stain does not influence WSL detection with OCT. Improved PRS analysis methods are needed to differentiate carious from stained enamel.

Magnetic resonance imaging findings of the proximal metacarpus in Quarter Horses used for cutting: Retrospective analysis of 32 horses 2009-2012.

Science.gov (United States)

Barrett, M F; Manchon, P T; Hersman, J; Kawcak, C E

2018-03-01

Injury to the proximal suspensory ligament is a common cause of lameness in cutting horses. Radiographic and ultrasonographic imaging of lesions responsible for lameness can provide ambiguous results. MRI provides the most comprehensive diagnostic imaging evaluation of lesions specifically affecting cutting horses. To describe the distribution and severity of bone and soft tissue lesions present in the proximal metacarpus of Quarter Horse cutting horses and to assess the impact of these lesions on return to competition. Retrospective case series. Retrospective analysis of 32 cutting horses referred for MRI of the proximal metacarpus between 2009 and 2012 with a 2-year follow-up period. MRI studies were evaluated by a board-certified veterinary radiologist; the severity of lesions was graded from 0 (absent) to 3 (severe). A total of 20 right and 24 left forelimbs (12 bilateral studies) of 32 horses were evaluated. The most common findings were: third metacarpal (McIII) sclerosis at the proximal suspensory ligament (PSL) origin (42/44), McIII resorption at the PSL origin (32/44), PSL dorsal margin fibre irregularity (30/44) and McIII bone contusion (22/39). Of the 30 horses, 22 horses successfully returned to competition, irrespective of severity of injury. Strong correlation exists between the degree of resorption in the palmar cortex of proximal McIII, degree of McIII sclerosis and severity of dorsal margin fibre irregularity. Statistical significance was limited by small study population. Further analysis of prognosis was limited by availability of comprehensive medical records. Cutting horses with proximal metacarpal pain have significant pathological change within the proximal suspensory ligament and its enthesis on the palmar cortex of McIII. Severity of lesions and degree of lameness at the time of diagnosis does not influence return to performance. Accurate diagnosis of proximal metacarpal lesions based on MRI offers clinicians the capacity to select

Investigation of dental caries using laser and light-induced autofluorescence methods

International Nuclear Information System (INIS)

Borisova, E.; Avramov, L.; Uzunov, T.

2006-01-01

The aim of this study was to investigate the intrinsic fluorescence in human teeth in vitro and its correspondence to the stages of the carious lesions using different excitation sources. Fluorescence spectra of teeth illuminated with light with wavelengths of 337, 440 and 488 nm were recorded. The spectra were obtained from the healthy, pre-carious and carious stages of the teeth investigated. Fluorosa dentis and odontolithiasis lesions were also studied to determine the effect of other pathologies on the teeth fluorescence spectra. We observed a significant decrease of the autofluorescence signal intensity related to the carious stage. The carious samples also revealed characteristic emission with fluorescence bands in the red spectral region which relative peak intensity increases depending on the stage. Healthy hard dental tissue exhibited no emission bands in the long-wave region. (authors)

Molecular analysis of microbial diversity in advanced caries.

Science.gov (United States)

Chhour, Kim-Ly; Nadkarni, Mangala A; Byun, Roy; Martin, F Elizabeth; Jacques, Nicholas A; Hunter, Neil

2005-02-01

Real-time PCR analysis of the total bacterial load in advanced carious lesions has shown that the total load exceeds the number of cultivable bacteria. This suggests that an unresolved complexity exists in bacteria associated with advanced caries. In this report, the profile of the microflora of carious dentine was explored by using DNA extracted from 10 lesions selected on the basis of comparable total microbial load and on the relative abundance of Prevotella spp. Using universal primers for the 16S rRNA gene, PCR amplicons were cloned, and approximately 100 transformants were processed for each lesion. Phylogenetic analysis of 942 edited sequences demonstrated the presence of 75 species or phylotypes in the 10 carious lesions. Up to 31 taxa were represented in each sample. A diverse array of lactobacilli were found to comprise 50% of the species, with prevotellae also abundant, comprising 15% of the species. Other taxa present in a number of lesions or occurring with high abundance included Selenomonas spp., Dialister spp., Fusobacterium nucleatum, Eubacterium spp., members of the Lachnospiraceae family, Olsenella spp., Bifidobacterium spp., Propionibacterium sp., and Pseudoramibacter alactolyticus. The mechanisms by which such diverse patterns of bacteria extend carious lesions, including the aspect of infection of the vital dental pulp, remain unclear.

MR imaging of sacral and perisacral lesions

International Nuclear Information System (INIS)

Wetzel, L.H.; Levine, E.; Murphey, M.D.

1987-01-01

This exhibit demonstrates the utility of MR imaging in evaluating sacral and perisacral lesions. Thirty-two lesions were studied using a superconducting 1.0-T MR imager. Eleven primary and 13 metastatic tumors, four congenital lesions, and four arachnoid cysts were evaluated. MR did not usually enable a more specific histologic diagnosis than other imaging techniques. However, extraosseous and proximal spinal extent of tumors was well defined without use of oral or intravenous contrast material. MR imaging is an excellent noninvasive technique for evaluating most sacral and perisacral lesions and is particularly helpful when precise tumor extent must be determined for treatment planning

Dental Pulp Cells Isolated from Teeth with Superficial Caries Retain an Inflammatory Phenotype and Display an Enhanced Matrix Mineralization Potential

Directory of Open Access Journals (Sweden)

Reem El-Gendy

2017-04-01

Full Text Available We have isolated dental pulp cells (DPCs from three healthy (hDPCs and three carious (cDPCs donors and shown that compared to hDPCs cells isolated from superficial carious lesions show higher clonogenic potential; show an equivalent proportion of cells with putative stem cell surface markers; show enhanced matrix mineralization capability; have enhanced angiogenic marker expression and retain the inflammatory phenotype in vitro characteristic of superficial caries lesions in vivo. Our findings suggest that cDPCs may be used for further investigation of the cross talk between inflammatory, angiogenic and mineralization pathways in repair of carious pulp. In addition cells derived from carious pulps (almost always discarded may have potential for future applications in mineralized tissue repair and regeneration.

Relationship between caries experience and demarcated hypomineralised lesions (including MIH) in the permanent dentition of 15-year-olds.

Science.gov (United States)

Kühnisch, Jan; Kabary, Lamiaa; Malyk, Yuri; Rothmaier, Katrin; Metz, Isabel; Hickel, Reinhard; Heinrich, Joachim; Manton, David; Standl, Marie

2018-06-01

This cross-sectional study compared the caries experience in 15-year-olds with and without demarcated hypomineralised lesions (DHL) in permanent teeth. One thousand three hundred and two 15-year-old adolescents from two ongoing birth cohorts (GINIplus15 and LISAplus15) were examined to determine non-cavitated carious lesions (NCCL) and the DMF index. Furthermore, DHL was scored on all permanent teeth/surfaces according to the molar-incisor hypomineralisation criteria of the European Academy of Paediatric Dentistry (MIH/EAPD). Adolescents with DHL were categorised into those with a minimum of one DHL in the permanent dentition (DHL ≥ 1), with DHL on at least one first permanent molar (MIH/EAPD) and with DHL on at least one first permanent molar and permanent incisor (MIH/Severe). The study was conducted in the metropolitan area of Munich. The proportion of children without caries amounted to 63.7% (DMF > 0) and 26.0% (D 1-4 MF > 0); the caries experience was mean = 4.0(SD = 5.2) NCCL/T and 0.9(1.7) DMF/T. Existence of DHL ≥ 1, MIH/EAPD and MIH/Severe was detected in 40.2, 17.2 and 9.8% of all adolescents, respectively. The corresponding DMF/T values were: no DHL 0.9(1.7); DHL ≥ 1 1.0(1.7); MIH/EAPD 1.1(1.6); MIH/Severe 1.1(1.7). The group of adolescents with MIH/EAPD and MIH/Severe were found to have statistically higher caries rates in comparison to those with no DHL. Caries and DHL are prevalent and influenced the dental health of 15-year-old adolescents. A significant positive association existed between the presence of caries and DHL. Children with MIH/EAPD or MIH/Severe had a higher probability to develop carious lesions in the permanent dentition.

Some observations on lameness associated with pain in the proximal metacarpal region

International Nuclear Information System (INIS)

Dyson, S.

1988-01-01

The carpus and metacarpus of 40 horses which were free from lameness and 40 horses with lameness associated with the metacarpophalangeal joint or more distal limb were examined radiographically (Group A). The opacity of the proximal third of the third metacarpal bone was regular, with a uniform trabecular pattern. Osseous cyst-like lesions (OCLLs) were identified in the radial carpal bone (1), the ulnar carpal bone (2), the second carpal bone (15) and the fourth carpal bone (1). Thirty-one of 638 horses (4.8 percent) with forelimb lameness had pain localised to the proximal metacarpal region using local anaesthesia (Group B). All these horses were examined radiographically and an ultrasonographic examination was performed in seven. No definitive diagnosis was reached in 16 horses, seven of which had an OCLL in one of the carpal bones or the second metacarpal bone. One horse had, in addition to a poorly defined lucent area in the second carpal bone, radiographic evidence of degenerative joint disease of the carpometacarpal joint and an hypoechoic lesion in the accessory ligament of the deep digital flexor tendon. One horse had an hypoechoic lesion in the proximal part of the suspensory ligament. Abnormalities of the trabecular structure of the third metacarpal bone were identified in 13 horses. In 11 of these there was a vertically orientated lucent line, usually surrounded by sclerotic bone. These lucent lines may represent fatigue fractures seen end on. In one horse an horizontal lucent line was seen. One of these 13 horses also had a lesion in the proximal part of the suspensory ligament. Ten of the 13 (77 per cent) horses with presumed fractures of the third metacarpal bone recovered completely, whereas only eight of the 16 (50 per cent) horses in which no definitive diagnosis was reached returned to their former function

Caries Experience and Salivary Parameters among Overweight Children and Adolescents

Directory of Open Access Journals (Sweden)

Michele B. Diniz

2013-11-01

Full Text Available Obesity is a chronic disease characterized by excess body fat, which can lead to other health problems, including insulin resistance, non-alcoholic fatty liver disease, polycystic ovary syndrome, hypertension, dyslipidemia, sleep apnea, asthma, heart attack, stroke, atherosclerosis and metabolic syndrome. Currently, obesity and dental caries are major public health concerns and dietary habits are a very important common component of their etiological factors, showing some correlation with the sociodemographic characteristics of individuals presenting these diseases. In relation to caries experience, the literature suggests a correlation between obesity and dental caries in children and adolescents, in primary and/or permanent dentition, though divergent results exist regarding assessment based on the method recommended by the WHO (1997, i.e., restricted to carious lesions with cavitation. Some studies indicate greater prevalence of proximal carious lesions in obese adolescents compared with those with normal weight. Salivary changes, such as the concentrations of phosphate, sialic acid, proteins and immunoglobulins and in peroxidase activity could explain the increased probability of obese children presenting greater risk of dental caries. Thus, it is important to consider the contribution of salivary parameters in caries experience of overweight children and adolescents and the implementation of preventive measures in this population.

Giant Cell Reparative Granuloma Mimicking Aneurysmal Bone Cyst in Proximal Phalanx of Toe

Directory of Open Access Journals (Sweden)

Huan CM

2016-03-01

Full Text Available Giant Cell Reparative Granuloma (GCRG of phalanx is uncommon. It is a benign osteolytic lesion but can be locally aggressive. GCRG has certain radiology and histological features that are similar to other giant cell lesions of the bone. We present a case report of a young patient with giant cell reparative granuloma of proximal phalanx of left third toe. The bone lesion was successfully treated surgically.

INCIDENCE OF SECONDARY ROOT CARIES LESIONS IN PATIENTS REFERRED FOR TREATMENT IN THE FACULTY OF DENTAL MEDICINE – SOFIA.

Directory of Open Access Journals (Sweden)

Mirela Marinova-Takorova

2014-07-01

Full Text Available Purpose: The aim of the presented study was to determine the incidence of secondary root caries lesions in patients referred for treatment in the Faculty of Dental Medicine – Sofia. Material/Methods: The subjects who took part in the study were patients referred for treatment of caries lesions in the Faculty of Dental Medicine, Sofia. They were interviewed for smoking, presence of systematic diseases and medications and debris and plaque were removed from natural teeth prior to examination. Dental examination was carried out with a dental mirror and a probe. Decayed, missed and filled teeth (DMFT were recorded. Root caries lesions, restorations of those lesions and secondary caries lesions were recorded separately. Results: A total number of 603 patients were examined. The frequency of appearance of root caries in the investigated population was 33.5% (202 patients. The whole number of root caries lesions was 857. Three hundred forty three (41.4% of those lesions were restored. Presence of secondary caries lesions was observed in 138 cases (39.1%. Conclusions: Based on the data obtained from the presented study it may be concluded that most of the root caries lesions remain untreated (58.8%. Secondary carious was diagnosed in 39.1% of the root caries restorations. The patients with secondary caries lesions presented with higher incidence of concomitant diseases and lower incidence of smoking.

Parental attitudes to the care of the carious primary dentition.

Science.gov (United States)

Tickle, M; Milsom, K M; Humphris, G M; Blinkhorn, A S

2003-10-25

To examine parents' attitudes to the dental care of their children, taking into account the family's socio-economic background, dentally-related behaviour including the child's level of dental anxiety and dental treatment history. A cross sectional study of all 5-year-old children living in Ellesmere Port and Chester. All children were clinically examined; dmft and its components were recorded. A postal questionnaire was sent to the children's parents to measure their preferences for dental care with reference to two scenarios, (1) if their child had a carious but asymptomatic primary tooth, or (2) if their child had a carious primary tooth which was causing toothache. Parents were also asked to provide information on the dental attendance pattern of their child and an assessment of their child's dental anxiety. Family socio-economic status was recorded using the Townsend material deprivation index of the electoral ward in which they resided. Questionnaires were distributed to the home addresses of the 1,745 children who were clinically examined, and 1,437 were returned, giving a response rate of 82%. In both scenarios the majority of parents were happy to leave the decision on treatment to the dentist. In the asymptomatic tooth scenario, approximately one third of parents wanted the tooth to remain untreated but periodically monitored, only 6% expressed a desire to have their child's tooth restored. Multivariate analysis showed that parents of children who had a filling (OR 4.32 95%CI 2.21-8.43) or extraction (OR 2.24 95%CI 1.11-4.53) in the past were significantly more likely to want restorative care for their children. In the scenario where the child had toothache, multivariate analysis confirmed that parents had a preference for an intervention (extraction or filling) if they lived in a deprived area (Townsend score OR 1.10, 95% CI 1.04, 1.16) or if their child had had an extraction (OR 4.35, 95% CI 1.59, 11.88) or filling (OR 2.39, 95% CI 1.05, 5.45) in the

Stereomicroscopic study of the human tooth caries: clinical and morphological correlations

Science.gov (United States)

Oancea, Roxana; Vasile, Liliana; Marchese, Cristian; Sava-Rosianu, Ruxandra

2012-06-01

loss that is very useful in grading the progression of the carious lesion. Conclusions: The stereomicroscopic study correlated with clinical and morphological data allowed to appreciate the extent of tissue involved in the carious process, but also the understanding of the enamel, dentine and cement matrix demineralization process, in proximity with the morpho-embryological markings of the human tooth structure.

Comparative analysis of bacterial decrease by Er:YAG laser radiation and by a tip mounted on a high-rotation device after remove of carious tissue in dentine: study 'in anima mobile'

International Nuclear Information System (INIS)

Blay, Claudia Campos

2001-01-01

The purpose of this study was to analyze bacterial decrease after removal of carious tissue in dentine by Er:YAG laser, comparing the results with those achieved by using a tip mounted on a high-rotation device. In view of the difficulty of totally eliminating microorganisms from dentine, even after removing all the carious tissue, and since the presence of a smear layer is a proven fact, it would be extremely convenient to eliminate or to achieve better disinfecting of this notoriously contaminated dentine layer, so as to prevent failure of the restoration process in most cases. For this study, we selected 30 pre-molars and molars with caries rated as medium sized and which required restoration treatment. The teeth were divided in two groups, where 15 teeth received conventional treatment (control group - I) and 15 teeth were treated with Er:YAG laser (Kavo Key Laser) (laser group - II). Microbiologic analysis was used in order to determine presence or absence of bacteria. In group I as well as in group II a previous curettage of part of the dentine caries was performed, and the sample was seeded in an Agar culture medium and incubated at 37 deg C for 72 hours, for a quantitative analysis of bacteria colony forming units (c.f.u.) and qualitative bacterial analysis. After this procedure, carious lesions were removed in group I, using a spherical diamond drill mounted on a high rotation tip, followed by cleaning of the cavity with chlorhexidine digluconate at 2%. In group II, an Er:YAG laser emitting a wave length of 2,94 μm, delivering a 250 mJ energy per pulse at a repetition rate of 2 Hz was used for carious tissue removal. Furthermore in group II (laser), the cavity was conditioned by performing a sweeping at all walls of the preparation with the 50/10 fiber (Kavo), in contact mode, using an energy of 60 mJ per pulse at a frequency of 10 Hz. After removing all caries and performing a cleaning operation in both groups, dentine shavings were collected and seeded

Metatranscriptomics reveals overall active bacterial composition in caries lesions

Directory of Open Access Journals (Sweden)

Aurea Simón-Soro

2014-10-01

Full Text Available Background: Identifying the microbial species in caries lesions is instrumental to determine the etiology of dental caries. However, a significant proportion of bacteria in carious lesions have not been cultured, and the use of molecular methods has been limited to DNA-based approaches, which detect both active and inactive or dead microorganisms. Objective: To identify the RNA-based, metabolically active bacterial composition of caries lesions at different stages of disease progression in order to provide a list of potential etiological agents of tooth decay. Design: Non-cavitated enamel caries lesions (n=15 and dentin caries lesions samples (n=12 were collected from 13 individuals. RNA was extracted and cDNA was constructed, which was used to amplify the 16S rRNA gene. The resulting 780 bp polymerase chain reaction products were pyrosequenced using Titanium-plus chemistry, and the sequences obtained were used to determine the bacterial composition. Results: A mean of 4,900 sequences of the 16S rRNA gene with an average read length of 661 bp was obtained per sample, giving a comprehensive view of the active bacterial communities in caries lesions. Estimates of bacterial diversity indicate that the microbiota of cavities is highly complex, each sample containing between 70 and 400 metabolically active species. The composition of these bacterial consortia varied among individuals and between caries lesions of the same individuals. In addition, enamel and dentin lesions had a different bacterial makeup. Lactobacilli were found almost exclusively in dentin cavities. Streptococci accounted for 40% of the total active community in enamel caries, and 20% in dentin caries. However, Streptococcus mutans represented only 0.02–0.73% of the total bacterial community. Conclusions: The data indicate that the etiology of dental caries is tissue dependent and that the disease has a clear polymicrobial origin. The low proportion of mutans streptococci

Functional remineralization of dentin lesions using polymer-induced liquid-precursor process.

Directory of Open Access Journals (Sweden)

Anora K Burwell

Full Text Available It was hypothesized that applying the polymer-induced liquid-precursor (PILP system to artificial lesions would result in time-dependent functional remineralization of carious dentin lesions that restores the mechanical properties of demineralized dentin matrix. 140 µm deep artificial caries lesions were remineralized via the PILP process for 7-28 days at 37°C to determine temporal remineralization characteristics. Poly-L-aspartic acid (27 KDa was used as the polymeric process-directing agent and was added to the remineralization solution at a calcium-to-phosphate ratio of 2.14 (mol/mol. Nanomechanical properties of hydrated artificial lesions had a low reduced elastic modulus (E(R = 0.2 GPa region extending about 70 μm into the lesion, with a sloped region to about 140 μm where values reached normal dentin (18-20 GPa. After 7 days specimens recovered mechanical properties in the sloped region by 51% compared to the artificial lesion. Between 7-14 days, recovery of the outer portion of the lesion continued to a level of about 10 GPa with 74% improvement. 28 days of PILP mineralization resulted in 91% improvement of E(R compared to the artificial lesion. These differences were statistically significant as determined from change-point diagrams. Mineral profiles determined by micro x-ray computed tomography were shallower than those determined by nanoindentation, and showed similar changes over time, but full mineral recovery occurred after 14 days in both the outer and sloped portions of the lesion. Scanning electron microscopy and energy dispersive x-ray analysis showed similar morphologies that were distinct from normal dentin with a clear line of demarcation between the outer and sloped portions of the lesion. Transmission electron microscopy and selected area electron diffraction showed that the starting lesions contained some residual mineral in the outer portions, which exhibited poor crystallinity. During remineralization

Diagnostic Performance of the Intraoral Radiographs on the Interproximal Dental Caries

International Nuclear Information System (INIS)

Kim, Soo Ji; Kang, Byung Cheol

1998-01-01

The purpose of this study was to evaluated the diagnostic performance of the senior dental students for the proximal dental caries in intraoral radiographs and to compare it with the dental hospital residents, the reference group. It was also investigated the diagnostic performance according to the carious lesion depth. Thirty-five intraoral periapical and bitewing radiographs with 213 proximal surface included in this study were selected from the dental patients at Chonnam National University Hospital. The observers were 181 senior dental students from 5 dental schools and 40 dentists who were second year resident from 5 dental hospitals. They were asked to evaluate the presence ro the absence of the proximal dental caries. The results were as follows : 1. The mean of the hitting rate for the overall observers was 184.51 surfaces and the diagnostic accuracy was 86.62%. 2. The diagnostic performance of the sound proximal tooth surfaces was very high, i.e., 91.5% true negative rate and 8.5% false positive rate. 3. The diagnostic performance of the dentist group was higher than the student group (P 0.001).

Analysis 'in vivo' of the employ of the Er:YAG laser and conventional method to remove carious tissue

International Nuclear Information System (INIS)

Ribeiro, Rafael Cardoso

2002-01-01

The aim of this study was to evaluate the removal of carious tissue employing the use of Er:YAG laser in comparison with the conventional burr rotary instrument. The wavelength of this laser is 2,64 μm and have a good absorption by the water and hydroxyapatite present in dental hard tissue. For this purpose were selected 24 molar teeth with occlusal carious, which were divided in random in two groups. For enamel, the laser energy used was in the interval from 250 mJ to 400 mJ, and the frequency range from 2 Hz to 4 Hz; for the dentine the energy laser range was from 150 mJ to 200 mJ and the laser frequency was in the range from 2 Hz to 6 Hz. For the evaluation of the results was used a questionaire to critical evaluation of the professional and another one to evaluation of the patient. The results have shown that the Er:YAG laser is able to remove carious enamel and dentin, without cause crunch or fracture and the irradiated surface was creasy. The patients reported greatest comfort when the cavity preparation was done with the Er:YAG laser than the conventional burr and all the patients treated reported prefer to future treatments the use of the Er:YAG laser. In conclusion, for the critical evaluation of the professional the treatment with the Er:YAG laser is a safe and effective method, and for the critical evaluation of the patient the treatment is one alternative more comfortable than the conventional method to remove caries. (author)

Rehardening of caries-like lesions in root surfaces by saliva substitutes.

Science.gov (United States)

Turssi, Cecilia P; Lima, Renata Q V; Faraoni-Romano, Juliana J; Serra, Mônica C

2006-12-01

This study sought to evaluate whether root dentine caries-like lesions could be remineralised by saliva substitutes. Root dentine slabs (3 x 3 x 2 mm) were cut from bovine incisors, ground flat, polished and pre-tested for Knoop microhardness (KHN) at five locations spaced 500 microm apart and 500 microm from the left edge of each sectioned piece. After 60 out of the 100 slabs had been selected based upon their KHN values, specimens were coated with wax except for their outer surface. Specimens were then cycled through a highly cariogenic challenge model to induce caries-like lesions, whose formation was confirmed by KHN measurements located 500 microm from the right edge of the specimen. According to a randomised complete block design, the experimental units (n = 15) were exposed to 1.5 ml of saliva substitutes, based on either mucin (MC) or carboxymethylcellulose (CM), to natural human saliva (HS) or to 100% relative humidity (RH) over 20 days. Remineralisation was verified by KHN measurements located 1000 microm apart from the right edge of the specimen. Analysis of variance indicated a significant (p < 0.0001) difference among the KHN values attained by the carious root dentine after exposure to the remineralising agents. Tukey's test ascertained that remineralisation was greatest with MC, intermediate with CM and least with HS, but rehardening did not reach the pre-caries lesion formation values. Saliva substitutes may provide partial remineralisation to preformed caries-like lesions in root dentine.

A case of unusual root morphology: Maxillary canine with two roots

Directory of Open Access Journals (Sweden)

Nagesh Bolla

2009-01-01

Full Text Available The case describes a 3 months follow-up of the treatment of a maxillary canine with two roots. Clinical examination revealed a maxillary canine with a large carious lesion and an exaggerated response to cold thermal tests. Radiographic examination revealed a large distal carious lesion that appeared to invade the pulp chamber. The radiograph also revealed what appeared to be an extra root in this permanent maxillary canine.

An ex vivo study of arrested primary teeth caries with silver diamine fluoride therapy.

Science.gov (United States)

Mei, May L; Ito, L; Cao, Y; Lo, Edward C M; Li, Q L; Chu, C H

2014-04-01

This ex vivo study compared the physico-chemical structural differences between primary carious teeth biannually treated with silver diamine fluoride (SDF) and carious teeth without such treatment. Twelve carious primary upper-central incisors were collected from 6-year-old children. Six teeth had arrested caries after 24-month biannual SDF applications and 6 had active caries when there was no topical fluoride treatment. The mineral density, elemental contents, surface morphology, and crystal characteristics were assessed by micro-computed tomography (micro-CT), energy-dispersive X-ray spectrometry (EDX), scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Micro-CT examination revealed a superficial opaque band approximately 150μm on the arrested cavitated dentinal lesion. This band was limited in the active carious lesion. EDX examination detected a higher intensity of calcium and phosphate of 150μm in the surface zone than in the inner zone, but this zone was restricted in the active cavitated dentinal lesion. SEM examination indicated that the collagens were protected from being exposed in the arrested cavitated dentinal lesion, but were exposed in the active cavitated dentinal lesion. TEM examination suggested that remineralised hydroxyapatites were well aligned in the arrested cavitated dentinal lesion, while those in the active cavitated dentinal lesion indicated a random apatite arrangement. A highly remineralised zone rich in calcium and phosphate was found on the arrested cavitated dentinal lesion of primary teeth with an SDF application. The collagens were protected from being exposed in the arrested cavitated dentinal lesion. Clinical SDF application positively influences dentine remineralisation. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Contemporary operative caries management: consensus recommendations on minimally invasive caries removal

NARCIS (Netherlands)

Banerjee, A.; Frencken, J.E.F.M.; Schwendicke, F.; Innes, N.P.

2017-01-01

The International Caries Consensus Collaboration (ICCC) presented recommendations on terminology, on carious tissue removal and on managing cavitated carious lesions. It identified 'dental caries' as the name of the disease that dentists should manage, and the importance of controlling the activity

Wavelength comparison for laser induced breakdown spectroscopy caries detection

Science.gov (United States)

Amaral, Marcello M.; Raele, Marcus P.; Ana, Patrícia A.; Núñez, Sílvia C.; Zamataro, Claudia B.; Zezell, Denise M.

2018-02-01

Laser Induced Breakdown Spectroscopy (LIBS) is a technique capable to perform elemental analyses of a variety of samples, independent of matter state. Other spectroscopy techniques may require a destructive and time-consuming sample preparation. On the other hand, LIBS is a less destructive technique with no (or considerably less) sample preparation, using a relatively simple experimental setup. LIBS also provides a multielement analysis into one single spectrum acquisition, applying a Nd:YAG short-pulsed laser to ensure the stoichiometry between the sample and the generated plasma. LIBS have been applied on the study of carious lesions using a Nd:YAG into its fundamental emission at 1064 nm. It was shown that ratio of P/Ca and Zn/Ca can be used to monitor the cariogenic process. Another minor elements, e.g. C and Cu, associated with bacteria biofilm were also measured with the Nd:YAG laser. The fundamental wavelength emission (1064 nm) of Nd:YAG is coincident with a hydroxyapatite transmission window and it may affect the result. In order to address this issue a study used the second harmonic of the Nd:YAG laser at 532 nm. It was show that it is also possible perform LIBS on carious lesion using the Nd:YAG at 532 nm. However, there is not a work direct comparing the LIBS at 532 nm and 1064 nm for carious lesion detection. So, the aim of this work was to investigate the influence of laser wavelength on the LIBS performance for carious lesion detection. In both cases the carious lesion was detected with the advantage of no interference with hydroxyapatite at 532 nm.

The state-of-the-art of ART sealants.

Science.gov (United States)

Frencken, Jo E

2014-03-01

Sealing caries-prone pits and fissure systems is an effective caries-preventive measure. There are basically two types of sealant materials: glass-ionomer and resin-based materials. Low- and medium-viscosity glass-ionomers were initially used and showed a low level of retention. With the advent of the ART approach in the mid-nineties, high-viscosity glass-ionomers were introduced as sealant material and the retention rate of ART sealants increased substantially. As the effectiveness of a sealant is measured by its capacity to prevent (dentine) carious lesion development, sealant retention is considered a surrogate endpoint. The ART sealant protocol is described. Systematic reviews and meta-analysis covering low- medium- and high-viscosity glass-ionomer (ART) sealants have concluded that there is no evidence that either glass-ionomer or resin-based sealants prevent dentine carious lesions better. The annual dentine carious lesion development in teeth with high-viscosity glass-ionomer ART sealants over the first three years is 1%. These ART sealants have a high capacity of preventing carious lesion development. Because no electricity and running water is required, ART sealants can be placed both inside and outside the dental surgery. High-viscosity glass-ionomer ART sealants can be used alongside resin-based sealants.41:119-124

Simple bone cyst involving proximal epiphysis of the humerus : a case report

Energy Technology Data Exchange (ETDEWEB)

Yi, Bum Ha; Ryu, Kyung Nam; Park, Yong Koo; Han, Chung Soo [Kyughee Univ. Hospital, Seoul (Korea, Republic of)

1998-08-01

Simple or unicameral bone cysts are metaphyseal lesions of long bones. They usually move away from the physis with growth to become diaphyseal in location. Involvement of the physis and epiphysis by these cystic lesions is very rare. This paper reports a case of simple bone cyst of the proximal humerus in a 11- year -old girl which was shown by MR imaging to extend through the physis into the epiphysis.

Simple bone cyst involving proximal epiphysis of the humerus : a case report

International Nuclear Information System (INIS)

Yi, Bum Ha; Ryu, Kyung Nam; Park, Yong Koo; Han, Chung Soo

1998-01-01

Simple or unicameral bone cysts are metaphyseal lesions of long bones. They usually move away from the physis with growth to become diaphyseal in location. Involvement of the physis and epiphysis by these cystic lesions is very rare. This paper reports a case of simple bone cyst of the proximal humerus in a 11- year -old girl which was shown by MR imaging to extend through the physis into the epiphysis

Discrimination between intact and decayed pulp regions in carious teeth by ADC mapping.

Science.gov (United States)

Cankar, Ksenija; Nemeth, Lidija; Bajd, Franci; Vidmar, Jernej; Serša, Igor

2014-01-01

The aim of this study was to evaluate an advanced magnetic resonance imaging (MRI) method, apparent diffusion coefficient (ADC) mapping, in the functional assessment of carious teeth. 38 extracted human teeth with scores of 0, 3 and 6 according to International Caries Detection and Assessment System (ICDAS) criteria were screened and subsequently analyzed by MRI at 2.35 T. Histology sectioning of teeth was used for the gold standard by analyzing two extreme cases (intact and severely decayed). ADC maps of the same teeth were calculated from corresponding diffusion-weighted images and used to obtain ADC distributions along dental pulp as functions of the relative pulp length measured from the occlusal pulp side. The measured distributions were analyzed for the best fit by a four-parameter three-segment linear regression model for ADC distribution along the pulp. MRI results were in good agreement with findings in histological sections of identical teeth. The best fit model parameters, relative decayed region depth, relative transition region width and ADC values of intact and decayed pulp tissue, showed statistically significant differences between the ADC values of intact and decayed pulp tissue (1.0 × 10(-9) m(2)/s vs. 0.74-0.89 × 10(-9) m(2)/s) and the relative decayed region depth progressing with ICDAS score (3 vs. 46% with ICDAS 3 vs. ICDAS 6). The results of this feasibility study confirmed relevance of ADC mapping for the discrimination and localization of intact and decayed regions in dental pulps of carious teeth. © 2014 S. Karger AG, Basel.

Computed tomography in the evaluation of plexopathies and proximal neuropathies

International Nuclear Information System (INIS)

Stewart, J.D.

1983-01-01

The article describes nine patients with plexopathies or proximal mononeuropathies due to mass lesions. In four, computed tomography (CT) was the only radiological technique to show the cause of the neuropathy. In five patients, CT either unequivocally confirmed the presence of an abnormality or was superior to other imaging techniques in showing its full anatomical extent. CT scanning is a valuable aid in the assessment of lesions of the peripheral nervous system, particularly plexopathies and mononeuropathies caused by retroperitoneal, pelvic or superior pulmonary sulcus tumors

Computed tomography in the evaluation of plexopathies and proximal neuropathies

Energy Technology Data Exchange (ETDEWEB)

Stewart, J.D. (McGill Univ., Montreal, Quebec (Canada). Dept. of Neurology and Neurosurgery); Schmidt, B. (McGill Univ., Montreal, Quebec (Canada). Dept. of Radiology); Wee, R. (Montreal General Hospital, Quebec (Canada))

1983-11-01

The article describes nine patients with plexopathies or proximal mononeuropathies due to mass lesions. In four, computed tomography (CT) was the only radiological technique to show the cause of the neuropathy. In five patients, CT either unequivocally confirmed the presence of an abnormality or was superior to other imaging techniques in showing its full anatomical extent. CT scanning is a valuable aid in the assessment of lesions of the peripheral nervous system, particularly plexopathies and mononeuropathies caused by retroperitoneal, pelvic or superior pulmonary sulcus tumors.

Critical evaluation of incidence and prevalence of white spot lesions during fixed orthodontic appliance treatment: A meta-analysis.

Science.gov (United States)

Sundararaj, Dhinahar; Venkatachalapathy, Sudhakar; Tandon, Akshay; Pereira, Aaron

2015-01-01

Development of dental caries, specifically, white spot lesions (WSLs), continues to be a well-recognized and troubling side effect of orthodontic fixed appliance therapy, despite vast improvement in preventive dental techniques and procedures. The aim of this meta-analysis is to evaluate, determine, and summarize the incidence and prevalence rates of WSLs during orthodontic treatment that have been published in the literature. According to predetermined criteria, databases were searched for appropriate studies. References of the selected articles and relevant reviews were searched for any missed publications. In the 14 studies evaluated for WSLs, the incidence of new carious lesions formed during orthodontic treatment in patients was 45.8% and the prevalence of lesions in patients undergoing orthodontic treatment was 68.4%. The incidence and prevalence rates of WSLs in patients undergoing orthodontic treatment are quite high and significant. This widespread problem of WSL development is an alarming challenge and warrants significant attention from both patients and providers, which should result in greatly increased emphasis on effective caries prevention.

Nd:YAG laser irradiation on temporary teeth carious tissue using 12% diamine silver fluoride as a photo-absorber - a morphological study

International Nuclear Information System (INIS)

Calmon, Andrea de Avillez

2001-01-01

Since Nd:YAG laser radiation was first introduced in Dentistry various photo-absorbers were employed with the intent of improving its efficacy when used on dental carious tissue. The purpose of the present study was to analyze the influence of this radiation using Scanning and Optical microscopy over carious tissue of primary teeth using two photo-absorbers. 15 primary human teeth were used and, in each one, 3 cavity preparations were performed. Specimens were then submitted to an in vitro demineralizing environment during 18 days. Two of the cavities of each specimen were laser irradiated using the Nd:YAG laser with 60 mJ of energy per pulse, 10 Hz and average power of 0,6 W. The 12% diamine silver fluoride or the mineral coal were used as photo-absorbers. The third cavity of the specimens was used as a control and received no laser irradiation. Samples were transversally cut and the section analyzed by SEM and OM. Results showed that the 12% diamine silver fluoride is an efficient photo-absorber and, when used it the Nd:YAG laser, leading to melting and resolidification of the carious tissue. It can be concluded that the 12% diammine silver fluoride presents advantages over the mineral coal as a photo absorber when used in primary teeth as it promotes and improves the efficacy of laser irradiation. This substance also works as a barrier on the carie progression in deeper areas such as the infected and necrotic zones. (author)

Effect of caries infiltration technique and fluoride therapy on the colour masking of white spot lesions.

Science.gov (United States)

Rocha Gomes Torres, Carlos; Borges, Alessandra Buhler; Torres, Luciana Marcondes Sarmento; Gomes, Isabela Silva; de Oliveira, Rodrigo Simões

2011-03-01

A carious lesion is initiated through the subsurface demineralization of enamel, and presents clinically as a white spot, interfering with the aesthetics. This lesion should not receive restorative treatment because it is capable of remineralization. The aim of this study was to evaluate the performance of different treatments on masking white spot lesions by assessing the colour change. Artificial white spot lesions were produced in bovine enamel of 60 cylindrical-shaped samples. The samples were randomly divided into four groups: CON (control) - immersion in artificial saliva; DF - daily application of 0.05% fluoride solution; WF - weekly application of 2% fluoride gel; and IC - resin infiltration (Icon(®) - DMG). The assessment of colour was performed by a spectrophotometer in four distinct stages: baseline, after the production of artificial caries; after 4 weeks; after 8 weeks; and after a new acid challenge. The ΔL values were calculated at each stage in relation to the baseline colour. The application of RM ANOVA revealed significant differences between the factors' treatment and time (p=0.001). For the interaction between factors there were no significant differences (p=0.27). The Tukey's test (pwhite spot lesions. Also, after a new acid challenge, the group infiltrated with low viscosity resin presented the lowest means of colour change. Copyright © 2011. Published by Elsevier Ltd.

Klatskin-mimicking lesions--a case series and literature review.

Science.gov (United States)

Dumitrascu, Traian; Ionescu, Mihnea; Ciurea, Silviu; Herlea, Vlad; Lupescu, Ioana; Popescu, Irinel

2010-01-01

Obstruction of the hepatic hilum in patients without prior surgery is generally due to hilar adenocarcinoma (Klatskin tumor). However, not all the hilar strictures are malignant. Although uncommon, benign strictures of the proximal bile duct should be taken into consideration in differential diagnosis of Klatskin tumors, since the incidence could reach up to 25% of patients with presumed Klatskin tumor diagnosis. This group of benign proximal bile duct strictures (Klatskin-mimicking lesions) is usually represented by segmental fibrosis and non-specific chronic inflammation. The clinical and imaging features can not differentiate between benign and malignant strictures. Herein, we present a case series of three patients with benign proximal bile duct strictures (representing 4.1% of 73 patients resected with presumptive preoperative diagnosis of Klatskin tumor) and literature review. There are presented the clinical and biochemical features, imaging preoperative workup, surgical treatment and histological analysis of the specimen, along with postoperative outcome. For benign strictures of the hilum limited resections are curative. However, despite new diagnosis tools developed in the last years, patients with hilar obstructions still require unnecessary extensive resections due to impossibility of excluding the malignancy. In all cases of proximal bile duct obstruction presumed malignant, they should be managed accordingly, even with the risk of over-treatment for some benign lesions.

Nonsurgical endodontic therapy along with minimal invasive treatment utilizing Bhasker's hypothesis for the management of infected radicular cystic lesion: A rare case report

Directory of Open Access Journals (Sweden)

Sanjeev Kumar Salaria

2016-01-01

Full Text Available Radicular cyst (RC is the most common odontogenic cyst of inflammatory origin affecting the jaws; involves the roots of the carious or traumatic non-vital tooth. Different therapeutic modalities, such as nonsurgical endodontic therapy or surgical enucleation with primary closure, decompression etc., were proposed for the management of such lesions. Presenting a case of a 28-year-old otherwise healthy male patient who reported with pain and swelling with respect to tooth #41, 31. Diagnosis of infected RC at a rare location was established on the basis of clinical, radiographical and fine needle aspiration cytological examination. Looking after the clinical characteristics, origin, extension, size of cystic lesion and patient cooperation; nonsurgical endodontic therapy utilizing Bhasker's hypothesis was opted. One year post-operative result suggested that nonsurgical endodontic therapy along with minimally invasive treatment utilizing Bhasker's hypothesis is an effective tool to transform infected radicular cystic lesion to healthy periapical periodontal tissue.

Molecular Analysis of Microbial Diversity in Advanced Caries

OpenAIRE

Chhour, Kim-Ly; Nadkarni, Mangala A.; Byun, Roy; Martin, F. Elizabeth; Jacques, Nicholas A.; Hunter, Neil

2005-01-01

Real-time PCR analysis of the total bacterial load in advanced carious lesions has shown that the total load exceeds the number of cultivable bacteria. This suggests that an unresolved complexity exists in bacteria associated with advanced caries. In this report, the profile of the microflora of carious dentine was explored by using DNA extracted from 10 lesions selected on the basis of comparable total microbial load and on the relative abundance of Prevotella spp. Using universal primers fo...

A rare case of chondroblastioma of the proximal tibia

International Nuclear Information System (INIS)

Gecov, P.; Terziev, I.; Hristoskova, R.; Georgiev, G.; Kinov, P.; Tivchev, P.

2011-01-01

The authors report a rare case of chondroblastoma which was localised in the proximal tibial epiphysis in a 14-year-old boy. The lesion was evaluated with routine roentgenography and computer tomography. The imaging techniques revealed eccentric lesion, predominantly in the medial part of the bone, periosteal reaction in the metaphysic, calcification and sclerosis. After diagnostic evaluation including biopsy, the lesion was treated surgically with curettage and grafting. He was followed up for two years with routine radiographs and physical examination. Two years after surgery the patient had no recurrence, no pain and had nearly full range of motion of the knee. Roentgenographic characteristics of the disease as well as differential diagnostics are discussed. In conclusion, imaging techniques should be supplemented with an open biopsy for the final diagnosis.

One-step partial or complete caries removal and bonding with antibacterial or traditional self-etch adhesives: study protocol for a randomized controlled trial.

Science.gov (United States)

Villat, Cyril; Attal, Jean-Pierre; Brulat, Nathalie; Decup, Franck; Doméjean, Sophie; Dursun, Elisabeth; Fron-Chabouis, Hélène; Jacquot, Bruno; Muller Bolla, Michèle; Plasse-Pradelle, Nelly; Roche, Laurent; Maucort-Boulch, Delphine; Nony, Patrice; Gritsch, Kerstin; Millet, Pierre; Gueyffier, François; Grosgogeat, Brigitte

2016-08-15

Current concepts in conservative dentistry advocate minimally invasive dentistry and pulp vitality preservation. Moreover, complete removal of carious dentin in deep carious lesions often leads to pulp exposure and root canal treatment, despite the absence of irreversible pulp inflammation. For years, partial caries removal has been performed on primary teeth, but little evidence supports its effectiveness for permanent teeth. Furthermore, the recent development of new antibacterial adhesive systems could be interesting in the treatment of such lesions. The objectives of this study are to compare the effectiveness of partial versus complete carious dentin removal in deep lesions (primary objective) and the use of an antibacterial versus a traditional two-step self-etch adhesive system (main secondary objective). The DEep CAries Treatment (DECAT) study protocol is a multicenter, randomized, controlled superiority trial comparing partial versus complete caries removal followed by adhesive restoration. The minimum sample size required is 464 patients. Two successive randomizations will be performed (allocation ratio 1:1): the first for the type of excavation (partial versus complete) and the second (if no root canal treatment is required) for the type of adhesive (antibacterial versus traditional). For the two objectives, the outcome is the success of the treatment after 1 year, measured according to a composite outcome of five FDI criteria: material fracture and retention, marginal adaptation, radiographic examination (including apical pathologies), postoperative sensitivity and tooth vitality, and carious lesion recurrence. The study will investigate the interest of a conservative approach for the management of deep carious lesions in terms of dentin excavation and bioactive adhesive systems. The results may help practitioners achieve the most efficient restorative procedure to maintain pulp vitality and increase the restoration longevity. Clinical

Comparative analisys of three different diagnostic methods to evaluate carious activity in a community basis Análise comparativa de três métodos de diagnóstico de atividade cariosa em âmbito coletivo

Directory of Open Access Journals (Sweden)

Luciana Cardoso

2005-06-01

Full Text Available The present research has made a comparison between three distinct methods to evaluate carious activity in a community basis. The studied method was based in a modified DMFS/dmfs index including non-cavitated lesions. Two factors were analyzed: the possible reproduction of the inclusion of carious activity criteria and the presence of bacterial plaque. Thus, the three study groups presented with plaque, after supervised self-performed plaque removal with dental toothbrush and without plaque after professional prophylaxis, which corresponded to three diagnostic methods. The three exams took place one week apart from each other. For this analysis, a modified DMFS/dmfs index was proposed with alterations in diagnostic criteria due to the inclusion of carious activity parameters. The study was performed in a group of 30 children aged 11 years old. According to the results, the diagnostic method for carious activity in the three situations was reproducible and can be considered a proper approach to perform caries diagnosis in a community basis.Este trabalho realizou uma comparação entre três métodos distintos para avaliação da atividade cariosa em âmbito coletivo. Os métodos estudados foram baseados em um CPOS/ceos modificado, com inclusão de lesões não cavitadas. Os fatores estudados foram a possibilidade de reprodutibilidade da inclusão de critérios de atividade cariosa, bem como a presença de placa bacteriana. Portanto, os três grupos avaliados apresentavam-se com placa bacteriana; com remoção de placa bacteriana pelo próprio paciente (sob supervisão com escova dental e sem placa bacteriana, após profilaxia profissional, que correspondiam aos três métodos de diagnóstico. Os três exames foram realizados com intervalo de uma semana entre cada um. Para esta análise, propõe-se um índice CPOS/ceos modificado com alterações nos critérios de diagnóstico através da inclusão de parâmetros de atividade de doença. O estudo

Appraisal of the remineralizing potential of child formula dentifrices on primary teeth: An i n vitropH cycling model

Directory of Open Access Journals (Sweden)

M Kiranmayi

2015-01-01

Full Text Available Aim: To evaluate the remineralizing potential of child formula dentifrices on primary teeth using an in vitro 7 days pH cycling model. Materials and Methods: Twenty-one primary teeth were placed in demineralizing solution for 96 h to produce artificial carious lesions; then cut longitudinally into 100-150 μm thick sections and randomly assigned to three groups. Sections in Group A were treated with dentifrice containing 458 ppm monofluorophosphate (MFP and sections in Group B with 500 ppm sodium fluoride (NaF. Group C sections were treated with a nonfluoridated dentifrice. Results: Group A (458 ppm MFP and Group B (500 ppm NaF showed significant decrease in lesion depth, whereas Group C (non F showed a significant increase in depth (P ≤ 0.05, paired t-test. Conclusion: Though dentifrices containing 458 ppm MFP and 500 ppm NaF demonstrated remineralization of carious lesions, it was not complete. Therefore, it is also important to emphasize on other preventive methods in the prevention and/or reversal of carious lesions.

Laser and caries diagnosis: the state of the art and evaluation in vitro of the differences of the fluorescence between sound, carious and demineralized enamel; Laser e diagnostico de caries: estado da arte e avaliacao in vitro das diferencas de fluorescencia entre esmalte sadio, cariado e desmineralizado

Energy Technology Data Exchange (ETDEWEB)

Mendonca, Maria Angelica Lopes Chaves

2001-07-01

The aim of this study was to evaluate the methods for establishing dental caries diagnosis that make use of Laser light as source of illumination, establishing the 'state of the art'. Experimental observation of the differences among fluorescence of sound, demineralized and carious enamel by visible luminescent spectroscopy was also done. Six human teeth, extracted for clinical reasons were studied, and the results showed that the spectrum of carious enamel is different from the sound and demineralized ones. The differences are more evident relative to sond enamel and carious enamel, the same occurring between demineralized and carious enamel. The review of the literature aimed to make comparative considerations between QLF, LF and DELF; their effectiveness relative to traditional methods such as visual, visual with probe, radiography. It was verified that DELF was more sensitive, but could not discriminate between different degrees of mineral loss. QLF, compared to DIAGNOdent has the same sensitivity, but it is better for scientific purposes. The experimental part of the present study used on argon ion Laser to illuminated the teeth and signs of emission of fluorescence were captured by a PMT and then analyzed by a computer system with EG and G software. The results showed that the spectrum of carious enamel is different from the sound and demineralized. The differences are more evident in relation to sound and carious enamel, the same occurs between demineralized and carious enamel. (author)

Laser and caries diagnosis: the state of the art and evaluation in vitro of the differences of the fluorescence between sound, carious and demineralized enamel; Laser e diagnostico de caries: estado da arte e avaliacao in vitro das diferencas de fluorescencia entre esmalte sadio, cariado e desmineralizado

Energy Technology Data Exchange (ETDEWEB)

Mendonca, Maria Angelica Lopes Chaves

2001-07-01

The aim of this study was to evaluate the methods for establishing dental caries diagnosis that make use of Laser light as source of illumination, establishing the 'state of the art'. Experimental observation of the differences among fluorescence of sound, demineralized and carious enamel by visible luminescent spectroscopy was also done. Six human teeth, extracted for clinical reasons were studied, and the results showed that the spectrum of carious enamel is different from the sound and demineralized ones. The differences are more evident relative to sond enamel and carious enamel, the same occurring between demineralized and carious enamel. The review of the literature aimed to make comparative considerations between QLF, LF and DELF; their effectiveness relative to traditional methods such as visual, visual with probe, radiography. It was verified that DELF was more sensitive, but could not discriminate between different degrees of mineral loss. QLF, compared to DIAGNOdent has the same sensitivity, but it is better for scientific purposes. The experimental part of the present study used on argon ion Laser to illuminated the teeth and signs of emission of fluorescence were captured by a PMT and then analyzed by a computer system with EG and G software. The results showed that the spectrum of carious enamel is different from the sound and demineralized. The differences are more evident in relation to sound and carious enamel, the same occurs between demineralized and carious enamel. (author)

Unicameral bone cyst of the proximal tibia in a five year old girl.

Science.gov (United States)

Tahririan, Mohammadali; Motiffard, Mehdi

2012-01-01

Unicameral bone cysts (UBCs) are benign, osteolytic lesions which are often asymptomatic and are commonly seen in the proximal of humerus and femur. The average age at diagnosis is 9-11 years and there is a male preponderance with a male-to-female ratio of approximately 2-2.5 to 1. We describe a case of 5-year-old girl who presented to orthopedic clinic with a 4-month history of painful limping. Plain radiography of the right knee demonstrated a well-defined lytic lesion in the proximal of the tibia. Open biopsy and then curettage and bone grafting with bone- substitute was performed. The diagnosis of this condition requires a high index of suspicion. This report demonstrates that all UBCs do not have the same clinical patterns and with adequate attention good results can be achieved.

Unicameral bone cyst of the proximal tibia in a five year old girl

Directory of Open Access Journals (Sweden)

Mohammadali Tahririan

2012-01-01

Full Text Available Unicameral bone cysts (UBCs are benign, osteolytic lesions which are often asymptomatic and are commonly seen in the proximal of humerus and femur. The average age at diagnosis is 9-11 years and there is a male preponderance with a male-to-female ratio of approximately 2-2.5 to 1. We describe a case of 5-year-old girl who presented to orthopedic clinic with a 4-month history of painful limping. Plain radiography of the right knee demonstrated a well-defined lytic lesion in the proximal of the tibia. Open biopsy and then curettage and bone grafting with bone- substitute was per-formed. The diagnosis of this condition requires a high index of suspicion. This report demonstrates that all UBCs do not have the same clinical patterns and with adequate attention good results can be achieved.

Clinical comparative study between the use of lasers and conventional methods of diagnosis and treatment in deciduous teeth with presence of carious lesion; Estudo clinico comparativo entre o uso de lasers e metodos convencionais de diagnostico e tratamento em dentes deciduos da presenca de lesao cariosa

Energy Technology Data Exchange (ETDEWEB)

Pulga, Fabiane Galvao

2001-07-01

The aim of this work was to evaluate the efficiency of deciduous tooth cavity preparation by the Er:YAG laser in comparison with the conventional burr rotary instrument. Besides, we have used the laser fluorescence technique (DIAGNOdent equipment) for diagnosis and compared it to the usual tactile and visual examination as well as X-ray diagnosis. For this purpose, 20 chronic occlusal carious deciduous molar teeth from children with the ages between 5 to 10 years old were selected. Selection was ma de according to visual inspection, X-ray periapical image and measures of the DIAGNOdent. For treatment the teeth were divided in two groups, 10 to be treated by the Er:YAG laser and 10 with conventional burr. For enamel, the laser energy used was in the interval from 200 to 300 mJ; for the dentine the range was from 100 mJ to 200 mJ. In both cases, the laser frequency was in the range from 2 to 4 Hz. The results have shown that the laser treatment was more accepted by the children than the conventional burro Clinical evaluation of the cavity preparation indicates that the Er:YAG laser treatment is recommend. The DIAGNOdent evaluation method was very effective for diagnosis of carious tissue for initial detection. After successful removal of the carious tissue, confirmed by visual inspection, the DIAGNOdent evaluation method was only effective for the treatment with conventional burro For evaluation of the tooth after cavity preparation with the Er:YAG laser, the measurements oscillate covering the full range of the equipment. Therefore, the use of the DIAGNOdent equipment is indicated only for initial caries diagnosis. (author)

Detection method of proximal caries using line profile in digital intra-oral radiography

Energy Technology Data Exchange (ETDEWEB)

Choi, Yong Suk; Kim, Gyu Tae; Hwang, Eui Hwan; Lee, Min Ja; Choi, Sam Jin; Park, Hun Kuk [Department of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Biology, Kyung Hee University, Seoul (Korea, Republic of); Park, Jeong Hoon [Department of Biomedical Engineering, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

2009-12-15

The purpose of this study was to investigate how to detect proximal caries using line profile and validate linear measurements of proximal caries lesions by basic digital manipulation of radiographic images. The X-ray images of control group (15) and caries teeth (15) from patients were used. For each image, the line profile at the proximal caries-susceptible zone was calculated. To evaluate the contrast as a function of line profile to detect proximal caries, a difference coefficient (D) that indicates the relative difference between caries and sound dentin or intact enamel was measured. Mean values of D were 0.0354 {+-} 0.0155 in non-caries and 0.2632 {+-} 0.0982 in caries (p<0.001). The mean values of caries group were higher than non-caries group and there was correlation between proximal dental caries and D. It is demonstrated that the mean value of D from caries group was higher than that of control group. From the result, values of D possess great potentiality as a new detection parameter for proximal dental caries.

Detection method of proximal caries using line profile in digital intra-oral radiography

International Nuclear Information System (INIS)

Choi, Yong Suk; Kim, Gyu Tae; Hwang, Eui Hwan; Lee, Min Ja; Choi, Sam Jin; Park, Hun Kuk; Park, Jeong Hoon

2009-01-01

The purpose of this study was to investigate how to detect proximal caries using line profile and validate linear measurements of proximal caries lesions by basic digital manipulation of radiographic images. The X-ray images of control group (15) and caries teeth (15) from patients were used. For each image, the line profile at the proximal caries-susceptible zone was calculated. To evaluate the contrast as a function of line profile to detect proximal caries, a difference coefficient (D) that indicates the relative difference between caries and sound dentin or intact enamel was measured. Mean values of D were 0.0354 ± 0.0155 in non-caries and 0.2632 ± 0.0982 in caries (p<0.001). The mean values of caries group were higher than non-caries group and there was correlation between proximal dental caries and D. It is demonstrated that the mean value of D from caries group was higher than that of control group. From the result, values of D possess great potentiality as a new detection parameter for proximal dental caries.

Diagnostic quality and observer variation in radiographic diagnoses of approximal caries

International Nuclear Information System (INIS)

Espelid, I.; Tveit, A.B.

1986-01-01

The aim of the study was to compare observer variations, observer strategy, and diagnostic quality with regard to radiographic caries diagnoses made at different depth levels. Qualitative assessment of approximal carious lesions on the basis of radiographs were made for sound (n=28) and carious (n=123) lesions by seven dentists. The inter- and intra-observer variations were lowest when lesions were diagnosed as being in the outermost parts of the teeth. The frequency of false positive scores was lower when dentin was examined as compared with enamel. The quality of radiographic diagnoses showed small variations (p>0.05) when different levels of pulpal depths were interpreted

Classic metaphyseal lesion following external cephalic version and cesarean section

Energy Technology Data Exchange (ETDEWEB)

Lysack, John T.; Soboleski, Don [Department of Diagnostic Radiology, Queen' s University, Kingston General Hospital, 76 Stuart Street, K7L 2V7, Kingston, Ont. (Canada)

2003-06-01

We report a case of an otherwise healthy neonate diagnosed at birth with a classic metaphyseal lesion of the proximal tibia following external cephalic version for frank breech presentation and a subsequent urgent cesarean section. Although the classic metaphyseal lesion is considered highly specific for infant abuse, this case demonstrates the importance of obtaining a history of obstetric trauma for neonates presenting to the imaging department for suspected non-accidental injury. (orig.)

Classic metaphyseal lesion following external cephalic version and cesarean section

International Nuclear Information System (INIS)

Lysack, John T.; Soboleski, Don

2003-01-01

We report a case of an otherwise healthy neonate diagnosed at birth with a classic metaphyseal lesion of the proximal tibia following external cephalic version for frank breech presentation and a subsequent urgent cesarean section. Although the classic metaphyseal lesion is considered highly specific for infant abuse, this case demonstrates the importance of obtaining a history of obstetric trauma for neonates presenting to the imaging department for suspected non-accidental injury. (orig.)

Restorations in abrasion/erosion cervical lesions: 8-year results of a triple blind randomized controlled trial.

Science.gov (United States)

Dall'Orologio, Giovanni Dondi; Lorenzi, Roberta

2014-10-01

An equivalence randomized controlled trial within the subject was organized to evaluate the clinical long-term success of a new 2-step etch & rinse adhesive and a new nano-filled ormocer. 50 subjects, 21 males and 29 females aged between 21 and 65, were randomized to receive 150 restorations, 100 with the new restorative material, 50 with the composite as control, placed in non-carious cervical lesions with the same bonding system. The main outcome measure was the cause of failure at 8 years. Randomization was number table-generated, with allocation concealment by opaque sequentially numbered sealed and stapled envelopes. Subjects, examiner, and analyst were blinded to group assignment. Two interim analyses were performed. Data were analyzed by ANOVA and Cox test (P failures in the experimental group and four failures in the control group. The cumulative loss rate was 7% for both restorative materials, with the annual failure lower than 1%, without any statistically significant difference. There were two key elements of failure: the presence of sclerotic dentin and the relationship between lesion and gingival margin.

A comparative study of roentgenographic appearance of periodontal osseous lesions

International Nuclear Information System (INIS)

Kim, Jhai Duck

1980-01-01

The purpose of this article is to re-examine the roentgenographic appearance of alveolar osseous in an effort to determine the value of the orthopantomogram in the diagnosis of periodontal disease. A total of 158 osseous lesions from 13 human dry panoramic film are used to obtain radiographs of all defects. The bisecting technic was used, with a target-film distance of 8 inches and exposure factors of 70 kVp, 10 mA and 0.4 sec. at anterior teeth, 0.6 sec at posterior teeth in exposure time. For orthopantomogram, Panoura Eight-C was used with a exposure factors of 90 kVp, 10 mA. and 15 sec. exposure time. All films were developed in alight-tight darkroom at 68 .deg. for 4 1/2 minutes. Comparison of orthopantomogram and intraoral films on the view-box was carefully studied in relation to the types of osseous defect visually evident; Proximal intraosseous defects, Interproximal craters, Interproximal hemisepta, Furcal defects on multirooted teeth, and Facial or Lingual one-walled defects. The results obtained were as follows; 1. Proximal osseous defects throughout the dental arches and furcal defects on facial and lingual surfaces of multirooted teeth can be identified with a high degree of accuracy from their orthopantomographic appearances. 2. Lesions on facial or lingual surface of the alveolar arches are rather difficult to locate or recognize on the dental radiographs. 3. In determining whether the proximal and furcal lesions are located facially or lingually, Orthopantomogram is superior to the conventional film Orthopantomogram obtained with standardization of head in proper position revealed the complete visualization of alveolar bone without showing occlusal surface of molars and proximal superimposition of teeth. Thus, on the standardized orthopantomograms, The roentgenographic characteristics of each defect were determined.

A comparative study of roentgenographic appearance of periodontal osseous lesions

Energy Technology Data Exchange (ETDEWEB)

Kim, Jhai Duck [Department of Dental Radiology College of Dentistry, Cho-Sun University, Kwangju (Korea, Republic of)

1980-11-15

The purpose of this article is to re-examine the roentgenographic appearance of alveolar osseous in an effort to determine the value of the orthopantomogram in the diagnosis of periodontal disease. A total of 158 osseous lesions from 13 human dry panoramic film are used to obtain radiographs of all defects. The bisecting technic was used, with a target-film distance of 8 inches and exposure factors of 70 kVp, 10 mA and 0.4 sec. at anterior teeth, 0.6 sec at posterior teeth in exposure time. For orthopantomogram, Panoura Eight-C was used with a exposure factors of 90 kVp, 10 mA. and 15 sec. exposure time. All films were developed in alight-tight darkroom at 68 .deg. for 4 1/2 minutes. Comparison of orthopantomogram and intraoral films on the view-box was carefully studied in relation to the types of osseous defect visually evident; Proximal intraosseous defects, Interproximal craters, Interproximal hemisepta, Furcal defects on multirooted teeth, and Facial or Lingual one-walled defects. The results obtained were as follows; 1. Proximal osseous defects throughout the dental arches and furcal defects on facial and lingual surfaces of multirooted teeth can be identified with a high degree of accuracy from their orthopantomographic appearances. 2. Lesions on facial or lingual surface of the alveolar arches are rather difficult to locate or recognize on the dental radiographs. 3. In determining whether the proximal and furcal lesions are located facially or lingually, Orthopantomogram is superior to the conventional film Orthopantomogram obtained with standardization of head in proper position revealed the complete visualization of alveolar bone without showing occlusal surface of molars and proximal superimposition of teeth. Thus, on the standardized orthopantomograms, The roentgenographic characteristics of each defect were determined.

Imaging of noncarious cervical lesions by means of a fast swept source optical coherence tomography system

Science.gov (United States)

Stoica, Eniko T.; Marcauteanu, Corina; Bradu, Adrian; Sinescu, Cosmin; Topala, Florin Ionel; Negrutiu, Meda Lavinia; Duma, Virgil Florin; Podoleanu, Adrian Gh.

2014-01-01

Non-carious cervical lesions (NCCL) are defined as the loss of tooth substance at the cemento-enamel junction and are caused by abrasion, erosion and/or occlusal overload. In this paper we proved that our fast swept source OCT system is a valuable tool to track the evolution of NCCL lesions in time. On several extracted bicuspids, four levels of NCCL were artificially created. After every level of induced lesion, OCT scanning was performed. B scans were acquired and 3D reconstructions were generated. The swept source OCT instrument used in this study has a central wavelength of 1050 nm, a sweeping range of 106 nm (measured at 10 dB), an average output power of 16 mW and a sweeping rate of 100 kHz. A depth resolution determined by the swept source of 12 μm in air was experimentally obtained. NCCL were measured on the B-scans as 2D images and 3D reconstructions (volumes). For quantitative evaluations of volumes, the Image J software was used. By calculating the areas of the amount of lost tissue corresponding to each difference of Bscans, the final volumes of NCCL were obtained. This swept source OCT method allows the dynamic diagnosis of NCCL in time.

Selective treatment of carious dentin using a mid-infrared tunable pulsed laser at 6 μm wavelength range

Science.gov (United States)

Saiki, Masayuki; Ishii, Katsunori; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

2011-03-01

Optical technologies have good potential for caries detection, prevention, excavation, and the realization of minimal intervention dentistry. This study aimed to develop a selective excavation technique of carious tissue using the specific absorption in 6 μm wavelength range. Bovine dentin demineralized with lactic acid solution was used as a carious dentin model. A mid-infrared tunable pulsed laser was obtained by difference-frequency generation technique. The wavelength was tuned to 6.02 and 6.42 μm which correspond to absorption bands called amide I and amide II, respectively. The laser delivers 5 ns pulse width at a repetition rate of 10 Hz. The morphological change after irradiation was observed with a scanning electron microscope, and the measurement of ablation depth was performed with a confocal laser microscope. At λ = 6.02 μm and the average power density of 15 W/cm2, demineralized dentin was removed selectively with less-invasive effect on sound dentin. The wavelength of 6.42 μm also showed the possibility of selective removal. High ablation efficiency and low thermal side effect were observed using the nanosecond pulsed laser with λ = 6.02 μm. In the near future, development of compact laser device will open the minimal invasive laser treatment to the dental clinic.

A shift from distal to proximal neoplasia in the colon: a decade of polyps and CRC in Italy

Directory of Open Access Journals (Sweden)

Panzone Sergio

2010-11-01

Full Text Available Abstract Background In the last years a trend towards proximalization of colorectal carcinomas (CRC has been reported. This study aims to evaluate the distribution of CRC and adenomatous polyps (ADP to establish the presence of proximalization and to assess the potential predictors. Methods We retrieved histology reports of colonic specimens excised during colonoscopy, considering the exams performed between 1997 and 2006 at Cuneo Hospital, Italy. We compared the proportion of proximal lesions in the period 1997-2001 and in the period 2002-2006. Results Neoplastic lesions were detected in 3087 people. Proximal CRC moved from 25.9% (1997-2001 to 30.0% (2002-2006. Adjusting for sex and age, the difference was not significant (OR 1.23; 95% CI: 0,95-1,58. The proximal ADP proportion increased from 19.2% (1997-2001 to 26.0% (2002-2006 (OR: 1.43; 95% CI: 1.17-1.89. The corresponding figures for advanced proximal ADP were 6.6% and 9.5% (OR: 1.48; 95% CI: 1.02-2.17. Adjusting for gender, age, diagnostic period, symptoms and number of polyps the prevalence of proximal advanced ADP was increased among people ≥ 70 years compared to those aged 55-69 years (OR 1.49; 95% CI: 1.032.16. The main predictor of proximal advanced neoplasia was the number of polyps detected per exam (> 1 polyp versus 1 polyp: considering all ADP: OR 2.16; 95% CI: 1.59-2.93; considering advanced ADP OR 1.63; 95% CI: 1.08-2.46. Adjusting for these factors, the difference between the two periods was no longer significant. Conclusions CRC do not proximalize while a trend towards a proximal shift in adenomas was observed among people ≥ 70 years.

Class II glass ionomer cermet tunnel, resin sandwich and amalgam restorations over 2 years.

Science.gov (United States)

Wilkie, R; Lidums, A; Smales, R

1993-08-01

This study compared the clinical behavior of a glass ionomer (polyalkenoate) silver cermet, a posterior resin composite used with the "tunnel" technique, a posterior resin composite used with the "closed sandwich" technique, and a high-copper amalgam for restoring small, proximal surface carious lesions. Two dentists placed 86 restorations in the posterior permanent teeth of 26 adults treated at a dental hospital. Restorations were assessed at 6-month intervals over 2 years for gingivitis adjacent to them, the tightness of proximal contacts, occlusal wear, surface voids, roughness and cracking, surface and marginal staining, and marginal fracture. Small filling defects, surface voids and occlusal wear were obvious with the cermet material, with surface crazing and cracking present in 48% of the tunnel restorations. Two of the posterior resin composites, but none of the amalgam restorations, also failed. The cermet cannot be recommended as a long-term permanent restorative material in situations where it is likely to be subjected to heavy occlusal stresses and abrasive wear.

The Effect of Casein Phosphopeptide-amorphous Calcium Fluoride Phosphate on the Remineralization of Artificial Caries Lesions: An In Vitro Study

Directory of Open Access Journals (Sweden)

Ngoc Vo Truong Nhu

2017-08-01

Full Text Available The studies on electron microstructure of the effect of the use of products that contain casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACPF on enamel remineralization are still needed. It is important method to observe of the morphological changes of teeth in different conditions. Objective: To evaluate the remineralization potential of paste on enamel lesions using scanning electron microscopy (SEM. Methods: Sixty enamel specimens were prepared from extracted human premolars. The specimens were placed in a demineralizing solution for four days to produce artificial carious lesions. The specimens were then randomly assigned to two study groups: group A (control group and group B. Group B was incubated in remineralizing paste (CPP-ACPF for 30 minutes per day for 10 days. The control group received no intervention with remineralizing paste. All 60 specimens were stored in artificial saliva at 370C. After remineralization, the samples were observed using SEM. Results: The statistical analysis showed a decrease in the lesion area between the demineralized and remineralized samples, but no significant difference was observed in the lesion depth for group B. There was a significant increase observed in both the lesion depth and lesion area for group A (p = 0.03. Conclusion: The results showed the capacity of CPP-ACPF in supplying calcium and phosphate to the enamel, decreasing the dissolution of the enamel surface and increasing the remineralization of the enamel surface. 

Effect of two X-ray tube voltages on detection of approximal caries in digital radiographs. An in vitro study.

Science.gov (United States)

Hellén-Halme, Kristina

2011-04-01

This study evaluated the effect of two different tube voltages on clinicians' ability to diagnose approximal carious lesions in digital radiographs. One hundred extracted teeth were radiographed twice at two voltage settings, 60 and 70 kV, using a standardized procedure. Seven observers evaluated the radiographs on a standard color monitor pre-calibrated according to DICOM part 14. Evaluations were made at ambient light levels below 50 lx. All observations were analyzed with receiver operating characteristic curves. A histological examination of the teeth served as the criterion standard. A paired t test compared the effects of the two voltages. The significance level was set to p < 0.05. Weighted kappa statistics estimated intra-observer agreement. No significant difference in accuracy of approximal carious lesion diagnosis was found between the two voltage settings. But five observers rated dentin lesions on radiographs exposed at 70 kV better than on radiographs exposed at 60 kV. Intra-observer agreement differed from fair to moderate. There was no significant difference in accuracy of approximal carious lesion diagnosis between digital radiographs exposed with 60 or 70 kV.

Treatment for proximal humeral fractures with percutaneous plating: our first results.

Science.gov (United States)

Imarisio, D; Trecci, A; Sabatini, L; Scagnelli, R

2013-06-01

Proximal humeral fractures are common lesions; there is no generally accepted strategy about the treatment for displaced and unstable two- to four-part fractures. We have nowadays many different surgical solutions, ranging from percutaneous pinning to shoulder arthroplasty. Percutaneous plating can be a good solution to treat some of these fractures using a minimally invasive technique and performing stable fixation that can allow early mobilization. Purpose of this paper is to evaluate the results of our first cases of percutaneous plating in proximal humeral fractures in order to assess the theoretical advantages and the incidence of possible complications. From June 2009 to February 2012, we treated 29 proximal humeral fractures with a percutaneous plating (NCB-PH plate) through an anterolateral deltoid split. For each patient, we evaluated the clinical outcome according to Constant score and the radiographic results, paying attention to fracture healing, loss of reduction, hardware complications, and head necrosis. The clinical evaluation gave a mean Constant score value of 79 points. Comparing each value to the unaffected shoulder, we could find these results: 7 excellent, 10 good, 8 fair, and 4 poor. No axillary nerve lesions were clinically detected. The radiographic evaluation showed a complete bone healing in all cases within the first 3 months. No head necrosis was detected, as well as screws loosening. In two cases, the X-ray at 2 months revealed a little loss of reduction in varus. Two patients had an anterior pain; in one of these two cases, the plate was removed. In our series, we had no cases of head necrosis, screws cutout, fracture collapse, hardware mobilization, and we think this could be the real advantage of the percutaneous technique compared to the open one, thanks to the reduced biological damage. We had some poor results, related more to patient's age than to other factors. The safety of the technique for the axillary nerve is

Cerebral ischemic lesions detected with diffusion-weighted magnetic resonance imaging after carotid artery stenting: Comparison of several anti-embolic protection devices.

Science.gov (United States)

Taha, Mahmoud M; Maeda, Masayuki; Sakaida, Hiroshi; Kawaguchi, Kenji; Toma, Naoki; Yamamoto, Akitaka; Hirose, Tomofumi; Miura, Youichi; Fujimoto, Masashi; Matsushima, Satoshi; Taki, Waro

2009-09-01

Distal embolism is an important periprocedural technical complication with carotid angioplasty and carotid artery stenting (CAS). We evaluated the safety and efficacy of protection devices used during CAS by detecting new cerebral ischemic lesions using diffusion-weighted magnetic resonance imaging in 95 patients who underwent 98 CAS procedures: 34 using single PercuSurge GuardWire, 31 using double balloon protection, 15 using proximal flow reverse protection devices, 14 using Naviballoon, and 4 using filter anti-embolic devices. Diffusion-weighted imaging was performed preoperatively and postoperatively to evaluate the presence of any new embolic cerebral lesions. Postoperative diffusion-weighted imaging revealed 117 new ischemic lesions. Three patients had new ischemic stroke, two minor and one major, all ipsilateral to the treated carotid artery. The remaining patients had clinically silent ischemia. The incidence of new embolic lesions was lower using the proximal flow reverse protection device than with the double balloon protection (33% vs. 48.4%), but the volume of ipsilateral new ischemic lesions per patient was 136.6 mm(3) vs. 86.9 mm(3), respectively. Neuroprotection with Naviballoon yielded ipsilateral lesions of large volume (86.6 mm(3)) and higher number (5.7 lesions per patient) than using the filter anti-embolic device (34.8 mm(3) and 1 lesion per patient). New cerebral ischemic lesions after neuroprotected CAS are usually silent. The lower incidence of distal ischemia using proximal flow reverse and double balloon protection devices is limited by the larger volume and higher number of ischemic lesions.

Cerebral ischemic lesions detected with diffusion-weighted magnetic resonance imaging after carotid artery stenting. Comparison of several anti-embolic protection devices

International Nuclear Information System (INIS)

Taha, M.M.; Maeda, Masayuki; Sakaida, Hiroshi

2009-01-01

Distal embolism is an important periprocedural technical complication with carotid angioplasty and carotid artery stenting (CAS). We evaluated the safety and efficacy of protection devices used during CAS by detecting new cerebral ischemic lesions using diffusion-weighted magnetic resonance imaging in 95 patients who underwent 98 CAS procedures: 34 using single PercuSurge GuardWire, 31 using double balloon protection, 15 using proximal flow reverse protection devices, 14 using Naviballoon, and 4 using filter anti-embolic devices. Diffusion-weighted imaging was performed preoperatively and postoperatively to evaluate the presence of any new embolic cerebral lesions. Postoperative diffusion-weighted imaging revealed 117 new ischemic lesions. Three patients had new ischemic stroke, two minor and one major, all ipsilateral to the treated carotid artery. The remaining patients had clinically silent ischemia. The incidence of new embolic lesions was lower using the proximal flow reverse protection device than with the double balloon protection (33% vs. 48.4%), but the volume of ipsilateral new ischemic lesions per patient was 136.6 mm 3 vs. 86.9 mm 3 , respectively. Neuroprotection with Naviballoon yielded ipsilateral lesions of large volume (86.6 mm 3 ) and higher number (5.7 lesions per patient) than using the filter anti-embolic device (34.8 mm 3 and 1 lesion per patient). New cerebral ischemic lesions after neuroprotected CAS are usually silent. The lower incidence of distal ischemia using proximal flow reverse and double balloon protection devices is limited by the larger volume and higher number of ischemic lesions. (author)

Remineralizing Efficacy of Fluorohydroxyapatite Gel on Artificial Dentinal Caries Lesion

Directory of Open Access Journals (Sweden)

Qianqian Wang

2015-01-01

Full Text Available The aim was to evaluate the remineralizing efficacy of fluorohydroxyapatite (FHA gel on artificial dentinal caries lesion in vitro. Artificial carious lesions were made on occlusal cavities of teeth by exposing the dentin surface to a demineralizing solution. Each cavity was capped with a 3 mm thick FHA gel for 4 weeks. After the FHA gel was removed, the surface morphology and structure of the dentin were characterized by scanning electron microscopy (SEM, energy-dispersive X-ray spectroscopy (EDX, X-ray diffraction (XRD, and Fourier transform infrared spectroscopy (FT-IR. The dentin mineral density (DMD was measured by micro-computed tomography (Micro-CT. A layer of dense and orderly hexagonal crystal structure, with average diameter of 1 μm and thickness of 4~5 μm, could be observed on dentin surface. These crystals exhibited elemental peaks for calcium, phosphorus, carbon, and oxygen and characteristic peaks of hydroxyapatite (HA and fluorapatite (FA via XRD and FT-IR. The DMD of dentin surface layer significantly increased after it was capped with FHA gel (P<0.05. In the present study, the FHA gel could rapidly construct apatite on the artificial dentin caries surface and significantly increase the mineral density, which suggests that FHA gel might be a proper IPT material with remineralizing function.

Prophylactic clipping for the prevention of bleeding following wide-field endoscopic mucosal resection of laterally spreading colorectal lesions: an economic modeling study.

Science.gov (United States)

Bahin, Farzan F; Rasouli, Khalid N; Williams, Stephen J; Lee, Eric Y T; Bourke, Michael J

2016-08-01

Clinically significant bleeding (CSPEB) is the most common adverse event following endoscopic mucosal resection (EMR) of large sessile and laterally spreading colorectal lesions (LSLs), and is associated with morbidity and resource utilization. CSPEB occurs more frequently with proximal LSLs. Prophylactic clipping of the post-EMR defect may be beneficial in CSPEB prevention. The aim of this study was to determine the cost-effectiveness of a prophylactic clipping strategy. We hypothesized that prophylactic clipping in the proximal colon was cost-effective. An economic model was applied to outcomes from the Australian Colonic Endoscopic Mucosal Resection (ACE) Study. Clip distances of 3, 5, 8, and 10 mm were analyzed. The cost of treating CSPEB was determined from an independent costing agency. The funds needed to spend (FNS) was the cost incurred in order to prevent one episode of CSPEB. A break-even analysis was performed to determine cost equivalence of the costs of clipping and CSPEB. Outcomes of 1717 LSLs (mean size 35.8 mm; 52.6 % proximal colon) that underwent EMR were analyzed. The overall rate of CSPEB was 6.4 % (proximal 8.9 %; distal 3.7 %). Endoscopic management was required in 45 % of CSPEB episodes. With a clip distance of 3 mm, the expected cost of prophylactic clipping was € 1106 per lesion compared with € 157 per lesion for the expected cost of CSPEB without clipping. At 100 % clipping efficacy, the FNS was € 14 826 (proximal and distal lesions € 9309 and € 29 540, respectively). A clip price of € 10.35 was required for the cost of clipping to offset the cost of CSPEB. A prophylactic clipping strategy is not cost-effective and at present cannot be justified for all lesions or selectively for lesions in the proximal colon. ClinicalTrials.gov (NCT01368289). © Georg Thieme Verlag KG Stuttgart · New York.

Laboratory investigations into the potential anticaries efficacy of fluoride varnishes.

Science.gov (United States)

Lippert, Frank; Hara, Anderson Takeo; Martinez-Mier, Esperanza Angeles; Zero, Domenick T

2014-01-01

The purpose of this study was to investigate the potential anticaries efficacy of fluoride varnishes (FVs) by studying their ability to reharden and deliver fluoride to carious lesions and to release fluoride into saliva. Enamel carious lesions were created and allocated to 24 groups (11 FVs with two FV incubation times and two control groups) based on Knoop microhardness test values. FVs were applied to lesions, which were incubated in artificial saliva for two or six hours, with saliva being renewed hourly. FV was removed and lesions were remineralized in artificial saliva for 22 hours. Microhardness was measured and enamel fluoride uptake (EFU) was determined. Saliva samples (six-hour groups) were analyzed to determine fluoride release characteristics. Data were analyzed using analysis of variance. FVs differed considerably in their ability to reharden and deliver fluoride to carious lesions and in their fluoride release characteristics. Little consistency was found between investigated study variables for virtually all tested FVs. For example, a particular FV showed the highest EFU and fluoride release values but the lowest rehardening value. A longer FV contact time led to increased EFU for five of the 11 FVs. Some FVs delivered more fluoride to lesions in two hours than others did in six hours. Fluoride varnishes differ greatly in their in vitro anticaries efficacy.

Ultrasonographic assessment of the proximal digital annular ligament in the equine forelimb

International Nuclear Information System (INIS)

Dik, K.J.; Boroffka, S.; Stolk, P.

1994-01-01

Ultrasonography was used with 6 normal cadaver forelimbs of Dutch Warmblood horses to delineate the ultrasonographic anatomy of the palmar pastern region, with emphasis on the proximal digital annular ligament. Using a 5.5 MHz sector scanner, the thin proximal digital annular ligament was not visible on offset sonograms. Only if the digital sheath in the normal limb was distended was the distal border of this ligament outlined. In all normal limbs the palmarodistal thickness of the combined skin-proximal digital annular ligament layer in the mid-pastern region was 2 mm. The flexor tendons and distal sesamoidean ligaments were easily identified as hyperechoic structures. Distension of the digital sheath in the normal limbs clearly outlined the anechoic digital sheath pouches. In 4 lame horses ultrasonography aided the diagnosis of functional proximal digital annular ligament constriction. In all 4 diseased forelimbs ultrasonography demonstrated thickening of the skin-proximal digital annular ligament layer and distension of the digital sheath. In one of these limbs the distended digital sheath was also thickened. The flexor tendons and distal sesamoidean ligaments were normal. There was no radiographic evidence of additional bone or joint lesions

Ultrasonographic assessment of the proximal digital annular ligament in the equine forelimb.

Science.gov (United States)

Dik, K J; Boroffka, S; Stolk, P

1994-01-01

Ultrasonography was used with 6 normal cadaver forelimbs of Dutch Warmblood horses to delineate the ultrasonographic anatomy of the palmar pastern region, with emphasis on the proximal digital annular ligament. Using a 5.5 MHz sector scanner, the thin proximal digital annular ligament was not visible on offset sonograms. Only if the digital sheath in the normal limb was distended was the distal border of this ligament outlined. In all normal limbs the palmarodistal thickness of the combined skin-proximal digital annular ligament layer in the mid-pastern region was 2 mm. The flexor tendons and distal sesamoidean ligaments were easily identified as hyperechoic structures. Distension of the digital sheath in the normal limbs clearly outlined the anechoic digital sheath pouches. In 4 lame horses ultrasonography aided the diagnosis of functional proximal digital annular ligament constriction. In all 4 diseased forelimbs ultrasonography demonstrated thickening of the skin-proximal digital annular ligament layer and distension of the digital sheath. In one of these limbs the distended digital sheath was also thickened. The flexor tendons and distal sesamoidean ligaments were normal. There was no radiographic evidence of additional bone or joint lesions.

Surface variations affecting human dental enamel studied using nanomechanical and chemical analysis

Science.gov (United States)

Dickinson, Michelle Emma

The enamel surface is the interface between the tooth and its ever changing oral environment. Cavity (caries) formation and extrinsic tooth staining are due, respectively, to degradation of the enamel structure under low pH conditions and interactions between salivary pellicle and dietary elements. Both of these occur at the enamel surface and are caused by the local environment changing the chemistry of the surface. The results can be detrimental to the enamel's mechanical integrity and aesthetics. Incipient carious lesions are the precursor to caries and form due to demineralisation of enamel. These carious lesions are a reversible structure where ions (e.g. Ca2+, F -) can diffuse in (remineralisation) to preserve the tooth's structural integrity. This investigation used controlled in vitro demineralisation and remineralisation to study artificial carious lesion formation and repair. The carious lesions were cross-sectioned and characterised using nanoindentation, electron probe micro-analysis and time of flight secondary ion mass spectrometry. Mechanical and chemical maps showed the carious lesion had a significantly reduced hardness and elastic modulus, and the calcium and phosphate content was lower than in sound enamel. Fluoride based remineralisation treatments gave a new phase (possibly fluorohydroxyapatite) within the lesion with mechanical properties higher than sound enamel. The acquired salivary pellicle is a protein-rich film formed by the physisorption of organic molecules in saliva onto the enamel surface. Its functions include lubrication during mastication and chemical protection. However, pellicle proteins react with dietary elements such as polyphenols (tannins in tea) causing a brown stain. This study has used in vitro dynamic nanoindentation and atomic force microscopy to examine normal and stained pellicles formed in vivo. The effects of polyphenols on the pellicle's mechanical properties and morphology have been studied. It was found that the

Atraumatic restorative treatment and minimal intervention dentistry.

Science.gov (United States)

Frencken, J E

2017-08-11

Too many people worldwide suffer from the consequences of untreated dentine carious lesions. This finding reflects the inability of the currently used traditional mode of treatments to manage such lesions. A change is needed. Dental training institutions should depart from the traditional 'drill and fill' treatments and embrace the holistic oral healthcare approach that is minimal intervention dentistry (MID) and includes within it minimally invasive operative skills. Dental caries is, after all, a preventable disease. The atraumatic restorative treatment (ART) concept is an example of MID. ART consists of a preventive (ART sealant) and a restorative (ART restoration) component. ART sealants using high-viscosity glass-ionomer (HVGIC) have a very high dentine carious lesion preventive effect. The survival rate of these sealants is not significantly different from that of sealants produced with resin. The survival rate of ART/HVGIC restorations matches those of amalgam and resin composite in single- and multiple-surface cavities in primary teeth and in single-surface cavities in permanent teeth. The principles of carious tissue removal within a cavity recommended by the International Caries Consensus Collaboration are in line with those of treating a cavity using ART. Owing to its good performance and the low levels of discomfort/pain and dental anxiety associated with it, ART and/or other evidence-based atraumatic care procedures should be the first treatment for a primary dentine carious lesion. Only if the use of ART is not indicated should other more invasive and less-atraumatic care procedures be used in both primary and permanent dentitions.

Efficacy of Motivational Interviewing in Conjunction with Caries Risk Assessment (MICRA) Programmes in Improving the Dental Health Status of Preschool Children: A Randomised Controlled Trial.

Science.gov (United States)

Saengtipbovorn, Saruta

To assess the efficacy of motivational interviewing in conjuction with a caries risk assessment (MICRA) programme to improve the dental health status of preschool children. A randomised controlled trial was conducted among 214 parents or caregivers and their children at Health Centre 54, Bangkok, Thailand, from September 2015 to February 2016. The participants were randomised to the intervention and the control groups (107 participants per group). At baseline, the intervention group received a caries risk assessment, individual counseling by using motivational interviewing, and oral hygiene instruction. The intervention group received reinforcement education and individual counseling by motivational interviewing every 3 months. The control group received a routine programme. Participants were assessed at baseline, 3 months, and 6 months for plaque index and caries. The data were analysed by using descriptive statistics, the chi-squared test, Fisher's exact test, t-test, repeated-measures ANOVA, and negative binomial distribution. After the 6-month follow-up, participants in the intervention group had a significantly lower plaque index, non-cavitated plus cavitated carious lesions, and cavitated carious lesions when compared to the control group. The intervention group had a lower caries incidence, non-cavitated plus cavitated carious lesions (1.81 times) and cavitated carious lesions (2.04 times) than the control group. The combination of motivational interviewing and caries risk assessment in one programme decreased early childhood caries in preschool children. It is not known whether the effects are due to the motivational interviewing, the caries risk assessment, or the combination of both.

Case report 390: Tuberculous pseudotumor of the proximal end of the right tibia without obvious synovial involvement

Energy Technology Data Exchange (ETDEWEB)

Abdelwahab, I.F.; Present, D.A.; Klein, M.J.

1986-11-01

A case of osseous tuberculosis has been presented in a young black man who was known to be an addict to cocaine. An osteolytic lesion involved the proximal end of the tibia, being eccentric and subarticular in location. The knee joint spaces were intact, suggesting that no obvious involvement of the cartilages was present. Thus, neoplastic lesions such as chondroblastoma and giant cell tumor were considered in the differential diagnosis of the lesion which appeared to be benign radiologically. The lesion proved to be tuberculous in nature, with intact knee joint cartilages. A diagnosis of tuberculous 'pseudotumor' might be used aptly. (orig./SHA).

Poor outcome of bilateral lower extremity morel-lavallee lesions: a case report.

Science.gov (United States)

Stanley, Sharon S; Molmenti, Ernesto P; Siskind, Eric; Kasabian, Armen K; Huang, Su-I D

2014-03-01

The Morel-Lavallee lesion is a closed, internal degloving injury that results when a strong, shearing force is applied parallel to the plane of injury, as is common in vehicular trauma. It is an underdiagnosed entity that is often missed during the initial trauma workup as symptoms can be subtle. There are few reports of lesions occurring below the knee. Most cases affect the proximal thigh and trochanter, as these tend to be dependent areas in high velocity trauma. To the best of our knowledge, this is the first literature report of bilateral lower extremity Morel-Lavallee lesions.

Evaluation of the effect of photodynamic antimicrobial therapy in dentin caries: a pilot in vivo study

Science.gov (United States)

Borges, F. M. C.; de-Melo, M. A. S.; Lima, J. M. P.; Zanin, I. C. J.; Rodrigues, L. K. A.; Nobre-dos-Santos, M.

2010-02-01

In vitro and in situ studies have demonstrated that the photodynamic antimicrobial therapy (PACT) is effective in reducing Streptococcus mutans population in artificially carious dentin. This pilot in vivo study evaluated the antimicrobial effect of PACT using toluidine blue O (TBO) and a light-emitting diode (LED) in carious dentin lesions. Five healthy adult volunteers (19-36 yr), with at least 4 active carious cavities each, participated in this study. Teeth of each volunteer were randomly divided into four groups: (1) without TBO and without light (Control); (2) with TBO alone (TBO); (3) with LED at 94/J cm2 alone (LED); and (4) with TBO plus LED at 94 J/cm2 (PACT). Each cavity was divided into two halves. The baseline carious dentin sample was collected from half of each cavity. Following, the treatments were performed using a random distribution of tooth into treatments. Then, the second collection of carious dentin samples was performed. Before and after treatments, dentin samples were analyzed with regard to the counts of total viable microorganisms, total streptococci, mutans streptococci, and lactobacilli. The data were statistically analyzed by Kruskal-Wallis and Student-Newman-Keuls tests (α=5%). Log reductions ranged from -0.12 to 2.68 and significant reductions were observed for PACT (group 4) when compared to the other groups (1, 2, and 3) for total streptococci and mutans streptococci. Concluding, PACT was effective in killing oral microorganisms present in in vivo carious dentin lesions and may be a promising technique for eliminating bacteria from dentin before restoration.

In vitro remineralization of enamel subsurface lesions and assessment of dentine tubule occlusion from NaF dentifrices with and without calcium

Directory of Open Access Journals (Sweden)

A R Prabhakar

2013-01-01

Full Text Available Currently, fluoride is the most effective preventive treatment for remineralization of incipient carious lesions and dentinal hypersensitivity due to wasting disorders. The products containing fluoride, calcium and phosphate are also claim to remineralize early, non-cavitated enamel demineralization. The aim of this study was to investigate and compare the efficacy of two such products, Tooth Mousse and Clinpro tooth crème on remineralization and tubule occluding ability with 5000ppm fluoride-containing toothpaste. Materials and Methods :Thirty third molar teeth were placed in demineralizing solution for 5 days such that only a window of 1mm x 5mm was exposed to the environment to produce artificial caries-like lesions and randomly assigned to three groups: Group I, 5000ppm sodium fluoride; Group II, GC MI paste plus and Group III, Clinpro tooth crème. Axial longitudinal sections of 140-160 μm of each tooth which included the artificial carious lesion taken and were photographed under polarized light microscope. The demineralized areas were then quantified with a computerized imaging system. The experimental materials were applied onto the tooth sections as a topical coating and subjected to pH-cycling for 28 days. To evaluate tubule occlusion ability, thirty dentin specimens of 2mm thickness were obtained from cervical third of sound third molars. Specimens were ultrasonicated and etched with 6% citric acid for 2 minutes to simulate the hypersensitive dentin. Specimens were randomly divided into above mentioned three groups (n=10. The test agents were brushed over the specimens with an electric toothbrush, prepared and observed under Scanning Electron Microscope for calculation of the percentage of occluded tubules. Results: Group I showed a significantly greater percentage of remineralization than Group III and Group II. Comparison of the remineralization potential between group II and group III were not significant.In case of dentine

Autosomal dominant HMSN with proximal involvement: new Brazilian cases HMSN autossômica dominante com envolvimento proximal: novos casos brasileiros

Directory of Open Access Journals (Sweden)

Cristiane Borges Patroclo

2009-09-01

Full Text Available We report four Brazilian siblings with Autosomal Dominant Hereditary Motor Sensory Neuropathy with Proximal Dominant Involvement (HMSN-P, a rare form of HMSN, that was characterized by proximal dominant muscle weakness and atrophy onset after the age of 30 years, fasciculation, arreflexia and sensory disturbances with autosomal dominant inheritance. Electrophysiological study and sural nerve biopsy were in the accordance with axonal sensory motor polyneuropathy and laboratorial analysis disclosed serum lipids and muscle enzymes abnormalities. Our report is the first done by a group outside Japan, where the disease initially seemed to be restricted and stressed the phenotypic variability from the original report.Relatamos os casos de quatro irmãos brasileiros com Neuropatia Sensitivo Motora Hereditária com Envolvimento Proximal Dominante (HMSN-P, uma forma rara de HMSN caracterizada por fraqueza muscular de predomínio proximal e atrofia de instalação após os 30 anos, fasciculações, arreflexia, distúrbios sensitivos e padrão de herança autossômica dominante. Os estudos eletrofisiológicos e de biópsia do nervo sural confirmaram o diagnóstico de polineuropatia sensitivo-motora com padrão lesional axonal. Laboratorialmente foram constatadas anormalidades séricas no metabolismo lipídico e enzimas musculares. Nosso relato é o primeiro feito por um grupo fora do Japão, onde a doença parecia restrita até então e ressalta a variabilidade fenotípica apresentada nos casos Brasileiros.

One-year clinical evaluation of tooth-colored materials in non-carious cervical lesions Avaliação clínica de restaurações de lesões cervicais não cariosas

Directory of Open Access Journals (Sweden)

Sérgio Lima Santiago

2003-09-01

Full Text Available The purpose of this study was to assess the clinical performance of bonded composite (Excite/Tetric Ceram - Vivadent versus a resin-modified glass ionomer cement (Vitremer - 3M for restoring non-carious cervical lesions. A total of 70 restorations (thirty-five per material were placed in 30 patients, 18-50 aged, by one operator. Rubber dam was employed in all cases, lesions were pumiced, enamel margins were not beveled, and no mechanical retention was placed. The restorations were directly assessed by two independent evaluators using modified-USPHS criteria for six clinical categories. The ratings for clinical acceptability restorations (alfa plus bravo were as follows (Tetric Ceram/Vitremer: retention (86%/100%, marginal integrity (100%/100%, marginal discoloration (100%/100%, wear (97%/100%, postoperative sensitivity (100%/100% and recurrent caries (100%/100%. Statistical analysis was completed with Fisher's exact or Pearson Chi-square tests at a significance level of 5% (PAvaliou-se o desempenho clínico de um sistema restaurador adesivo (Excite - Tetric Ceram/ Vivadent e do cimento de ionômero de vidro modificado por resina (Vitremer/ 3M na restauração de lesões cervicais não cariosas por meio do sistema de avaliação do USPHS modificado. Um total de setenta restaurações, trinta e cinco por material, foi realizado por um único operador em trinta pacientes voluntários com idades de 18 a 50 anos. Previamente à execução das restaurações, foi realizada uma profilaxia com pedra-pomes e água a fim de remover quaisquer resíduos. As lesões cervicais não foram submetidas a qualquer tipo de preparo cavitário, sendo restauradas sob isolamento absoluto e de acordo com as instruções do fabricante. Todas as restaurações foram avaliadas pelo método direto por dois examinadores usando os critérios de retenção (R, integridade marginal (IM, descoloração marginal (DM, desgaste (D, sensibilidade pós-operatória (S e incidência de

Subacute narrowing of the left main coronary artery following directional atherectomy for proximal obstructive coronary artery disease

NARCIS (Netherlands)

Piek, J. J.; Koch, K. T.; van der Wal, A. C.; Becker, A. E.

1997-01-01

Directional atherectomy is an alternative device for treatment of highly eccentric or proximal coronary lesions considered less suitable for balloon angioplasty. We report a patient with exuberant neointimal proliferation, extending into the left main coronary artery, following directional

How Should We Perform Rotational Atherectomy to an Angulated Calcified Lesion?

Science.gov (United States)

Sakakura, Kenichi; Taniguchi, Yousuke; Matsumoto, Mitsunari; Wada, Hiroshi; Momomura, Shin-Ichi; Fujita, Hideo

2016-05-25

Rotational atherectomy to an angulated calcified lesion is always challenging. The risk of catastrophic complications such as a burr becoming stuck or vessel perforation is greater when the calcified lesion is angulated. We describe the case of an 83-year-old female suffering from unstable angina. Diagnostic coronary angiography revealed an angulated calcified lesion in the proximal segment of the right coronary artery. We performed rotational atherectomy to the lesion, but intentionally did not advance the rotational atherectomy burr beyond the top of the angulation. We controlled the rotational atherectomy burr and stopped it just before the top of the angulation to avoid complications. Following rotational atherectomy, balloon dilatation with a non-compliant balloon was performed, and drug-eluting stents were successfully deployed. In this manuscript, we provide a review of the literature on this topic, and discuss how rotational atherectomy to an angulated calcified lesion should be performed.

Radiographic features of large cystic lesions of the jaws in children

International Nuclear Information System (INIS)

Bodner, Lipa; Woldenberg, Yitzhak; Bar-Ziv, Jacob

2003-01-01

The surgical approach to cystic lesions of the jaws is either marsupialisation or enucleation. The treatment of choice is dependent on the size of the lesion, the bony integrity of the cyst and its proximity to anatomical structures.Objectives. To assess large (>2.0 cm) cystic lesions of the jaws using plain film radiography (PFR), CT, multiplanar reconstruction program (MPR) and three-dimensional CT (3D-CT).Patients and methods. Twelve children aged 7-14 years.Results. The classic radiological feature was a unilocular radiolucent area surrounded by a well-defined radio-opaque margin adjacent to the root of a non-viable tooth or associated with the crown of an unerupted tooth. Malposition of teeth and root resorption were more common in dentigerous cysts. The features seen on CT were clear and more precise than those seen on PFR. MPR, by the three-dimensional visualisation of the jaw (axial, panoramic, and bucco-lingual), provided useful information for determining the outline of the cyst and its proximity to adjacent anatomical structures, such as teeth, nerves or maxillary sinus. 3-D CT further and more clearly demonstrated discontinuity in the buccal or palatal/lingual cortices of the jaw bone. PFR was very accurate in determining root resorption.Conclusions. CT with MPR and, ideally, 3-D CT should be used for the comprehensive diagnostic work-up and meticulous surgical management of large cystic lesions of the jaws in children. (orig.)

The hamatolunate facet: characterization and association with cartilage lesions - magnetic resonance arthrography and anatomic correlation in cadaveric wrists

Energy Technology Data Exchange (ETDEWEB)

Pfirrmann, C.W.A. [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States); Orthopedic University Hospital Balgrist, Department of Radiology, Forchstrasse 340, 8008 Zurich (Switzerland); Theumann, N.H.; Chung, C.B.; Trudell, D.J.; Resnick, D. [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States)

2002-08-01

The objective of this study was to characterize the appearance of the hamatolunate facet using high-resolution magnetic resonance (MR) arthrography in cadavers and to correlate the presence of this anatomic variant with the presence of osteoarthritis in the wrist. High-resolution MR images of 22 cadaveric wrist specimens were obtained after tri-compartmental arthrography. Two readers in consensus analyzed the MR images and recoded the presence or absence of a hamatolunate facet. Geometric characteristics and cartilage and ligament integrity were analyzed. A third reader, who was blinded to the purpose of the study, recorded cartilage lesions of all the bones of the proximal and distal carpal rows. A hamatolunate facet was present in 11 of 22 wrists (50%). The mean coronal size of the lunate facet at the lunate (type II lunate) was 4.5 mm (range, 2-6 mm). The highest frequencies of cartilage lesions were seen in the scapho-trapezio-trapezoid joint (45.5%) and at the proximal pole of the hamate (54.4% and 40.9% for consensus reading/blinded reading, respectively). In cases with a hamatolunate facet, the frequency of cartilage lesions in the proximal pole of the hamate was 81.8% and 63.6% versus 27.3% and 18.2% without such a facet (chi-squared, P=0.01/P=0.03). No correlation of the presence of a hamatolunate facet with interosseous ligament tears or lesions of the triangular fibrocartilage was seen. In conclusion, the hamatolunate facet is a very common anatomic variant. The presence of a hamatolunate facet is associated with cartilage damage in the proximal pole of the hamate. (orig.)

Proximal onychomycosis due to Malassezia furfur: a case report

Directory of Open Access Journals (Sweden)

Zareei M

2013-03-01

Full Text Available Background: The etiologic role of Malassezia furfur in onychomycosis, because of its controversial keratinolytic ability, has not been proven. The most reported cases are distal subungual onychomycosis (DSO. In our knowledge no cases of proximal onychomycosis (PO has been reported. For the first time we report proximal onychomycosis. This case report describes the isolation of Malassezia furfur from fingernails. Case presentation: An Iranian 56- year- old women had been referred to mycology lab with hyperkeratosis in proximal regions of right hand nails and clinical diagnosis of onychomycosis without paronychia in May 2012. She used several medicines for her cardiac disease, mental illness, severe stress and blood glucose fluctuation diseases. Scraping and sampling from nail lesions were done, budding yeast cells with broadband connections were observed in 15% KOH wet mounts. Also, other differentiation tests, consist of staining with methylen blue, cultures and biochemical tests were done. In order to rejecting the probable etiologic role of any dermatophytic or non-dermatophytic fungi in this case, samples were collected from other parts of the body by scotch tape and scraping with scalpel blade too, but the results of direct microscopy and culture were negative. Finally, Malassezia furfur was identified as the causative agent of onychomycosis.Conclusion: Despite failure to prove Malassezia furfur keratinolytic ability, it can be the etiologic agent of proximal onychomycosis that shows the aggressive properties of this species. Its clinical importance is the easier transmission to hospitalized patients and other people.

Fracturas de extremidad proximal de cubito en el niño

OpenAIRE

Martínez Castroverde Pérez, Jesús; Casas Cebrián, M.; Doñate Pérez, F.; Martínez Arnáiz, R.; Delgado Mateo, Ricardo; Gallach Sanchís, D.

2002-01-01

Las fracturas y epifisiolisis proximales de cubito, son lesiones raras y cuando se producen suelen estar mínimamente ó no desplazadas, pudiendo ser tratadas de forma conservadoras. En los casos en que existe desplazamiento significativo, requieren reducción abierta y osteosíntesis. Independientemente del tipo de tratamiento utilizado, el resultado final suele ser satisfactorio. Realizamos un estudio retrospectivo de 13 casos de fractura-epifisiolisis de extremo proximal de cubito, ocurridas d...

The proximal hamstring muscle–tendon–bone unit: A review of the normal anatomy, biomechanics, and pathophysiology

International Nuclear Information System (INIS)

Beltran, Luis; Ghazikhanian, Varand; Padron, Mario; Beltran, Javier

2012-01-01

Proximal hamstring injuries occur during eccentric contraction with the hip and the knee on extension; hence they are relatively frequent lesions in specific sports such as water skiing and hurdle jumping. Additionally, the trend toward increasing activity and fitness training in the general population has resulted in similar injuries. Myotendinous strains are more frequent than avulsion injuries. Discrimination between the two types of lesions is relevant for patient management, since the former is treated conservatively and the latter surgically. MRI and Ultrasonography are both well suited techniques for the diagnosis and evaluation of hamstring tendon injuries. Each one has its advantages and disadvantages. The purpose of this article is to provide a comprehensive review of the anatomy and biomechanics of the proximal hamstring muscle–tendon–bone unit and the varied imaging appearances of hamstring injury, which is vital for optimizing patient care. This will enable the musculoskeletal radiologist to contribute accurate and useful information in the treatment of athletes at all levels of participation.

The proximal hamstring muscle–tendon–bone unit: A review of the normal anatomy, biomechanics, and pathophysiology

Energy Technology Data Exchange (ETDEWEB)

Beltran, Luis, E-mail: luisbeltran@mac.com [Department of Radiology, Hospital for Joint Diseases, NYU, New York, NY (United States); Ghazikhanian, Varand, E-mail: varandg@aol.com [Department of Radiology, Maimonides Medical Center, Brooklyn, NY (United States); Padron, Mario, E-mail: mario.padron@cemtro.es [Clinica CEMTRO, Avenida del Ventisquero de la Condesa 42, 28035 Madrid (Spain); Beltran, Javier, E-mail: Jbeltran46@msn.com [Department of Radiology, Maimonides Medical Center, Brooklyn, NY (United States)

2012-12-15

Proximal hamstring injuries occur during eccentric contraction with the hip and the knee on extension; hence they are relatively frequent lesions in specific sports such as water skiing and hurdle jumping. Additionally, the trend toward increasing activity and fitness training in the general population has resulted in similar injuries. Myotendinous strains are more frequent than avulsion injuries. Discrimination between the two types of lesions is relevant for patient management, since the former is treated conservatively and the latter surgically. MRI and Ultrasonography are both well suited techniques for the diagnosis and evaluation of hamstring tendon injuries. Each one has its advantages and disadvantages. The purpose of this article is to provide a comprehensive review of the anatomy and biomechanics of the proximal hamstring muscle–tendon–bone unit and the varied imaging appearances of hamstring injury, which is vital for optimizing patient care. This will enable the musculoskeletal radiologist to contribute accurate and useful information in the treatment of athletes at all levels of participation.

Endoscopic surgical management of a large Morel-Lavallée lesion.

Science.gov (United States)

Walls, Andrew; McMahon, Samuel E; MacDonald, Jonathan; Bunn, Jonathan

2017-09-23

The Morel-Lavallée lesion is a closed degloving injury that usually occurs following high-energy trauma. We present a case demonstrating endoscopic management of this lesion. A 44-year-old man fell from scaffolding. Initial assessment demonstrated no significant injury. An ultrasound scan 2 days post injury revealed a large fluid collection along the lateral right thigh. This subsequently became infected and did not respond to antibiotic therapy.Due to the extent of the lesion, we were reluctant to perform a traditional open drainage. An endoscopic probe was inserted at the proximal and distal poles of the lesion and the wound debrided.This resulted in a rapid improvement in symptoms and a complete resolution of the lesion at 1 year postsurgery, with no wound-associated morbidity.This is only the second description of endoscopic debridement of a large, acute Morel-Lavallée lesion, with an excellent outcome. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Atraumatic restorative treatment and minimal intervention dentistry

NARCIS (Netherlands)

Frencken, J.E.F.M.

2017-01-01

Too many people worldwide suffer from the consequences of untreated dentine carious lesions. This finding reflects the inability of the currently used traditional mode of treatments to manage such lesions. A change is needed. Dental training institutions should depart from the traditional 'drill and

Hypomineralized second primary molars: prevalence, defect characteristics and relationship with dental caries in Melbourne preschool children.

Science.gov (United States)

Owen, M L; Ghanim, A; Elsby, D; Manton, D J

2018-03-01

Dental caries and enamel defects (DDE) are prevalent amongst children. The presence of DDE, especially enamel hypomineralization, may increase caries experience. The reported prevalence of hypomineralized second primary molars (HSPM) is 2.7-21.8%, although the occurrence in Australian children remains unknown. These HSPM represent a potential predictive factor for molar-incisor hypomineralization (MIH). In total, 623 children aged 3-5 years from 30 randomly selected kindergartens participated. The HSPM were recorded using an index combining the European Academy of Paediatric Dentistry MIH Judgment Criteria and modified DDE Index. Caries was recorded using International Caries Detection and Assessment System criteria. In total, 144 HSPM were observed in 88 of the 623 (14.1%) children, a tooth-level prevalence of 5.8%. The prevalence of dentinal carious lesions was 13.2%, and caries prevalence (d 2-6 mft > 0) was 36.4%. Cavitated carious lesions affected 30.7% of HSPM. The relationship between an increase in HSPM lesion extent and increasing number of HSPM per child was statistically significant. A positive association between HSPM severity and extent at tooth level existed (P < 0.05). There was a positive relationship between the extent of HSPM and carious lesion severity (P < 0.05). In this population, children with HSPM did not have overall greater caries experience. © 2017 Australian Dental Association.

[Onychomatricoma, a rare lesion of the nail].

Science.gov (United States)

Pommepuy, Isabelle; Roblet, Denis; Blaise, Sophie; Delage-Corre, Manuela; Bonnetblanc, Jean-Marie; Fayol, Jacqueline; Labrousse, François

2004-09-01

Onychomatricoma is a rare fibroepithelial lesion of the nail matrix with peculiar clinical and histological features. Clinically, it is characterized by a longitudinal band of yellow thickening of the nail plate with transverse overcurvature and splinter hemorrhages. Nail avulsion exposes a villous tumor of the matrix with filamentous digitations extending into multiple holes of the nail plate. Histologically, a thick keratogenous zone forms a thickened nail plate. The lesion in its proximal portion is characterized by deep epithelial invaginations and by a stroma organized in two layers. The distal zone corresponds to multiple fibroepithelial projections extending into the nail plate. The diagnosis can be difficult in the presence of misleading clinical features or when the specimen is incomplete or examined with an improper orientation. Surgical resection is the recommended treatment.

Association between proximal internal carotid artery steno-occlusive disease and diffuse wall thickening in its petrous segment: a magnetic resonance vessel wall imaging study

Energy Technology Data Exchange (ETDEWEB)

Chen, Xiaoyi; Li, Dongye [Capital Medical University and Beijing Institute for Brain Disorders, Center for Brain Disorders Research, Beijing (China); Tsinghua University School of Medicine, Center for Biomedical Imaging Research, Department of Biomedical Engineering, Beijing (China); Zhao, Huilin [Shanghai Jiao Tong University, Department of Radiology, Renji Hospital, School of Medicine, Shanghai (China); Chen, Zhensen; Qiao, Huiyu; He, Le; Li, Rui [Tsinghua University School of Medicine, Center for Biomedical Imaging Research, Department of Biomedical Engineering, Beijing (China); Cui, Yuanyuan [PLA General Hospital, Department of Radiology, Beijing (China); Zhou, Zechen [Philips Research China, Healthcare Department, Beijing (China); Yuan, Chun [Tsinghua University School of Medicine, Center for Biomedical Imaging Research, Department of Biomedical Engineering, Beijing (China); University of Washington, Department of Radiology, Seattle, WA (United States); Zhao, Xihai [Tsinghua University School of Medicine, Center for Biomedical Imaging Research, Department of Biomedical Engineering, Beijing (China); Beijing Institute for Brain Disorders, Center for Stroke, Beijing (China)

2017-05-15

Significant stenosis or occlusion in carotid arteries may lead to diffuse wall thickening (DWT) in the arterial wall of downstream. This study aimed to investigate the correlation between proximal internal carotid artery (ICA) steno-occlusive disease and DWT in ipsilateral petrous ICA. Symptomatic patients with atherosclerotic stenosis (>0%) in proximal ICA were recruited and underwent carotid MR vessel wall imaging. The 3D motion sensitized-driven equilibrium prepared rapid gradient-echo (3D-MERGE) was acquired for characterizing the wall thickness and longitudinal extent of the lesions in petrous ICA and the distance from proximal lesion to the petrous ICA. The stenosis degree in proximal ICA was measured on the time-of-flight (TOF) images. In total, 166 carotid arteries from 125 patients (mean age 61.0 ± 10.5 years, 99 males) were eligible for final analysis and 64 showed DWT in petrous ICAs. The prevalence of severe DWT in petrous ICA was 1.4%, 5.3%, 5.9%, and 80.4% in ipsilateral proximal ICAs with stenosis category of 1%-49%, 50%-69%, 70%-99%, and total occlusion, respectively. Proximal ICA stenosis was significantly correlated with the wall thickness in petrous ICA (r = 0.767, P < 0.001). Logistic regression analysis showed that proximal ICA stenosis was independently associated with DWT in ipsilateral petrous ICA (odds ratio (OR) = 2.459, 95% confidence interval (CI) 1.896-3.189, P < 0.001). Proximal ICA steno-occlusive disease is independently associated with DWT in ipsilateral petrous ICA. (orig.)

Association between proximal internal carotid artery steno-occlusive disease and diffuse wall thickening in its petrous segment: a magnetic resonance vessel wall imaging study

International Nuclear Information System (INIS)

Chen, Xiaoyi; Li, Dongye; Zhao, Huilin; Chen, Zhensen; Qiao, Huiyu; He, Le; Li, Rui; Cui, Yuanyuan; Zhou, Zechen; Yuan, Chun; Zhao, Xihai

2017-01-01

Significant stenosis or occlusion in carotid arteries may lead to diffuse wall thickening (DWT) in the arterial wall of downstream. This study aimed to investigate the correlation between proximal internal carotid artery (ICA) steno-occlusive disease and DWT in ipsilateral petrous ICA. Symptomatic patients with atherosclerotic stenosis (>0%) in proximal ICA were recruited and underwent carotid MR vessel wall imaging. The 3D motion sensitized-driven equilibrium prepared rapid gradient-echo (3D-MERGE) was acquired for characterizing the wall thickness and longitudinal extent of the lesions in petrous ICA and the distance from proximal lesion to the petrous ICA. The stenosis degree in proximal ICA was measured on the time-of-flight (TOF) images. In total, 166 carotid arteries from 125 patients (mean age 61.0 ± 10.5 years, 99 males) were eligible for final analysis and 64 showed DWT in petrous ICAs. The prevalence of severe DWT in petrous ICA was 1.4%, 5.3%, 5.9%, and 80.4% in ipsilateral proximal ICAs with stenosis category of 1%-49%, 50%-69%, 70%-99%, and total occlusion, respectively. Proximal ICA stenosis was significantly correlated with the wall thickness in petrous ICA (r = 0.767, P < 0.001). Logistic regression analysis showed that proximal ICA stenosis was independently associated with DWT in ipsilateral petrous ICA (odds ratio (OR) = 2.459, 95% confidence interval (CI) 1.896-3.189, P < 0.001). Proximal ICA steno-occlusive disease is independently associated with DWT in ipsilateral petrous ICA. (orig.)

Insulin-Like Growth Factor Axis Expression in Dental Pulp Cells Derived From Carious Teeth

Directory of Open Access Journals (Sweden)

Hanaa Esa Alkharobi

2018-04-01

Full Text Available The insulin-like growth factor (IGF axis plays an important role in dental tissue regeneration and most components of this axis are expressed in human dental pulp cells (DPCs. In our previous study, we analyzed IGF axis gene expression in DPCs and demonstrated a novel role of IGF binding protein (IGFBP-2 and -3 in coordinating mineralized matrix formation in differentiating DPCs. A more recent study from our laboratory partially characterized dental pulp stem cells from teeth with superficial caries (cDPCs and showed that their potential to differentiate odontoblasts and/or into osteoblasts is enhanced by exposure to the mild inflammatory conditions characteristic of superficial caries. In the present study, we examine whether changes apparent in IGF axis expression during osteogenic differentiation of healthy DPCs are also apparent in DPCs derived from carious affected teeth.

Visual scoring of non-cavitated caries lesions and clinical trial efficiency, testing xylitol in caries active adults

Science.gov (United States)

Brown, JP; Amaechi, BT; Bader, JD; Gilbert, GH; Makhija, SK; Lozano-Pineda, J; Leo, MC; Chuhe, C; Vollmer, WM

2013-01-01

Objectives To better understand the effectiveness of xylitol in caries prevention in adults, and to attempt improved clinical trial efficiency. Methods As part of the Xylitol for Adult Caries Trial (X-ACT), non-cavitated and cavitated caries lesions were assessed in subjects who were experiencing the disease. The trial was a test of the effectiveness of 5 grams/day of xylitol, consumed by dissolving in the mouth five 1 gram lozenges spaced across each day, compared with a sucralose placebo. For this analysis, seeking trial efficiency, 538 subjects aged 21–80, with complete data for four dental examinations were selected from the 691 randomized into the three year trial, conducted at three sites. Acceptable inter and intra examiner reliability before and during the trial was quantified using the kappa statistic. Results The mean annualized non-cavitated plus cavitated lesion transition scores in coronal and root surfaces, from sound to carious favoured xylitol over placebo, during the three cumulative periods of 12, 24, and 33 months, but these clinically and statistically non-significant differences declined in magnitude over time. Restricting the present assessment to those subjects with a higher baseline lifetime caries experience showed possible but inconsistent benefit. Conclusions There was no clear and clinically relevant preventive effect of xylitol on caries in adults with adequate fluoride exposure when non-cavitated plus cavitated lesions were assessed. This conformed to the X-ACT trial result assessing cavitated lesions. Including non-cavitated lesion assessment in this full scale, placebo controlled, multi site, randomized, double blinded clinical trial in adults experiencing dental caries, did not achieve added trial efficiency or demonstrate practical benefit of xylitol. Trial Registration ClinicalTrials.Gov NCT00393055 PMID:24205951

Visual scoring of non cavitated caries lesions and clinical trial efficiency, testing xylitol in caries-active adults.

Science.gov (United States)

Brown, John P; Amaechi, Bennett T; Bader, James D; Gilbert, Gregg H; Makhija, Sonia K; Lozano-Pineda, Juanita; Leo, Michael C; Chen, Chuhe; Vollmer, William M

2014-06-01

To better understand the effectiveness of xylitol in caries prevention in adults and to attempt improved clinical trial efficiency. As part of the Xylitol for Adult Caries Trial (X-ACT), non cavitated and cavitated caries lesions were assessed in subjects who were experiencing the disease. The trial was a test of the effectiveness of 5 g/day of xylitol, consumed by dissolving in the mouth five 1 g lozenges spaced across each day, compared with a sucralose placebo. For this analysis, seeking trial efficiency, 538 subjects aged 21-80, with complete data for four dental examinations, were selected from the 691 randomized into the 3-year trial, conducted at three sites. Acceptable inter- and intra-examiner reliability before and during the trial was quantified using the kappa statistic. The mean annualized noncavitated plus cavitated lesion transition scores in coronal and root surfaces, from sound to carious favoured xylitol over placebo, during the three cumulative periods of 12, 24, and 33 months, but these clinically and statistically nonsignificant differences declined in magnitude over time. Restricting the present assessment to those subjects with a higher baseline lifetime caries experience showed possible but inconsistent benefit. There was no clear and clinically relevant preventive effect of xylitol on caries in adults with adequate fluoride exposure when non cavitated plus cavitated lesions were assessed. This conformed to the X-ACT trial result assessing cavitated lesions. Including non cavitated lesion assessment in this full-scale, placebo-controlled, multisite, randomized, double-blinded clinical trial in adults experiencing dental caries did not achieve added trial efficiency or demonstrate practical benefit of xylitol. ClinicalTrials.Gov NCT00393055. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Osteomyelitis of the proximal sesamoid bone in a horse - a case report

International Nuclear Information System (INIS)

Kofler, J.

1994-01-01

Suppurative osteomyelitis of the lateral proximal sesamoid bone and chronic septic tenosynovitis of the digital flexor tendon sheath of the right hind limb was diagnosed in a 8 year old warmblood mare. Three months earlier the horse had received a puncture wound in the plantar fetlock region, penetrating the plantar annular ligament, tendon sheath and intersesamoidian ligament up to the plantaro-axial surface of the lateral sesamoid bone. The clinical, radiographic and ultrasonographic findings are described. The horse showed grade 2 / 4 right hindlimb lameness, marked thickening of the entire digital flexor tendon sheath area as well as the puncture wound in the middle of the annular ligament region. Radiographs revealed a 10 x 12 mm centro-axial, circular translucent lesion and marked bony proliferation on the abaxial and plantar margins of the lateral proximal sesamoid. Adhesions and marked anechoic areas between the plantar septum of the tendon sheath and the superficial flexor tendon, a thickening of the plantar annular ligament and structural alterations of the deep flexor tendon were demonstrated by sonography. Due to these severe findings a very poor prognosis was given and therefore surgery was not recommended. The horse was euthanized 4 months later as a result of further deterioration. Additional clinical, radiographic and sonographic findings as well as post mortem findings are mentioned. Gross pathology showed a fibrino-purulent tenosynovitis of the digital flexor tendon sheath and tendinitis of both flexor tendons, as well as a fistulous lesion of the intersesamoidian ligament over the lateral proximal sesamoid bone. The patho-histologic examination revealed focal suppurative osteomyelitis of the lateral sesamoid bone with necrotic bone tissue in the osteolytic area and accumulated neutrophils and macrophages [de

Experimental rickets in broilers: gross, microscopic, and radiographic lesions. II. Calcium deficiency

International Nuclear Information System (INIS)

Long, P.H.; Lee, S.R.; Rowland, G.N.; Britton, W.M.

1984-01-01

Day-old broiler chicks were fed a calcium-deficient diet for 30 days. Gross, microscopic, and radiographic examinations of the proximal tibiotarsus were done at 2, 3, and 4 weeks of age. In 2-week-old chicks, the growth-plate proliferating-prehypertrophied zone (P-PHZ) was variably lengthened and disorganized, cartilage columns of the degenerating hypertrophied zone and metaphyseal primary spongiosa were shortened, and bone spicules of the secondary spongiosa were bordered by increased osteoid. In 3-week-old chicks, lesions were either similar or more pronounced, with the additional finding of metaphyseal peritrabecular fibrosis. In 4-week-old chicks, the P-PHZ decreased in relative length, osteoid seams and fibrous connective tissue were less prominent, and tibial dyschondroplasia-like lesions were present. Results demonstrated that dietary calcium deficiency produced rachitic lesions, that the lesions were very different from those of phosphorus deficiency or calcium excess, and that the lesions were variable over time. (author)

The effect of MTA application on the affected dentine remineralization after partial caries excavation (in vivo)

Science.gov (United States)

Pratiwi, A. R.; Meidyawati, R.; Djauharie, N.

2017-08-01

On deep carious lesions, only thin dentine remains, causing a high risk of pulp exposure during the removal of all infected dentine. A minimally invasive technique is required, such as a partial caries excavation method in the infected dentine tissue and the use of bioactive material that can promote (Mineral Trioxide Aggregate) MTA remineralization. To compare the remineralization of deep carious lesion-affected dentine with the removal of some and all the infected dentine after the application of MTA. Subjects were divided into two groups: group I had only some parts of the infected dentine removed before MTA application, while group II had all the infected dentine removed before MTA application. Each group was measured on the pixel grey value before the treatment and again four weeks after the MTA application, and then the results were compared. Furthermore, the enhancement of both groups’ grey values were compared. Remineralization occurred in both groups after the MTA application. There was no significant difference in the remineralization level of the affected dentine in both groups I and II four weeks after the MTA application. Remineralization occurred in the affected dentine in both groups, either by removing only some parts or all the infected dentine in the deep carious lesion.

Detection of occlusal caries lesions using fluorescence: correlation between histology and obtained results for Diagnodent and spectroscopy

International Nuclear Information System (INIS)

Rocha-Cabral, Renata Maciel

2006-01-01

The aims of this study were to develop and test a method to detect caries lesions in vivo and in vitro, using a portable spectrometer (PS); to analyze the performance of PS as well as the commercial device Diagnodent (Dd); correlate them with the gold standard, their transversal section areas and lesions depth and between themselves. 66 occlusal pre-molars sites were examined in vivo with Dd. Sequentially, fluorescence (λexc ∼ 657 nm) was collected by an optical fiber, conducted to PS and then analyzed as spectra, which were normalized and had calculated the Ratios of their Areas Under the Curves (RAUC) of carious and sound tissues. Experiments were conducted in vitro in the same sites. Gold Standard was obtained by polarized light microscopy. Pearson correlation was used to compare the devices with transversal section area, lesions depth and between themselves. The area under ROC curve, sensitivity, specificity as well as accuracy were calculated and verified with McNemar test. Dd and RAUC showed statistically significant correlation with gold standard (p < 0.01 for Dd and p < 0.05 for RAUC) and between themselves (r = 0,83 in vivo and r = 0,87 in vitro). Although it was significant, the devices showed low correlation with depth of lesions in vivo and in vitro (r = ∼ 0.43). The transversal section area of the lesion had no influence on readings in both devices. Dd showed higher sensitivity (0.76) than PS (0.60) in vivo (p < 0.05), though this fact was not able to improve its performance. In turn, PS showed higher sensitivity (0.88) than Dd (0.79) in vitro, but this difference was not significantly. The other parameters did not show statistically significant differences (p < 0.05) between methods. PS showed positive correlation with Dd, equal correlation with lesions depth and higher ability of detecting the disease in vitro, what suggests that if accompanied with a conic and an angulated probe and a dedicated software, the PS method could be useful in clinics

Preventing Advanced Carious Lesions with Caries Atraumatic Restorative Technique.

Science.gov (United States)

Byrd, Tammi O

2016-06-01

An alternative approach to controlling dental caries and preventing the associated pain, called atraumatic restorative technique (ART), is described for populations in need, where dental hygienists restore decayed teeth with glass ionomer restorations without prior removal of all decayed tooth structure. There are populations whose decay needs are not adequately being met within the current oral health care delivery system. These include those in poverty conditions, vulnerable children, and the elderly who are often in long-term care facilities without adequate resources or opportunities for traditional dentistry. ART provides a viable option for controlling caries and relieving the pain of untreated decay. The purpose of this article is to suggest that the evidence surrounding ART be viewed objectively and that dental hygienists, with additional education in this approach, can contribute to relieving the pain of untreated dental decay. Evidence suggests that teeth can be effectively restored with ART. Dental hygienists represent an appropriate workforce to provide ART with their current background and education combined plus a brief training program; it is suggested that dental hygiene educational programs include ART within the curriculum. Along with dental sealants and fluoride varnish application, ART can be an important component of a comprehensive preventive program to address the unmet needs of vulnerable populations. Copyright © 2016 Elsevier Inc. All rights reserved.

Modified jailed balloon technique for bifurcation lesions.

Science.gov (United States)

Saito, Shigeru; Shishido, Koki; Moriyama, Noriaki; Ochiai, Tomoki; Mizuno, Shingo; Yamanaka, Futoshi; Sugitatsu, Kazuya; Tobita, Kazuki; Matsumi, Junya; Tanaka, Yutaka; Murakami, Masato

2017-12-04

We propose a new systematic approach in bifurcation lesions, modified jailed balloon technique (M-JBT), and report the first clinical experience. Side branch occlusion brings with a serious complication and occurs in more than 7.0% of cases during bifurcation stenting. A jailed balloon (JB) is introduced into the side branch (SB), while a stent is placed in the main branch (MB) as crossing SB. The size of the JB is half of the MB stent size. While the proximal end of JB attaching to MB stent, both stent and JB are simultaneously inflated with same pressure. JB is removed and then guidewires are recrossed. Kissing balloon dilatation (KBD) and/or T and protrusion (TAP) stenting are applied as needed. Between February 2015 and February 2016, 233 patients (254 bifurcation lesions including 54 left main trunk disease) underwent percutaneous coronary intervention (PCI) using this technique. Procedure success was achieved in all cases. KBD was performed for 183 lesions and TAP stenting was employed for 31 lesions. Occlusion of SV was not observed in any of the patients. Bench test confirmed less deformity of MB stent in M-JBT compared with conventional-JBT. This is the first report for clinical experiences by using modified jailed balloon technique. This novel M-JBT is safe and effective in the preservation of SB patency during bifurcation stenting. © 2017 Wiley Periodicals, Inc.

Impact of Proximal Cap Ambiguity on Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Multicenter US Registry.

Science.gov (United States)

Karatasakis, Aris; Danek, Barbara A; Karmpaliotis, Dimitri; Alaswad, Khaldoon; Jaffer, Farouc A; Yeh, Robert W; Patel, Mitul P; Bahadorani, John N; Wyman, R Michael; Lombardi, William L; Grantham, J Aaron; Kandzari, David E; Lembo, Nicholas J; Doing, Anthony H; Moses, Jeffrey W; Kirtane, Ajay J; Garcia, Santiago; Parikh, Manish A; Ali, Ziad A; Karacsonyi, Judit; Kalra, Sanjog; Rangan, Bavana V; Kalsaria, Pratik; Thompson, Craig A; Banerjee, Subhash; Brilakis, Emmanouil S

2016-10-01

We sought to determine the impact of proximal cap ambiguity on procedural techniques and outcomes for coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We examined the clinical and angiographic characteristics and outcomes of 1021 CTO-PCIs performed between 2012 and 2015 at 11 United States centers. Proximal cap ambiguity was present in 31% of target lesions and was associated with increased clinical and angiographic complexity (prior coronary artery bypass graft surgery: 43% vs 33%; P=.01; moderate/severe calcification 66% vs 51%; Pambiguity (68% vs 33%; Pambiguity was associated with increased use of intravascular ultrasound (49% vs 36%; P=.01) and contrast (281 mL vs 250 mL; Pambiguity is present in one-third of CTO-PCI target lesions and is associated with lower success rates, higher utilization of the retrograde approach, and lower procedural efficiency, but no significant difference in the incidence of major adverse cardiac events.

Panographic Survey of U. S. Army Recruits: Analysis of Dental Health Status.

Science.gov (United States)

1981-09-16

pathoses which may not be evident on a routine periapical survey.3-6 The advantages of panoramic radiography make it particularly attractive for mass...perlapical radiolucencles. Radiolucent lesions, other than periapical or anatomical, were recorded separately. Folli- cular enlargements (over 3 m) surrounding...retention cysts . RESULTS Table I summarizes the findings. Dental Caries. A 58 percent incidence of carious lesions was noted overall. Many of these lesions

Can classic metaphyseal lesions follow uncomplicated caesarean section?

Energy Technology Data Exchange (ETDEWEB)

O' Connell, AnnaMarie [Children' s University Hospital, Radiology Department, Dublin 1 (Ireland); Donoghue, Veronica B. [Children' s University Hospital, Radiology Department, Dublin 1 (Ireland); National Maternity Hospital, Radiology Department, Dublin (Ireland)

2007-05-15

Classic metaphyseal lesion (CML) is the term given to a fracture that most often occurs in the posteromedial aspect of the distal femur, proximal tibia, distal tibia, and proximal humerus in infants; this finding is strongly associated with non-accidental injury. To demonstrate that the CML may occur following simple lower segment caesarean section (LSCS). A review of 22 years of an obstetric practice that delivers 8,500 babies per year. We identified three neonates born by elective LSCS, each with distal femoral metaphyseal fractures on postpartum radiographs. All caesarean sections were elective and uncomplicated. External cephalic version was not employed preoperatively. Postpartum radiographs demonstrated a fracture of the distal femoral metaphysis in each neonate, typical of a CML. We propose that a CML can occur in the setting of a simple, elective and uncomplicated LSCS where no external cephalic version is employed. (orig.)

Can classic metaphyseal lesions follow uncomplicated caesarean section?

International Nuclear Information System (INIS)

O'Connell, AnnaMarie; Donoghue, Veronica B.

2007-01-01

Classic metaphyseal lesion (CML) is the term given to a fracture that most often occurs in the posteromedial aspect of the distal femur, proximal tibia, distal tibia, and proximal humerus in infants; this finding is strongly associated with non-accidental injury. To demonstrate that the CML may occur following simple lower segment caesarean section (LSCS). A review of 22 years of an obstetric practice that delivers 8,500 babies per year. We identified three neonates born by elective LSCS, each with distal femoral metaphyseal fractures on postpartum radiographs. All caesarean sections were elective and uncomplicated. External cephalic version was not employed preoperatively. Postpartum radiographs demonstrated a fracture of the distal femoral metaphysis in each neonate, typical of a CML. We propose that a CML can occur in the setting of a simple, elective and uncomplicated LSCS where no external cephalic version is employed. (orig.)

Proximal Humerus

NARCIS (Netherlands)

Diercks, Ron L.; Bain, Gregory; Itoi, Eiji; Di Giacomo, Giovanni; Sugaya, Hiroyuki

2015-01-01

This chapter describes the bony structures of the proximal humerus. The proximal humerus is often regarded as consisting of four parts, which assists in understanding function and, more specially, describes the essential parts in reconstruction after fracture or in joint replacement. These are the

Imaging of rectus femoris proximal tendinopathies

Energy Technology Data Exchange (ETDEWEB)

Pesquer, Lionel; Poussange, Nicolas; Meyer, Philippe; Dallaudiere, Benjamin; Feldis, Matthieu [Clinique du Sport de Bordeaux, Centre d' Imagerie Osteo-articulaire, Merignac (France); Sonnery-Cottet, Bertrand [Groupe Ramsay Generale de Sante - Hopital Prive Jean Mermoz, Centre Orthopedique Santy, Lyon (France); Graveleau, Nicolas [Clinique du Sport de Bordeaux, Centre de Chirurgie Orthopedique et Sportive, Merignac (France)

2016-07-15

The rectus femoris is the most commonly injured muscle of the anterior thigh among athletes, especially soccer players. Although the injury pattern of the muscle belly is well documented, less is known about the anatomy and specific lesions of the proximal tendons. For each head, three distinctive patterns may be encountered according to the location of the injury, which can be at the enthesis, within the tendon, or at the musculotendinous junction. In children, injuries correspond most commonly to avulsion of the anteroinferior iliac spine from the direct head and can lead to subspine impingement. Calcific tendinitis and traumatic tears may be encountered in adults. Recent studies have shown that traumatic injuries of the indirect head may be underdiagnosed and that injuries of both heads may have a surgical issue. Finally, in the case of tears, functional outcome and treatment may vary if the rupture involves one or both tendons and if the tear is partial or complete. Thus, it is mandatory for the radiologist to know the different ultrasound and magnetic resonance imaging (MRI) patterns of these lesions in order to provide accurate diagnosis and treatment. The purpose of this article is to recall the anatomy of the two heads of rectus femoris, describe a reliable method of assessment with ultrasound and MRI and know the main injury patterns, through our own experience and literature review. (orig.)

Imaging of rectus femoris proximal tendinopathies

International Nuclear Information System (INIS)

Pesquer, Lionel; Poussange, Nicolas; Meyer, Philippe; Dallaudiere, Benjamin; Feldis, Matthieu; Sonnery-Cottet, Bertrand; Graveleau, Nicolas

2016-01-01

The rectus femoris is the most commonly injured muscle of the anterior thigh among athletes, especially soccer players. Although the injury pattern of the muscle belly is well documented, less is known about the anatomy and specific lesions of the proximal tendons. For each head, three distinctive patterns may be encountered according to the location of the injury, which can be at the enthesis, within the tendon, or at the musculotendinous junction. In children, injuries correspond most commonly to avulsion of the anteroinferior iliac spine from the direct head and can lead to subspine impingement. Calcific tendinitis and traumatic tears may be encountered in adults. Recent studies have shown that traumatic injuries of the indirect head may be underdiagnosed and that injuries of both heads may have a surgical issue. Finally, in the case of tears, functional outcome and treatment may vary if the rupture involves one or both tendons and if the tear is partial or complete. Thus, it is mandatory for the radiologist to know the different ultrasound and magnetic resonance imaging (MRI) patterns of these lesions in order to provide accurate diagnosis and treatment. The purpose of this article is to recall the anatomy of the two heads of rectus femoris, describe a reliable method of assessment with ultrasound and MRI and know the main injury patterns, through our own experience and literature review. (orig.)

Heritability and prevalence of selected osteochondrosis lesions in yearling Thoroughbred horses.

Science.gov (United States)

Russell, J; Matika, O; Russell, T; Reardon, R J M

2017-05-01

Osteochondrosis is considered multifactorial in origin, with factors such as nutrition, conformation, body size, trauma and genetics thought to contribute to its pathogenesis. Few studies have investigated the effects of genetic variability of osteochondrosis in Thoroughbreds. To describe the prevalence and genetic variability of a subset of osteochondrosis lesions in a group of Thoroughbred yearlings. Retrospective cohort study. Radiographs of 1962 Thoroughbred yearlings were retrieved from clinical records obtained between 2005 and 2013. Pedigree information was obtained from the Australian Stud Book. Osteochondrosis lesions were documented in selected joints and estimates of heritability were obtained by fitting linear mixed models in ASREML software. The overall prevalence of osteochondrosis was 23%. Osteochondrosis was identified in 10% of stifle joints, 6% of hock joints and 8% of fetlock joints. The heritability estimates ranged from 0 to 0.21. The largest estimates were 0.10, 0.14, 0.16 and 0.21 for lesions of the distal intermediate ridge of the tibia, dorso-proximal proximal phalanx (P1), any stifle osteochondrosis, and lesions of the lateral trochlear ridge of the distal femur, respectively. Although calculated heritability estimates had high standard errors, meta-analyses combining the present results with published estimates were significant at 0.10, 0.17, 0.15 and 0.20 for stifle, tarsal, fetlock and these joints combined, respectively. In addition, there was a permanent environment attributable to the dam effect. Inclusion criteria were based on radiographic findings in specific joints at a specific age range in Thoroughbreds. The present results indicate that only a proportion of osteochondrosis in Thoroughbreds is heritable. The permanent environment effects of the dam were observed to have effects on some categories of osteochondrosis. © 2016 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.

A study of tooth brushing pattern and its effects on dental tissues in ...

African Journals Online (AJOL)

The prevalence of non carious cervical lesion was 3% and these lesions were found in males only. Conclusion: The pattern of tooth brushing was correct in 51.7% of the respondents as reported. However the effect on dental tissues though present is not exaggerated when compared to other studies done in other parts of ...

Comparison of the Level of Substance P and Neurokinin A in Gingival Crevicular Fluid of Sound and Symptomatic Carious Primary Teeth by ELISA

Directory of Open Access Journals (Sweden)

Alireza Heidari

2017-10-01

Full Text Available Objectives: Pulpal inflammation is often associated with odontogenic pain. Dental pulp is abundantly innervated with sensory fibers encompassing neuropeptides. Neurokinin A (NKA and substance P (SP are important neuropeptides in the dental pulp that can cause neurogenic inflammation. Since no previous study has assessed dental pulp neuropeptides in children, this study aimed to compare the level of NKA and SP in gingival crevicular fluid (GCF of sound and symptomatic carious primary teeth.Materials and Methods: Samples of GCF were obtained of 20 sound and 20 painful carious primary teeth. Enzyme-linked immunosorbent assay (ELISA was used to quantify neuropeptides in GCF. Data were analyzed using paired t-test, ANOVA, Kolmogorov-Smirnov test and correlation coefficient test.Results: A significant difference was noted in the level of NKA in GCF of painful and sound teeth (2.23 pg/ml in painful, and 1.84 pg/ml in sound teeth, P<0.05. The difference between the two groups regarding SP was not significant (2.23 pg/ml in painful, and 2.02 pg/ml in sound teeth, P>0.05.Conclusions: The results showed that the level of NKA and SP was higher in GCF of painful teeth compared to that of sound teeth. This difference was statistically significant with regard to NKA. Thus, these neuropeptides can serve as indicators for pathological activities in teeth with symptomatic irreversible pulpitis.

Minimal Intervention Dentistry (MID) for managing dental caries – a review

Science.gov (United States)

Frencken, Jo E.; Peters, Mathilde C.; Manton, David J.; Leal, Soraya C.; Gordan, Valeria V.; Eden, Ece

2012-01-01

This publication describes the history of Minimal Intervention Dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non-restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow-up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the ‘surgical’ care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI’s policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing. PMID:23106836

Proximal Tubular Injury in Medullary Rays Is an Early Sign of Acute Tacrolimus Nephrotoxicity

Directory of Open Access Journals (Sweden)

Diane Cosner

2015-01-01

Full Text Available Tacrolimus (FK506 is one of the principal immunosuppressive agents used after solid organ transplantations to prevent allograft rejection. Chronic renal injury induced by tacrolimus is characterized by linear fibrosis in the medullary rays; however, the early morphologic findings of acute tacrolimus nephrotoxicity are not well characterized. Kidney injury molecule-1 (KIM-1 is a specific injury biomarker that has been proven to be useful in the diagnosis of mild to severe acute tubular injury on renal biopsies. This study was motivated by a patient with acute kidney injury associated with elevated serum tacrolimus levels in whom KIM-1 staining was present only in proximal tubules located in the medullary rays in the setting of otherwise normal light, immunofluorescent, and electron microscopy. We subsequently evaluated KIM-1 expression in 45 protocol and 39 indicated renal transplant biopsies to determine whether higher serum levels of tacrolimus were associated with acute segment specific injury to the proximal tubule, as reflected by KIM-1 staining in the proximal tubules of the cortical medullary rays. The data suggest that tacrolimus toxicity preferentially affects proximal tubules in medullary rays and that this targeted injury is a precursor lesion for the linear fibrosis seen in chronic tacrolimus toxicity.

Role of dental restoration materials in oral mucosal lichenoid lesions

Directory of Open Access Journals (Sweden)

Rajneesh Sharma

2015-01-01

Full Text Available Background: Dental restorative materials containing silver-mercury compounds have been known to induce oral lichenoid lesions. Objectives: To determine the frequency of contact allergy to dental restoration materials in patients with oral lichenoid lesions and to study the effect of removal of the materials on the lesions. Results: Forty-five patients were recruited in three groups of 15 each: Group A (lesions in close contact with dental materials, Group B (lesions extending 1 cm beyond the area of contact and Group C (no topographic relationship. Thirty controls were recruited in two groups of 15 individuals each: Group D (oral lichenoid lesions but no dental material and Group E (dental material but no oral lichenoid lesions. Patch tests were positive in 20 (44.5% patients. Mercury was the most common allergen to elicit a positive reaction in eight patients, followed by nickel (7, palladium (5, potassium dichromate (3, balsam of Peru, gold sodium thiosulphate 2 and tinuvin (2 and eugenol (1, cobalt chloride (1 and carvone (1. Seven patients elicited positive response to more than one allergen. In 13 of 20 patients who consented to removal of the dental material, complete healing was observed in 6 (30%, marked improvement in 7 (35% and no improvement in 7 (35% patients. Relief of symptoms was usually observed 3 months after removal. Limitations: Limited number of study subjects and short follow up after removal/replacement of dental restoration materials are the main limitations of this study. Conclusion: Contact allergy to amalgam is an important etiologic factor in oral lichenoid lesions and removal of restorative material should be offered to patients who have lesions in close proximity to the dental material.

Short frontal plane fractures involving the dorsoproximal articular surface of the proximal phalanx: Description of the injury and a technique for repair.

Science.gov (United States)

Wright, I M; Minshall, G J

2018-01-01

Chip fractures of the dorsoproximal articular margin of the proximal phalanx are common injuries in racehorses. Large fractures can extend distal to the joint capsule insertion and have been described as dorsal frontal fractures. To report the location and morphology of short frontal plane fractures involving the dorsoproximal articular surface of the proximal phalanx and describe a technique for repair under arthroscopic and radiographic guidance. Single centre retrospective case study. Case records of horses with frontal plane fractures restricted to the dorsoproximal epiphysis and metaphysis of the proximal phalanx referred to Newmarket Equine Hospital were retrieved, images reviewed and lesion morphology described. A technique for repair and the results obtained are reported. A total of 22 fractures in 21 horses commencing at the proximal articular surface exited the dorsal cortex of the proximal phalanx distal to the metacarpophalangeal/metatarsophalangeal joint capsule in 17 hind- and five forelimbs. All were in Thoroughbred racehorses. In 16 cases these were acute racing or training injuries; 20 fractures were medial, one lateral and one was midline. All were repaired with a single lag screw using arthroscopic and radiographically determined landmarks. A total of 16 horses raced after surgery with performance data similar to their preinjury levels. The study demonstrates substantial morphological similarities between individual lesions supporting a common pathophysiology, but does not identify precise causation. There are no cases managed differently that might permit assessment of the comparative efficacy of the treatment described. Short frontal plane fractures involving the dorsoproximal margin of the proximal phalanx that exit the bone distal to the metacarpophalangeal/metatarsophalangeal joint capsule have substantial morphological similarities, are amenable to minimally invasive repair and carry a good prognosis for return to training and racing. �

Early diagnosis of incipient caries based on non-invasive lasers

Science.gov (United States)

Velescu, A.; Todea, C.; Vitez, B.

2016-03-01

AIM: The aim of this study is to detect incipient caries and enamel demineralization using laser fluorescence.This serves only as an auxilary aid to identify and to monitor the development of these lesions. MATERIALS AND METHODS: 6 patients were involved in this study, three females and three male. Each patient underwent a professional cleaning, visual examination of the oral cavity, and then direct inspection using DiagnoCam and DIAGNOdent. After data recording each patient was submitted to retro-alveolar X-ray on teeth that were detected with enamel lesions. All data was collected and analyzed statistically. RESULTS: Of 36 areas considered in clinically healthy, 24 carious surfaces were found using laser fluorescence, a totally non-invasive method for detecting incipient carious lesions compared with the radiographic examination. CONCLUSIONS: This method has good applicability for patients because it improves treatment plan by early detection of caries and involves less fear for anxious patients and children.

The MRI appearance of cystic lesions around the knee

International Nuclear Information System (INIS)

McCarthy, Catherine L.; McNally, Eugene G.

2004-01-01

This review presents a comprehensive illustrated overview of the wide variety of cystic lesions around the knee. The aetiology, clinical presentation, MRI appearances and differential diagnosis are discussed. Bursae include those related to the patella as well as pes anserine, tibial collateral ligament, semimembranosus-tibial collateral ligament, iliotibial and fibular collateral ligament-biceps femoris. The anatomical extension, imaging features and clinical significance of meniscal cysts are illustrated. Review of ganglia includes intra-articular, extra-articular, intraosseous and periosteal ganglia, highlighting imaging findings and differential diagnoses. The relationship between proximal tibiofibular joint cysts and intraneural peroneal nerve ganglia is discussed. Intraosseous cystic lesions, including insertional and degenerative cysts, as well as lesions mimicking cysts of the knee are described and illustrated. Knowledge of the location, characteristic appearance and distinguishing features of cystic masses around the knee as well as potential imaging pitfalls such as normal anatomical recesses and atypical cyst contents on MR imaging aids in allowing a specific diagnosis to be made. This will prevent unnecessary additional investigations and determine whether intra-articular surgery or conservative management is appropriate. (orig.)

After facial nerve damage, regenerating axons become aberrant throughout the length of the nerve and not only at the site of the lesion: an experimental study.

Science.gov (United States)

Choi, D; Raisman, G

2004-02-01

After facial nerve trauma, aberrant regeneration is associated with synkinesis. Animal models of mechanical nerve guides or reparative cell transplants at the site of a lesion have not been shown to improve disorganized regeneration. We examined whether this is because regenerating axons become disorganized throughout the length of the nerve and not only at the site of the lesion. In rats (n = 12), retrograde fluorescent tracer techniques were used to establish that most of the temporal branch fibres were carried in the superior half of the facial nerve trunk. In two further groups of rats (n = 24) a complete proximal facial nerve lesion was made, and the nerve immediately repaired by suture. After 4 weeks, at a second operation, the superior half of the facial nerve trunk was cut, either proximal or distal to the original lesion, and retrograde tracers were applied to distal branches of the nerve. It was possible to localize the points at which regenerating fibres became aberrant in their course by studying the number of labelled motoneurons in the facial nucleus after application of the tracer to the temporal branch of the nerve: this was similar in the distal and proximal hemisection groups, suggesting that aberrant axonal development occurred throughout the length of the nerve. Future strategies aimed at improving the organization of regeneration need to provide guidance cues not only at the site of the lesion as previously thought, but also throughout the length of the nerve.

Muscle magnetic resonance imaging sensitivity does not decrease in chronic, mild, or proximal lower limb neuropathies.

Science.gov (United States)

Deroide, Nicolas; Bousson, Valérie; Daguet, Edouard; Dumurgier, Julien; Tin, Sophie Ng Wing; Hannouche, Didier; Richette, Pascal; Beaudreuil, Johann; Lioté, Frédéric; Lévy, Bernard; Vicaut, Eric; Laredo, Jean Denis; Kubis, Nathalie

2012-05-01

Muscle magnetic resonance imaging (MRI) is an innovative tool for exploring focal neuropathies. However, its usefulness in mild, proximal, or chronic lesions, when electromyography (EMG), the current "gold standard" sensitivity is inadequate, has yet to be studied. Clinical, MRI, and EMG examinations were performed in 113 muscles of 17 consecutive patients with clinically diagnosed lower limb focal neuropathies. The sensitivity and specificity of MRI and EMG were evaluated in relation to disease duration, severity, and anatomical location. Muscle MRI was highly sensitive for the detection of denervated muscle, and, unlike EMG, its sensitivity did not decrease regardless of the anatomical location, duration, or severity of the neuropathy. Five MRI false positives were noted, including three in the thigh muscles. Muscle MRI is an alternative tool to EMG in proximal, mild, or chronic clinical diagnoses of lower limb focal neuropathies. However, it also seems prone to false-positive results, particularly in proximal muscles. Copyright © 2012 Wiley Periodicals, Inc.

Nigerian Journal of Clinical Practice - Vol 20, No 5 (2017)

African Journals Online (AJOL)

Surgical difficulties, success, and complication rates of orthodontic miniplate ... Early pregnancy plasminogen activator inhibitor-1 levels in Nigerian women and its ... of deep carious lesions · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

Effect of Deproteinization Before and after Acid Etching on the ...

African Journals Online (AJOL)

2018-05-22

May 22, 2018 ... 2018 Nigerian Journal of Clinical Practice | Published by Wolters Kluwer ‑ Medknow. Objective: .... resin in artificial enamel carious lesions was evaluated after using ... glass ionomer cement concluded that 10% papain gel.

Incidental Radiographic Discovery of a Screw in a Primary Molar: An Unusual Case Report in a 6 Year Old Child

Directory of Open Access Journals (Sweden)

Farhin Katge

2013-01-01

Full Text Available Dentists often find foreign bodies in the primary dentition of children who habitually place objects in their mouths. The objects are frequently embedded in exposures that result from carious or traumatic lesions or from endodontic procedures that have been left open for drainage. Such bodies are often detected on routine radiographs and, less frequently, during clinical examination. We report a case of a 6-year-old boy who had inadvertently embedded a screw in his mandibular right first primary molar and had forgotten about it until it became symptomatic. The screw was impacted in the exposed pulp chamber due to a large carious lesion in the affected molar. This case report considers the possible medical and dental consequences of placing foreign bodies in the mouth.

Effect of mineral trioxide aggregate and formocresol pulpotomy on ...

African Journals Online (AJOL)

2014-09-16

Sep 16, 2014 ... ... and Methods: Fifty primary molars, with deep carious lesion that exposed a vital but asymptomatic pulp, .... and/or periapical bone destruction or pulp stones. ... following: A normal periodontal ligament space, no furcation.

Incomplete longitudinal fracture of the proximal palmar cortex of the third metacarpal bone in horses

International Nuclear Information System (INIS)

Ross, M.W.; Ford, T.S.; Orsini, P.G.

1988-01-01

Seven horses, 2 to 4 years of age, were examined because of moderate-to-severe forelimb lameness, mild effusion of the middle carpal joint (3 horses), and pain on palpation of the origin of the suspensory ligament (4 horses). The lameness was abolished by anesthetic infiltration of the middle carpal joint in six horses. In four of them, a high palmar nerve block also abolished the lameness. A linear radiolucency in the proximal end of the third metacarpal bone (McIII) was interpreted as an incomplete longitudinal fracture. In one horse, distinct intramedullary sclerosis limited to the palmar cortex was indicative of an incomplete fracture confined to the palmar cortex. No osteoproliferative lesions were identified on the dorsal cortex of any of the horses. Surgical treatment with cortical screws in lag fashion accompanied by a rest period was successful in one horse. In four horses, rest for at least 3 months resulted in clinical soundness. In two horses, a shorter rest period resulted in recurrence of the lameness even though the horses were sound when put back into training. Careful clinical and radiographic examinations helped differentiate incomplete longitudinal fractures from lesions involving the carpus and proximal aspect of the suspensory ligament

Actinomyces spp. gene expression in root caries lesions

Directory of Open Access Journals (Sweden)

Naile Dame-Teixeira

2016-09-01

Full Text Available Background: The studies of the distribution of Actinomyces spp. on carious and non-carious root surfaces have not been able to confirm the association of these bacteria with root caries, although they were extensively implicated as a prime suspect in root caries. Objective: The aim of this study was to observe the gene expression of Actinomyces spp. in the microbiota of root surfaces with and without caries. Design: The oral biofilms from exposed sound root surface (SRS; n=10 and active root caries (RC; n=30 samples were collected. The total bacterial RNA was extracted, and the mRNA was isolated. Samples with low RNA concentration were pooled, yielding a final sample size of SRS=10 and RC=9. Complementary DNA (cDNA libraries were prepared and sequenced on an Illumina® HiSeq 2500 system. Sequence reads were mapped to eight Actinomyces genomes. Count data were normalized using DESeq2 to analyse differential gene expression applying the Benjamini-Hochberg correction (false discovery rate [FDR]0.05, except for Actinomyces OT178 (p=0.001 and Actinomyces gerencseriae (p=0.004, which had higher read counts in the SRS. Genes that code for stress proteins (clp, dnaK, and groEL, enzymes of glycolysis pathways (including enolase and phosphoenolpyruvate carboxykinase, adhesion (Type-2 fimbrial and collagen-binding protein, and cell growth (EF-Tu were highly – but not differentially (p>0.001 – expressed in both groups. Genes with the most significant upregulation in RC were those coding for hypothetical proteins and uracil DNA glycosylase (p=2.61E-17. The gene with the most significant upregulation in SRS was a peptide ABC transporter substrate-binding protein (log2FC=−6.00, FDR=2.37E-05. Conclusion: There were similar levels of Actinomyces gene expression in both sound and carious root biofilms. These bacteria can be commensal in root surface sites but may be cariogenic due to survival mechanisms that allow them to exist in acid environments and

The Efficacy of the Coaxial Technique Using a 6-Fr Introducer Sheath in Stent Placement for Treating the Obstructions Proximal to the Descending Colon

Energy Technology Data Exchange (ETDEWEB)

Chang, Il Soo; Park, Sang Woo; Hwang, Dae Yong; Seong, Moo Kyung; Joh, Hee Kyung; Yoon, So Young; Cho, Yo Han; Choe, Won Hyeok [Konkuk University Hospital, Seoul (Korea, Republic of)

2011-02-15

We wanted to evaluate the efficacy of stent placement using the coaxial technique with a stiff, long introducer sheath in patients with technical failure using an angiographic catheter for the obstructions proximal to the descending colon. Self-expandable metallic stent placement was attempted under fluoroscopy-guidance in 77 consecutive patients who had malignant colorectal obstruction. Stent placement was performed using an angiographic catheter and a guide wire. If the angiographic catheter could not be advanced over the guide wire into the obstructive lesions proximal to the descending colon, then a 6-Fr introducer sheath was used. The technical success rate, the clinical success rate and the complications were analyzed. Successful stent placement was achieved in 75 of 77 patients (97%). The angiographic catheter failed to advance into the obstructive lesions of 11 patients (M:F = 7:4: mean age, 65.5 years) whose lesions were at the level of the splenic flexure or transverse colon. Therefore, the coaxial technique was implemented in all these 11 patients using a 6-Fr stiff introducer sheath and then the stent placement was successful. There were no complications related to the use of a stiff introducer sheath. Clinical success, which was defined as relief of clinical obstructive bowel symptoms, was obtained within 24 hours in all of patients. The coaxial technique using a stiff introducer sheath can increase the technical success of fluoroscopy-guided, self-expandable metallic stent placement in patients with colonic obstruction proximal to the descending colon

The Efficacy of the Coaxial Technique Using a 6-Fr Introducer Sheath in Stent Placement for Treating the Obstructions Proximal to the Descending Colon

International Nuclear Information System (INIS)

Chang, Il Soo; Park, Sang Woo; Hwang, Dae Yong; Seong, Moo Kyung; Joh, Hee Kyung; Yoon, So Young; Cho, Yo Han; Choe, Won Hyeok

2011-01-01

We wanted to evaluate the efficacy of stent placement using the coaxial technique with a stiff, long introducer sheath in patients with technical failure using an angiographic catheter for the obstructions proximal to the descending colon. Self-expandable metallic stent placement was attempted under fluoroscopy-guidance in 77 consecutive patients who had malignant colorectal obstruction. Stent placement was performed using an angiographic catheter and a guide wire. If the angiographic catheter could not be advanced over the guide wire into the obstructive lesions proximal to the descending colon, then a 6-Fr introducer sheath was used. The technical success rate, the clinical success rate and the complications were analyzed. Successful stent placement was achieved in 75 of 77 patients (97%). The angiographic catheter failed to advance into the obstructive lesions of 11 patients (M:F = 7:4: mean age, 65.5 years) whose lesions were at the level of the splenic flexure or transverse colon. Therefore, the coaxial technique was implemented in all these 11 patients using a 6-Fr stiff introducer sheath and then the stent placement was successful. There were no complications related to the use of a stiff introducer sheath. Clinical success, which was defined as relief of clinical obstructive bowel symptoms, was obtained within 24 hours in all of patients. The coaxial technique using a stiff introducer sheath can increase the technical success of fluoroscopy-guided, self-expandable metallic stent placement in patients with colonic obstruction proximal to the descending colon

Atraumatic Restorative Treatment compared to the Hall Technique for occluso-proximal cavities in primary molars : study protocol for a randomized controlled trial

NARCIS (Netherlands)

Hesse, D.; Pinheiro de Araujo, M.; Olegário, I.C.; Innes, N.; Prócida Raggio, D.; Calil Bonifácio, C.

2016-01-01

Background: In many parts of the world, school-age children have high dental treatment needs; however, there is often low, or no, dental care provision. Although Atraumatic Restorative Treatment (ART) was developed to address this, its survival rate in occluso-proximal lesions is low. An

Rate of detection of advanced neoplasms in proximal colon by simulated sigmoidoscopy vs fecal immunochemical tests.

Science.gov (United States)

Castells, Antoni; Quintero, Enrique; Álvarez, Cristina; Bujanda, Luis; Cubiella, Joaquín; Salas, Dolores; Lanas, Angel; Carballo, Fernando; Morillas, Juan Diego; Hernández, Cristina; Jover, Rodrigo; Hijona, Elizabeth; Portillo, Isabel; Enríquez-Navascués, José M; Hernández, Vicent; Martínez-Turnes, Alfonso; Menéndez-Villalva, Carlos; González-Mao, Carmen; Sala, Teresa; Ponce, Marta; Andrés, Mercedes; Teruel, Gloria; Peris, Antonio; Sopeña, Federico; González-Rubio, Francisca; Seoane-Urgorri, Agustín; Grau, Jaume; Serradesanferm, Anna; Pozo, Àngels; Pellisé, Maria; Balaguer, Francesc; Ono, Akiko; Cruzado, José; Pérez-Riquelme, Francisco; Alonso-Abreu, Inmaculada; Carrillo-Palau, Marta; de la Vega-Prieto, Mariola; Iglesias, Rosario; Amador, Javier; Blanco, José Manuel; Sastre, Rocio; Ferrándiz, Juan; González-Hernández, Ma José; Andreu, Montserrat; Bessa, Xavier

2014-10-01

We compared the ability of biennial fecal immunochemical testing (FIT) and one-time sigmoidoscopy to detect colon side-specific advanced neoplasms in a population-based, multicenter, nationwide, randomized controlled trial. We identified asymptomatic men and women, 50-69 years old, through community health registries and randomly assigned them to groups that received a single colonoscopy examination or biennial FIT. Sigmoidoscopy yield was simulated from results obtained from the colonoscopy group, according to the criteria proposed in the UK Flexible Sigmoidoscopy Trial for colonoscopy referral. Patients who underwent FIT and were found to have ≥75 ng hemoglobin/mL were referred for colonoscopy. Data were analyzed from 5059 subjects in the colonoscopy group and 10,507 in the FIT group. The main outcome was rate of detection of any advanced neoplasm proximal to the splenic flexure. Advanced neoplasms were detected in 317 subjects (6.3%) in the sigmoidoscopy simulation group compared with 288 (2.7%) in the FIT group (odds ratio for sigmoidoscopy, 2.29; 95% confidence interval, 1.93-2.70; P = .0001). Sigmoidoscopy also detected advanced distal neoplasia in a higher percentage of patients than FIT (odds ratio, 2.61; 95% confidence interval, 2.20-3.10; P = .0001). The methods did not differ significantly in identifying patients with advanced proximal neoplasms (odds ratio, 1.17; 95% confidence interval, 0.78-1.76; P = .44). This was probably due to the lower performance of both strategies in detecting patients with proximal lesions (sigmoidoscopy detected these in 19.1% of patients and FIT in 14.9% of patients) vs distal ones (sigmoidoscopy detected these in 86.8% of patients and FIT in 33.5% of patients). Sigmoidoscopy, but not FIT, detected proximal lesions in lower percentages of women (especially those 50-59 years old) than men. Sigmoidoscopy and FIT have similar limitations in detecting advanced proximal neoplasms, which depend on patients' characteristics

Transillumination and HDR Imaging for Proximal Caries Detection.

Science.gov (United States)

Lederer, A; Kunzelmann, K H; Hickel, R; Litzenburger, F

2018-02-01

The purpose was to develop an in vitro model for the validation of near-infrared transillumination (NIRT) for proximal caries detection, to enhance NIRT with high-dynamic-range imaging (HDRI), and to compare both methods, using micro-computed tomography (µCT) as a reference standard. Both proximal surfaces of 53 healthy or decayed permanent human teeth were examined using the Diagnocam (DC) (KaVo) and NIRT with HDRI (NIRT-HDRI). NIRT was combined with HDRI to improve the diagnostic performance by reducing under- and overexposed image areas. For NIRT-HDRI, an exposure series was captured and merged into a single HDR image. A classification was applied according to lesion depth. All surfaces were assessed twice by 2 trained examiners, and additionally with µCT for validation. The Kappa statistic was used to calculate inter-rater reliability and agreement between DC and NIRT-HDRI. Inter-rater reliability (weighted Kappa, wκ) showed very good agreement for the DC (0.90) and NIRT-HDRI (0.96). The overall agreement (wκ) was almost perfect (0.85). In the individual categories (0 to 4), the agreement (simple Kappa) ranged from almost perfect (category 4) to moderate (1 and 2) to substantial (categories 0 and 3). Sensitivity and specificity of sound surfaces, enamel, and dentin caries ranged from 0.57 to 0.99 and were similar for both methods in the different categories. NIRT-HDRI had a higher sensitivity for sound surfaces and enamel caries, as well as a higher specificity for dentin caries. Regarding the obtained images, HDRI allowed for the detection of caries within a greater range of luminance levels, resulting in a more detailed visualization of structures without under- or overexposure. However, HDRI this did not improve the diagnostics significantly. Distinguishing between a processed demineralized enamel and dentin lesions appears to be a problem specific to NIRT and cannot be balanced using HDRI.

DENTINE CARIES: ACID-TOLERANT MICROORGANISMS AND ASPECTS ON COLLAGEN DEGRADATION.

Science.gov (United States)

Lager, Anders Hedenbjörk

2014-01-01

Dental caries is a common disease all over the world, despite the fact that it can be both effectively prevented and treated. It is driven by acids produced by oral microorganisms as a consequence of their metabolism of dietary carbohydrates. Given enough acid challenge, eventually the tooth enamel barrier will be broken down, and the carious lesion will extend into underlying hard tissue, forming a macroscopic cavity in the dentine. In comparison to biofilm on enamel, a dentine carious lesion provides a vastly different environment for the residing microorganisms. The environment influences the types and numbers of microorganisms that can colonize the dentine caries lesion. The overall aims for this thesis are to enumerate and further study microorganisms found in established dentine caries lesions and also to illuminate how host-derived proteolytic enzymes might contribute to this degradation, not only to better understand the caries process in dentine but also to find incitements for new methods to influence the natural progression of caries lesions. In Paper I, the numbers of remaining viable microorganisms after completed excavation using two excavation methods were investigated. Samples of carious dentine tissue were collected before and after excavation and cultivated on different agar media in different atmospheres. Analysis was performed by counting the number of colony-forming units (CFUs). Key findings: The number of remaining microorganisms after excavation was low for both methods, but some microorganisms always remained in the cavity floors even when the cavities were judged as caries free using normal clinical criteria. In Paper II, the acid tolerant microbiota in established dentine caries lesions was investigated. Samples were taken as in Paper I, but on three levels (superficial, center of lesion, floor of lesion after completed excavation). The samples were cultivated in anaerobic conditions on solid pH-selective agar media of different acidity

Partial lesions of the intratemporal segment of the facial nerve: graft versus partial reconstruction.

Science.gov (United States)

Bento, Ricardo F; Salomone, Raquel; Brito, Rubens; Tsuji, Robinson K; Hausen, Mariana

2008-09-01

In cases of partial lesions of the intratemporal segment of the facial nerve, should the surgeon perform an intraoperative partial reconstruction, or partially remove the injured segment and place a graft? We present results from partial lesion reconstruction on the intratemporal segment of the facial nerve. A retrospective study on 42 patients who presented partial lesions on the intratemporal segment of the facial nerve was performed between 1988 and 2005. The patients were divided into 3 groups based on the procedure used: interposition of the partial graft on the injured area of the nerve (group 1; 12 patients); keeping the preserved part and performing tubulization (group 2; 8 patients); and dividing the parts of the injured nerve (proximal and distal) and placing a total graft of the sural nerve (group 3; 22 patients). Fracture of the temporal bone was the most frequent cause of the lesion in all groups, followed by iatrogenic causes (p lesion of the facial nerve is still questionable. Among these 42 patients, the best results were those from the total graft of the facial nerve.

Download this PDF file

African Journals Online (AJOL)

mwakagugu

2011-11-08

Nov 8, 2011 ... participated in the study by being interviewed on their oral health care seeking behaviour. Results: Seventy nine ... was advanced carious lesions that had destroyed most ... of shorter treatment time and less material used for.

Accurate determination of high-risk coronary lesion type by multidetector cardiac computed tomography.

Science.gov (United States)

Alasnag, Mirvat; Umakanthan, Branavan; Foster, Gary P

2008-07-01

Coronary arteriography (CA) is the standard method to image coronary lesions. Multidetector cardiac computerized tomography (MDCT) provides high-resolution images of coronary arteries, allowing a noninvasive alternative to determine lesion type. To date, no studies have assessed the ability of MDCT to categorize coronary lesion types. The objective of this study was to determine the accuracy of lesion type categorization by MDCT using CA as a reference standard. Patients who underwent both MDCT and CA within 2 months of each other were enrolled. MDCT and CA images were reviewed in a blinded fashion. Lesions were categorized according to the SCAI classification system (Types I-IV). The origin, proximal and middle segments of the major arteries were analyzed. Each segment comprised a data point for comparison. Analysis was performed using the Spearman Correlation Test. Four hundred eleven segments were studied, of which 110 had lesions. The lesion distribution was as follows: 35 left anterior descending (LAD), 29 circumflex (Cx), 31 right coronary artery (RCA), 2 ramus intermedius, 8 diagonal, 4 obtuse marginal and 2 left internal mammary arteries. Correlations between MDCT and CA were significant in all major vessels (LAD, Cx, RCA) (p < 0.001). The overall correlation coefficient was 0.67. Concordance was strong for lesion Types II-IV (97%) and poor for Type I (30%). High-risk coronary lesion types can be accurately categorized by MDCT. This ability may allow MDCT to play an important noninvasive role in the planning of coronary interventions.

Study of cloisonne kidney lesion frequency in slaughtered sheeps of Tabriz and Rashta slaughterhouse

Directory of Open Access Journals (Sweden)

A Khaki

2016-07-01

Full Text Available Cloisonne kidney is an accidental finding of the kidneys observed in abattoir. The lesion caused by the thickening of the proximal and sometimes distal convoluted tubules basement membranes due to iron pigmentation is so far reported in goats, sheep and horses. Renal cortex is brown but the condition does not involve the medulla. The lesion brings about no impairment of the renal normal function and affected animals are clinically normal. Although the exact cause of this condition remains unknown but intravascular hemolysis is considered to have a role. The following study was undertaken to determine sheep cloisonne kidney frequency rate in Tabriz and Rasht abattoir. A number of 10000 sheep carcasses in Rasht slaughterhouse and 8600 carcasses in Tabriz slaughterhouse were randomly examined and tissue samples were stained with H&E. Only eleven cases were diagnosed with the cloisonne kidney lesion. Thus the frequency rate of the lesion was estimated at 0.059% in sheep of these cities.

Quantitative analysis of diverse Lactobacillus species present in advanced dental caries.

Science.gov (United States)

Byun, Roy; Nadkarni, Mangala A; Chhour, Kim-Ly; Martin, F Elizabeth; Jacques, Nicholas A; Hunter, Neil

2004-07-01

Our previous analysis of 65 advanced dental caries lesions by traditional culture techniques indicated that lactobacilli were numerous in the advancing front of the progressive lesion. Production of organic acids by lactobacilli is considered to be important in causing decalcification of the dentinal matrix. The present study was undertaken to define more precisely the diversity of lactobacilli found in this environment and to quantify the major species and phylotypes relative to total load of lactobacilli by real-time PCR. Pooled DNA was amplified by PCR with Lactobacillus genus-specific primers for subsequent cloning, sequencing, and phylogenetic analysis. Based on 16S ribosomal DNA sequence comparisons, 18 different phylotypes of lactobacilli were detected, including strong representation of both novel and gastrointestinal phylotypes. Specific PCR primers were designed for nine prominent species, including Lactobacillus gasseri, L. ultunensis, L. salivarius, L. rhamnosus, L. casei, L. crispatus, L. delbrueckii, L. fermentum, and L. gallinarum. More than three different species were identified as being present in most of the dentine samples, confirming the widespread distribution and numerical importance of various Lactobacillus spp. in carious dentine. Quantification by real-time PCR revealed various proportions of the nine species colonizing carious dentine, with higher mean loads of L. gasseri and L. ultunensis than of the other prevalent species. The findings provide a basis for further characterization of the pathogenicity of Lactobacillus spp. in the context of extension of the carious lesion.

Nail lesions as a main manifestation of lichen nitidus

Directory of Open Access Journals (Sweden)

Michał Sobjanek

2015-09-01

Full Text Available Introduction . Lichen nitidus (LN is a rare, chronic, inflammatory dermatosis usually affecting children and young adults. Nails involvement is very rare. Until now, 7 cases of LN with nail involvement have been described. Objective. To present a rare case of childhood lichen nitidus where trachyonychia was the main manifestation of the disease. Case report. A 7-year-old, Caucasian, previously healthy boy presented thumbnail longitudinal ridges, distal splitting and subungual hyperkeratosis for 7 months. Numerous mycological and bacteriological examinations were negative. Dermatological examination also revealed erythematous lesions on the proximal nail fold as well as small skin-pigmented papules on the thumb. Similar papules grouped into patches were also observed on the upper limbs, trunk and forehead. Treatment was not recommended. Conclusions . Lichen nitidus may rarely affect nails and should be considered as a possible cause of nail lesions in childhood.

Proximal Alternating Direction Method with Relaxed Proximal Parameters for the Least Squares Covariance Adjustment Problem

Directory of Open Access Journals (Sweden)

Minghua Xu

2014-01-01

Full Text Available We consider the problem of seeking a symmetric positive semidefinite matrix in a closed convex set to approximate a given matrix. This problem may arise in several areas of numerical linear algebra or come from finance industry or statistics and thus has many applications. For solving this class of matrix optimization problems, many methods have been proposed in the literature. The proximal alternating direction method is one of those methods which can be easily applied to solve these matrix optimization problems. Generally, the proximal parameters of the proximal alternating direction method are greater than zero. In this paper, we conclude that the restriction on the proximal parameters can be relaxed for solving this kind of matrix optimization problems. Numerical experiments also show that the proximal alternating direction method with the relaxed proximal parameters is convergent and generally has a better performance than the classical proximal alternating direction method.

Progressive tumefactive fibroinflammatory lesion of the infratemporal fossa treated by radiation therapy

Directory of Open Access Journals (Sweden)

Brian O’Sullivan

2012-01-01

Full Text Available Tumefactive fibroinflammatory lesion (TFIL is a rare benign tumor in the head and neck region. We present a case of a 40-year-old female with a benign but progressive lesion of the infratemporal fossa, which was diagnosed as TFIL. Patient responded briefly to a course of steroid treatment but eventually showed progression and was unresponsive to further steroids. She was then treated with external beam radiation to a dose of 60 Gy in 30 fractions. After radiation a slow, gradual decrease in tumor size was noted over the course of years and she is free of disease after more than 11 years of follow-up. The major longterm side effect this patient developed was an expected unilateral radiation-induced retinopathy, due to the close proximity of the lesion to the orbit. The dilemma of treatment of benign disease with radiation with potential long-term complications is discussed and a review of the literature on TFIL is presented.

Oral health and school performance in a group of schoolchildren from the Federal District, Brazil.

Science.gov (United States)

Almeida, Raquel Francis; Leal, Soraya Coelho; Medonca, Jordana Guedes Amorim; Hilgert, Leandro Augusto; Ribeiro, Ana Paula Dias

2018-05-12

To evaluate whether an association exists between school performance, quality of life, dental caries, and dental pain in children between 6 and 8 years of age. All 6- to 8-year-old children enrolled in the second year of the six public schools in Paranoá-FD were invited to participate in this cross-sectional study. In total, 374 consented. Dental caries was recorded according to the Caries Assessment Spectrum and Treatment (CAST) index by two trained examiners. Dental pain was assessed during clinical examination. The Child Perceptions Questionnaire (CPQ) was used to assess the oral health-related quality of life, and sociodemographic data were collected. The child's school performance was measured through Provinha Brasil according to the regulations of the Ministry of Education. Descriptive statistics, bivariate analysis, and a multivariate regression model were used for data analysis. 185 boys and 189 girls participants with a mean age of 7.2 (±0.5) years were included in the study. The prevalence of dentin carious lesions for this group was 40.6 and 49.2 percent, including enamel-only lesions. The prevalence of dental pain was 2.8 percent. A high performance in reading (63.6 percent) and in mathematics (79.4 percent) was observed and were not associated with the presence of cavitated dentin carious lesions or dental pain. A significant association was found between school performance and the final CPQ score. School performance as measured by the Provinha Brasil examination was not associated with carious lesions or dental pain. Students with lower school performance had higher CPQ scores. © 2018 American Association of Public Health Dentistry.

Development, characterization and comparison of two strontium doped nano hydroxyapatite molecules for enamel repair/regeneration.

Science.gov (United States)

Krishnan, Vinod; Bhatia, Ankit; Varma, Harikrishna

2016-05-01

Enamel damage resulting or arising from/associated with orthodontic treatment such as white spot lesions and surface deterioration after debonding brackets along with incipient carious lesions are considered problems not amenable for routine restorations due to its invasive nature. The present study was aimed at synthesizing and characterizing nHAp and 25 and 50 mol% strontium nHAp as a surface application modality for dental enamel remineralization/repair. 25 and 50 mol% Sr nHAp was synthesized and characterized in comparison with custom made pure nHAp initially with the help of transmission and scanning electron microscopy as well as toxicological assessment. Further, comparative evaluation of these novel synthesized strontium substituted particles was assessed for its efficacy in repairing damaged enamel with the help of atomic force microscopy, scanning electron microscopy and micro indentation testing. There is increase in crystallinity and reduced particle size favoring dissolution and re-precipitation through small incipient carious lesions and soft white spot areas with 25% Sr-nHAp. Sr doped specimens showed more cell viability in comparison with pure nHAP make it less cytotoxic and hence a biologically friendly material which can be safely applied in patient's mouth. AFM images obtained from 25% and 50% Sr nHAp treated specimens clearly indicated increased roughness in surface topography and performed well with micro indentation test. The novel synthesized Sr doped nHAp forms an improved treatment modality to tackle the long standing quest for solving the problem of enamel loss with incipient carious lesions and WSL from orthodontic procedures. Copyright © 2016 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Caries experience of Egyptian adolescents: does the atraumatic restorative treatment approach offer a solution?

NARCIS (Netherlands)

Mobarak, E.H.; Shabayek, M.M.; Mulder, J.; Reda, A.H.; Frencken, J.E.F.M.

2011-01-01

OBJECTIVES: To assess the prevalence and severity of dental caries amongst Egyptian adolescents and the prevalence of carious lesions treatable through the atraumatic restorative treatment (ART) approach. SUBJECTS AND METHODS: Using a convenient sample procedure, two secondary schools with a dental

Designing Preclinical Instruction for Psychomotor Skills (II)--Instructional Engineering: Task Analysis.

Science.gov (United States)

Knight, G. William; And Others

1994-01-01

The first step in engineering the instruction of dental psychomotor skills, task analysis, is explained. A chart details the procedural, cognitive, desired-criteria, and desired-performance analysis of a single task, occlusal preparation for amalgam restoration with carious lesion. (MSE)

Browse Title Index

African Journals Online (AJOL)

Items 301 - 350 of 1732 ... Vol 17, No 2 (2014), Chronic kidney disease in children as seen in a ... Vol 18, No 6 (2015), Chronic Myeloid Leukemia Presented with Priapism: ... aggregate in the treatment of deep carious lesions, Abstract PDF.

Clinical and SEM assessment of ART high-viscosity glass-ionomer sealants after 8-13 years in 4 teeth.

NARCIS (Netherlands)

Frencken, J.E.F.M.; Wolke, J.G.C.

2010-01-01

OBJECTIVES: Resin composite sealants are retained longer than low-viscosity glass-ionomer sealants. Nevertheless, a systematic review showed that there is no evidence that resin composite sealants are superior to low-viscosity glass-ionomers in preventing dentine carious lesion development. This

Anatomic feature of deltoid ligament attachment in posteromedial osteochondral lesion of talar dome.

Science.gov (United States)

Nakasa, Tomoyuki; Sawa, Mikiya; Ikuta, Yasunari; Yoshikawa, Masahiro; Tsuyuguchi, Yusuke; Adachi, Nobuo

2018-03-01

Osteochondral lesions of the talus (OLT) are recognized as being commonly associated with trauma. However, the etiology of OLT remains unclear. In the case of a posteromedial lesion of OLT (medial OLT), the deep layer of the deltoid ligament is located close to the medial OLT, and this relationship between a medial lesion and deltoid ligament could be a risk factor for medial OLT. The purpose of this study is to investigate the unique anatomic feature of the deep deltoid attachment to the talus in patients with medial OLT compared with patients with non-medial OLT. Forty ankles with medial OLT and 40 ankles without medial OLT were retrospectively reviewed in this study. On the coronal images of MRI, the attachment of deltoid ligament was measured. The continuity of the osteochondral fragment and its bed was evaluated on MRI and arthroscopic findings. Coronal MRI images showed that the attachment of the deep deltoid ligament to the medial OLT was broader and located more proximally than in non-medial OLT. The continuity of fibers from the insertion site of deltoid ligament to the talus to the osteochondral fragment was observed (76.7%). In the arthroscopic findings, the osteochondral fragment was obviously connected to the talus at the medial site in 85.2% of feet. The location of the deep deltoid ligament attachment to the medial OLT was more proximal and there was the possibility of these anatomic feature might contribute to the pathogenesis of medial OLT. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

The fluorescence in the diagnosis of dental tissue

International Nuclear Information System (INIS)

Puron, E.; Homs, R.; Paya, R. M.

2012-01-01

An experimental method for obtaining fluorescence of the dental tissue is described. A comparative analysis for the behaviour of the tissue fluorescence, both, healthy or intact enamel and carious samples is presented; the comparison of the obtained results with the ones described in the literature is done. Optical methods for the detection of carious lesions have the advantage of being minimally invasive. For this reason, induced fluorescence with a blue light to detect the presence of the Streptococcus in the oral cavity is proposed as an identifier method for find initial caries in dentistry in our country. (Author)

Features of electrocardiogram in patients with stenosis of the proximal right coronary artery.

Science.gov (United States)

Koh, Moo Seong; Lee, Jae Hoon; Jeong, Jin Woo; Chung, Jun Young

2017-03-01

Prediction of lesions of the proximal right coronary artery (pRCA) through electrocardiogram (ECG) is very important because pRCA occlusion has many complications and a high mortality rate, which has frequently been related with right ventricular infarction. The purpose of this study was to devise a screening tool that takes into account multiple leads from a 12-lead ECG to predict the pRCA lesion. A hundred and fifty-eight patients who were diagnosed as acute coronary syndrome and had a pure lesion of RCA or left circumf lex artery (LCX) by ECGs and angiographic findings were enrolled retrospectively. Forty-eight patients with a pure pRCA occlusion were compared to a control group of 110 patients who were diagnosed as having either a pure mid to distal RCA lesion (57 patients) or a pure LCX lesion (53 patients). ECGs of patients in the pRCA group showed more prominent ST depression in lead I ( p = 0.001) and ST elevation in V1 ( p = 0.002) than in the control group. The combination of ST depression (≤ 0 mm) in I and ST elevation (> 0.5 mm) in V1 was the best diagnostic tool (area under the curve, 0.84). ST changes in leads V1 and I allow more accurate prediction of pRCA occlusion than other criteria, such as the difference between ST elevation of leads II and III or vector direction and amplitude. These variables could help to screen for right ventricular infarction before performing reverse ECG and predicting prognosis.

Proximity credentials: A survey

International Nuclear Information System (INIS)

Wright, L.J.

1987-04-01

Credentials as a means of identifying individuals have traditionally been a photo badge and more recently, the coded credential. Another type of badge, the proximity credential, is making inroads in the personnel identification field. This badge can be read from a distance instead of being veiewed by a guard or inserted into a reading device. This report reviews proximity credentials, identifies the companies marketing or developing proximity credentials, and describes their respective credentials. 3 tabs

Non tuberculous mycobacterial lesion of the parotid gland and facial skin in a 4year old girl: A proposed treatment strategy.

Science.gov (United States)

Berkovic, Juraj; Vanchiere, John A; Gungor, Anil

2016-01-01

We report a case of a parotid-facial caseating granulomatous infection caused by atypical mycobacteria (Mycobacterium avium) in an immuno-competent child. The size and depth of the lesion and its proximity to the facial nerve present a challenge for a purely surgical treatment strategy. An alternative treatment strategy is developed to avoid severe disfigurement. Atypical mycobacterial infection of the parotid region in a 5 year old girl: timeline and definition of a planned combined treatment strategy with antibiotics and surgical excision. Cervicofacial infections caused by non-tuberculous mycobacteria (NTM) may present surgical challenges due to the size and depth of the lesion and its proximity to the facial nerve and major vascular structures. Even minor scars are highly visible and poorly tolerated. Close clinical monitoring combined with judicious treatment strategies is necessary for successful treatment and good cosmesis. Recent literature provides insufficient guidance in formulating the best treatment strategy for the individual patient. Comparisons of antibiotic therapy with variations of surgical excision are abundant but poorly formulated. Our case presented with a lesion involving skin, superficial and deep lobe of the parotid gland. Lesion was in immediate proximity to the distribution of the facial nerve through the parotid gland. The risk of surgical damage to the facial nerve in the acute phase of the inflammation and the required extent of skin excision were significant. We decided to start treatment with combination antimycobacterial antibiotics in close cooperation with the pediatric infectious disease specialists. We observed and documented the regress and executed a delayed surgical excision when the lesion was reduced to skin only. In our opinion this was the best treatment strategy that helped us avoid extensive dissection in the vicinity of the facial nerve as well as a parotidectomy. Excision of the involved skin with the deep portion

Distinguishing and diagnosing contemporary and conventional features of dental erosion.

Science.gov (United States)

Bassiouny, Mohamed A

2014-01-01

The vast number and variety of erosion lesions encountered today require reconsideration of the traditional definition. Dental erosion associated with modern dietary habits can exhibit unique features that symbolize a departure from the decades-old conventional image known as tooth surface loss. The extent and diversity of contemporary erosion lesions often cause conflicting diagnoses. Specific examples of these features are presented in this article. The etiologies, genesis, course of development, and characteristics of these erosion lesions are discussed. Contemporary and conventional erosion lesions are distinguished from similar defects, such as mechanically induced wear, carious lesions, and dental fluorosis, which affect the human dentition.

Safety of hydrophilic guidewires used for side-branch protection during stenting and proximal optimization technique in coronary bifurcation lesions

Energy Technology Data Exchange (ETDEWEB)

Chatterjee, Arka [Division of Cardiology, University of Alabama-Birmingham (United States); Brott, Brigitta C. [Division of Cardiology, University of Alabama-Birmingham (United States); Department of Biomedical Engineering, University of Alabama-Birmingham (United States); Foley, Robin [Department of Material Science and Engineering, University of Alabama-Birmingham (United States); Alli, Oluseun; Sasse, Mark; Ahmed, Mustafa; Al Solaiman, Firas; Reddy, Gautam; Ather, Sameer [Division of Cardiology, University of Alabama-Birmingham (United States); Leesar, Massoud A., E-mail: mleesar@uab.edu [Division of Cardiology, University of Alabama-Birmingham (United States)

2016-10-15

Background and propose: In coronary bifurcation lesions (CBL), hydrophilic guidewires used for side-branch (SB) protection can be withdrawn from underneath the stent easier than other wires. However, the safety of which has not been investigated. Methods/materials: We performed scanning electron microscopic (SEM) examination of hydrophilic wires – the Whisper and Runthrough wires – used for SB protection during stenting and proximal optimization technique (POT) in 30 patients with CBL. The distal 15 cm of the wire was examined every 1 mm by SEM and 4500 segments were analyzed to investigate for wire fracture, polymer shearing (PS), and its correlations with post-stenting creatine kinase (CK)-MB release. Results: SEM examination showed no evidence for wire fracture. The total area of PS and the largest defect on the wire were significantly larger with the Whisper wire versus the Runthrough wire (0.15 ± 0.04 mm{sup 2} vs. 0.026 ± 0.01 mm{sup 2} and 0.04 ± 0.05 mm{sup 2} vs. 0.01 ± 0.01 mm{sup 2}; P < 0.05, respectively). The total length of PS and the longest defect on the wire were significantly longer with the Whisper wire vs. the Runthrough wire (12.1 ± 14.5 mm vs. 2.7 ± 3.0 mm and 2.9 ± 4.2 mm vs. 1.0 ± 1.2 mm; P < 0.05, respectively), but there were weak correlations between the extents of PS with CK-MB release. Conclusions: Hydrophilic guidewires may be safely used for SB protection during stenting and POT in CBLs. The extent of PS was significantly greater with the Whisper wire than with the Runthrough wire, but its correlation with post-stenting CK-MB release was weak. - Highlights: • There was no wire fracture by jailing hydrophilic wires. • There was no wire entrapment by jailing hydrophilic wires. • There were weak correlations between polymer shearing and creatine kinase-MB levels. • The impact of polymer shearing on myocardial infraction warrants future studies.

Microtensile bond strength of three simplified adhesive systems to caries-affected dentin

NARCIS (Netherlands)

Scholtanus, J.D.; Purwanta, K.; Dogan, N.; Kleverlaan, C.J.; Feilzer, A.J.

2010-01-01

Purpose: The purpose of the study was to determine the microtensile bond strength of three different simplified adhesive systems to caries-affected dentin. Materials and Methods: Fifteen extracted human molars with primary carious lesions were ground flat until dentin was exposed. Soft

Microtensile Bond Strength of Three Simplified Adhesive Systems to Caries-affected Dentin

NARCIS (Netherlands)

Scholtanus, Johannes; Purwanta, Kenny; Dogan, Nilgun; Kleverlaan, Cees J.; Feilzer, Albert J.

Purpose: The purpose of the study was to determine the microtensile bond strength of three different simplified adhesive systems to caries-affected dentin. Materials and Methods: Fifteen extracted human molars with primary carious lesions were ground flat until dentin was exposed. Soft

Mechanical performance of encapsulated restorative glass-ionomer cements for use with Atraumatic Restorative Treatment (ART)

NARCIS (Netherlands)

Molina, G.F.; Cabral, R.J.; Mazzola, I.; Lascano, L.B.; Frencken, J.E.F.M.

2013-01-01

The Atraumatic Restorative Treatment (ART) approach was suggested to be a suitable method to treat enamel and dentine carious lesions in patients with disabilities. The use of a restorative glass-ionomer with optimal mechanical properties is, therefore, very important. OBJECTIVE: To test the

Atypical location of osteonecrosis of the proximal femur: a case report

International Nuclear Information System (INIS)

Álvarez López, Alejandro; García Lorenzo, Yenima

2016-01-01

Background: avascular necrosis of the femoral head is an infrequent lesion, especially when it is located in other areas of the proximal femur like the femoral neck. Objective: to present the case of a patient with atypical location of avascular necrosis in the proximal femur. Clinical case: a forty-nine-year-old white female patient with a personal medical record who six months ago started presenting pain in the right hip. The intensity and duration of the pain gradually increased. It also got worse at walking and standing for long periods of time, associated with limp. A simple radiographic examination showed an osteolytic image of well-defined edges in the anteroposterior side of the right hip. To check the presence of this image, a CT scan was performed. A sliding screw fixation was placed to keep the normal anatomical structure and avoid a pathological fracture. Conclusion: the location of avascular necrosis out of the femoral head is extremely infrequent. In these cases other surgical procedures, like resection and fixation with nails and screws, are needed particularly when the location is at the level of the femoral neck and there are risks of a pathological fracture. (author)

Diagnosis and Management of Closed Internal Degloving Injuries: The Morel-Lavallée Lesion.

Science.gov (United States)

Jalota, Leena; Ukaigwe, Anene; Jain, Shashank

2015-07-01

Morel-Lavallée (ML) lesions are closed degloving injuries described as posttraumatic subcutaneous fluid collections. They are most commonly seen in the proximal thigh. They can present several days to months after the inciting event. A 55-year-old woman with a recent admission for trauma presented to the Emergency Department with increasing swelling and pain in the right thigh for the previous 3 days. Ultrasound of the thigh was negative. Magnetic resonance imaging performed to further evaluate for leg swelling revealed a "Morel-Lavallée lesion" of the thigh that required drainage. The patient recovered completely after the surgery. WHY SHOULD THE EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be aware of these rare lesions because they are often mistaken for tumors or hematomas. Early recognition may avoid subsequent complications and help in obtaining prompt specialist care. Copyright © 2015 Elsevier Inc. All rights reserved.

A proximal point algorithm with generalized proximal distances to BEPs

OpenAIRE

Bento, G. C.; Neto, J. X. Cruz; Lopes, J. O.; Soares Jr, P. A.; Soubeyran, A.

2014-01-01

We consider a bilevel problem involving two monotone equilibrium bifunctions and we show that this problem can be solved by a proximal point method with generalized proximal distances. We propose a framework for the convergence analysis of the sequences generated by the algorithm. This class of problems is very interesting because it covers mathematical programs and optimization problems under equilibrium constraints. As an application, we consider the problem of the stability and change dyna...

An unusual case of posterior elbow dislocation with proximal radioulnar translocation.

Science.gov (United States)

Gómez Robledo, J; Díez Lizuaín, M L

2018-03-07

We present a 9-year-old girl who suffered a posterior dislocation of the right elbow with a proximal translocation between the ulna and the radius. It is a type of exceptional dislocation which in our case was not accompanied by lesions of the joint surfaces of the elbow unlike most cases already published. This article stresses the importance of making an early diagnosis of this variety of dislocation; this is the best way to prevent it from going unnoticed. The use of Computed Tomography (CT) helped this early diagnosis, enabling an immediate closed orthopaedic reduction and achieving a cure without sequelae. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Induction of Maturogenesis by Partial Pulpotomy: 1 Year Follow-Up

Directory of Open Access Journals (Sweden)

A. Bacaksiz

2013-01-01

Full Text Available In cariously exposed immature permanent teeth, the treatment choice is controversial in pediatric dentistry. Radical root canal treatment usually appears to be the solution for these teeth. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. This article describes the partial pulpotomy of a cariously affected immature permanent teeth and the follow-up for 1 year. A healthy 11-year-old male patient was referred to Gazi University Faculty of Dentistry Department of Pediatric Dentistry. The patient had reversible pulpitis symptoms on teeth numbered 45. At radiographic examination, immature apex and deep caries lesion were observed and partial pulpotomy was performed by using calcium hydroxide to maintain vitality of the pulp and allow continued development of root dentin expecting the root will attain full maturity. Clinical and radiographic follow-up demonstrated a vital pulp besides not only closure of the apex (apexogenesis, but also physiologic root development (maturogenesis after 1 year. Partial pulpotomy is an optional treatment for cariously exposed immature permanent teeth for preserving vitality and physiological root development.

PLACEMENT OF PREFORMED METAL CROWNS ON CARIOUS PRIMARY MOLARS BY DENTAL HYGIENE/THERAPY VOCATIONAL TRAINEES IN SCOTLAND: A SERVICE EVALUATION ASSESSING PATIENT AND PARENT SATISFACTION.

Science.gov (United States)

Jackson, Guy

2015-11-01

The utility and acceptability of preformed metal crowns (PMC) for management of carious primary molars has been established in the literature and published guidance. The role of dental hygienist and therapists (DHT) in the evolving team model in primary care has been recognised as requiring further investigation. The importance of patient and parental acceptance is acknowledged in recent healthcare research. This study focuses on patient and parent acceptance of preformed metal crowns placed by DHTs. Prescription format is investigated and the availability of bitewing radiographs considered. Reflective assignments at the end of training gave an indication of DHTs views on increased professional autonomy and the issue of direct access. Patient and parent satisfaction following placement of PMCs by DHT vocational trainees (DHTVT) were evaluated. Data was collected in two audit rounds from 2013 to 2014 using a 'faces' scale for children and a Likert scale for parents following placement of PMCs on carious primary molars. 133 PMCs were placed (110 children) by 10 DHTVTs over an eight-month period. Overall, radiographs were available for 10.5% of cases. The data showed high levels of patient and parent acceptance of the use of PMCs. Low availability of radiographs may represent a missed diagnostic opportunity. PMC placement by DHTVTs resulted in high patient and parent satisfaction, comparable to other studies. Although caries has been declining over the last decade in Scotland, evidence shows that inequalities and a social gradient in experience of caries in children remain. There is a need for tools and strategies for the prevention, recognition, risk assessment, diagnosis, and management of caries in the primary dentition. These must be accessible, acceptable to children and their parents/carers, cost effective, affordable and applicable in the primary care general dental practice environment where most families are likely to be registered. The emerging theme of

STRATIFICATION TECHNIQUE IN MAXILLARY ANTERIOR INCISORS RESTORATION

Directory of Open Access Journals (Sweden)

Janet Kirilova

2014-08-01

Full Text Available Background: Because of their main characteristics: transparency, opalescence and color density, the tooth structures are extremely difficult to restore by means of completely inconspicuous restorations of the natural tooth tissue characteristics. The aim is to show successful aesthetic restoration of III Class dental lesions in upper incisors by means of high quality composites. Materials and method: A female patient visited the clinic being not satisfied with the esthetics of her front teeth. The intraoral examination showed previous restorations and carious lesions in 12, 11, 21, 22. After defining the tooth color a silicone key was made. The treatment was performed under anesthesia, the existing restorations were removed and the carious lesions in teeth 11, 12, 21, 22 were treated with restorations using Vanini edge preparation. The teeth were restored by means of stratification technique. After etching and rinsing, bonding was applied for 20 sec. and then polymerized. After fixing the silicone key enamel shade was applied and then dentine shades UD2, UD3, UD4 of 0.5mm thickness each. The polymerization was done layer by layer. Applied were 10 to 15 layers in total. The composite material was preheated in oven up to 55. Teeth 21 and 22 are restored with Enamel Plus HRi (Micerium. Results and Discussion: Excellent aesthetics is achieved with composite material. They have enamel and dentine shades and allow high quality aesthetics. The polishing is excellent in Enamel Plus HRi (Micerium which is typical for this type of composite. The result of the carious lesion treatment in this patient is real improvement of the dental appearance of her anterior incisors. Conclusion: Materials show excellent aesthetic results due to their characteristics and the stratification technique used.

Two years survival rate of class II composite resin restorations prepared by ART with and without a chemomechanical caries removal gel in primary molars.

NARCIS (Netherlands)

Topaloglu-Ak, A.; Eden, E.; Frencken, J.E.F.M.; Oncag, O.

2009-01-01

The aim was to test the null hypotheses that there is no difference: (1) in carious lesion development at the restoration margin between class II composite resin restorations in primary molars produced through the atraumatic restorative treatment (ART) with and without a chemomechanical caries

Knowledge and practice of new advances in occlusal caries ...

African Journals Online (AJOL)

Conclusion: Overall knowledge and utilisation of advanced diagnostic methods for occlusal caries among dentists in Nairobi was low. Sticky fissures with evidence of demineralised enamel or discoloration of underlying dentine were identified as main indicators for operative treatment for early carious lesions while resin ...

Acid production by oral strains of Candida albicans and Lactobacilli

NARCIS (Netherlands)

Klinke, T.; Kneist, S.; de Soet, J.J.; Kuhlisch, E.; Mauersberger, S.; Forster, A.; Klimm, W.

2009-01-01

Both Candida albicans and lactobacilli are common colonizers of carious lesions in children and adolescents. The purpose of this study is to compare the velocity of acid production between C. albicans and several Lactobacillus species at different pH levels and concentrations of glucose. Washed,

Treatment of proximal superficial caries lesions on primary molar teeth with resin infiltration and fluoride varnish versus fluoride varnish only: efficacy after 1 year

DEFF Research Database (Denmark)

Ekstrand, K R; Bakhshandeh, A; Martignon, S

2010-01-01

detected on bitewing radiographs were included. After written parental consent, two lesions in each of 50 children were randomly allocated to one of two treatments: resin infiltration followed by FV (2.26% F) application (test lesion) versus only FV (control lesion). The ICDAS scores of the selected...... external examiner not familiar with the study scored the radiographs twice (weighted kappa 0.88). Baseline mean age of the children was 7.17 +/- (SD) 0.68 and mean def-s was 8.1 +/- (SD) 6.9. After 1 year the ICDAS scores of 31% of the test lesions and 67% of the control lesions had progressed (p

Evaluación del módulo de elasticidad de materiales estéticos para la restauración de lesiones cervicales Assessment of the elasticity module of aesthetic materials for restoration of cervical lesions

Directory of Open Access Journals (Sweden)

Claudia Estela Bonnin

2012-06-01

Full Text Available La pérdida de tejido en la zona cervical ha sido atribuida principalmente a la erosión y abrasión producidas por el cepillo de dientes. El rol de las fuerzas oclusales es un factor muy importante a tener en cuenta en el desarrollo y avance de estas lesiones cervicales no cariosas. Distinguir las diferentes propiedades mecánicas y sobre todo el módulo de elasticidad de los materiales estéticos utilizados para la restauración de este tipo de lesiones, permitirá una sobrevida mayor de las obturaciones y una gran mejoría en el tratamiento de nuestros pacientes. El objetivo de este trabajo fue evaluar el módulo de elasticidad de 6 materiales restauradores estéticos. Siguiendo la norma ISO 4049 se confeccionaron 10 probetas de cada material experimental. Se empleó el ensayo de flexión de 3 puntos con una INSTRON 4486. De la relación numérica entre los valores de tensión (T y deformación (D, se obtuvo el módulo de elasticidad o de Young (E, para cada material experimental. El análisis de varianza mostró diferencias significativas (p Te loss of tissue in the cervical zone has been attributed to the erosion and abrasion provoked by toothbrush. The role of occlusal forces is a very important factor to be taken into account in the development and advance of these carious non-cervical lesions. To distinguish the different mechanical properties and mainly the elasticity module of aesthetic material used for repair of this type of lesion, will allows a great survival of the obturations and in large extent in the treatment of our patients. The aim of present paper was to assess the elasticity module of 6 esthetic restoring materials. Following the ISO 4049 rule 10 test tubes of ach experimental material. A flexion assay of 3 points with INSTRON 4486 was used. From the numerical relation among the tension values (T and deformation (D we obtained the elasticity or Young (E elasticity module for each experimental material. The variance

'Trampoline fracture' of the proximal tibia in children: report of 3 cases and review of literature.

Science.gov (United States)

Bruyeer, E; Geusens, E; Catry, F; Vanstraelen, L; Vanhoenacker, F

2012-01-01

We present three cases of fracture of the proximal tibia in young children who were jumping on a trampoline. The typical radiological findings and the underlying mechanism of trauma are discussed. The key radiological features are: a transverse hairline fracture of the upper tibia often accompanied by a buckle fracture of the lateral or medial tibial cortex, buckling of the anterior upper tibial cortex and anterior tilting of the epiphyseal plate. New types of injuries related to specific recreational activities are recognized. It is often helpful to associate a typical injury with a particular activity. Trampoline related injuries have increased dramatically over the last years. The most common lesions are fractures and ligamentous injuries, in particular a transverse fracture of the proximal tibia. However the radiological findings can be very subtle and easily overlooked. It is therefore important to be aware of the typical history and radiological findings.

The association of lesion eccentricity with plaque morphology and components in the superficial femoral artery: a high-spatial-resolution, multi-contrast weighted CMR study

Directory of Open Access Journals (Sweden)

Zhao Xihai

2010-07-01

Full Text Available Abstract Background Atherosclerotic plaque morphology and components are predictors of subsequent cardiovascular events. However, associations of plaque eccentricity with plaque morphology and plaque composition are unclear. This study investigated associations of plaque eccentricity with plaque components and morphology in the proximal superficial femoral artery using cardiovascular magnetic resonance (CMR. Methods Twenty-eight subjects with an ankle-brachial index less than 1.00 were examined with 1.5T high-spatial-resolution, multi-contrast weighted CMR. One hundred and eighty diseased locations of the proximal superficial femoral artery (about 40 mm were analyzed. The eccentric lesion was defined as [(Maximum wall thickness- Minimum wall thickness/Maximum wall thickness] ≥ 0.5. The arterial morphology and plaque components were measured using semi-automatic image analysis software. Results One hundred and fifteen locations were identified as eccentric lesions and sixty-five as concentric lesions. The eccentric lesions had larger wall but similar lumen areas, larger mean and maximum wall thicknesses, and more calcification and lipid rich necrotic core, compared to concentric lesions. For lesions with the same lumen area, the degree of eccentricity was associated with an increased wall area. Eccentricity (dichotomous as eccentric or concentric was independently correlated with the prevalence of calcification (odds ratio 3.78, 95% CI 1.47-9.70 after adjustment for atherosclerotic risk factors and wall area. Conclusions Plaque eccentricity is associated with preserved lumen size and advanced plaque features such as larger plaque burden, more lipid content, and increased calcification in the superficial femoral artery.

Oral diagnosis and treatment planning: part 5. Preventive and treatment planning for dental caries.

Science.gov (United States)

Yip, K; Smales, R

2012-09-01

The practice of operative dentistry continues to evolve, to reflect the many changes occurring in society and in dental diseases and conditions. However, the belief that all questionable and early carious lesions should be restored still persists. This belief is largely based upon the concept that the removal of all carious tissue followed by meticulous restoration of the tooth is the treatment of choice for dental caries. Yet restorations are not permanent and do not cure caries, as the causes remain. On the other hand, preventive measures can remove or partially remove the causes, thereby reducing the risks for future caries recurrence at the same site or elsewhere in the mouth.

Ph-activated nano-amorphous calcium phosphate-based cement to reduce dental enamel demineralization.

Science.gov (United States)

Melo, Mary A S; Weir, Michael D; Passos, Vanara F; Powers, Michael; Xu, Hockin H K

2017-12-01

Enamel demineralization is destructive, esthetically compromised, and costly complications for orthodontic patients. Nano-sized amorphous calcium phosphate (NACP) has been explored to address this challenge. The 20% NACP-loaded ortho-cement notably exhibited favorable behavior on reducing demineralization of enamel around brackets in a caries model designed to simulate the carious attack. The 20% NACP-loaded ortho-cement markedly promotes higher calcium and phosphate release at a low pH, and the mineral loss was almost two fold lower and carious lesion depth decreased the by 1/3. This novel approach is promising co-adjuvant route for prevention of dental caries dissemination in millions of patients under orthodontic treatment.

A case of monostotic fibrous dysplasia of proximal femur managed with curettage and cortical bone grafting

Directory of Open Access Journals (Sweden)

A D Sud

2013-01-01

Full Text Available We present a case report of a young military personnel with monostotic fibrous dysplasia of proximal femur with painful, dysplasticlesion of the femoral neck and fatigue fracture who underwent cortical bone grafting using autogenous fibular strut graft and iliac crest bone graft. The fibular cortical grafts was used to bridge the lesion in the femoral neck and were securely anchored to the normal bone of the lateral femoral cortex and a head of the femur. No supplemental internal fixation was required.

Carotid Artery Stenting in a Patient with Spontaneous Recanalization of a Proximal Internal Carotid Artery Occlusion: a Case Report

International Nuclear Information System (INIS)

Kim, Eui Jong; Koh, Jun Seok; Choi, Woo Suk

2006-01-01

We report here on a rare case of carotid artery angioplasty and stenting in a patient with spontaneous recanalization after complete occlusion of the proximal internal carotid artery (ICA). The patient initially showed severe stenosis at the left proximal ICA on MR angiography (MRA). Digital subtraction angiography (DSA) performed three days after MRA showed complete occlusion of the proximal ICA. The follow-up DSA after four weeks showed recanalization of the ICA, and then carotid artery stenting was successfully performed. There has been no neurologic complication during more than one year follow-up. cute internal carotid artery (ICA) occlusions may result in profound disability and death (1). An occluded ICA can spontaneously recanalize, but this doesn't happen frequently, and the natural course of a proximal ICA occlusion and its possibility of recanalization, including the exact time of recanalization after occlusion, are not well known (2, 3). A few studies have reported the incidence of spontaneous recanalization of the proximal internal carotid artery, which has mostly occurred in patients with ICA dissections (4 6). A few limited studies have reported a considerable incidence of spontaneous recanalization in patients with underlying atherosclerotic lesion or atherothombotic diseases (2). The possibility of repeated occlusion and repeated cerebral ischemic infarction may exist for the patients exhibiting spontaneous recanalization of the ICA and underlying atherosclerosis. We report here on a case of carotid artery stenting (CAS) in a patient who exhibited underlying atherosclerosis with spontaneous recanalization after complete occlusion of the proximal ICA

Comparison of chemotherapy and hematopoietic stem cell ...

African Journals Online (AJOL)

2013-02-19

Feb 19, 2013 ... scores before and after hematopoietic stem cell transplantation (HSCT) and chemotherapy. Materials and Methods: Thirty-six patients undergoing HSCT were included in the study. A pre-HSCT dental treatment protocol was implemented that consisted of restoration of all active carious lesions, treatment of ...

Pattern of Prescription of Antibiotics among Dental Practitioners in ...

African Journals Online (AJOL)

This is an open access article distributed under the terms of the Creative Commons ... engaged in treatment of pediatric dental patients in different public and ..... carious lesion on tooth number 85 (mandibular right ... complicated crown fractures, severe tooth displacement, ... Why we must reduce dental prescription of.

The impact of the ART approach on the treatment pattern in a public oral health service in South Africa.

NARCIS (Netherlands)

Mickenautsch, S.

2007-01-01

The Atraumatic Restorative Treatment (ART) approach stands for restoring and preventing carious lesions in tooth surfaces without the use of the drill. It was introduced in South Africa in 1996 and adopted by all dental schools. However, no information was available on the introduction of ART into

Antioxidant Protection against Pathological Mycotoxins Alterations on Proximal Tubules in Rat Kidney

Directory of Open Access Journals (Sweden)

Susan Abdu

2011-04-01

Full Text Available Background: Ochratoxin A (OTA was one of the mycotoxins and received attention worldwide because of the hazard it posed to human and animal health, where the kidney was the primary target organ for OTA toxicity. In the other hand, dates served as a good source of natural antioxidants and could potentially be considered as a functional food.Methods: The study was performed in the department of biology in King Abdulaziz University. Animals were gavage administrated and divided into four groups: first group received (sodium bicarbonate, second group received (289 µg OTA /kg B.W. /day, third group received (1mg Ajwa/kg B.W. / day and fourth group received (289 µg OTA /kg B.W./day+ 1mg Ajwa /kg B.W. / day. Serum (creatinine - urea levels were measured in each group at the time of tissue collection , some biopsies were fixed in 10% buffered formalin solution for light microscopy processing stained with Haematoxylin and Eosin (H& E., Periodic Acid-Schiff (PAS and Masson´s Trichrome (M.T..Other biopsies were immediately collected into electron microscopy processing. Results: After 28 days, a significant decrease in body weight, kidney weight and relative weight was detected in OTA treated group. Also, Serum (creatinine - urea level were elevated .The normal cyto-architecture of proximal tubules were lost exhibiting damaged bruch border, degenerated, binucleated and karyomegalic cells. The most destructed ultra-structure was the mitochondria which severely swollen with disintegrated membranes. In Ajwa Date extract-group the proximal tubules were normal, whereas in Ajwa date extract + OTA -group the severity of the lesions was significantly reduced. Conclusion: The present results indicated that, Ajwa date have protective effects and ameliorated the lesions of Ochratoxin nepherotoxicity which might lead to kidney failure.

[Paradigm shift in conservative dentistry: from a mechanistic to a prevention-oriented perception].

Science.gov (United States)

Hellwig, E; Altenburger, M

2011-09-01

The application of different preventive measures has resulted in a decline of clinically detectable carious lesions in children and adolescents. Not only have caries symptoms changed significantly, but the number of extracted teeth in adults has decreased. Due to these epidemiological facts, modern conservative dentistry is based on a careful risk analysis and caries diagnosis, which also takes into consideration biological and psychosocial components of caries etiology. Conservative dentistry will fail if the dentists are only interested in repairing defects. Simultaneous with the positive outcome of prevention, some unanswered problems have arisen, for which there are no adequate solutions. In young children, caries prevalence is still high and the restorative care of these primary teeth should be improved. For adolescents, early detection of carious lesions should be improved and polarization of caries prevalence should be eliminated. In older adults, evidence-based therapy options for treatment of erosions, abrasions, and root caries are lacking. For seniors needing general care, preventive and restorative concepts should be established.

Lesion progression in post-treatment persistent endodontic lesions.

Science.gov (United States)

Yu, Victoria Soo Hoon; Messer, Harold Henry; Shen, Liang; Yee, Robert; Hsu, Chin-ying Stephen

2012-10-01

Radiographic lesions related to root-filled teeth may persist for long periods after treatment and are considered to indicate failure of initial treatment. Persistent lesions are found in a proportion of cases, but information on lesion progression is lacking. This study examined the incidence of lesion improvement, remaining unchanged, and deterioration among persistent lesions in a group of patients recruited from a university-based clinic and identified potential predictors for lesion progression. Patients of a university clinic with persistent endodontic lesions at least 4 years since treatment and with original treatment radiographs available were recruited with informed consent. Data were obtained by interview and from dental records and clinical and radiographic examinations. Univariate and multivariate statistical analyses were carried out by using SPSS (version 19). One hundred fifty-one persistent lesions were identified in 114 patients. A majority of the lesions (107, 70.9%) received treatment between 4 and 5 years prior. Eighty-six lesions (57.0%) improved, 18 (11.9%) remained unchanged, and 47 (31.1%) deteriorated since treatment. Potential predictors for lesions that did not improve included recall lesion size, pain on biting at recall examination, history of a postobturation flare-up, and a non-ideal root-filling length (P < .05). Lesions that had persisted for a longer period appeared less likely to be improving (relative risk, 1.038; 95% confidence interval, 1.000-1.077). A specific time interval alone should not be used to conclude that a lesion will not resolve without intervention. This study identified several clinical factors that are associated with deteriorating persistent lesions, which should aid in identifying lesions that require further intervention. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Differential patterns of injury to the proximal tubule of renal cortical slices following in vitro exposure to mercuric chloride, potassium dichromate, or hypoxic conditions.

Science.gov (United States)

Ruegg, C E; Gandolfi, A J; Nagle, R B; Brendel, K

1987-09-15

The innate susceptibility of renal cell types to these agents was investigated using precision-cut rabbit renal cortical slices made perpendicular to the cortical-papillary axis. Slices were incubated in DME/F12 medium containing 10 microM, 100 microM, or 1 mM concentrations of either metal for 12 hr or in Krebs-Hepes buffer gassed with nitrogen (100%) for 0.75 to 5 hr of hypoxic exposure. To simulate postischemic reperfusion, some slices were transferred to vessels gassed with oxygen after an initial hypoxic period. Mercuric chloride (100 microM) exposure resulted in damage to the straight regions of proximal tubules by 12 hr leaving convoluted regions unaffected. Hypoxia (2.25 hr) and potassium dichromate (100 microM for 12 hr) both caused injury to the convoluted proximal tubules without affecting straight proximal tubular regions. Mercury concentrations of 10 microM and 1 mM had no effect or injured all cell types within the slice, respectively. Similar results were observed for hypoxic periods less than 1.5 hr or greater than 3 hr of exposure. Potassium dichromate had no measurable affect at 10 microM, but at 1 mM focal lesions were observed after 4 hr of exposure, and by 12 hr all cell types within the slice were affected. Intracellular potassium content normalized to DNA correlated well, but always preceded the pathological lesions observed. These results demonstrate that injury to specific regions of the proximal tubule by these agents relates to an innate susceptibility of the intoxicated cell type independent of physiologic feedback or blood delivery patterns proposed as mechanisms of selective injury from in vivo studies.

Polarization sensitive optical coherence tomography detection method

International Nuclear Information System (INIS)

Colston, B W; DaSilva, L B; Everett, M J; Featherstone, J D B; Fried, D; Ragadio, J N; Sathyam, U S.

1999-01-01

This study demonstrates the potential of polarization sensitive optical coherence tomography (PS-OCT) for non-invasive in vivo detection and characterization of early, incipient caries lesions. PS-OCT generates cross-sectional images of biological tissue while measuring the effect of the tissue on the polarization state of incident light. Clear discrimination between regions of normal and demineralized enamel is first shown in PS-OCT images of bovine enamel blocks containing well-characterized artificial lesions. High-resolution, cross-sectional images of extracted human teeth are then generated that clearly discriminate between the normal and carious regions on both the smooth and occlusal surfaces. Regions of the teeth that appeared to be demineralized in the PS-OCT images were verified using histological thin sections examined under polarized light microscopy. The PS-OCT system discriminates between normal and carious regions by measuring the polarization state of the back-scattered 1310 nm light, which is affected by the state of demineralization of the enamel. Demineralization of enamel increases the scattering coefficient, thus depolarizing the incident light. This study shows that PS-OCT has great potential for the detection, characterization, and monitoring of incipient caries lesions

Clinicopathologic review of 19 patients with systemic candidiasis with skin lesions.

Science.gov (United States)

Bae, Gee Young; Lee, Hae Woong; Chang, Sung Eun; Moon, Kee Chan; Lee, Mi Woo; Choi, Jee Ho; Koh, Jai Kyoung

2005-07-01

A diagnosis of systemic candidiasis is often delayed or missed owing to the absence of sensitive, specific, and timely diagnostic tools. Skin lesions are not common, but they can help to rapidly establish a diagnosis. We report on a 14-year experience of systemic candidiasis with skin lesions in our institution. We report the prevalence, clinical findings, histologic findings, etiologic Candida species, underlying conditions, treatment modalities, and outcomes of the cases and compare them with the previous reports. We reviewed the medical records and laboratory data of patients diagnosed with systemic candidiasis from June 1989 to September 2002 at Asan Medical Center, Seoul, Korea. We thoroughly reviewed the data on those patients with characteristic skin lesions. We included the cases in which Candida organisms were either shown or cultured from the skin. We also included the patients who had developed the characteristic rash at the onset of infection if there was no other possible explanation for the rash. Of 53 documented systemic candidiasis cases, 19 (35.8%) had the characteristic skin lesions. Fifteen patients (78.9%) had hematologic problems and were neutropenic. The skin lesions were a maculopapular or nodular rash and plaques. In addition to the trunk and proximal extremities, the rash also involved the face and distal extremities. The rashes were mostly purpuric, not consistently associated with underlying thrombocytopenia but also associated with underlying vascular damage as a result of Candida organisms. The underlying vascular damage also caused intraepidermal necrotic and vesicular change. One case of transepidermal elimination of organisms was newly found. The most common causative species was Candida tropicalis in the 19 patients with skin lesions, in contrast with Candida albicans in a total of 53 patients. The mortality rate was 84.2%. The prevalence of systemic candidiasis-associated skin lesions may be higher than previously reported

Accuracy of a Computer Assisted Program for ’Classic’ Presentations of Dental Pain

Science.gov (United States)

1989-04-11

diagnosis of trauma and non-trauma related dental pain. Abscess /infection/cellulitis Acute apical abscess Acute apical periodontitis Acute...spasms Necrotizing ulcerative gingivitis Neurologic injury Osseous sequestrum Occlusal trauma Periodontal abscess Periocoronitis/erupting tooth...Acute apical abscess Acute apical periodontitis Acute gingivitis Carious lesion (decay) Dentin hypersensitivity Defective restoration

Survey of comprehensive restorative treatment for children under general anesthesia

Directory of Open Access Journals (Sweden)

Yai-Tin Lin

2015-09-01

Conclusion: Although general anesthesia provides an optimal condition for treating children with high caries risk, high failure rates of composite restorations were noted. Indirect pulp capping and ferric sulfate pulpotomy followed by stainless steel crown restorations are successful techniques and can be used to treat deep carious lesions.

Taking the Pain out of Waiting: The Oral Health Counselling Experiences of Parents of Children with Extensive Dental Caries

Science.gov (United States)

Cashmore, Aaron W.; Noller, Jennifer; Johnson, Bronwyn; Ritchie, Jan; Blinkhorn, Anthony S.

2011-01-01

Objective: The Tooth Smart Programme is a hospital-based parent-counselling programme established to stabilize existing carious lesions and prevent new caries in children. The purpose of this qualitative study was to: explore participating parents' experiences of and views about parent counselling; identify and describe factors that influence the…

Complexity of the ultraviolet mutation frequency response curve in Escherichia coli B/r: SOS induction, one-lesion and two-lesion mutagenesis

International Nuclear Information System (INIS)

Doudney, C.O.

1976-01-01

Three distinct sections of the ultraviolet mutation frequency response (MFR) curve toward tryptophan prototrophy have been demonstrated in Escherichia coli B/r WP2 trp thy and its uvrA derivative in log-phase growth in minimal medium. The initial section, which appears fluence-squared, may reflect the necessity, if mutation is to result, for induction of two lesions, one located within the potentially mutated genetic locus and the other damaging deoxyribonucleic acid replication and resulting in induction of the error-prone SOS repair function. A second linear section is ascribed to the continued induction, after exposure above that sufficient for complete SOS expression, of isolated lesions which lead to mutation in potentially mutated loci. The third section demonstrates an increased rate of mutagenesis and suggests the induction of two lesions in proximity which result in additional mutations. Split-exposure studies support the inducible nature of the SOS function and suggest that mutation frequency decline (MFD) is due to excision resulting from or related to the prevention of SOS induction by inhibition of protein synthesis. Preirradiation tryptophan starvation of the uvr + strain for 30 min decreases MFR in the first and second sections of the curve. Reduction of MFR in the third section requires more prestarvation time and is blocked by nalidixic acid. The decreased MFR of the first and second sections is ascribed to promotion of postirradiation MFD based on excision and that of the third section to completion of the chromosome during the prestarvation period

Detection of Carious Lesions and Restorations Using Particle Swarm Optimization Algorithm

Directory of Open Access Journals (Sweden)

Mohammad Naebi

2016-01-01

Full Text Available Background/Purpose. In terms of the detection of tooth diagnosis, no intelligent detection has been done up till now. Dentists just look at images and then they can detect the diagnosis position in tooth based on their experiences. Using new technologies, scientists will implement detection and repair of tooth diagnosis intelligently. In this paper, we have introduced one intelligent method for detection using particle swarm optimization (PSO and our mathematical formulation. This method was applied to 2D special images. Using developing of our method, we can detect tooth diagnosis for all of 2D and 3D images. Materials and Methods. In recent years, it is possible to implement intelligent processing of images by high efficiency optimization algorithms in many applications especially for detection of dental caries and restoration without human intervention. In the present work, we explain PSO algorithm with our detection formula for detection of dental caries and restoration. Also image processing helped us to implement our method. And to do so, pictures taken by digital radiography systems of tooth are used. Results and Conclusion. We implement some mathematics formula for fitness of PSO. Our results show that this method can detect dental caries and restoration in digital radiography pictures with the good convergence. In fact, the error rate of this method was 8%, so that it can be implemented for detection of dental caries and restoration. Using some parameters, it is possible that the error rate can be even reduced below 0.5%.

Percutaneous coronary intervention of osteal lesions in newly established tertiary care cardiac hospital

International Nuclear Information System (INIS)

Sultana, R.; Sultana, N.; Rasheed, S.J.; Jafary, M.H.; Ishaq, M.; Samad, A.

2010-01-01

To assess the outcome of percutanious Angioplasty in patients with osteal lesions in Coronary artery Diseases. This is a retrospective analysis of all coronary angiograms performed at the catheterization laboratory of Karachi Institute of Heart Diseases (KIHD), a tertiary referral center in Karachi, Pakistan, between the periods August 2006 to August 2008. Fifty patients were enrolled which included thirty-five men and fifteen women and all were >40 years of age. Each patient had a single target osteal lesion: twenty nine patients underwent PCI for ostial LAD lesion (among them twenty males and nine females), six had ostial LCX (five males and one female), and fifteen patients had osteal RCA stenosis (10-male patients and 5- female patients). After high-pressure balloon dilatation residual stenosis was reduced. Twelve patients were treated with bare metal stents (BMS) while thirty eight with drug eluting stents (DES). In all cases the procedure was successful without any pre and post procedural complications. A key issue in the treatment of an osteal lesion is to assure that the stent is inserted proximal enough to fully cover the osteal junction. Improvements in technique, equipment, adjunctive drug therapy and better understanding of the procedure have remarkably changed the practice of interventional cardiology. (author)

The influence of parotid gland sparing on radiation damages of dental hard tissues.

Science.gov (United States)

Hey, Jeremias; Seidel, Johannes; Schweyen, Ramona; Paelecke-Habermann, Yvonne; Vordermark, Dirk; Gernhardt, Christian; Kuhnt, Thomas

2013-07-01

The aim of the present study was to evaluate whether radiation damage on dental hard tissue depends on the mean irradiation dose the spared parotid gland is subjected to or on stimulated whole salivary flow rate. Between June 2002 and October 2008, 70 patients with neck and cancer curatively irradiated were included in this study. All patients underwent dental treatment referring to the guidelines and recommendations of the German Society of Dental, Oral and Craniomandibular Sciences prior, during, and after radiotherapy (RT). During the follow-up period of 24 months, damages on dental hard tissues were classified according to the RTOG/EORTC guidelines. The mean doses (D(mean)) during spared parotid gland RT were determined. Stimulated whole saliva secretion flow rates (SFR) were measured before RT and 1, 6, 12, 24 months after RT. Thirty patients showed no carious lesions (group A), 18 patients developed sporadic carious lesions (group B), and 22 patients developed general carious lesions (group C). Group A patients received a D mean of 21.2 ± 11.04 Gy. Group B patients received a D(mean) of 26.5 ± 11.59 Gy and group C patients received a D(mean) of 33.9 ± 9.93 Gy, respectively. The D(mean) of group A was significantly lower than the D(mean) of group C (p dental hard tissue correlates with increased mean irradiation doses as well as decreased salivary flow rates. Parotid gland sparing resulting in a dose below 20 Gy reduces radiation damage on dental hard tissues, and therefore, the dose may act as a predictor for the damage to be expected.

Clinical and radiographic evaluation of cermet tunnel restorations on primary molars.

Science.gov (United States)

Zenkner, J E; Baratieri, L N; Monteiro, S J; de Andrada, M A; Vieira, L C

1993-11-01

Fifty-one restorations of the tunnel type were performed with "cermet" cement on primary molars. The restorations were assessed clinically, radiographically, and by direct examination of the proximal surface 6 months (group I) and 12 months (group II) after placement. The incidence of fractured marginal ridges was found to be 3.8% in group I and 4.2% in group II. All restorations had their occlusal portion intact and were caries-free. Clinically detectable occlusal wear was found in 7.7% of teeth in group I and in 4.2% of teeth in group II. No correlation was found between direct and radiographic assessment of proximal caries. White spots, without carious penetration, were detected on 53.8% of proximal surfaces at 6 months and on 60.0% of proximal surfaces at 12 months.

PROXIMITY MANAGEMENT IN CRISIS CONDITIONS

Directory of Open Access Journals (Sweden)

Ion Dorin BUMBENECI

2010-01-01

Full Text Available The purpose of this study is to evaluate the level of assimilation for the terms "Proximity Management" and "Proximity Manager", both in the specialized literature and in practice. The study has two parts: the theoretical research of the two terms, and an evaluation of the use of Proximity management in 32 companies in Gorj, Romania. The object of the evaluation resides in 27 companies with less than 50 employees and 5 companies with more than 50 employees.

Distinct focal lesions of the femoral head: imaging features suggesting an atypical and minimal form of bone necrosis

International Nuclear Information System (INIS)

Theodorou, Daphne J.; Theodorou, Stavroula J.; Resnick, Donald; Haghighi, Parviz

2002-01-01

Heading AbstractObjective. To document the imaging findings observed in patients with an unusual pattern of abnormality of the femoral head, most likely representing osteonecrosis.Design and patients. The imaging findings in 11 patients (10 men, 1 woman; age range 32-55 years) with a distinct lesion of the femoral head were reviewed with particular attention to the morphologic appearance, location, and extent of the lesion(s) in the proximal femur.Results. The 16 lesions identified in these patients extended to the subchondral area. Articular collapse was not evident in any hip. Radiography and CT showed areas of mixed bone sclerosis and osteolysis surrounded by sclerotic margins. On MR imaging, the signal intensity characteristics of the osseous lesion(s) were most commonly similar to those of fluid. Histopathologic findings, available in two hips, were typical of osteonecrosis. There was evidence of correlation of the site of the lesion with the known general distribution and anastomoses of arteries supplying the femoral head.Conclusion. A distinct, focal lesion of the femoral head is believed to represent an atypical form of bone necrosis. Its restriction to a small portion of the femoral head may relate to localized vascular anatomy. Recognition of the quite characteristic imaging findings can prevent misdiagnosis and may have implications for the prediction of the natural course of the disease. (orig.)

Treatment options for permanent teeth with deep caries

OpenAIRE

Marending, Monika; Attin, Thomas; Zehnder, Matthias

2016-01-01

The goal of this narrative review was to summarize and compare treatment options for permanent teeth carious lesions that are radiographically close to the pulp chamber. Thanks to adhesive restorative materials, minimally invasive approaches are possible. In this context, the old question arises as to whether caries must be excavated completely, i.e., down to hard dentin, or whether it could be advantageous to leave some soft dentin, or even merely seal the whole lesion. To answer this questi...

Dilemma of managing multi-surface dental caries in the primary ...

African Journals Online (AJOL)

Background: A lot of research work has been carried out to determine the effectiveness of using atraumatic restorative treatment (ART ) in the management of dental caries, but there are still unresolved issues surrounding the use of the technique particularly in very large carious lesions. Objective: To determine the current ...

Evaluating a Team-Based Learning Method for Detecting Dental Caries in Dental Students

Science.gov (United States)

Park, Sang E.; Kim, Junhyck; Anderson, Nina

2014-01-01

The purpose of the study was to investigate whether the team-based learning environment facilitated the competency of third year dental students in caries detection and activity assessment. Corresponding data were achieved using digital radiographs to determine the carious lesions in three clinical cases. The distribution of the caries evaluations…

Proximal tubular hypertrophy and enlarged glomerular and proximal tubular urinary space in obese subjects with proteinuria.

Directory of Open Access Journals (Sweden)

Ana Tobar

Full Text Available BACKGROUND: Obesity is associated with glomerular hyperfiltration, increased proximal tubular sodium reabsorption, glomerular enlargement and renal hypertrophy. A single experimental study reported an increased glomerular urinary space in obese dogs. Whether proximal tubular volume is increased in obese subjects and whether their glomerular and tubular urinary spaces are enlarged is unknown. OBJECTIVE: To determine whether proximal tubules and glomerular and tubular urinary space are enlarged in obese subjects with proteinuria and glomerular hyperfiltration. METHODS: Kidney biopsies from 11 non-diabetic obese with proteinuria and 14 non-diabetic lean patients with a creatinine clearance above 50 ml/min and with mild or no interstitial fibrosis were retrospectively analyzed using morphometric methods. The cross-sectional area of the proximal tubular epithelium and lumen, the volume of the glomerular tuft and of Bowman's space and the nuclei number per tubular profile were estimated. RESULTS: Creatinine clearance was higher in the obese than in the lean group (P=0.03. Proteinuria was similarly increased in both groups. Compared to the lean group, the obese group displayed a 104% higher glomerular tuft volume (P=0.001, a 94% higher Bowman's space volume (P=0.003, a 33% higher cross-sectional area of the proximal tubular epithelium (P=0.02 and a 54% higher cross-sectional area of the proximal tubular lumen (P=0.01. The nuclei number per proximal tubular profile was similar in both groups, suggesting that the increase in tubular volume is due to hypertrophy and not to hyperplasia. CONCLUSIONS: Obesity-related glomerular hyperfiltration is associated with proximal tubular epithelial hypertrophy and increased glomerular and tubular urinary space volume in subjects with proteinuria. The expanded glomerular and urinary space is probably a direct consequence of glomerular hyperfiltration. These effects may be involved in the pathogenesis of obesity

Fractures of the proximal humerus

DEFF Research Database (Denmark)

Brorson, Stig

2013-01-01

Fractures of the proximal humerus have been diagnosed and managed since the earliest known surgical texts. For more than four millennia the preferred treatment was forceful traction, closed reduction, and immobilization with linen soaked in combinations of oil, honey, alum, wine, or cerate......, classification of proximal humeral fractures remains a challenge for the conduct, reporting, and interpretation of clinical trials. The evidence for the benefits of surgery in complex fractures of the proximal humerus is weak. In three systematic reviews I studied the outcome after locking plate osteosynthesis...

Impact of positive and negative lesion site remodeling on clinical outcomes: insights from PROSPECT.

Science.gov (United States)

Inaba, Shinji; Mintz, Gary S; Farhat, Naim Z; Fajadet, Jean; Dudek, Dariusz; Marzocchi, Antonio; Templin, Barry; Weisz, Giora; Xu, Ke; de Bruyne, Bernard; Serruys, Patrick W; Stone, Gregg W; Maehara, Akiko

2014-01-01

This study investigated coronary artery remodeling patterns associated with clinical outcomes. In the prospective, multicenter PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree: An Imaging Study in Patients With Unstable Atherosclerotic Lesions) study, reported predictors of nonculprit lesion (NCL) major adverse cardiac events (MACE) were an intravascular ultrasound (IVUS) minimal lumen area (MLA) ≤4 mm(2), a plaque burden ≥70%, and a IVUS-virtual histology (VH) thin-cap fibroatheroma (TCFA), but not lesion site remodeling. Overall, 697 consecutive patients with an acute coronary syndrome were enrolled and underwent 3-vessel gray-scale and IVUS-VH; 3,223 NCLs were identified by IVUS. The remodeling index (RI) was calculated as the external elastic membrane area at the MLA site divided by the average of the proximal and distal reference external elastic membrane areas. First, one third of the patients were randomly selected to determine RI cutoffs related to NCL MACE (development cohort). Receiver-operating characteristic analysis showed that there were 2 separate cut points that predicted NCL MACE: RI = 0.8789 and RI = 1.0046 (area under the curve = 0.663). These cut points were used to define negative remodeling as an RI 1.00. Second, we used the remaining two-thirds of patients to validate these cut points with respect to lesion morphology and clinical outcomes (validation cohort). Kaplan-Meier curve analysis in the validation cohort showed that NCL MACE occurred more frequent (and equally) in negative and positive remodeling lesions compared with intermediate remodeling lesions. In this cohort, negative remodeling lesions had the smallest MLA, positive remodeling lesions had the largest plaque burden, and VH TCFA, especially VH TCFA with multiple necrotic cores, was most common in negatively remodeling lesions. The present study showed the novel concept that positive and negative lesion site remodeling was

Comparison of Percutaneous Cementoplasty with and Without Interventional Internal Fixation for Impending Malignant Pathological Fracture of the Proximal Femur

Energy Technology Data Exchange (ETDEWEB)

Tian, Qing-Hua, E-mail: ddqinghua-tian@163.com; He, Cheng-Jian, E-mail: tianhechengjian@163.com; Wu, Chun-Gen, E-mail: 649514608@qq.com; Li, Yong-Dong, E-mail: tianliyongdong@163.com; Gu, Yi-Feng, E-mail: tianyifenggu@163.com; Wang, Tao, E-mail: tianandwangtao@163.com; Xiao, Quan-Ping, E-mail: tianxiaoquanping@163.com; Li, Ming-Hua, E-mail: tianminghuali@163.com [Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Department of Diagnostic and Interventional Radiology (China)

2016-01-15

PurposeTo compare the efficacy of percutaneous cementoplasty (PCP) with and without interventional internal fixation (IIF) on malignant impending pathological fracture of proximal femur.MethodsA total of 40 patients with malignant impending pathological fracture of proximal femur were selected for PCP and IIF (n = 19, group A) or PCP alone (n = 21, group B) in this non-randomized prospective study. Bone puncture needles were inserted into the proximal femur, followed by sequential installation of the modified trocar inner needles through the puncture needle sheath. Then, 15–45 ml cement was injected into the femur lesion.ResultsThe overall excellent and good pain relief rate during follow-ups were significantly higher in group A than that in group B (89 vs. 57 %, P = 0.034). The average change of VAS, ODI, KPS, and EFES in group A were significantly higher than those in group B at 1-, 3-, 6-month, 1-year (P < 0.05). Meanwhile, The stability of the treated femur was significantly higher in group A than that in group B (P < 0.05).ConclusionPCP and IIF were not only a safe and effective procedure, but resulted in greater pain relief, bone consolidation, and also reduced the risk of fracture than the currently recommended approach of PCP done on malignant proximal femoral tumor.

Comparison of Percutaneous Cementoplasty with and Without Interventional Internal Fixation for Impending Malignant Pathological Fracture of the Proximal Femur

International Nuclear Information System (INIS)

Tian, Qing-Hua; He, Cheng-Jian; Wu, Chun-Gen; Li, Yong-Dong; Gu, Yi-Feng; Wang, Tao; Xiao, Quan-Ping; Li, Ming-Hua

2016-01-01

PurposeTo compare the efficacy of percutaneous cementoplasty (PCP) with and without interventional internal fixation (IIF) on malignant impending pathological fracture of proximal femur.MethodsA total of 40 patients with malignant impending pathological fracture of proximal femur were selected for PCP and IIF (n = 19, group A) or PCP alone (n = 21, group B) in this non-randomized prospective study. Bone puncture needles were inserted into the proximal femur, followed by sequential installation of the modified trocar inner needles through the puncture needle sheath. Then, 15–45 ml cement was injected into the femur lesion.ResultsThe overall excellent and good pain relief rate during follow-ups were significantly higher in group A than that in group B (89 vs. 57 %, P = 0.034). The average change of VAS, ODI, KPS, and EFES in group A were significantly higher than those in group B at 1-, 3-, 6-month, 1-year (P < 0.05). Meanwhile, The stability of the treated femur was significantly higher in group A than that in group B (P < 0.05).ConclusionPCP and IIF were not only a safe and effective procedure, but resulted in greater pain relief, bone consolidation, and also reduced the risk of fracture than the currently recommended approach of PCP done on malignant proximal femoral tumor

Chondrosarcoma of the Proximal Phalanx of the Fourth Digit: A Rare Location

Directory of Open Access Journals (Sweden)

Thivi Vasilakaki

2012-10-01

Full Text Available Introduction: Cartilaginous tumors involving the small bones of the hands and feet are usually benign such as enchondroma, chondromyxoid fibroma and chondroblastoma. The small bones of the hands and feet are rarely involved by primary chondrosarcoma. Proximal phalanges are the most common sites in the hands, but the fourth digit is the least common site. Case Presentation: We report a case of a 76-year-old Greek female who presented to our hospital with a painful swollen mass measuring 4.5 × 2.6 cm on the fourth digit of the left hand. The radiograph showed a destructive, permeative lytic tumor of the proximal phalanx with extension into soft tissue. The patient underwent curettage, and the microscopic examination of the specimen revealed grade 2 chondrosarcoma. Conclusion: Cartilaginous tumors involving the small bones of the hands and feet are usually benign such as enchondroma, chondromyxoid fibroma and chondroblastoma. Primary chondrosarcoma is the third most common malignancy of bone after myeloma and osteosarcoma, but the small bones of the hands and feet are very rarely involved by chondrosarcoma (1% of all chondrosarcoma. However, in these cases differentiation between a benign lesion and chondrosarcoma may be difficult. Occasionally chondrosarcoma of the hands and feet is associated with multiple recurrences or distal metastasis.

Initial outcome and efficacy of S3 proximal humerus locking plate in the treatment of proximal humerus fractures

International Nuclear Information System (INIS)

Zhang Zhiming; Zhu Xuesong; Bao Zhaohua; Yang Huilin

2012-01-01

Objective: to explore the initial outcome and efficacy of S 3 proximal humerus locking plate in the treatment of proximal humerus fractures. Methods: Twenty-two patients with proximal humerus fracture were treated with the S 3 proximal humerus locking plate. Most of the fractures were complex, two-part (n=4), three-part (n=11) and four-part (n=7) fractures according to the Neer classification of the proximal humerus fractures. Results: All patients were followed up for 3∼15 months. There were no complications related to the implant including loosening or breakage of the plate. Good and excellent results were documented in 17 patients fair results in 4 patients according the Neer scores of shoulder. Conclusion: New design concepts of S 3 proximal humerus plate provide the subchondral support and the internal fixation support. With the addition of the proper exercise of the shoulder joint, the outcomes would be satisfied. (authors)

Hyperparathyroidism and bone lesions. A case report

International Nuclear Information System (INIS)

Garrido Modesto, M.; Costa, P.A.; Sapienza, M.T.; Watanabe, T.; Hironaka, F.; Buchpigel, C.A.

1997-01-01

Full text: Primary hyperparathyroidism can course with bone lesions known as fibrocystic osteitis in 25% to 60% of the cases and manifest itself by fractures, bone pain, deformations and inflammatory reaction. A 17 years old patient was listened with report of trauma in the left wrist, lumbar and in the right knee pain, with inflammatory signals and thinning 15 kg in 8 months. After x-ray of the left wrist and hand, bone rarefaction and insufflated lesion in the left chiro-dactyl third proximal phalanx were observed. The laboratory examinations have demonstrated hyper calcemia (13mg/dl), hypo phosphatemia (1,3mg/dl) with alkaline phosphatase (1086UI/I) e PTH (1050ng/ml). X-ray of the cranium cap, hip and coxofemoral articulations, knees and ankle was realized and observed disseminated lithic lesions. The bone scintilography with Technetium-99m MDP revealed hypo and hyper uptaked regions in several segments of the appendicular axial skeleton. Because of primary hyperparathyroidism suspicion, parathyroid scintilography with Technetium-99m MIBI in two phases was realized. 30 min after the injection of the radiopharmaceutical whole body images were realized which demonstrated hyper absorption in the areas previously hypo to the bone scintilography. 3 hours after injection the uptake was maintained in projection of the left inferior parathyroid, with posterior adenoma resection. The patient presented a significant reduction of the bone pain and normalization of the serum calcium levels. Nuclear medicine had an important role in the investigation of parathyroid diseases and showed to be useful in the evaluation of the disseminated bone compromising, which can come along with this pathology, avoiding the realization of repeated radiological studies

Numerical investigation and identification of susceptible sites of atherosclerotic lesion formation in a complete coronary artery bypass model.

Science.gov (United States)

Zhang, Jun-Mei; Chua, Leok Poh; Ghista, Dhanjoo N; Yu, Simon Ching Man; Tan, Yong Seng

2008-07-01

As hemodynamics is widely believed to correlate with anastomotic stenosis in coronary bypass surgery, this paper investigates the flow characteristics and distributions of the hemodynamic parameters (HPs) in a coronary bypass model (which includes both proximal and distal anastomoses), under physiological flow conditions. Disturbed flows (flow separation/reattachment, vertical and secondary flows) as well as regions of high oscillatory shear index (OSI) with low wall shear stress (WSS), i.e., high-OSI-and-low-WSS and low-OSI-and-high-WSS were found in the proximal and distal anastomoses, especially at the toe and heel regions of distal anastomosis, which indicate highly suspected sites for the onset of the atherosclerotic lesions. The flow patterns found in the graft and distal anastomoses of our model at deceleration phases are different from those of the isolated distal anastomosis model. In addition, a huge significant difference in segmental averages of HPs was found between the distal and proximal anastomoses. These findings further suggest that intimal hyperplasia would be more prone to form in the distal anastomosis than in the proximal anastomosis, particularly along the suture line at the toe and heel of distal anastomosis.

NEW DATA ON THE CLINICAL AND THERAPEUTIC MANAGEMENT OF OCCLUSAL CARIES (III

Directory of Open Access Journals (Sweden)

Sorin ANDRIAN

2017-06-01

Full Text Available In the control of occlusal caries, the major challenges are related not only to the detection of non-cavitary lesions, but also to the establishment of the treatment strategies to be subsequently applied. Considering the objective of each treatment, that of helping the patient, it is essential to control the progression of carious lesions by means of nonsurgical, preventive/therapeutical methods, whenever necessary. The new strategies applied in caries management are based on the evaluation and predictibility of possible risks, a major aspect in the daily taking of therapeutical decisions. The management plan should include: (I patient’s level of risk, (II patient’s activity level and (III severity of the lesion. Various strategies for a most efficient management of patient’s problems, as well as of the carious lesions, have been elaborated by specialized medical organisms, such as: strategies established within ICDAS, CAMBRA, strategies of the caries management system (SMC and protocols indicated by the system of caries classification according to ADA (American Dental Association. The mission of any new model of caries management is first of all to preserve the dental tissues, and to restore them when only recommended – an idea to guide the decisions of practitioners, starting with the moment of anamnesis, clinical examination and estabishment of diagnosis, until the end of the treatment

Preliminary study on leadership proximity

Directory of Open Access Journals (Sweden)

Ghinea Valentina Mihaela

2017-07-01

Full Text Available In general, it is agreed that effective leadership requires a certain degree of proximity, either physical or mental, which enables leaders to maintain control over their followers and communicate their vision. Although we agree with the leadership proximity principles which states that leaders are able to efficiently serve only those people with whom they interact frequently, in this article we focus instead on the disadvantages of being too close and the way in which close proximity can actually hurt the effectiveness of leadership. The main effects that we discuss regard the way in which proximity and familiarity allow followers to see the weaknesses and faults of the leader much more easily and thus diminish the leader’s heroic aura, and the emotional bias that results from a leader being too familiar with his followers which will impede the process of rational decision making. As a result, we argue that there exists a functional proximity which allows the leader the necessary space in which to perform effective identity work and to hide the backstage aspects of leadership, while also allowing him an emotional buffer zone which will enable him to maintain the ability to see clearly and make rational decisions.

HIF1α deficiency reduces inflammation in a mouse model of proximal colon cancer

Directory of Open Access Journals (Sweden)

Dessislava N. Mladenova

2015-09-01

Full Text Available Hypoxia-inducible factor 1α (HIF1α is a transcription factor that regulates the adaptation of cells to hypoxic microenvironments, for example inside solid tumours. Stabilisation of HIF1α can also occur in normoxic conditions in inflamed tissue or as a result of inactivating mutations in negative regulators of HIF1α. Aberrant overexpression of HIF1α in many different cancers has led to intensive efforts to develop HIF1α-targeted therapies. However, the role of HIF1α is still poorly understood in chronic inflammation that predisposes the colon to carcinogenesis. We have previously reported that the transcription of HIF1α is upregulated and that the protein is stabilised in inflammatory lesions that are caused by the non-steroidal anti-inflammatory drug (NSAID sulindac in the mouse proximal colon. Here, we exploited this side effect of long-term sulindac administration to analyse the role of HIF1α in colon inflammation using mice with a Villin-Cre-induced deletion of Hif1α exon 2 in the intestinal epithelium (Hif1αΔIEC. We also analysed the effect of sulindac sulfide on the aryl hydrocarbon receptor (AHR pathway in vitro in colon cancer cells. Most sulindac-treated mice developed visible lesions, resembling the appearance of flat adenomas in the human colon, surrounded by macroscopically normal mucosa. Hif1αΔIEC mice still developed lesions but they were smaller than in the Hif1α-floxed siblings (Hif1αF/F. Microscopically, Hif1αΔIEC mice had significantly less severe colon inflammation than Hif1αF/F mice. Molecular analysis showed reduced MIF expression and increased E-cadherin mRNA expression in the colon of sulindac-treated Hif1αΔIEC mice. However, immunohistochemistry analysis revealed a defect of E-cadherin protein expression in sulindac-treated Hif1αΔIEC mice. Sulindac sulfide treatment in vitro upregulated Hif1α, c-JUN and IL8 expression through the AHR pathway. Taken together, HIF1α expression augments inflammation

Magnetic resonance imaging of lower abdominal and pelvic lesions

International Nuclear Information System (INIS)

Van Beers, Bernard

1992-01-01

To determine the value of oral particles (OMP) as a superpara-magnetic MR contrast agent for the gastrointestinal tract in lower abdominal and pelvic lesions, 30 patients underwent spin-echo imaging before and after ingestion of OMP at a dose of approximately 80 mg of iron in 800 ml water. The preparation was divided into 4 portions and taken by the patient over a 2-h period. Two readers independently reviewed the MR images. The contrast material was well tolerated and the distribution of the contrast material was good to excellent in the proximal and pelvic small bowel, but was not sufficient in the colon with the dose and timing used in the study. Postcontrast images showed a significantly better delineation of the lesions, the small bowel and the paraaortic region, but no significant improvement in delineation of the colon, the iliac vessels are, bladder or genital tract. Compared with precontrast images, confidence in defining or excluding disease on postcontrast images was better, equal or worse in 40, 60 and 0% respectively (P<0.001) with a substantial agreement between readers (K0.71). OMP produced susceptibility artefacts of significant intensity in only one case. These results indicate that OMP may be useful in the delineation of lower abdominal and pelvic lesions at MR imaging. Marking of the colon by a contrast agent might improve the results. (author). 22 refs.; 3 figs.; 1 tab

Diagnostic Value of Conventional and Digital Radiography for Detection of Cavitated and Non-Cavitated Proximal Caries

Directory of Open Access Journals (Sweden)

Mahdieh Dehghani

2017-02-01

Full Text Available Objectives: This study aimed to assess the diagnostic value of conventional and digital radiography for detection of cavitated and non-cavitated proximal caries.Materials and Methods: Fifty extracted human premolars and molars were mounted in a silicone block. Charge-coupled device (CCD and photostimulable phosphor plate (PSP receptors and intra-oral films were exposed with 60 and 70 kVp with parallel technique. Two observers interpreted the radiographs twice with a two-week interval using a 5-point scale. Teeth were then serially sectioned in mesiodistal direction and evaluated under a stereomicroscope (gold standard. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated.Results: Sensitivity of all three receptors for detection of enamel lesions was low (5.5-44.4% but it was higher for dentin lesions (42.8-62.8%; PSP with 70 kVp and 0.03s exposure time had the highest sensitivity for enamel lesions, but the difference among receptors was not statistically significant (P>0.05. Sensitivity of all three receptors for detection of non-cavitated lesions was lower than that for cavitated lesions; PSP with 60 kVp and 0.07s exposure time had higher sensitivity and lower patient radiation dose for detection of cavitated and non-cavitated lesions, but the difference was not significant (P>0.05.Conclusions: Digital radiography using PSP receptor with 70 kVp is recommended to detect initial enamel caries. For detection of non-cavitated and cavitated dentin caries, PSP with 60 kVp is more appropriate. Change in kVp did not affect the diagnostic accuracy for detection of caries, and type of receptor was a more important factor.Keywords: Dental Caries; Diagnostic Imaging; Radiography, Dental, Digital

ProxImaL: efficient image optimization using proximal algorithms

KAUST Repository

Heide, Felix; Diamond, Steven; Nieß ner, Matthias; Ragan-Kelley, Jonathan; Heidrich, Wolfgang; Wetzstein, Gordon

2016-01-01

domain-specific language and compiler for image optimization problems that makes it easy to experiment with different problem formulations and algorithm choices. The language uses proximal operators as the fundamental building blocks of a variety

Analysis of the effects of different iodine concentrations on the characterization of small renal lesions detected by multidetector computed tomography scan: A pilot study

Energy Technology Data Exchange (ETDEWEB)

Lee, Hak Jong; Kim, Sang Youn; Cho, Jeong Yeon; Hwang, Sung Il; Moon, Min Hoan; Kim, Seung Hyup [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

2017-05-15

Our objective was to compare the effects of different iodine concentrations on characterizing small renal lesions. Thirty-eight patients were enrolled in this study. All patients underwent an initial CT scan using 370 mgI/mL iodinated contrast media. Patients were then randomized into two groups for a follow-up CT. Group A (n = 19) received 250 mgI/mL iodinated contrast media, and group B (n = 19) received 300 mgI/mL contrast media. The mean Hounsfield units (HU values) of small renal lesions with a maximum size of less than 2 cm were calculated. Signal to noise ratios (SNR values) were likewise evaluated. Three uroradiologists assessed the lesion's conspicuity and the diagnostic influence of the artifact's proximity to the adjacent renal parenchyma. In group A, there were significant differences between the HU values of renal lesions and those of the adjacent renal parenchyma between the initial and follow-up CT. Conversely, in group B, there was no significant difference. Moreover, SNR values showed no statistically significant difference between both groups. Regarding lesion conspicuity, only one reader identified a significant difference (p = 0.032) in group A; whereas in group B, there was no statistical difference. The artifact's proximity to the adjacent renal parenchyma did not appear to have any diagnostic influence on differentiating the two (p < 0.05). In evaluating small renal lesions, 300 mgI/mL instead of 370 mgI/mL contrast media can be used; however, it is important to note that the use of 250 mgI/mL contrast media may reveal different results from that of 370 mgI/mL contrast media.

Analysis 'in vivo' of the employ of the Er:YAG laser and conventional method to remove carious tissue; Analise 'in vivo' do emprego laser de Er:YAG e do metodo convencional para remocao do tecido cariado

Energy Technology Data Exchange (ETDEWEB)

Ribeiro, Rafael Cardoso

2002-07-01

The aim of this study was to evaluate the removal of carious tissue employing the use of Er:YAG laser in comparison with the conventional burr rotary instrument. The wavelength of this laser is 2,64 {mu}m and have a good absorption by the water and hydroxyapatite present in dental hard tissue. For this purpose were selected 24 molar teeth with occlusal carious, which were divided in random in two groups. For enamel, the laser energy used was in the interval from 250 mJ to 400 mJ, and the frequency range from 2 Hz to 4 Hz; for the dentine the energy laser range was from 150 mJ to 200 mJ and the laser frequency was in the range from 2 Hz to 6 Hz. For the evaluation of the results was used a questionaire to critical evaluation of the professional and another one to evaluation of the patient. The results have shown that the Er:YAG laser is able to remove carious enamel and dentin, without cause crunch or fracture and the irradiated surface was creasy. The patients reported greatest comfort when the cavity preparation was done with the Er:YAG laser than the conventional burr and all the patients treated reported prefer to future treatments the use of the Er:YAG laser. In conclusion, for the critical evaluation of the professional the treatment with the Er:YAG laser is a safe and effective method, and for the critical evaluation of the patient the treatment is one alternative more comfortable than the conventional method to remove caries. (author)

Radiation-induced osteochondroma-like lesion in young rat radius

International Nuclear Information System (INIS)

Delgado, E.; Rodriguez, J.I.; Serrada, A.; Tellez, M.; Paniagua, R.

1985-01-01

To investigate the effects of radiation on the perichondrial groove of Ranvier in osteochondroma development, the external surface of the distal growth plate of the radius in both forelimbs of 30 ten-day-old rats was exposed to a single low dose of radiation (150 r), which was focused on the perichondrial groove. This induced the formation of a chondrocyte nest at the proximal external edge of the growth plate (five to nine days after irradiation). With advancing longitudinal growth of the bone, the chondrocyte nest occupied a diaphyseal position. At nine to 11 days the chondrocyte nest underwent endochondral ossification. At 13-15 days, this osteochondroma-like lesion began to regress with the disappearance of the chondrocyte nest. After 19-21 days, only an irregularly thickened cortical bone remains at the osteochondroma site. Although the possible role of the growth plate subjacent to the irradiated perichondrial groove must be taken into account, the continuity between the perichondrial groove and the osteochondroma, which is separated from the growth plate by the periosteal ring (bone bark), suggests that the perichondrial groove was involved in osteochondroma-like lesion development

Colonoscopia ou sigmoidoscopia: risco de lesões isoladas no cólon direito Colonoscopy or flexible sigmoidoscopy: risk of isolated right colon lesions

Directory of Open Access Journals (Sweden)

Frank Shigueo NAKAO

2001-09-01

Full Text Available Racional — Atualmente existem dúvidas quanto ao método ideal de rastreio e vigilância para o câncer colorretal. A retossigmoidoscopia é preconizada, já que é barata, eficaz e causa pouco desconforto, mas não pode diagnosticar tumores do cólon proximal. Objetivo - Avaliar quantas lesões encontradas no cólon proximal seriam perdidas caso a colonoscopia só fosse empregada em pacientes com lesões detectadas durante sigmoidoscopia. Casuística e Método - Foram revistas as colonoscopias consecutivas com achado de pólipos ou neoplasia, realizadas no Setor de Endoscopia da Disciplina de Gastroenterologia da Universidade Federal de São Paulo, excluindo pacientes repetidos, operados ou com doença inflamatória intestinal. Resultados - Cento e um exames foram elegíveis, sendo 45 pacientes do sexo masculino. A idade média foi 62 anos (DP ± 13,7 anos. Cento e oito fragmentos foram enviados separadamente para exame anatomopatológico, sendo 38 com suspeita de neoplasia e 70 pólipos. Ao se considerarem apenas os achados no cólon proximal, observou-se o total de 45 lesões, sendo 23 adenomas, 10 adenocarcinomas, 1 linfoma e 11 lesões benignas. Destas lesões, 28 eram isoladas, sendo 16 adenomas, 7 adenocarcinomas. Conclusão — Observaram-se que 23 pacientes (22,77% tinham adenoma ou adenocarcinoma apenas no cólon direito, que não seriam diagnosticados se sigmoidoscopia flexível fosse usada isoladamente.Background — Colorectal cancer is an important cause of death in western countries. Screening methods are based on flexible sigmoidoscopy, a cheap, effective, and less painful procedure, but some important lesions on the right colon can be missed. Aim - Evaluate how many important lesions would be missed if colonoscopy indicated only for patients with distal lesions identified during flexible sigmoidoscopy. Material and Methods - All consecutive colonoscopy performed in the Endoscopy Unit of the Gastroenterology Division of Federal

PROXIMAL DISABILITY AND SPINAL DEFORMITY INDEX IN PATIENTS WITH PROXIMAL FEMUR FRACTURES

Directory of Open Access Journals (Sweden)

Sylvio Mistro Neto

2015-12-01

Full Text Available Objective : To evaluate the quality of life related to the spine in patients with proximal femoral fractures. Methods : Study conducted in a tertiary public hospital in patients with proximal femoral fractures caused by low-energy trauma, through the Oswestry Disability Index questionnaire to asses complaints related to the spine at the time of life prior to the femoral fracture. The thoracic and lumbar spine of patients were also evaluated applying the radiographic index described by Gennant (Spinal Deformity Index, which assesses the number and severity of fractures. Results : Seventeen subjects completed the study. All had some degree of vertebral fracture. Patients were classified in the categories of severe and very severe disability in the questionnaire about quality of life. It was found that the higher SDI, the better the quality of life. Conclusion : There is a strong association of disability related to the spine in patients with proximal femoral fracture, and this complaint must be systematically evaluated in patients with appendicular fracture.

Dental caries in Rome, 50-100 AD

DEFF Research Database (Denmark)

Fejerskov, Ole; Bilde, P. Guldager; Bizzarro, Martin

2012-01-01

Scarce information exists on the clinical features of dental caries in the Imperial Roman population and no structural data on caries lesions from this period have so far been published. We report on the findings of 86 teeth (50-100 AD) found during archaeological excavations of the temple...... of Castor and Pollux in the Forum Romanum. We found that nearly all teeth had large carious cavities extending into the pulp. The distribution and size of the caries lesions were similar to those found in contemporary adult populations in Africa and China living without access to dental care. Most lesions...

Noncarious Cervical Lessions: From Etiology to Therapy

OpenAIRE

Marta Krolo; Aleksandra Kovačević

2015-01-01

The purpose of this article was to briefly summarize the most important characteristics of non-carious cervical lesions, as well as the etiological factors that lead to their formation. Cervical area represents one of the most sensitive parts of the tooth due to the specific position, as well as the structure and thickness of hard tissue. It is less resistant to various chemical and mechanical stimuli, and as a result the lesions in this area are frequently encountered in everyday practice.

Processing closely spaced lesions during Nucleotide Excision Repair triggers mutagenesis in E. coli

Science.gov (United States)

Isogawa, Asako; Fujii, Shingo

2017-01-01

It is generally assumed that most point mutations are fixed when damage containing template DNA undergoes replication, either right at the fork or behind the fork during gap filling. Here we provide genetic evidence for a pathway, dependent on Nucleotide Excision Repair, that induces mutations when processing closely spaced lesions. This pathway, referred to as Nucleotide Excision Repair-induced Mutagenesis (NERiM), exhibits several characteristics distinct from mutations that occur within the course of replication: i) following UV irradiation, NER-induced mutations are fixed much more rapidly (t ½ ≈ 30 min) than replication dependent mutations (t ½ ≈ 80–100 min) ii) NERiM specifically requires DNA Pol IV in addition to Pol V iii) NERiM exhibits a two-hit dose-response curve that suggests processing of closely spaced lesions. A mathematical model let us define the geometry (infer the structure) of the toxic intermediate as being formed when NER incises a lesion that resides in close proximity of another lesion in the complementary strand. This critical NER intermediate requires Pol IV / Pol II for repair, it is either lethal if left unrepaired or mutation-prone when repaired. Finally, NERiM is found to operate in stationary phase cells providing an intriguing possibility for ongoing evolution in the absence of replication. PMID:28686598

ProxImaL: efficient image optimization using proximal algorithms

KAUST Repository

Heide, Felix

2016-07-11

Computational photography systems are becoming increasingly diverse, while computational resources-for example on mobile platforms-are rapidly increasing. As diverse as these camera systems may be, slightly different variants of the underlying image processing tasks, such as demosaicking, deconvolution, denoising, inpainting, image fusion, and alignment, are shared between all of these systems. Formal optimization methods have recently been demonstrated to achieve state-of-the-art quality for many of these applications. Unfortunately, different combinations of natural image priors and optimization algorithms may be optimal for different problems, and implementing and testing each combination is currently a time-consuming and error-prone process. ProxImaL is a domain-specific language and compiler for image optimization problems that makes it easy to experiment with different problem formulations and algorithm choices. The language uses proximal operators as the fundamental building blocks of a variety of linear and nonlinear image formation models and cost functions, advanced image priors, and noise models. The compiler intelligently chooses the best way to translate a problem formulation and choice of optimization algorithm into an efficient solver implementation. In applications to the image processing pipeline, deconvolution in the presence of Poisson-distributed shot noise, and burst denoising, we show that a few lines of ProxImaL code can generate highly efficient solvers that achieve state-of-the-art results. We also show applications to the nonlinear and nonconvex problem of phase retrieval.

Fracture Resistance of Pulpotomized Primary Molar Restored with Extensive Class II Amalgam Restorations

Directory of Open Access Journals (Sweden)

F. Mazhari

2008-06-01

Full Text Available Objective: The aim of the present study was to evaluate fracture resistance of pulpoto-mized primary molar teeth restored with extensive multisurface amalgam restorations.Materials and Methods: Eighty extracted carious human primary molar teeth were se-lected forpresent study. Teeth were divided in to eight groups of ten. Mesio- or disto-occlusal and Mesio-occluso-distal cavities with different cavity wall thickness (1.5 or 2.5mm were prepared in both first and second primary molar teeth. After restoring teeth with amalgam, all specimens were stored in distilled water at 37°C for 7 days. Then samples were thermocycled for 1000 cycles from 5°C to 55°C. The specimens then were subjected to a compressive load in a universal testing machine at a crosshead speed of 0.5 mm min-1. ANOVA and t-test were used for statistical analysis.Results: Mean fracture resistance of first and second molar teeth were 975.5 N (SD=368.8 and 1049.2 N (SD=540.1 respectively. In the first molar group, fracture resis-tance of two-surface cavities was significantly more than three-surface cavities (P<0.001, however this difference was not statistically significant in the second molar group. In both first and second molar group, fracture resistance incavities with 2.5 mm wall thickness, was significantly more than the group with 1.5 mm wall thickness.Conclusion: The mean fracture resistance in pulpotomized primary molar restored with amalgam restorations was higher than reported maximum bite force in primary teeth even in extensive multi-surface restorations. Therefore, the teeth with large proximal carious lesions in schoolchildren could be restored with amalgam.

Comparative Evaluation of Oral Candida albicans Carriage in Children with and without Dental Caries: A Microbiological in vivo Study.

Science.gov (United States)

Srivastava, Binita; Bhatia, Hind Pal; Chaudhary, Visuja; Aggarwal, Archana; Kumar Singh, Ashish; Gupta, Nidhi

2012-05-01

The aim of this study was to examine the presence of Candida albicans in extensive carious lesions before and after treatment of the carious lesions and to evaluate the carriage of Candida albicans in children with and without caries. The study was conducted on 60 childrens who were divided into two groups: Experimental group (group 1) and controlled group (group 2). Each group was further divided into 3 subgroups according to the dentition as: Group A (Deciduous), group B (Mixed) and group C (Permanent). Swab samples for mycological studies were collected from the dorsum of the tongue, vestibular sulcus and peak of the palatal vault. All samples were cultured directly on SDA plate (Sabouraud's dextrose agar). Number of Candida colonies was determined by counting colony forming unit on SDA plates. Further identification of Candida albicans was done by germ-tube test and corn-meal agar. Overall prevalence of Candida albicans carriage was significantly higher and mean value of Candida albicans CFU (colony forming unit) was remarkably higher in group 1 (experimental group) as compare to group 2 (control group). Significant reduction in the frequency and mean value of Candida albicans CFU/plate was seen in children after treatment of carious lesions. This study supports the active role of Candida species in dental caries. Hence, Candida albicans may play an important role as a risk factor for dental caries. It was also seen that the oral environment stabilization procedures were able to reduce Candida albicans counts. Thus, these procedures can be considered efficient in the reduction of caries risk. How to cite this article: Srivastava B, Bhatia HP, Chaudhary V, Aggarwal A, Singh AK, Gupta N. Comparative Evaluation of Oral Candida albicans Carriage in Children with and without Dental Caries: A Microbiological in vivo Study. Int J Clin Pediatr Dent 2012;5(2):108-112.

Evaluation of the Efficacy of Caries Removal Using Polymer Bur, Stainless Steel Bur, Carisolv, Papacarie – An Invitro Comparative Study

Science.gov (United States)

Prasad, Madhu Ghanashyam; Vasa, Aron Arun Kumar; Vasanthi, Done; Ramanarayana, Boyapati; Mynampati, Praffulla

2015-01-01

Context Dental caries continues to affect a significant portion of the world population and treatment of the decay is associated with pain by many patients. Intervention and application of rotary instruments for treatment of carious lesions has often resulted in considerable removal of tooth structure. Chemo-mechanical method, a minimal invasive technique for caries removal was developed to overcome these shortcomings. This innovative method seems to be efficient in removing infected dentine without altering the healthy dental tissue or harming the adjacent oral mucosa. Aim To evaluate the efficacy and efficiency of Caries removal Using Polymer Bur, Stainless Steel Bur, Carisolv and Papacarie. Materials and Methods A total of 120 sectioned specimens were obtained from 60 extracted teeth. Each tooth was sectioned mesiodistally in the center of the carious lesion so that two halves (buccal and lingual or palatal) having equal sized carious lesions are compared. The sectioned specimens were subdivided into four groups (Polymer Bur, Stainless Steel Bur, Carisolv, Papacarie) allotting 30 specimens to each for caries excavation. Results One-way ANOVA, Chi-square test analysis was done for comparison between groups which showed significant results with Stainless Steel Bur excavation taking less mean time when compared to other agents and Polymer Bur showed more amount of bacterial remnants after excavation whereas Carisolv and Papacarie were efficient with less dentinal tubule destruction and bacterial remnants after excavation. Further inter comparison between groups was done using Paired t-test and Fischer’s Exact-test. Conclusion The Mean time taken by Stainless Steel Bur excavation was found to be less and caused more amount of dentinal tubule destruction when compared to Polymer Bur, Carisolv and Papacarie. Chemo-mechanical methods found to be more efficient with lesser amount of bacterial remnants and dentinal tubule destruction after caries excavation when

Morel-Lavallee Lesion: Case Report with Review of Literature.

Science.gov (United States)

Padmanabhan, Elamparidhi; Rudrappa, Ramesh Kumar; Bhavishya, Talluri; Rajakumar, Sibhithran; Selvakkalanjiyam, Sivaranjinie

2017-07-01

Morel-Lavallee lesions are closed degloving soft tissue injuries which occur because of trauma and in which the skin and subcutaneous tissue are separated from superficial fascia. This shear trauma results in creation of a potential space filled with serosanguinous fluid, blood and necrotic fat. We discuss a case of 52-year-old female with history of trauma one week back, who presented with a boggy swelling over the postero-lateral aspect of proximal forearm and distal arm. Local examination showed fluctuating fluid collection. MRI showed variable intensity fluid collection in a potential space between the subcutaneous tissue and deep fascia in arm and forearm. Percutaneous decompression and evacuation of the collection with systemic antibiotic therapy resulted in rapid improvement.

Progressive motor cortex functional reorganization following 6-hydroxydopamine lesioning in rats.

Science.gov (United States)

Viaro, Riccardo; Morari, Michele; Franchi, Gianfranco

2011-03-23

Many studies have attempted to correlate changes of motor cortex activity with progression of Parkinson's disease, although results have been controversial. In the present study we used intracortical microstimulation (ICMS) combined with behavioral testing in 6-hydroxydopamine hemilesioned rats to evaluate the impact of dopamine depletion on movement representations in primary motor cortex (M1) and motor behavior. ICMS allows for motor-effective stimulation of corticofugal neurons in motor areas so as to obtain topographic movements representations based on movement type, area size, and threshold currents. Rats received unilateral 6-hydroxydopamine in the nigrostriatal bundle, causing motor impairment. Changes in M1 were time dependent and bilateral, although stronger in the lesioned than the intact hemisphere. Representation size and threshold current were maximally impaired at 15 d, although inhibition was still detectable at 60-120 d after lesion. Proximal forelimb movements emerged at the expense of the distal ones. Movement lateralization was lost mainly at 30 d after lesion. Systemic L-3,4-dihydroxyphenylalanine partially attenuated motor impairment and cortical changes, particularly in the caudal forelimb area, and completely rescued distal forelimb movements. Local application of the GABA(A) antagonist bicuculline partially restored cortical changes, particularly in the rostral forelimb area. The local anesthetic lidocaine injected into the M1 of the intact hemisphere restored movement lateralization in the lesioned hemisphere. This study provides evidence for motor cortex remodeling after unilateral dopamine denervation, suggesting that cortical changes were associated with dopamine denervation, pathogenic intracortical GABA inhibition, and altered interhemispheric activity.

A randomized clinical trial on the use of medical Portland cement, MTA and calcium hydroxide in indirect pulp treatment.

Science.gov (United States)

Petrou, Marina Agathi; Alhamoui, Fadi Alhaddad; Welk, Alexander; Altarabulsi, Mohammed Basel; Alkilzy, Mohammed; H Splieth, Christian

2014-01-01

Studies on indirect pulp treatment (IPT) show varying success rates of 73 to 97 %. The necessity of re-opening the cavity and the question of the optimal capping material is still under debate. The aim of this prospective in vivo study was to compare the clinical and microbiological outcomes of mineral trioxide aggregate (MTA), medical Portland cement, and calcium hydroxide on the dentin-pulp complex of permanent and primary teeth treated with two-step IPT. In 86 regular patients (51 % men; 49 % women; age 17.2 years ±13.8), one deep carious lesion each was treated with incomplete caries removal, randomly selected capping with either calcium hydroxide (n = 31), medical Portland cement (29) or white MTA (26), and re-entry (6.3 months ±1.0). Clinical (color, humidity, and consistency of dentin) and microbiological (Lactobacilli/Mutans Strep. counts) parameters were recorded at the first and second treatment. The IPT had a high success rate of 90.3 % regardless of the material used (p = 0.72). The arrested lesions showed consistently darker, dry, and therefore, sclerotic dentine (p Portland cement. The findings of this study could promote the improvement of the IPT as a one-step treatment of deep carious lesions when the remaining demineralized dentin would be sealed with durable restorations.

Molecular detection of bacteria associated to dental caries in 4-12-year-old Tunisian children.

Science.gov (United States)

Kouidhi, Bochra; Fdhila, Kais; Ben Slama, Rihab; Mahdouani, Kacem; Hentati, Hajer; Najjari, Fayrouz; Bakhrouf, Amina; Chaieb, Kamel

2014-01-01

The occurrence of several microbial species in the oral cavity of 4-12-year-old Tunisian children was investigated. Samples were taken from 158 children (81 caries actives and 77 caries free). Genomic DNA was extracted and analyzed for the presence of 17 microbial species using a polymerase chain reaction assay. All samples were positive for at least one of the target microbial strains. Streptococcus mutans was the most prevalent species (76.5%) detected in genomic DNA collected from carious lesions. Other prevalent species were Candida spp (63%), Streptococcus salivarius (59%) and Streptococcus oralis (42%). The frequency of Lactobacillus acidophilus, Lactobacillus plantarum, and Lactobacillus casei-group in caries lesions was 29.5%, 34.5% and 22% respectively. Pathogenic bacteria such as Staphylococcus aureus was found in 28.5% of carious lesion samples compared to 15.5% in the control. Frequency of Porphyromonas endodontali, Actinomyces radicidentis and Treponema denticola recovery did not differ significantly between origins of samples. PCR analysis of genomic DNA detect various oral bacteria that differ between caries actives and caries-free children. In addition, the association of same aciduric bacteria (S. mutans, S. salivarius, L. acidophilus) and caries formation was noticed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Low-grade central osteosarcoma in proximal humerus: a rare entity

Directory of Open Access Journals (Sweden)

Tang F

2017-10-01

Full Text Available Fan Tang,1,2 Li Min,1,2 Yong Zhou,1 Yi Luo,1 Chongqi Tu1 1Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, MA, USA Abstract: Low-grade central osteosarcoma is a rare subtype of tumor with low-grade malignancy. Currently, wide resection with negative resection margin is the standard treatment for this disease. The role of neoadjuvant chemotherapy in low-grade central osteosarcoma was controversial and was mostly considered for tumors containing high-grade focal areas. Local tumor recurrences often exhibited a tumor with higher histologic grade or differentiation with the potential for metastases. In low-grade central osteosarcoma, timely wide resection after definite diagnosis can result in 5-year survival for almost 90%. However, the relatively nonspecific radiological and pathological findings make diagnosis very difficult. MDM2 and CDK4 are specific and provide sensitive markers for the diagnosis of low-grade central osteosarcoma, helping to differentiate low-grade central osteosarcoma from some benign lesions, including fibrous dysplasia, bone giant cell tumor, and chondrosarcoma. Here, we report the case of a 19-year-old woman with low-grade central osteosarcoma located at the proximal humerus. The affected site was rare, but the sensitive biomarkers CDK4 and MDM2 were positive. The patient recovered well after wide tumor resection following a proximal humerus endoprosthesis replacement. Our case highlighted the management strategies in low-grade central osteosarcoma. Being familiar with radiographic features, understanding the biological characteristics, and mastering diagnostic biomarkers can help oncologists avoid embarrassing situations in treatment when this rare tumor is highly suspected, even when located at an uncommon site. The discussion in this report

Proximal Probes Facility

Data.gov (United States)

Federal Laboratory Consortium — The Proximal Probes Facility consists of laboratories for microscopy, spectroscopy, and probing of nanostructured materials and their functional properties. At the...

Neighborhoods and manageable proximity

Directory of Open Access Journals (Sweden)

Stavros Stavrides

2011-08-01

Full Text Available The theatricality of urban encounters is above all a theatricality of distances which allow for the encounter. The absolute “strangeness” of the crowd (Simmel 1997: 74 expressed, in its purest form, in the absolute proximity of a crowded subway train, does not generally allow for any movements of approach, but only for nervous hostile reactions and submissive hypnotic gestures. Neither forced intersections in the course of pedestrians or vehicles, nor the instantaneous crossing of distances by the technology of live broadcasting and remote control give birth to places of encounter. In the forced proximity of the metropolitan crowd which haunted the city of the 19th and 20th century, as well as in the forced proximity of the tele-presence which haunts the dystopic prospect of the future “omnipolis” (Virilio 1997: 74, the necessary distance, which is the stage of an encounter between different instances of otherness, is dissipated.

Utility of lead aVR for identifying the culprit lesion in acute myocardial infarction

DEFF Research Database (Denmark)

Kühl, Jørgen Tobias; Berg, Ronan M G

2009-01-01

BACKGROUND: Lead aVR is a neglected, however, potentially useful tool in electrocardiography. Our aim was to evaluate its value in clinical practice, by reviewing existing literature regarding its utility for identifying the culprit lesion in acute myocardial infarction (AMI). METHODS: Based...... on a systematic search strategy, 16 studies were assessed with the intent to pool data; diagnostic test rates were calculated as key results. RESULTS: Five studies investigated if ST-segment elevation (STE) in aVR is valuable for the diagnosis of left main stem stenosis (LMS) in non-ST-segment AMI (NSTEMI......). The studies were too heterogeneous to pool, but the individual studies all showed that STE in aVR has a high negative predictive value (NPV) for LMS. Six studies evaluated if STE in aVR is valuable for distinguishing proximal from distal lesions in the left anterior descending artery (LAD) in anterior ST...

Calculus Rules for V-Proximal Subdifferentials in Smooth Banach Spaces

Directory of Open Access Journals (Sweden)

Messaoud Bounkhel

2016-01-01

Full Text Available In 2010, Bounkhel et al. introduced new proximal concepts (analytic proximal subdifferential, geometric proximal subdifferential, and proximal normal cone in reflexive smooth Banach spaces. They proved, in p-uniformly convex and q-uniformly smooth Banach spaces, the density theorem for the new concepts of proximal subdifferential and various important properties for both proximal subdifferential concepts and the proximal normal cone concept. In this paper, we establish calculus rules (fuzzy sum rule and chain rule for both proximal subdifferentials and we prove the Bishop-Phelps theorem for the proximal normal cone. The limiting concept for both proximal subdifferentials and for the proximal normal cone is defined and studied. We prove that both limiting constructions coincide with the Mordukhovich constructions under some assumptions on the space. Applications to nonconvex minimisation problems and nonconvex variational inequalities are established.

Super-Relaxed ( -Proximal Point Algorithms, Relaxed ( -Proximal Point Algorithms, Linear Convergence Analysis, and Nonlinear Variational Inclusions

Directory of Open Access Journals (Sweden)

Agarwal RaviP

2009-01-01

Full Text Available We glance at recent advances to the general theory of maximal (set-valued monotone mappings and their role demonstrated to examine the convex programming and closely related field of nonlinear variational inequalities. We focus mostly on applications of the super-relaxed ( -proximal point algorithm to the context of solving a class of nonlinear variational inclusion problems, based on the notion of maximal ( -monotonicity. Investigations highlighted in this communication are greatly influenced by the celebrated work of Rockafellar (1976, while others have played a significant part as well in generalizing the proximal point algorithm considered by Rockafellar (1976 to the case of the relaxed proximal point algorithm by Eckstein and Bertsekas (1992. Even for the linear convergence analysis for the overrelaxed (or super-relaxed ( -proximal point algorithm, the fundamental model for Rockafellar's case does the job. Furthermore, we attempt to explore possibilities of generalizing the Yosida regularization/approximation in light of maximal ( -monotonicity, and then applying to first-order evolution equations/inclusions.

Biomechanical evaluation of straight antegrade nailing in proximal humeral fractures: the rationale of the "proximal anchoring point".

Science.gov (United States)

Euler, Simon A; Petri, Maximilian; Venderley, Melanie B; Dornan, Grant J; Schmoelz, Werner; Turnbull, Travis Lee; Plecko, Michael; Kralinger, Franz S; Millett, Peter J

2017-09-01

Varus failure is one of the most common failure modes following surgical treatment of proximal humeral fractures. Straight antegrade nails (SAN) theoretically provide increased stability by anchoring to the densest zone of the proximal humerus (subchondral zone) with the end of the nail. The aim of this study was to biomechanically investigate the characteristics of this "proximal anchoring point" (PAP). We hypothesized that the PAP would improve stability compared to the same construct without the PAP. Straight antegrade humeral nailing was performed in 20 matched pairs of human cadaveric humeri for a simulated unstable two-part fracture. Biomechanical testing, with stepwise increasing cyclic axial loading (50-N increments each 100 cycles) at an angle of 20° abduction revealed significantly higher median loads to failure for SAN constructs with the PAP (median, 450 N; range, 200-1.000 N) compared to those without the PAP (median, 325 N; range, 100-500 N; p = 0.009). SAN constructs with press-fit proximal extensions (endcaps) showed similar median loads to failure (median, 400 N; range, 200-650 N), when compared to the undersized, commercially available SAN endcaps (median, 450 N; range, 200-600 N; p = 0.240). The PAP provided significantly increased stability in SAN constructs compared to the same setup without this additional proximal anchoring point. Varus-displacing forces to the humeral head were superiorly reduced in this setting. This study provides biomechanical evidence for the "proximal anchoring point's" rationale. Straight antegrade humeral nailing may be beneficial for patients undergoing surgical treatment for unstable proximal humeral fractures to decrease secondary varus displacement and thus potentially reduce revision rates.

Individual Assessment of Brain Tissue Changes in MS and the Effect of Focal Lesions on Short-Term Focal Atrophy Development in MS: A Voxel-Guided Morphometry Study

Directory of Open Access Journals (Sweden)

Jan Fox

2016-04-01

Full Text Available We performed voxel-guided morphometry (VGM investigating the mechanisms of brain atrophy in multiple sclerosis (MS related to focal lesions. VGM maps detect regional brain changes when comparing 2 time points on high resolution T1-weighted (T1w magnetic resonace imaging (MRI. Two T1w MR datasets from 92 relapsing-remitting MS patients obtained 12 months apart were analysed with VGM. New lesions and volume changes of focal MS lesions as well as in the surrounding tissue were identified by visual inspection on colour coded VGM maps. Lesions were dichotomized in active and inactive lesions. Active lesions, defined by either new lesions (NL (volume increase > 5% in VGM, chronic enlarging lesions (CEL (pre-existent T1w lesions with volume increase > 5%, or chronic shrinking lesions (CSL (pre-existent T1w lesions with volume reduction > 5% in VGM, were accompanied by tissue shrinkage in surrounding and/or functionally related regions. Volume loss within the corpus callosum was highly correlated with the number of lesions in its close proximity. Volume loss in the lateral geniculate nucleus was correlated with lesions along the optic radiation. VGM analysis provides strong evidence that all active lesion types (NL, CEL, and CSL contribute to brain volume reduction in the vicinity of lesions and/or in anatomically and functionally related areas of the brain.

CT colonography for preoperative examination of the proximal colon using a transanal drainage tube for acute malignant colonic obstruction

International Nuclear Information System (INIS)

Sasaki, Kazuaki; Hirano, Yuji; Oono, Keisuke; Sasaki, Kazunori; Someya, Tetsufumi; Harada, Keisuke; Ezoe, Eiri; Furuhata, Tomohisa; Hirata, Koichi

2011-01-01

The purpose of this study was to evaluate the feasibility of CT colonography for preoperative examination of the proximal colon using a transanal drainage tube in patients with acute colon obstruction caused by colorectal cancer. Ten patients who received initial treatment for acute malignant colon obstruction at our hospital between June 2004 and December 2008 were studied. In these patients, elective surgery was possible after transanal drainage tube insertion, and the colon on the oral side from the cancer lesion was examined using a drainage tube. Air was injected through the tube into the oral side of the colon, and CT colonography was assessed for the presence or absence of lesions on the oral side. The images of the oral side of the colon were good enough to allow adequate interpretation in 9 of the 10 patients. In the first patient, the visualization of the area near the lesion was somewhat fair, although the right side colon was well visualized. There were no complications associated with this examination. The present preoperative examination using a transanal drainage tube was useful for determining the extent of intestinal resection when patients were not candidates for colonoscopy or barium enema examination. (author)

A soft kinetic data structure for lesion border detection.

Science.gov (United States)

Kockara, Sinan; Mete, Mutlu; Yip, Vincent; Lee, Brendan; Aydin, Kemal

2010-06-15

The medical imaging and image processing techniques, ranging from microscopic to macroscopic, has become one of the main components of diagnostic procedures to assist dermatologists in their medical decision-making processes. Computer-aided segmentation and border detection on dermoscopic images is one of the core components of diagnostic procedures and therapeutic interventions for skin cancer. Automated assessment tools for dermoscopic images have become an important research field mainly because of inter- and intra-observer variations in human interpretations. In this study, a novel approach-graph spanner-for automatic border detection in dermoscopic images is proposed. In this approach, a proximity graph representation of dermoscopic images in order to detect regions and borders in skin lesion is presented. Graph spanner approach is examined on a set of 100 dermoscopic images whose manually drawn borders by a dermatologist are used as the ground truth. Error rates, false positives and false negatives along with true positives and true negatives are quantified by digitally comparing results with manually determined borders from a dermatologist. The results show that the highest precision and recall rates obtained to determine lesion boundaries are 100%. However, accuracy of assessment averages out at 97.72% and borders errors' mean is 2.28% for whole dataset.

Practitioner, patient and carious lesion characteristics associated with type of restorative material

DEFF Research Database (Denmark)

Makhija, Sonia K; Gordan, Valeria V; Gilbert, Gregg H

2011-01-01

The authors conducted a study to identify factors associated with the materials that dentists in The Dental Practice-Based Research Network (DPBRN) use when placing the first restoration on permanent posterior tooth surfaces....

Giant proximity effect in ferromagnetic bilayers

Science.gov (United States)

Ramos, Silvia; Charlton, Tim; Quintanilla, Jorge; Suter, Andreas; Moodera, Jagadeesh; Prokscha, Thomas; Salman, Zaher; Forgan, Ted

2013-03-01

The proximity effect is a phenomenon where an ordered state leaks from a material into an adjacent one over some finite distance, ξ. For superconductors, this distance is ~ the coherence length. Nevertheless much longer-range, ``giant'' proximity effects have been observed in cuprate junctions. This surprising effect can be understood as a consequence of critical opalescence. Since this occurs near all second order phase transitions, giant proximity effects should be very general and, in particular, they should be present in magnetic systems. The ferromagnetic proximity effect has the advantage that its order parameter (magnetization) can be observed directly. We investigate the above phenomenon in Co/EuS bilayer films, where both materials undergo ferromagnetic transitions but at rather different temperatures (bulk TC of 1400K for Co and 16.6K for EuS). A dramatic increase in the range of the proximity effect is expected near the TC of EuS. We present the results of our measurements of the magnetization profiles as a function of temperature, carried out using the complementary techniques of low energy muon rotation and polarized neutron reflectivity. Work supported by EPSRC, STFC and ONR grant N00014-09-1-0177 and NSF grant DMR 0504158.

Quantum Proximity Resonances

International Nuclear Information System (INIS)

Heller, E.J.

1996-01-01

It is well known that at long wavelengths λ an s-wave scatterer can have a scattering cross section σ on the order of λ 2 , much larger than its physical size, as measured by the range of its potential. Very interesting phenomena can arise when two or more identical scatterers are placed close together, well within one wavelength. We show that, for a pair of identical scatterers, an extremely narrow p-wave open-quote open-quote proximity close-quote close-quote resonance develops from a broader s-wave resonance of the individual scatterers. A new s-wave resonance of the pair also appears. The relation of these proximity resonances (so called because they appear when the scatterers are close together) to the Thomas and Efimov effects is discussed. copyright 1996 The American Physical Society

Early results for treatment of two- and three-part fractures of the proximal humerus using Contours PHP (proximal humeral plate).

Science.gov (United States)

Biazzo, Alessio; Cardile, Carlo; Brunelli, Luca; Ragni, Paolo; Clementi, Daniele

2017-04-28

The management of displaced 2- and 3-part fractures of the proximal humerus is controversial, both in younger and in elderly patients. The purpose of this paper is to evaluate the functional results of the Contours Proximal Humerus Plate (OrthofixR, Bussolengo,Verona, Italy), for the treatment of displaced 2- and 3-part fractures of the proximal humerus. We retrospectively reviewed 55 patients with proximal humerus fractures, who underwent osteosynthesis with Contours Proximal Humerus Plate from December 2011 to March 2015. We had 21 patients with 2-part fractures and with an average age of 67.1 years and 34 patients with 3-part fractures, with average age of 63.6 years. The average union time was 3 months. The mean Constant score was 67 for 2-part fracture group and 64.9 for 3-part fracture group. The difference was not statistically significant (p = 0.18). The overall complication rate was 14.5 %. Six patients underwent additional surgery (10.9%). The most frequent major complication was secondary loss of reduction following varus collapse of the fracture (2 cases). In these patients, there was loss of medial hinge integrity due to impaction and osteoporosis. The placement of the main locking screw in the calcar area to provide inferomedial support is the rational of the Contours Proximal Humerus Plate. Osteosynthesis with Contours Proximal Humerus Plate is a safe system for treating displaced 2- and 3-part fractures of the proximal humerus, with good functional results and complication rates comparable to those reported in the literature.

[Lightning strike and lesions outside the brain: Clinical cases and a review of the literature].

Science.gov (United States)

Morin, A; Lesourd, A; Cabane, J

2015-01-01

Every year, 240,000 people are struck by lightning worldwide, causing injuries leading to significant handicaps. Most of the symptoms involve brain lesions; neuromuscular sequelae and myelopathy are less common. We describe five cases of patients struck by lightning with various clinical presentations. The first patient presented painful paresthesias in both upper limbs that disappeared 18 months later; the injury was a plexopathy. The second patient developed proximal weakness in the upper-left limb due to a myopathy. Two patients presented with various motor weaknesses in the lower limbs due to motor neuron disease and myelopathy. The last patient had a transient tetraplegy, which resolved in 5minutes; the diagnosis was keraunoparalysis. Lightning injuries can have many consequences depending on the different mechanisms involved. The clinical presentation is often due to a very focal lesion without any secondary extension. Motor neuron disease probably results from post-traumatic myelopathy. We discuss the ALS-electrocution association, frequently described in the literature. Various peripheral nerve and spinal cord lesions can be seen in lightning strike victims involving myelopathy, motor neuron, muscle and plexus. Clinical syndromes are often atypical but outcome is often favorable. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Chest Wall Toxicity After Stereotactic Body Radiotherapy for Malignant Lesions of the Lung and Liver

International Nuclear Information System (INIS)

Andolino, David L.; Forquer, Jeffrey A.; Henderson, Mark A.; Barriger, Robert B.; Shapiro, Ronald H.; Brabham, Jeffrey G.; Johnstone, Peter A.S.; Cardenes, Higinia R.; Fakiris, Achilles J.

2011-01-01

Purpose: To quantify the frequency of rib fracture and chest wall (CW) pain and identify the dose-volume parameters that predict CW toxicity after stereotactic body radiotherapy (SBRT). Methods and Materials: The records of patients treated with SBRT between 2000 and 2008 were reviewed, and toxicity was scored according to Common Terminology Criteria for Adverse Events v3.0 for pain and rib fracture. Dosimetric data for CW and rib were analyzed and related to the frequency of toxicity. The risks of CW toxicity were then further characterized according to the median effective concentration (EC 50 ) dose-response model. Results: A total of 347 lesions were treated with a median follow-up of 19 months. Frequency of Grade I and higher CW pain and/or fracture for CW vs. non-CW lesions was 21% vs. 4%, respectively (p 2 > 0.9). According to the EC 50 model, 5 cc and 15 cc of CW receiving 40 Gy predict a 10% and 30% risk of CW toxicity, respectively. Conclusion: Adequate tumor coverage remains the primary objective when treating lung or liver lesions with SBRT. To minimize toxicity when treating lesions in close proximity to the CW, Dmax of the CW and/or ribs should remain <50 Gy, and <5 cc of CW should receive ≥40 Gy.

Proximal Hamstring Tendinosis and Partial Ruptures.

Science.gov (United States)

Startzman, Ashley N; Fowler, Oliver; Carreira, Dominic

2017-07-01

Proximal hamstring tendinosis and partial hamstring origin ruptures are painful conditions of the proximal thigh and hip that may occur in the acute, chronic, or acute on chronic setting. Few publications exist related to their diagnosis and management. This systematic review discusses the incidence, treatment, and prognosis of proximal hamstring tendinosis and partial hamstring ruptures. Conservative treatment measures include nonsteroidal anti-inflammatory drugs, physical therapy, rest, and ice. If these measures fail, platelet-rich plasma or shockwave therapy may be considered. When refractory to conservative management, these injuries may be treated with surgical debridement and hamstring reattachment. [Orthopedics. 2017; 40(4):e574-e582.]. Copyright 2017, SLACK Incorporated.

A System Approach to Navy Medical Education and Training. Appendix 44. Competency Curriculum for Dental Assistant.

Science.gov (United States)

1974-08-31

Apply medication/treat carious lesion g. Irrigate pericoroniti3 h. Drain periodontal abscess i. Apply temporary sedative crown to fractured tooth J...TASKS a. Educate patients regarding relationship of plaque, caries, periodontal disease and oral health b. Instruct patient in use of plaque...microorganisms, caries Causes and effects of periodontal disease 35 I| Competency: DENTAL ASSISTANT (DA) Unit: Preventive Dentistry ( MODULE 3: ORAL

MR imaging findings of anterior interosseous nerve lesions

Energy Technology Data Exchange (ETDEWEB)

Dunn, Andrew J. [Royal Liverpool University Hospital, Department of Medical Imaging, Liverpool (United Kingdom); Salonen, David C. [University of Toronto, Toronto Western Hospital, Department of Medical Imaging, Toronto, Ontario (Canada); Anastakis, Dimitri J. [University of Toronto, Toronto Western Hospital, Division of Plastic Surgery, Toronto, Ontario (Canada)

2007-12-15

To study and characterise the MR imaging findings of lesions of the anterior interosseous nerve (AIN). Magnetic resonance imaging (MRI) findings of the forearm of ten patients referred to our institution with suspected AIN lesions were retrospectively studied. Five healthy volunteers with normal forearm MRI findings formed a control group. Two musculoskeletal radiologists assessed the forearm musculature for oedema in the distribution of the AIN, median, posterior interosseous and radial nerves on T2-weighted (T2W) fat-saturated sequences. T1-weighted (T1W) images were assessed and graded for the presence of muscle atrophy and fatty involution. Six patients had undergone surgical exploration; five of these had surgically confirmed AIN compression. Four patients had diagnoses other than AIN compression made on imaging features. Of the cases of proven AIN compression, oedema within the pronator quadratus (PQ) muscle was identified in all cases. PQ atrophy and fatty involution were seen in three (43%) surgically confirmed cases. Cases 2 and 3 also demonstrated oedema in the flexor digitorum profundus (FDP)1 and FDP2 muscles. These cases also showed oedema in the flexor-carpi radialis (FCR) and FDP3/FDP4 muscles, respectively. The four cases of non-AIN compression demonstrated muscle oedema patterns that were atypical for the AIN distribution. They included a rupture of the flexor pollicis longus (FPL) tendon, brachial neuritis, amyotrophic lateral sclerosis and compression of the proximal median nerve. MRI is a useful investigation in the diagnostic workup of AIN syndrome. AIN syndrome is likely when there is diffuse oedema of AIN innervated muscles on T2W fat-saturated images. The most reliable sign of an AIN lesion is oedema within the PQ. Oedema in the flexor carpi radialis, FDP3 and FDP4, although not in the classical distribution of the AIN, does not preclude the diagnosis of AIN syndrome. (orig.)

MR imaging findings of anterior interosseous nerve lesions

International Nuclear Information System (INIS)

Dunn, Andrew J.; Salonen, David C.; Anastakis, Dimitri J.

2007-01-01

To study and characterise the MR imaging findings of lesions of the anterior interosseous nerve (AIN). Magnetic resonance imaging (MRI) findings of the forearm of ten patients referred to our institution with suspected AIN lesions were retrospectively studied. Five healthy volunteers with normal forearm MRI findings formed a control group. Two musculoskeletal radiologists assessed the forearm musculature for oedema in the distribution of the AIN, median, posterior interosseous and radial nerves on T2-weighted (T2W) fat-saturated sequences. T1-weighted (T1W) images were assessed and graded for the presence of muscle atrophy and fatty involution. Six patients had undergone surgical exploration; five of these had surgically confirmed AIN compression. Four patients had diagnoses other than AIN compression made on imaging features. Of the cases of proven AIN compression, oedema within the pronator quadratus (PQ) muscle was identified in all cases. PQ atrophy and fatty involution were seen in three (43%) surgically confirmed cases. Cases 2 and 3 also demonstrated oedema in the flexor digitorum profundus (FDP)1 and FDP2 muscles. These cases also showed oedema in the flexor-carpi radialis (FCR) and FDP3/FDP4 muscles, respectively. The four cases of non-AIN compression demonstrated muscle oedema patterns that were atypical for the AIN distribution. They included a rupture of the flexor pollicis longus (FPL) tendon, brachial neuritis, amyotrophic lateral sclerosis and compression of the proximal median nerve. MRI is a useful investigation in the diagnostic workup of AIN syndrome. AIN syndrome is likely when there is diffuse oedema of AIN innervated muscles on T2W fat-saturated images. The most reliable sign of an AIN lesion is oedema within the PQ. Oedema in the flexor carpi radialis, FDP3 and FDP4, although not in the classical distribution of the AIN, does not preclude the diagnosis of AIN syndrome. (orig.)

Proximal Participation: A Pathway into Work

Science.gov (United States)

Chan, Selena

2013-01-01

In a longitudinal case study of apprentices, the term proximal participation was coined to describe the entry process of young people, with unclear career destinations, into the trade of baking. This article unravels the significance of proximal participation in the decision-making processes of young people who enter a trade through initial…

Photoacoustic imaging of hidden dental caries by using a bundle of hollow optical fibers

Science.gov (United States)

Koyama, Takuya; Kakino, Satoko; Matsuura, Yuji

2018-02-01

Photoacoustic imaging system using a bundle of hollow-optical fibers to detect hidden dental caries is proposed. Firstly, we fabricated a hidden caries model with a brown pigment simulating a common color of caries lesion. It was found that high frequency ultrasonic waves are generated from hidden carious part when radiating Nd:YAG laser light with a 532 nm wavelength to occlusal surface of model tooth. We calculated by Fourier transform and found that the waveform from the carious part provides frequency components of approximately from 0.5 to 1.2 MHz. Then a photoacoustic imaging system using a bundle of hollow optical fiber was fabricated for clinical applications. From intensity map of frequency components in 0.5-1.2 MHz, photoacoustic images of hidden caries in the simulated samples were successfully obtained.

Ultimate and proximate explanations of strong reciprocity.

Science.gov (United States)

Vromen, Jack

2017-08-23

Strong reciprocity (SR) has recently been subject to heated debate. In this debate, the "West camp" (West et al. in Evol Hum Behav 32(4):231-262, 2011), which is critical of the case for SR, and the "Laland camp" (Laland et al. in Science, 334(6062):1512-1516, 2011, Biol Philos 28(5):719-745, 2013), which is sympathetic to the case of SR, seem to take diametrically opposed positions. The West camp criticizes advocates of SR for conflating proximate and ultimate causation. SR is said to be a proximate mechanism that is put forward by its advocates as an ultimate explanation of human cooperation. The West camp thus accuses advocates of SR for not heeding Mayr's original distinction between ultimate and proximate causation. The Laland camp praises advocates of SR for revising Mayr's distinction. Advocates of SR are said to replace Mayr's uni-directional view on the relation between ultimate and proximate causes by the bi-directional one of reciprocal causation. The paper argues that both the West camp and the Laland camp misrepresent what advocates of SR are up to. The West camp is right that SR is a proximate cause of human cooperation. But rather than putting forward SR as an ultimate explanation, as the West camp argues, advocates of SR believe that SR itself is in need of ultimate explanation. Advocates of SR tend to take gene-culture co-evolutionary theory as the correct meta-theoretical framework for advancing ultimate explanations of SR. Appearances notwithstanding, gene-culture coevolutionary theory does not imply Laland et al.'s notion of reciprocal causation. "Reciprocal causation" suggests that proximate and ultimate causes interact simultaneously, while advocates of SR assume that they interact sequentially. I end by arguing that the best way to understand the debate is by disambiguating Mayr's ultimate-proximate distinction. I propose to reserve "ultimate" and "proximate" for different sorts of explanations, and to use other terms for distinguishing

Prosthetic replacement for proximal humeral fractures.

Science.gov (United States)

Kontakis, George; Tosounidis, Theodoros; Galanakis, Ioannis; Megas, Panagiotis

2008-12-01

The ideal management of complex proximal humeral fractures continues to be debatable. Evolution of proximal humeral fracture management, during the past decade, led to the implementation of many innovations in surgical treatment. Even though the pendulum of treatment seems to swing towards new trends such as locked plating, hemiarthroplasty remains a valid and reliable option that serves the patient's needs well. Hemiarthroplasty is indicated for complex proximal humeral fractures in elderly patients with poor bone stock and when internal fixation is difficult or unreliable. Hemiarthroplasty provides a better result when it is performed early post-injury. Stem height, retroversion and tuberosity positioning are technical aspects of utmost importance. Additionally reverse total shoulder arthroplasty is an alternative new modality that can be used as a primary solution in selected patients with proximal humeral fracture treatment. Failed hemiarthroplasty and fracture sequelae can be successfully managed with reverse total shoulder arthroplasty. Individual decision-making and tailored treatment that takes into consideration the personality of the fracture and the patient's characteristics should be used.

Industrial Computed Tomography using Proximal Algorithm

KAUST Repository

Zang, Guangming

2016-04-14

In this thesis, we present ProxiSART, a flexible proximal framework for robust 3D cone beam tomographic reconstruction based on the Simultaneous Algebraic Reconstruction Technique (SART). We derive the proximal operator for the SART algorithm and use it for minimizing the data term in a proximal algorithm. We show the flexibility of the framework by plugging in different powerful regularizers, and show its robustness in achieving better reconstruction results in the presence of noise and using fewer projections. We compare our framework to state-of-the-art methods and existing popular software tomography reconstruction packages, on both synthetic and real datasets, and show superior reconstruction quality, especially from noisy data and a small number of projections.

Comparison of the Remineralizing Effects of Sodium Fluoride and Bioactive Glass Using Bioerodible Gel Systems

Directory of Open Access Journals (Sweden)

Attiguppe Ramashetty Prabhakar

2009-12-01

Full Text Available Background and aims. A carious lesion is the accumulation of numerous episodes of de- and remineralization, rather than a unidirectional demineralization process. Tooth destruction can be arrested or reversed by the frequent delivery of fluoride or calcium/phosphorous ions to the tooth surface. The present study compared and evaluated the remineralization potential of sodium fluoride and bioactive glass delivered through a bioerodible gel system. Materials and methods. Longitudinal sections of artificial carious lesions, created at the gingivofacial surface of 64 primary maxillary incisors were photographed under a polarized light microscope and quantified for demineralization. The sections were repositioned into the tooth form and randomly mounted in sets of four that simulated an arch form. The teeth were divided into 4 groups: 1 sodium fluoride films, 2 bioactive glass films, 3 control films placed interproximally and 4 nontreatment group. Following exposure to artificial saliva for 30 days, the lesions were again photographed and quantified as above. The recorded values were statistically analyzed using Student’s paired t-test for intragroup comparison, one-way ANOVA and Post-Hoc Tukey’s test for pairwise comparison. Results. The sodium fluoride and bioactive gel groups showed significant remineralization compared with the control groups (P < 0.001. Conclusion. Bioerodible gel films can be used to deliver remineralizing agents to enhance remineralization.

Health burden of skin lesions at low arsenic exposure through groundwater in Pakistan. Is river the source?

International Nuclear Information System (INIS)

Fatmi, Zafar; Azam, Iqbal; Ahmed, Faiza; Kazi, Ambreen; Gill, Albert Bruce; Kadir, Muhmmad Masood; Ahmed, Mubashir; Ara, Naseem; Janjua, Naveed Zafar

2009-01-01

A significant proportion of groundwater in south Asia is contaminated with arsenic. Pakistan has low levels of arsenic in groundwater compared with China, Bangladesh and India. A representative multi-stage cluster survey conducted among 3874 persons ≥15 years of age to determine the prevalence of arsenic skin lesions, its relation with arsenic levels and cumulative arsenic dose in drinking water in a rural district (population: 1.82 million) in Pakistan. Spot-urine arsenic levels were compared among individuals with and without arsenic skin lesions. In addition, the relation of age, body mass index, smoking status with arsenic skin lesions was determined. The geographical distribution of the skin lesions and arsenic-contaminated wells in the district were ascertained using global positioning system. The total arsenic, inorganic and organic forms, in water and spot-urine samples were determined by atomic absorption spectrophotometry. The prevalence of skin lesions of arsenic was estimated for complex survey design, using surveyfreq and surveylogistic options of SAS 9.1 software.The prevalence of definitive cases i.e. hyperkeratosis of both palms and soles, was 3.4 per 1000 and suspected cases i.e. any sign of arsenic skin lesions (melanosis and/or keratosis), were 13.0 per 1000 among ≥15-year-old persons in the district. Cumulative arsenic exposure (dose) was calculated from levels of arsenic in water and duration of use of current drinking water source. Prevalence of skin lesions increases with cumulative arsenic exposure (dose) in drinking water and arsenic levels in urine. Skin lesions were 2.5-fold among individuals with BMI 2 . Geographically, more arsenic-contaminated wells and skin lesions were alongside Indus River, suggests a strong link between arsenic contamination of groundwater with proximity to river.This is the first reported epidemiological and clinical evidence of arsenic skin lesions due to groundwater in Pakistan. Further investigations and

Health burden of skin lesions at low arsenic exposure through groundwater in Pakistan. Is river the source?

Energy Technology Data Exchange (ETDEWEB)

Fatmi, Zafar, E-mail: zafar.fatmi@aku.edu [Department of Community Health Sciences, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi (Pakistan); Azam, Iqbal; Ahmed, Faiza; Kazi, Ambreen; Gill, Albert Bruce; Kadir, Muhmmad Masood; Ahmed, Mubashir; Ara, Naseem; Janjua, Naveed Zafar [Department of Community Health Sciences, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi (Pakistan)

2009-07-15

A significant proportion of groundwater in south Asia is contaminated with arsenic. Pakistan has low levels of arsenic in groundwater compared with China, Bangladesh and India. A representative multi-stage cluster survey conducted among 3874 persons {>=}15 years of age to determine the prevalence of arsenic skin lesions, its relation with arsenic levels and cumulative arsenic dose in drinking water in a rural district (population: 1.82 million) in Pakistan. Spot-urine arsenic levels were compared among individuals with and without arsenic skin lesions. In addition, the relation of age, body mass index, smoking status with arsenic skin lesions was determined. The geographical distribution of the skin lesions and arsenic-contaminated wells in the district were ascertained using global positioning system. The total arsenic, inorganic and organic forms, in water and spot-urine samples were determined by atomic absorption spectrophotometry. The prevalence of skin lesions of arsenic was estimated for complex survey design, using surveyfreq and surveylogistic options of SAS 9.1 software.The prevalence of definitive cases i.e. hyperkeratosis of both palms and soles, was 3.4 per 1000 and suspected cases i.e. any sign of arsenic skin lesions (melanosis and/or keratosis), were 13.0 per 1000 among {>=}15-year-old persons in the district. Cumulative arsenic exposure (dose) was calculated from levels of arsenic in water and duration of use of current drinking water source. Prevalence of skin lesions increases with cumulative arsenic exposure (dose) in drinking water and arsenic levels in urine. Skin lesions were 2.5-fold among individuals with BMI <18.5 kg/m{sup 2}. Geographically, more arsenic-contaminated wells and skin lesions were alongside Indus River, suggests a strong link between arsenic contamination of groundwater with proximity to river.This is the first reported epidemiological and clinical evidence of arsenic skin lesions due to groundwater in Pakistan. Further

Health burden of skin lesions at low arsenic exposure through groundwater in Pakistan. Is river the source?

Science.gov (United States)

Fatmi, Zafar; Azam, Iqbal; Ahmed, Faiza; Kazi, Ambreen; Gill, Albert Bruce; Kadir, Muhmmad Masood; Ahmed, Mubashir; Ara, Naseem; Janjua, Naveed Zafar

2009-07-01

A significant proportion of groundwater in south Asia is contaminated with arsenic. Pakistan has low levels of arsenic in groundwater compared with China, Bangladesh and India. A representative multi-stage cluster survey conducted among 3874 persons > or = 15 years of age to determine the prevalence of arsenic skin lesions, its relation with arsenic levels and cumulative arsenic dose in drinking water in a rural district (population: 1.82 million) in Pakistan. Spot-urine arsenic levels were compared among individuals with and without arsenic skin lesions. In addition, the relation of age, body mass index, smoking status with arsenic skin lesions was determined. The geographical distribution of the skin lesions and arsenic-contaminated wells in the district were ascertained using global positioning system. The total arsenic, inorganic and organic forms, in water and spot-urine samples were determined by atomic absorption spectrophotometry. The prevalence of skin lesions of arsenic was estimated for complex survey design, using surveyfreq and surveylogistic options of SAS 9.1 software.The prevalence of definitive cases i.e. hyperkeratosis of both palms and soles, was 3.4 per 1000 and suspected cases i.e. any sign of arsenic skin lesions (melanosis and/or keratosis), were 13.0 per 1000 among > or = 15-year-old persons in the district. Cumulative arsenic exposure (dose) was calculated from levels of arsenic in water and duration of use of current drinking water source. Prevalence of skin lesions increases with cumulative arsenic exposure (dose) in drinking water and arsenic levels in urine. Skin lesions were 2.5-fold among individuals with BMI <18.5 kg/m2. Geographically, more arsenic-contaminated wells and skin lesions were alongside Indus River, suggests a strong link between arsenic contamination of groundwater with proximity to river.This is the first reported epidemiological and clinical evidence of arsenic skin lesions due to groundwater in Pakistan. Further

Clinical Evaluation of a Self-Etch Adhesive System in Non-Carious ...

African Journals Online (AJOL)

Objective: To evaluate the clinical performance of a selfetch adhesive system – Adper's Prompt L-Pop in noncarious cervical lesions over a six months period. Method: One hundred and eighty-one (181) restorations were placed by one operator for 35 patients. The self-etch adhesive was applied to the cavity and composite ...

Impact of Lesion Length on Functional Significance in Intermediate Coronary Lesions

Directory of Open Access Journals (Sweden)

Morteza Safi

2017-07-01

Full Text Available Introduction: The present study aimed at assessing the role of lesion length in predicting Fractional Flow Reserve (FFR value for physiological evaluation of intermediate coronary lesions.Methods: In the current study, 68 patients with 83 coronary lesions were enrolled. All of the patients in this study underwent routine coronary angiography, according to appropriate indications. To evaluate physiologically significant intermediate coronary stenosis (defined between 40% and 70% on visual estimation, the Fractional Flow Reserve (FFR study was performed and the Quantitative Coronary Angiography (QCA data were also assessed for measurement of lesion length. The correlation between QCA data and FFR values was also examined.Results: Eighty-three lesions were evaluated from 68 patients. Stenosis was considered physiologically significant when FFR was lower than 0.75. The FFR was significant in twelve lesions (14.5%. There was a negative correlation between FFR value and lesion length (r = -0.294 and P = 0.013. Moreover, lesion length in physiologically significant FFR group (21.07  ± 6.9 was greater than that of the non-significant FFR group (15.23 ± 6.5 (P value < 0.05. Furthermore, the correlation between QCA data and FFR values was also investigated, yet, there was only a positive correlation between FFR and Minimum Luminal Diameter (MLD values (r = 0.248 and P value = 0.04. The Receiver Operating Characteristic (ROC curve analysis for predicting the significant FFR value demonstrated that a lesion length greater than 17.5 mm was the best cut-off point for prediction of the significant FFR value with acceptable sensitivity and specificity of 83.3% and 68.8%, respectively.Conclusions: There is a negative correlation between lesion length and FFR value in intermediate coronary lesions. In addition, a lesion length greater than 17.5 mm is the best cut- off point for prediction of significant FFR values.

In vitro Comparative Evaluation of Various Restorative Materials used for restoring Class III Cavities in Deciduous Anterior Teeth: A Clinical Study.

Science.gov (United States)

Priyank, Harsh; Verma, Ankita; Gupta, Komal; Chaudhary, Esha; Khandelwal, Deepak; Nihalani, Shweta

2016-12-01

Beauty standards in today's modernized world scenario are formed by well-aligned and well-designed bright white teeth. One of the major reasons behind patients reporting to dental clinics is pain. Caries in the anterior primary teeth forms one of the major concerns from a restorative point of view. Very few studies are quoted in literature which stresses on the follow-up of anterior restorations in primary teeth. Hence, we evaluated and compared the efficacy of composite resin and resin-modified glass ionomer cement (RGIC) for class III restorations in primary anterior teeth. The present study was conducted in the pediatric dental wing and included a total of 80 patients aged 3 to 5½ years who reported with the chief complaint of carious lesions in the primary anterior teeth. Patients having minimal of a pair of similar appearing small carious lesions on the same proximal surfaces of the deciduous maxillary incisors were included for the study. All the patients were randomly divided into two groups: One in which RGIC restoration was done and other in which composite restoration was done. Cavity preparation was done and filling of the cavity with the restorative materials was carried out. Assessment of the restorations was done at 4, 8, and 12 months time following criteria given by Ryge et al. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Mann-Whitney test and one-way analysis of variance (ANOVA) were used to evaluate the level of significance; p value less than 0.05 was considered as significant. For composite and RGIC restorations, the mean score for anatomic shape was 1.21 and 1.10 respectively. While comparing the clinical parameters, nonsignificant results were obtained between composite and RGIC restorative materials at 4-, 8-, and 12-month interval. On comparing the clinical parameters for individual restorative materials at different time intervals, statistically significant results were obtained only for

Proximity sensor system development. CRADA final report

Energy Technology Data Exchange (ETDEWEB)

Haley, D.C. [Oak Ridge National Lab., TN (United States); Pigoski, T.M. [Merrit Systems, Inc. (United States)

1998-01-01

Lockheed Martin Energy Research Corporation (LMERC) and Merritt Systems, Inc. (MSI) entered into a Cooperative Research and Development Agreement (CRADA) for the development and demonstration of a compact, modular proximity sensing system suitable for application to a wide class of manipulator systems operated in support of environmental restoration and waste management activities. In teleoperated modes, proximity sensing provides the manipulator operator continuous information regarding the proximity of the manipulator to objects in the workspace. In teleoperated and robotic modes, proximity sensing provides added safety through the implementation of active whole arm collision avoidance capabilities. Oak Ridge National Laboratory (ORNL), managed by LMERC for the United States Department of Energy (DOE), has developed an application specific integrated circuit (ASIC) design for the electronics required to support a modular whole arm proximity sensing system based on the use of capacitive sensors developed at Sandia National Laboratories. The use of ASIC technology greatly reduces the size of the electronics required to support the selected sensor types allowing deployment of many small sensor nodes over a large area of the manipulator surface to provide maximum sensor coverage. The ASIC design also provides a communication interface to support sensor commands from and sensor data transmission to a distributed processing system which allows modular implementation and operation of the sensor system. MSI is a commercial small business specializing in proximity sensing systems based upon infrared and acoustic sensors.

Proximity sensor system development. CRADA final report

International Nuclear Information System (INIS)

Haley, D.C.; Pigoski, T.M.

1998-01-01

Lockheed Martin Energy Research Corporation (LMERC) and Merritt Systems, Inc. (MSI) entered into a Cooperative Research and Development Agreement (CRADA) for the development and demonstration of a compact, modular proximity sensing system suitable for application to a wide class of manipulator systems operated in support of environmental restoration and waste management activities. In teleoperated modes, proximity sensing provides the manipulator operator continuous information regarding the proximity of the manipulator to objects in the workspace. In teleoperated and robotic modes, proximity sensing provides added safety through the implementation of active whole arm collision avoidance capabilities. Oak Ridge National Laboratory (ORNL), managed by LMERC for the United States Department of Energy (DOE), has developed an application specific integrated circuit (ASIC) design for the electronics required to support a modular whole arm proximity sensing system based on the use of capacitive sensors developed at Sandia National Laboratories. The use of ASIC technology greatly reduces the size of the electronics required to support the selected sensor types allowing deployment of many small sensor nodes over a large area of the manipulator surface to provide maximum sensor coverage. The ASIC design also provides a communication interface to support sensor commands from and sensor data transmission to a distributed processing system which allows modular implementation and operation of the sensor system. MSI is a commercial small business specializing in proximity sensing systems based upon infrared and acoustic sensors

Locking plate fixation for proximal humerus fractures.

LENUS (Irish Health Repository)

Burke, Neil G

2012-02-01

Locking plates are increasingly used to surgically treat proximal humerus fractures. Knowledge of the bone quality of the proximal humerus is important. Studies have shown the medial and dorsal aspects of the proximal humeral head to have the highest bone strength, and this should be exploited by fixation techniques, particularly in elderly patients with osteoporosis. The goals of surgery for proximal humeral fractures should involve minimal soft tissue dissection and achieve anatomic reduction of the head complex with sufficient stability to allow for early shoulder mobilization. This article reviews various treatment options, in particular locking plate fixation. Locking plate fixation is associated with a high complication rate, such as avascular necrosis (7.9%), screw cutout (11.6%), and revision surgery (13.7%). These complications are frequently due to the varus deformation of the humeral head. Strategic screw placement in the humeral head would minimize the possibility of loss of fracture reduction and potential hardware complications. Locking plate fixation is a good surgical option for the management of proximal humerus fractures. Complications can be avoided by using better bone stock and by careful screw placement in the humeral head.

Proximal collagenous gastroenteritides:

DEFF Research Database (Denmark)

Nielsen, Ole Haagen; Riis, Lene Buhl; Danese, Silvio

2014-01-01

AIM: While collagenous colitis represents the most common form of the collagenous gastroenteritides, the collagenous entities affecting the proximal part of the gastrointestinal tract are much less recognized and possibly overlooked. The aim was to summarize the latest information through a syste...

Promoting proximal formative assessment with relational discourse

Science.gov (United States)

Scherr, Rachel E.; Close, Hunter G.; McKagan, Sarah B.

2012-02-01

The practice of proximal formative assessment - the continual, responsive attention to students' developing understanding as it is expressed in real time - depends on students' sharing their ideas with instructors and on teachers' attending to them. Rogerian psychology presents an account of the conditions under which proximal formative assessment may be promoted or inhibited: (1) Normal classroom conditions, characterized by evaluation and attention to learning targets, may present threats to students' sense of their own competence and value, causing them to conceal their ideas and reducing the potential for proximal formative assessment. (2) In contrast, discourse patterns characterized by positive anticipation and attention to learner ideas increase the potential for proximal formative assessment and promote self-directed learning. We present an analysis methodology based on these principles and demonstrate its utility for understanding episodes of university physics instruction.

The Influence of Insulin Dependent Diabetes Mellitus on Dental Caries and Salivary Flow.

Science.gov (United States)

Gupta, V K; Malhotra, Seema; Sharma, Vasuda; Hiremath, S S

2014-01-01

Objective. To assess whether or not there was any change in the dental caries and rate of salivary flow of patients with Insulin Dependent Diabetes Mellitus (IDDM) and the contribution of salivary flow to caries risk in IDDM. Setting. Department of Endocrinology, MS Ramaiah Hospital, Bangalore, India. Design. A comparative cross-sectional descriptive type. Materials and Methods. The sample consisted of two groups: 140 diabetic group (mean age 14.8 yr) and 140 nondiabetic group (mean age 13.7 yr). Dental caries by dmf(t) and dmf(s) indices for primary dentition and DMF(T) and DMF(S) indices was used in permanent dentition to assess the dental caries experience. Both stimulated and unstimulated salivary flow rate were assessed after collection of saliva. Results. In diabetic group 76% had carious lesion and in nondiabetic group 85.3% had carious lesion. Diabetics have lower mean DMFT, DMFS, dmft, and dmfs compared to the nondiabetic group. Diminished unstimulated and stimulated salivary flow rate in diabetic than nondiabetic group. Conclusions. The findings obtained conclude that even though there was reduced salivary flow rate in diabetic group the caries prevalence was low.

The Influence of Insulin Dependent Diabetes Mellitus on Dental Caries and Salivary Flow

Directory of Open Access Journals (Sweden)

V. K. Gupta

2014-01-01

Full Text Available Objective. To assess whether or not there was any change in the dental caries and rate of salivary flow of patients with Insulin Dependent Diabetes Mellitus (IDDM and the contribution of salivary flow to caries risk in IDDM. Setting. Department of Endocrinology, MS Ramaiah Hospital, Bangalore, India. Design. A comparative cross-sectional descriptive type. Materials and Methods. The sample consisted of two groups: 140 diabetic group (mean age 14.8 yr and 140 nondiabetic group (mean age 13.7 yr. Dental caries by dmf(t and dmf(s indices for primary dentition and DMF(T and DMF(S indices was used in permanent dentition to assess the dental caries experience. Both stimulated and unstimulated salivary flow rate were assessed after collection of saliva. Results. In diabetic group 76% had carious lesion and in nondiabetic group 85.3% had carious lesion. Diabetics have lower mean DMFT, DMFS, dmft, and dmfs compared to the nondiabetic group. Diminished unstimulated and stimulated salivary flow rate in diabetic than nondiabetic group. Conclusions. The findings obtained conclude that even though there was reduced salivary flow rate in diabetic group the caries prevalence was low.

Psychological responses to the proximity of climate change

Science.gov (United States)

Brügger, Adrian; Dessai, Suraje; Devine-Wright, Patrick; Morton, Thomas A.; Pidgeon, Nicholas F.

2015-12-01

A frequent suggestion to increase individuals' willingness to take action on climate change and to support relevant policies is to highlight its proximal consequences, that is, those that are close in space and time. But previous studies that have tested this proximizing approach have not revealed the expected positive effects on individual action and support for addressing climate change. We present three lines of psychological reasoning that provide compelling arguments as to why highlighting proximal impacts of climate change might not be as effective a way to increase individual mitigation and adaptation efforts as is often assumed. Our contextualization of the proximizing approach within established psychological research suggests that, depending on the particular theoretical perspective one takes on this issue, and on specific individual characteristics suggested by these perspectives, proximizing can bring about the intended positive effects, can have no (visible) effect or can even backfire. Thus, the effects of proximizing are much more complex than is commonly assumed. Revealing this complexity contributes to a refined theoretical understanding of the role that psychological distance plays in the context of climate change and opens up further avenues for future research and for interventions.

Critical Proximity as a Methodological Move in Techno-Anthropology

DEFF Research Database (Denmark)

Birkbak, Andreas; Petersen, Morten Krogh; Elgaard Jensen, Torben

2015-01-01

proximity.’ Critical proximity offers an alternative to critical distance, especially with respect to avoiding premature references to abstract panoramas such as democratization and capitalist exploitation in the quest to conduct ‘critical’ analysis. Critical proximity implies, instead, granting the beings...

Detection of occlusal caries lesions using fluorescence: correlation between histology and obtained results for Diagnodent and spectroscopy; Deteccao de lesoes de carie por fluorescencia: correlacao entre a histologia e os resultados obtidos com o Diagnodent e a espectroscopia

Energy Technology Data Exchange (ETDEWEB)

Rocha-Cabral, Renata Maciel

2006-07-01

The aims of this study were to develop and test a method to detect caries lesions in vivo and in vitro, using a portable spectrometer (PS); to analyze the performance of PS as well as the commercial device Diagnodent (Dd); correlate them with the gold standard, their transversal section areas and lesions depth and between themselves. 66 occlusal pre-molars sites were examined in vivo with Dd. Sequentially, fluorescence ({lambda}exc {approx} 657 nm) was collected by an optical fiber, conducted to PS and then analyzed as spectra, which were normalized and had calculated the Ratios of their Areas Under the Curves (RAUC) of carious and sound tissues. Experiments were conducted in vitro in the same sites. Gold Standard was obtained by polarized light microscopy. Pearson correlation was used to compare the devices with transversal section area, lesions depth and between themselves. The area under ROC curve, sensitivity, specificity as well as accuracy were calculated and verified with McNemar test. Dd and RAUC showed statistically significant correlation with gold standard (p < 0.01 for Dd and p < 0.05 for RAUC) and between themselves (r = 0,83 in vivo and r = 0,87 in vitro). Although it was significant, the devices showed low correlation with depth of lesions in vivo and in vitro (r = {approx} 0.43). The transversal section area of the lesion had no influence on readings in both devices. Dd showed higher sensitivity (0.76) than PS (0.60) in vivo (p < 0.05), though this fact was not able to improve its performance. In turn, PS showed higher sensitivity (0.88) than Dd (0.79) in vitro, but this difference was not significantly. The other parameters did not show statistically significant differences (p < 0.05) between methods. PS showed positive correlation with Dd, equal correlation with lesions depth and higher ability of detecting the disease in vitro, what suggests that if accompanied with a conic and an angulated probe and a dedicated software, the PS method could be

Human papillomavirus in oral lesions Virus papiloma humano en lesiones orales

Directory of Open Access Journals (Sweden)

Joaquín V. Gónzalez

2007-08-01

Full Text Available Growing evidence suggests a role for human papillomavirus (HPV in oral cancer; however its involvement is still controversial. This study evaluates the frequency of HPV DNA in a variety of oral lesions in patients from Argentina. A total of 77 oral tissue samples from 66 patients were selected (cases; the clinical-histopathological diagnoses corresponded to: 11 HPV- associated benign lesions, 8 non-HPV associated benign lesions, 33 premalignant lesions and 25 cancers. Sixty exfoliated cell samples from normal oral mucosa were used as controls. HPV detection and typing were performed by polymerase chain reaction (PCR using primers MY09, 11, combined with RFLP or alternatively PCR using primers GP5+, 6+ combined with dot blot hybridization. HPV was detected in 91.0% of HPV- associated benign lesions, 14.3% of non-HPV associated benign lesions, 51.5% of preneoplasias and 60.0% of cancers. No control sample tested HPV positive. In benign HPV- associated lesions, 30.0% of HPV positive samples harbored high-risk types, while in preneoplastic lesions the value rose to 59.9%. In cancer lesions, HPV detection in verrucous carcinoma was 88.9% and in squamous cell carcinoma 43.8%, with high-risk type rates of 75.5% and 85.6%, respectively. The high HPV frequency detected in preneoplastic and neoplastic lesions supports an HPV etiological role in at least a subset of oral cancers.Crecientes evidencias sugieren que el virus Papiloma humano (HPV tiene un rol en el cáncer oral; sin embargo su participación es todavía controvertida. Este estudio evalúa la frecuencia de ADN de HPV en una variedad de lesiones orales de pacientes de Argentina. Se seleccionaron 77 muestras de tejido oral de 66 pacientes (casos; el diagnóstico histo-patológico correspondió a: 11 lesiones benignas asociadas a HPV, 8 lesiones benignas no asociadas a HPV, 33 lesiones premalignas y 25 cánceres. Como controles se usaron 60 muestras de células exfoliadas de mucosa oral normal. La

Proximal femoral fractures

DEFF Research Database (Denmark)

Palm, Henrik; Teixidor, Jordi

2015-01-01

searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

Video-assisted microwave ablation for the treatment of a metastatic lung lesion in a dog with appendicular osteosarcoma and hypertrophic osteopathy.

Science.gov (United States)

Mazzaccari, Kaitlyn; Boston, Sarah E; Toskich, Beau B; Bowles, Kristina; Case, J Brad

2017-11-01

To describe video-assisted microwave ablation (VAMA) for the treatment of a metastatic lung lesion secondary to right forelimb osteosarcoma in a dog. Case report. A 10-year-old female spayed mixed breed dog with a metastatic lung lesion secondary to appendicular osteosarcoma. An osteosarcoma of the right distal scapula and proximal humerus that was suspected to be a radiation-induced osteosarcoma was treated with limb amputation and carboplatin chemotherapy. The patient developed pulmonary metastatic lesions and hypertrophic osteopathy (HO). VAMA of a metastatic lesion in the right caudal lung lobe was performed 227 days after amputation. The procedure was performed without complication. Follow-up information with the referring veterinarian 40 days after VAMA indicated that the patient was stable and that the clinical signs of HO had resolved. Thoracic radiographs taken by the referring veterinarian (RDVM) at monthly intervals showed that the previously treated metastatic lesion was stable. At 134 days from VAMA, the patient presented to the RDVM for lethargy and dyspnea and was transferred to an emergency clinic. The patient arrested and died 136 days from the VAMA procedure while hospitalized. A postmortem was not performed. VAMA for pulmonary metastatic lesions is technically feasible and allows for the treatment of symptoms associated with HO and minimally invasive management of pulmonary metastases in the case reported. © 2017 The American College of Veterinary Surgeons.

Proximity correction of high-dosed frame with PROXECCO

Science.gov (United States)

Eisenmann, Hans; Waas, Thomas; Hartmann, Hans

1994-05-01

Usefulness of electron beam lithography is strongly related to the efficiency and quality of methods used for proximity correction. This paper addresses the above issue by proposing an extension to the new proximity correction program PROXECCO. The combination of a framing step with PROXECCO produces a pattern with a very high edge accuracy and still allows usage of the fast correction procedure. Making a frame with a higher dose imitates a fine resolution correction where the coarse part is disregarded. So after handling the high resolution effect by means of framing, an additional coarse correction is still needed. Higher doses have a higher contribution to the proximity effect. This additional proximity effect is taken into account with the help of the multi-dose input of PROXECCO. The dose of the frame is variable, depending on the deposited energy coming from backscattering of the proximity. Simulation proves the very high edge accuracy of the applied method.

Dual pathology proximal median nerve compression of the forearm.

LENUS (Irish Health Repository)

Murphy, Siun M

2013-12-01

We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression.

Giant proximity effect and critical opalescence in EuS

Science.gov (United States)

Charlton, Timothy; Ramos, Silvia; Quintanilla, Jorge; Suter, Andreas; Moodera, Jagadeesh

2015-03-01

The proximity effect is a type of wetting phenomenon where an ordered state, usually magnetism or superconductivity, ``leaks'' from one material into an adjacent one over some finite distance. For superconductors, the characteristic range is of the order of the coherence length, usually hundreds of nm. Nevertheless much longer, ``giant'' proximity effects have been observed in cuprate perovskite junctions. Such giant proximity effects can be understood by taking into account the divergence of the pairing susceptibility in the non-superconducting material when it is itself close to a superconducting instability: a superconducting version of critical opalescence. Since critical opalescence occurs in all second order phase transitions, giant proximity effects are expected to be general, therefor there must be a giant ferromagnetic proximity effect. Compared to its superconducting counterpart, the giant ferromagnetic proximity effect has the advantage that the order parameter (magnetization) can be observed directly. We have fabricated Co/EuS thin films and measured the magnetization profiles as a function of temperature using the complementary techniques of low energy muon relaxation and polarized neutron reflectivity. Details of the proximity effect near TCEuS will be presented.

Strong Proximities on Smooth Manifolds and Vorono\\" i Diagrams

OpenAIRE

Peters, J. F.; Guadagni, C.

2015-01-01

This article introduces strongly near smooth manifolds. The main results are (i) second countability of the strongly hit and far-miss topology on a family $\\mathcal{B}$ of subsets on the Lodato proximity space of regular open sets to which singletons are added, (ii) manifold strong proximity, (iii) strong proximity of charts in manifold atlases implies that the charts have nonempty intersection. The application of these results is given in terms of the nearness of atlases and charts of proxim...

Intraosseous osteolytic lesions

Energy Technology Data Exchange (ETDEWEB)

Adler, C.P.; Wenz, W.

1981-10-01

Any pathological damage occurring in a bone will produce either an osteolytic or osteosclerotic lesion which can be seen in the macroscopic specimen as well as in the roentgenogram. Various bone lesions may lead to local destructions of the bone. An osteoma or osteoplastic osteosarcoma produces an osteosclerotic lesion showing a dense mass in the roentgenogram; a chondroblastoma or an osteoclastoma, on the other hand, induces an osteolytic focal lesion. This paper presents examples of different osteolytic lesions of the humerus. An osteolytic lesion seen in the roentgenogram may be either produced by an underlying non-ossifying fibroma of the bone, by fibrous dysplasia, osteomyelitis or Ewing's sarcoma. Differential diagnostic considerations based on the radiological picture include eosinophilic bone granuloma, juvenile or aneurysmal bone cyst, multiple myeloma or bone metastases. Serious differential diagnostic problems may be involved in case of osteolytic lesions occurring in the humerus. Cases of this type involving complications have been reported and include the presence of an teleangiectatic osteosarcoma as well as that of a hemangiosarcoma of the bone.

75 FR 5009 - Proximity Detection Systems for Underground Mines

Science.gov (United States)

2010-02-01

... Proximity Detection Systems for Underground Mines AGENCY: Mine Safety and Health Administration, Labor... information regarding whether the use of proximity detection systems would reduce the risk of accidents where... . Information on MSHA-approved proximity detection systems is available on the Internet at http://www.msha.gov...

Periodontal bone lesions

International Nuclear Information System (INIS)

Linden, L.W.J. van der.

1985-01-01

In the course of life the periodontum is subject to changes which may be physiological or pathological. Intraoral radiographs give insight into the hard structures of the dentomaxillar region and provides information on lesions in the bone of the periodontum in that they show radiopacities and radiolucencies caused by such lesions. In this thesis the relation is investigated between the true shape and dimensions of periodontal bone lesions and their radiographic images. A method is developed and tested of making standardized and reproducible radiographs suitable for longitudinal studies of periodontal lesions. Also the possibility is demonstrated of an objective and reproducible interpretation of radiographic characteristics of periodontal bone lesions. (Auth.)

Bimalleolar ankle fracture with proximal fibular fracture

NARCIS (Netherlands)

Colenbrander, R. J.; Struijs, P. A. A.; Ultee, J. M.

2005-01-01

A 56-year-old female patient suffered a bimalleolar ankle fracture with an additional proximal fibular fracture. This is an unusual fracture type, seldom reported in literature. It was operatively treated by open reduction and internal fixation of the lateral malleolar fracture. The proximal fibular

[Partial replantation following proximal limb injury].

Science.gov (United States)

Dubert, T; Malikov, S A; Dinh, A; Kupatadze, D D; Oberlin, C; Alnot, J Y; Nabokov, B B

2000-11-01

Proximal replantation is a technically feasible but life-threatening procedure. Indications must be restricted to patients in good condition with a good functional prognosis. The goal of replantation must be focused not only on reimplanting the amputated limb but also on achieving a good functional outcome. For the lower limb, simple terminalization remains the best choice in many cases. When a proximal amputation is not suitable for replantation, the main aim of the surgical procedure must be to reconstruct a stump long enough to permit fitting a prosthesis preserving the function of the adjacent joint. If the proximal stump beyond the last joint is very short, it may be possible to restore some length by partial replantation of spared tissues from the amputated part. We present here the results we obtained following this policy. This series included 16 cases of partial replantations, 14 involving the lower limb and 2 the upper limb. All were osteocutaneous microsurgical transfers. For the lower limb, all transfers recovered protective sensitivity following tibial nerve repair. The functional calcaeoplantar unit was used in 13 cases. The transfer of this specialized weight bearing tissue provided a stable distal surface making higher support unnecessary. In one case, we raised a 13-cm vascularized tibial segment covered with foot skin for additional length. For the upper limb, the osteocutaneous transfer, based on the radial artery, was not reinnervated, but this lack of sensitivity did not impair prosthesis fitting. One vascular failure was finally amputated. This was the only unsuccessful result. For all other patients, the surgical procedure facilitated prosthesis fitting and preserved the proximal joint function despite an initially very proximal amputation. The advantages of partial replantation are obvious compared with simple terminalization or secondary reconstruction. There is no secondary donor site and, because there is no major muscle mass in the

The current status of laser applications in dentistry.

Science.gov (United States)

Walsh, L J

2003-09-01

A range of lasers is now available for use in dentistry. This paper summarizes key current and emerging applications for lasers in clinical practice. A major diagnostic application of low power lasers is the detection of caries, using fluorescence elicited from hydroxyapatite or from bacterial by-products. Laser fluorescence is an effective method for detecting and quantifying incipient occlusal and cervical carious lesions, and with further refinement could be used in the same manner for proximal lesions. Photoactivated dye techniques have been developed which use low power lasers to elicit a photochemical reaction. Photoactivated dye techniques can be used to disinfect root canals, periodontal pockets, cavity preparations and sites of peri-implantitis. Using similar principles, more powerful lasers can be used for photodynamic therapy in the treatment of malignancies of the oral mucosa. Laser-driven photochemical reactions can also be used for tooth whitening. In combination with fluoride, laser irradiation can improve the resistance of tooth structure to demineralization, and this application is of particular benefit for susceptible sites in high caries risk patients. Laser technology for caries removal, cavity preparation and soft tissue surgery is at a high state of refinement, having had several decades of development up to the present time. Used in conjunction with or as a replacement for traditional methods, it is expected that specific laser technologies will become an essential component of contemporary dental practice over the next decade.

Biofilm three-dimensional architecture influences in situ pH distribution pattern on the human enamel surface.

Science.gov (United States)

Xiao, Jin; Hara, Anderson T; Kim, Dongyeop; Zero, Domenick T; Koo, Hyun; Hwang, Geelsu

2017-06-01

To investigate how the biofilm three-dimensional (3D) architecture influences in situ pH distribution patterns on the enamel surface. Biofilms were formed on human tooth enamel in the presence of 1% sucrose or 0.5% glucose plus 0.5% fructose. At specific time points, biofilms were exposed to a neutral pH buffer to mimic the buffering of saliva and subsequently pulsed with 1% glucose to induce re-acidification. Simultaneous 3D pH mapping and architecture of intact biofilms was performed using two-photon confocal microscopy. The enamel surface and mineral content characteristics were examined successively via optical profilometry and microradiography analyses. Sucrose-mediated biofilm formation created spatial heterogeneities manifested by complex networks of bacterial clusters (microcolonies). Acidic regions (pHinterior of microcolonies, which impedes rapid neutralization (taking more than 120 min for neutralization). Glucose exposure rapidly re-created the acidic niches, indicating formation of diffusion barriers associated with microcolonies structure. Enamel demineralization (white spots), rougher surface, deeper lesion and more mineral loss appeared to be associated with the localization of these bacterial clusters at the biofilm-enamel interface. Similar 3D architecture was observed in plaque-biofilms formed in vivo in the presence of sucrose. The formation of complex 3D architectures creates spatially heterogeneous acidic microenvironments in close proximity of enamel surface, which might correlate with the localized pattern of the onset of carious lesions (white spot like) on teeth.

Proximity functions for general right cylinders

International Nuclear Information System (INIS)

Kellerer, A.M.

1981-01-01

Distributions of distances between pairs of points within geometrical objects, or the closely related proximity functions and geometric reduction factors, have applications to dosimetric and microdosimetric calculations. For convex bodies these functions are linked to the chord-length distributions that result from random intersections by straight lines. A synopsis of the most important relations is given. The proximity functions and related functions are derived for right cylinders with arbitrary cross sections. The solution utilizes the fact that the squares of the distances between two random points are sums of independently distributed squares of distances parallel and perpendicular to the axis of the cylinder. Analogous formulas are derived for the proximity functions or geometric reduction factors for a cylinder relative to a point. This requires only a minor modification of the solution

Use of new minimum intervention dentistry technologies in caries management.

Science.gov (United States)

Tassery, H; Levallois, B; Terrer, E; Manton, D J; Otsuki, M; Koubi, S; Gugnani, N; Panayotov, I; Jacquot, B; Cuisinier, F; Rechmann, P

2013-06-01

Preservation of natural tooth structure requires early detection of the carious lesion and is associated with comprehensive patient dental care. Processes aiming to detect carious lesions in the initial stage with optimum efficiency employ a variety of technologies such as magnifying loupes, transillumination, light and laser fluorescence (QLF® and DIAGNOdent® ) and autofluorescence (Soprolife® and VistaCam®), electric current/impedance (CarieScan(®) ), tomographic imaging and image processing. Most fluorescent caries detection tools can discriminate between healthy and carious dental tissue, demonstrating different levels of sensitivity and specificity. Based on the fluorescence principle, an LED camera (Soprolife® ) was developed (Sopro-Acteon, La Ciotat, France) which combined magnification, fluorescence, picture acquisition and an innovative therapeutic concept called light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT). This article is rounded off by a Soprolife® illustration about minimally or even non-invasive dental techniques, distinguishing those that preserve or reinforce the enamel and enamel-dentine structures without any preparation (MIT1- minimally invasive therapy 1) from those that require minimum preparation of the dental tissues (MIT2 - minimally invasive therapy 2) using several clinical cases as examples. MIT1 encompasses all the dental techniques aimed at disinfection, remineralizing, reversing and sealing the caries process and MIT2 involves a series of specific tools, including microburs, air abrasion devices, sonic and ultrasonic inserts and photo-activated disinfection to achieve minimal preparation of the tooth. With respect to minimally invasive treatment and prevention, the use of lasers is discussed. Furthermore, while most practices operate under a surgical model, Caries Management by Risk Assessment (CaMBRA) encourages a medical model of disease prevention and management to control the manifestation of the

Cervical dentin hypersensitivity: a cross-sectional investigation in Athens, Greece.

Science.gov (United States)

Rahiotis, C; Polychronopoulou, A; Tsiklakis, K; Kakaboura, A

2013-12-01

The purpose of this study was to identify the prevalence of cervical dentin hypersensitivity in a cross-sectional investigation of Greek adults. Seven hundred and sixty-seven subjects were examined. Participants were patients processed for first examination in the Clinic of Oral Diagnosis and Radiology at the Faculty of Dentistry, University of Athens. The evaluation of hypersensitivity was performed using two methods: for each tooth, the response to a) tactile stimulus and b) air-blast stimulus was measured. Additional factors such as smoking habits, oral health behaviour, consumption of acidic foods, type of toothbrush, daily use of fluoride solution and of desensitising toothpaste, gingival recession and non-carious cervical lesions were recorded and evaluated as causative factors. Descriptive statistics on the demographics of the study sample, of oral health behaviour characteristics and of oral examination findings were performed. Comparisons of these characteristics in the presence or absence of hypersensitivity were conducted with the chi-square test. Data were further analysed using multiple logistic regression modelling. Among study participants, 21·3% had at least one cervical dentin hypersensitivity reaction to the tactile stimulus, and 38·6%, to the air-blast stimulus. Multivariate analysis detected association of the hypersensitivity in tactile or air-blast stimulus with the non-carious lesions and with the gingival recessions. Additionally, a relation between hypersensitivity and air-blast stimulus with gender (female) was found. There was no association between the hypersensitivity in both of the stimuli and the level of education, smoking, consumption of acidic foods, type of toothbrush and daily use of fluoride solution or desensitising toothpaste. The overall prevalence of cervical dentin hypersensitivity in the adult population in Athens ranged from 21·3% to 38·6% depending on the type of stimuli. Cervical non-carious lesions and gingival

Human papillomavirus in oral lesions Virus papiloma humano en lesiones orales

OpenAIRE

Joaquín V. Gónzalez; Rafael A. Gutiérrez; Alicia Keszler; Maria Del Carmen Colacino; Lidia V. Alonio; Angélica R. Teyssie; Maria Alejandra Picconi

2007-01-01

Growing evidence suggests a role for human papillomavirus (HPV) in oral cancer; however its involvement is still controversial. This study evaluates the frequency of HPV DNA in a variety of oral lesions in patients from Argentina. A total of 77 oral tissue samples from 66 patients were selected (cases); the clinical-histopathological diagnoses corresponded to: 11 HPV- associated benign lesions, 8 non-HPV associated benign lesions, 33 premalignant lesions and 25 cancers. Sixty exfoliated cell ...

Proximity effect at Millikelvin temperatures

International Nuclear Information System (INIS)

Mota, A.C.

1986-01-01

Proximity effects have been studied extensively for the past 25 years. Typically, they are in films several thousand angstroms thick at temperatures not so far below T/sub CNS/, the transition temperature of the NS system. Interesting is, however, the proximity effect at temperatures much lower than T/sub CNS/. In this case, the Cooper-pair amplitudes are not small and very long pair penetration lengths into the normal metal can be expected. Thus, we have observed pair penetration lengths. For these investigations very suitable specimens are commercial wires of one filament of NbTi or Nb embedded in a copper matrix. The reasons are the high transmission coefficient at the interface between the copper and the superconductor and the fact that the copper in these commercial wires is rather clean with electron free paths between 5 to 10 μm long. In this paper, the magnetic properties of thick proximity systems in the range of temperatures between T/sub CNS/ and 5 x 10/sup -4/ T/sub CNS/ in both low and high magnetic fields are discussed

Child neglect and oral health problems in offspring of substance-abusing fathers.

Science.gov (United States)

Mezzich, Ada C; Bretz, Walter A; Day, Bang-Shiuh; Corby, Patricia M; Kirisci, Levent; Swaney, Michelle; Cornelius, Jack R; Weyant, Robert J

2007-01-01

This study examined (1) orodental (OD) problems in 10-19-year-old children of substance use disorder (SUD) (n = 127) and non-SUD fathers (n = 111) and (2) the moderating effect of child's substance use (SU) involvement in the associations of paternal SUD and neglectful parenting with OD problems in the offspring. The results showed that periodontal problems differentiated between groups and the interactions between child's SU involvement and paternal SUD and neglectful parenting were respectively associated with hard/soft tissue lesions and carious lesions in the offspring, indicating that SU involvement increases risk for OD due to paternal SUD and neglectful parenting.

Dual pathology proximal median nerve compression of the forearm.

Science.gov (United States)

Murphy, Siun M; Browne, Katherine; Tuite, David J; O'Shaughnessy, Michael

2013-12-01

We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

MWA Versus RFA for Perivascular and Peribiliary CRLM: A Retrospective Patient- and Lesion-Based Analysis of Two Historical Cohorts

Energy Technology Data Exchange (ETDEWEB)

Tilborg, Aukje A. J. M. van, E-mail: a.vantilborg@vumc.nl; Scheffer, Hester J.; Jong, Marcus C. de; Vroomen, Laurien G. P. H. [VU University Medical Centre, Department of Radiology and Nuclear Medicine (Netherlands); Nielsen, Karin [VU University Medical Centre, Department of Surgical Oncology (Netherlands); Kuijk, Cornelis van [VU University Medical Centre, Department of Radiology and Nuclear Medicine (Netherlands); Tol, Petrousjka M. P. van den [VU University Medical Centre, Department of Surgical Oncology (Netherlands); Meijerink, Martijn R. [VU University Medical Centre, Department of Radiology and Nuclear Medicine (Netherlands)

2016-10-15

PurposeTo retrospectively analyse the safety and efficacy of radiofrequency ablation (RFA) versus microwave ablation (MWA) in the treatment of unresectable colorectal liver metastases (CRLM) in proximity to large vessels and/or major bile ducts.Method and MaterialsA database search was performed to include patients with unresectable histologically proven and/or {sup 18}F–FDG–PET avid CRLM who were treated with RFA or MWA between January 2001 and September 2014 in a single centre. All lesions that were considered to have a peribiliary and/or perivascular location were included. Univariate logistic regression analysis was performed to assess the distribution of patient, tumour and procedure characteristics. Multivariate logistic regression was used to correct for potential confounders.ResultsTwo hundred and forty-three patients with 774 unresectable CRLM were ablated. One hundred and twenty-two patients (78 males; 44 females) had at least one perivascular or peribiliary lesion (n = 199). Primary efficacy rate of RFA was superior to MWA after 3 and 12 months of follow-up (P = 0.010 and P = 0.022); however, after multivariate analysis this difference was non-significant at 12 months (P = 0.078) and vanished after repeat ablations (P = 0.39). More CTCAE grade III complications occurred after MWA versus RFA (18.8 vs. 7.9 %; P = 0.094); biliary complications were especially common after peribiliary MWA (P = 0.002).ConclusionFor perivascular CRLM, RFA and MWA are both safe treatment options that appear equally effective. For peribiliary CRLM, MWA has a higher complication rate than RFA, with similar efficacy. Based on these results, it is advised to use RFA for lesions in the proximity of major bile ducts.

MWA Versus RFA for Perivascular and Peribiliary CRLM: A Retrospective Patient- and Lesion-Based Analysis of Two Historical Cohorts

International Nuclear Information System (INIS)

Tilborg, Aukje A. J. M. van; Scheffer, Hester J.; Jong, Marcus C. de; Vroomen, Laurien G. P. H.; Nielsen, Karin; Kuijk, Cornelis van; Tol, Petrousjka M. P. van den; Meijerink, Martijn R.

2016-01-01

PurposeTo retrospectively analyse the safety and efficacy of radiofrequency ablation (RFA) versus microwave ablation (MWA) in the treatment of unresectable colorectal liver metastases (CRLM) in proximity to large vessels and/or major bile ducts.Method and MaterialsA database search was performed to include patients with unresectable histologically proven and/or "1"8F–FDG–PET avid CRLM who were treated with RFA or MWA between January 2001 and September 2014 in a single centre. All lesions that were considered to have a peribiliary and/or perivascular location were included. Univariate logistic regression analysis was performed to assess the distribution of patient, tumour and procedure characteristics. Multivariate logistic regression was used to correct for potential confounders.ResultsTwo hundred and forty-three patients with 774 unresectable CRLM were ablated. One hundred and twenty-two patients (78 males; 44 females) had at least one perivascular or peribiliary lesion (n = 199). Primary efficacy rate of RFA was superior to MWA after 3 and 12 months of follow-up (P = 0.010 and P = 0.022); however, after multivariate analysis this difference was non-significant at 12 months (P = 0.078) and vanished after repeat ablations (P = 0.39). More CTCAE grade III complications occurred after MWA versus RFA (18.8 vs. 7.9 %; P = 0.094); biliary complications were especially common after peribiliary MWA (P = 0.002).ConclusionFor perivascular CRLM, RFA and MWA are both safe treatment options that appear equally effective. For peribiliary CRLM, MWA has a higher complication rate than RFA, with similar efficacy. Based on these results, it is advised to use RFA for lesions in the proximity of major bile ducts.

MRI with microscopy coil of the proximal interphalangeal joints: preliminary study

International Nuclear Information System (INIS)

Liu Min; Sun Haixing; Liu Dimin; Hu Meiyu; Pan Shunping; Wang Ping; Huang Xiaoling; Men Quanfei; Chen Yingming

2009-01-01

Objective: To investigate the use of a microscopy coil in MR examination of proximal interphalangeal joints (PIJ) to collect evidence on micro-anatomical pathological changes for further MR diagnosis. Methods: Four PIJ in cadaver and 12 PIJ from 7 normal volunteers were scanned with a microscopy surface coil (23 mm in diameter) at 1.5 T MRI. Sagittal T 1 -weighted images were also obtained with a conventional surface coil using the same parameters for the volunteers. Based on the observation of sagittal, traverse, coronal PIJ imaging features of cadaver, the optimized sequences were chosen for the volunteer's application. Image quality of the PIJ structures from volunteers was analyzed by two radiologists on a 5-point scale (0, nonvisualization; 1, poor; 2, average; 3, good; 4, excellent) and compared with Wilcoxon signed tank test between the microscopy and C3 surface coil in sagittal direction. Results: With microscopy coil all sequences can visualize the main structures of PI J, and all the PIJ images were classified as good or excellent except for one as average, while all the 12 PIJ with C3 coil were classified as poor or invisible. PIJ structures (proximal phalanx head, middle phalanx base, cartilage, volar plate) from volunteers show higher scores of quality with microscopy coils than those with C3 coil, and the difference was significant (Z =-3.274, -3.274, -3.213, and -3.742 respectively, all P<0.01). Conclusion: High-resolution MRI of the normal PIJ with microscopy coil was superior to those with a conventional surface coil, and it can be a promising method to diagnose interphalangeal joints lesions. (authors)

Squamous cell dysplasia in the proximal rectum of three patients treated for ulcerative colitis on immunomodulators.

Science.gov (United States)

Connolly, James G; Goldstone, Stephen E

2017-05-01

Anal canal high-grade squamous intraepithelial lesion (HSIL) is the precursor to anal cancer. Immunocompromised patients are at increased risk and disease is usually within 3 cm from the anal verge. High-resolution anoscopy (HRA) with an 8-cm anoscope is used to identify and guide cautery treatment of HSIL. We report three patients with a long-term history of ulcerative colitis (UC) treated with systemic immunomodulators who developed proximally located rectal HSIL. Two patients were HIV-negative women, 63 and 48 years old, and the third was a 51-year-old HIV-positive man with underlying UC for 10, 16, and 3 years, respectively. They each presented with a HPV-positive HSIL visibly extending above the limits of the anoscope used for HRA. None developed cancer. All had episodes of active UC. It is unclear what causative role systemic immunomodulators play in predisposing UC patients to proximal HSIL. HSIL probably developed on a tongue of HPV-infected squamous epithelium growing proximally over the inflamed rectum. Islands developed when areas of squamous epithelium degenerated, creating skip areas. This study highlights the potential for HSIL to extend into the rectum either as a contiguous patch or isolated islands and the need for heightened surveillance in patients with extensive anal canal HSIL treated with immunodulator therapy. HSIL identified at the limit of the anoscope should be investigated further with colonoscopy, and argon plasma coagulation (APC) ablation can serve as an effective treatment option. Patients are at risk for stricture, but it is unclear what role the UC or the ablation played in stricture formation.

Effect of age on proximal esophageal response to swallowing

Directory of Open Access Journals (Sweden)

Roberto Oliveira Dantas

2010-12-01

Full Text Available CONTEXT: It has been demonstrated that the ageing process affects esophageal motility. OBJECTIVES: To evaluate the effect of the age on the proximal esophageal response to wet swallows. METHOD: We measured the proximal esophageal response to swallows of a 5 mL bolus of water in 69 healthy volunteers, 20 of them aged 18-30 years (group I, 27 aged 31-50 years (group II, and 22 aged 51-74 years (group III. We used the manometric method with continuous perfusion. The proximal esophageal contractions were recorded 5 cm from a pharyngeal recording site located 1 cm above the upper esophageal sphincter. The time between the onset of the pharyngeal and of the proximal esophageal recording (pharyngeal-esophageal time and the amplitude, duration and area under the curve of the proximal esophageal contraction were measured. RESULTS: The pharyngeal-esophageal time was shorter in group I subjects than in group II and III subjects (P<0.05. The duration of proximal esophageal contractions was longer in group I than in groups II and III (P<0.001. There was no differences between groups in the amplitude or area under the curve of contractions. There were no differences between groups II and III for any of the measurements. CONCLUSION: We conclude that the age may affects the response of the proximal esophagus to wet swallows.

Rare Head and Neck Benign Mesenchymoma in Close Proximity to Submandibular Gland in a Pediatric Patient: Case Report and Review of the Literature

Directory of Open Access Journals (Sweden)

Priyanka Jain

2015-01-01

Full Text Available Pediatric head and neck masses are commonly congenital in origin or of infectious etiology. We present a rare case of benign mesenchymoma in close proximity to the submandibular gland in an otherwise asymptomatic child. Computerized tomography (CT scan of the head and neck area revealed a benign lesion, which was later determined to be a benign mesenchymoma on histopathology. The child did well after surgery without any reported recurrence. We discuss the salient features of a benign mesenchymoma in a child and also discuss relevant imaging and management.

Hybrid treatment of tandem, common carotid/innominate artery and ipsilateral carotid bifurcation stenoses by simultaneous, retrograde proximal stenting and eversion carotid endarterectomy: Preliminary results of a case series.

Science.gov (United States)

Illuminati, Giulio; Pizzardi, Giulia; Pasqua, Rocco; Frezzotti, Francesca; Palumbo, Piergaspare; Macrina, Francesco; Calio', Francesco

2018-04-01

Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses. The proximal stenosis involved the left proximal CCA in 4 patients, the proximal innominate artery in 2 patients and the right CCA in one patient. The procedure was performed under general anesthesia in a conventional operating room equipped with a mobile C-arm. A covered, balloon expandable stent was deployed over the proximal stenosis via a 6-F sheath directly introduced into the proximal CCA through the obliquely transected carotid bulb. After removing the sheath, debris were flushed through the carotid bulb and eversion CEA completed the procedure. Study endpoints were: postoperative stroke/mortality rate, cardiac mortality and morbidity, peripheral nerve injury, cervical hematoma, overall late survival, freedom from ipsilateral stroke and patency of arterial reconstruction. No postoperative mortality or neurologic morbidity was observed in any patient. Cervical hematomas and peripheral nerve injuries were likewise absent. At a mean follow-up of 18 months, all the patients were alive, free from neurologic events of new onset and free from restenosis. Combined proximal stenting and eversion CEA for tandem lesions seems a valid treatment, with the advantages of eversion CEA over other techniques of carotid bifurcation

Benign fibroosseous lesions

Directory of Open Access Journals (Sweden)

Cansu Köseoğlu Seçgin

2016-05-01

Full Text Available Benign fibroosseous lesions represent a group of lesions that share the same basic evolutive mechanism and are characterized by replacement of normal bone with a fibrous connective tissue that gradually undergoes mineralization. These lesions are presented by a variety of diseases including developmental, reactive-dysplastic processes and neoplasms. Depending on the nature and amount of calcified tissue, they can be observed as radiolucent, mixed or radiopaque. Their radiographic features could be well-defined or indistinguishable from the surrounding bone tissue. They can be asymptomatic as in osseous dysplasias and can be detected incidentally on radiographs, or they can lead to expansion in the affected bone as in ossifying fibroma. All fibroosseous lesions seen in the jaws and face are variations of the same histological pattern. Therefore, detailed clinical and radiographic evaluation in differential diagnosis is important. In this review, fibroosseous benign lesions are classified as osseous dysplasia, fibrous dysplasia and fibroosseous tumors; and radiographic features and differential diagnosis of these lesions are reviewed taking into account this classification.

Optimum image compression rate maintaining diagnostic image quality of digital intraoral radiographs

International Nuclear Information System (INIS)

Song, Ju Seop; Koh, Kwang Joon

2000-01-01

The aims of the present study are to determine the optimum compression rate in terms of file size reduction and diagnostic quality of the images after compression and evaluate the transmission speed of original or each compressed images. The material consisted of 24 extracted human premolars and molars. The occlusal surfaces and proximal surfaces of the teeth had a clinical disease spectrum that ranged from sound to varying degrees of fissure discoloration and cavitation. The images from Digora system were exported in TIFF and the images from conventional intraoral film were scanned and digitalized in TIFF by Nikon SF-200 scanner(Nikon, Japan). And six compression factors were chosen and applied on the basis of the results from a pilot study. The total number of images to be assessed were 336. Three radiologists assessed the occlusal and proximal surfaces of the teeth with 5-rank scale. Finally diagnosed as either sound or carious lesion by one expert oral pathologist. And sensitivity and specificity and kappa value for diagnostic agreement was calculated. Also the area (Az) values under the ROC curve were calculated and paired t-test and oneway ANOVA test was performed. Thereafter, transmission time of the image files of the each compression level were compared with that of the original image files. No significant difference was found between original and the corresponding images up to 7% (1:14) compression ratio for both the occlusal and proximal caries (p<0.05). JPEG3 (1:14) image files are transmitted fast more than 10 times, maintained diagnostic information in image, compared with original image files. 1:14 compressed image file may be used instead of the original image and reduce storage needs and transmission time.

PROXIMAL: a method for Prediction of Xenobiotic Metabolism.

Science.gov (United States)

Yousofshahi, Mona; Manteiga, Sara; Wu, Charmian; Lee, Kyongbum; Hassoun, Soha

2015-12-22

Contamination of the environment with bioactive chemicals has emerged as a potential public health risk. These substances that may cause distress or disease in humans can be found in air, water and food supplies. An open question is whether these chemicals transform into potentially more active or toxic derivatives via xenobiotic metabolizing enzymes expressed in the body. We present a new prediction tool, which we call PROXIMAL (Prediction of Xenobiotic Metabolism) for identifying possible transformation products of xenobiotic chemicals in the liver. Using reaction data from DrugBank and KEGG, PROXIMAL builds look-up tables that catalog the sites and types of structural modifications performed by Phase I and Phase II enzymes. Given a compound of interest, PROXIMAL searches for substructures that match the sites cataloged in the look-up tables, applies the corresponding modifications to generate a panel of possible transformation products, and ranks the products based on the activity and abundance of the enzymes involved. PROXIMAL generates transformations that are specific for the chemical of interest by analyzing the chemical's substructures. We evaluate the accuracy of PROXIMAL's predictions through case studies on two environmental chemicals with suspected endocrine disrupting activity, bisphenol A (BPA) and 4-chlorobiphenyl (PCB3). Comparisons with published reports confirm 5 out of 7 and 17 out of 26 of the predicted derivatives for BPA and PCB3, respectively. We also compare biotransformation predictions generated by PROXIMAL with those generated by METEOR and Metaprint2D-react, two other prediction tools. PROXIMAL can predict transformations of chemicals that contain substructures recognizable by human liver enzymes. It also has the ability to rank the predicted metabolites based on the activity and abundance of enzymes involved in xenobiotic transformation.

Lesions of juxtacortical origin (surface lesions of bone)

International Nuclear Information System (INIS)

Kenan, S.; Abdelwahab, I.F.; Klein, M.J.; Hermann, G.; Lewis, M.M.

1993-01-01

A large variety of tumor and tumor-like conditions have been shown to originate from the surface of bone. Most surface lesions are associated with periosteal reaction. The periosteum is a multipotential membrane. Its cellular composition may give rise to a variety of both neoplasms and tumor-like conditions. To avoid misinterpretation, the orthopedist, radiologist, and pathologist should be familiar with the entire spectrum of surface lesions. A better understanding of the natural history and biological behavior at different lesional maturity stages and correlation of the history with the radiographic and pathological findings is essential to establish the correct diagnosis. A history of injury of blunt trauma is very important. A stress fracture may produce a periosteal reaction acd callus that can be difficult to distinguish from osteosarcoma. In this review article, the authors wish to describe and define each term by its anatomy and radiographic features while discussing the entire spectrum of surface lesions. All the illustrative cases in this review article have been proven histologically. (orig.)

Lateral-access Class II restoration using resin-modified glass-ionomer or silver-cermet cement.

Science.gov (United States)

Croll, T P

1995-02-01

Direct-access preparation of a carious proximal surface is perhaps the most conservative approach to restoration. Physical properties and handling characteristics of silver amalgam and of resin composite and lack of fluoride ion release make these materials unsuitable for direct buccal- or lingual-access proximal restoration. Insufficient strengths and radiolucency of self-hardening glass-ionomer cements preclude their use for Class II restorations. However, glass-ionomer silver-cermet cement and some resin-modified glass-ionomer materials are proving useful for non-stress-bearing Class II restorations and may have applications in preventive dentistry. This article describes lateral-access Class II restoration with modified glass-ionomer cements. Emphasis is placed on careful handling of materials, maintenance of an ideal operative field, and conservation of tooth structure.

Dental findings and treatment in consanguinity associated congenital chronic familial neutropenia.

Science.gov (United States)

Buduneli, Nurcan; Cogulu, Dilsah; Kardesler, Levent; Kütükçüler, Necil

2006-01-01

The purpose of this report is to describe dental findings and treatment of an 11-year old male patient and a 5-year old female patient, children of first cousins, suffering from severe benign congenital chronic familial neutropenia. This case report emphazises the importance of differential diagnosis of immunodeficiencies including congenital chronic familial neutropenia in the background of severe periodontal diseases and/or diffuse carious lesions in children.

The developmental spectrum of proximal radioulnar synostosis

Energy Technology Data Exchange (ETDEWEB)

Elliott, Alison M. [University of Manitoba, Winnipeg Regional Health Association Program of Genetics and Metabolism, Winnipeg, MB (Canada); University of Manitoba, Department of Paediatrics and Child Health, Winnipeg, MB (Canada); University of Manitoba, Department of Biochemistry and Medical Genetics, Winnipeg, MB (Canada); University of Manitoba, WRHA Program of Genetics and Metabolism, Departments of Paediatrics and Child Health, Biochemistry and Medical Genetics, Winnipeg, MB (Canada); Kibria, Lisa [University of Manitoba, Department of School of Medical Rehabilitation, Winnipeg, MB (Canada); Reed, Martin H. [University of Manitoba, Department of Paediatrics and Child Health, Winnipeg, MB (Canada); University of Manitoba, Department of Biochemistry and Medical Genetics, Winnipeg, MB (Canada); University of Manitoba, Department of Diagnostic Imaging, Winnipeg, MB (Canada)

2010-01-15

Proximal radioulnar synostosis is a rare upper limb malformation. The elbow is first identifiable at 35 days (after conception), at which stage the cartilaginous anlagen of the humerus, radius and ulna are continuous. Subsequently, longitudinal segmentation produces separation of the distal radius and ulna. However, temporarily, the proximal ends are united and continue to share a common perichondrium. We investigated the hypothesis that posterior congenital dislocation of the radial head and proximal radioulnar fusion are different clinical manifestations of the same primary developmental abnormality. Records were searched for ''proximal radioulnar fusion/posterior radial head dislocation'' in patients followed at the local Children's Hospital and Rehabilitation Centre for Children. Relevant radiographic, demographic and clinical data were recorded. Ethics approval was obtained through the University Research Ethics Board. In total, 28 patients met the inclusion criteria. The majority of patients (16) had bilateral involvement; eight with posterior dislocation of the radial head only; five had posterior radial head dislocation with radioulnar fusion and two had radioulnar fusion without dislocation. One patient had bilateral proximal radioulnar fusion and posterior dislocation of the left radial head. Nine patients had only left-sided involvement, and three had only right-sided involvement.The degree of proximal fusion varied, with some patients showing 'complete' proximal fusion and others showing fusion that occurred slightly distal to the radial head: 'partially separated.' Associated disorders in our cohort included Poland syndrome (two patients), Cornelia de Lange syndrome, chromosome anomalies (including tetrasomy X) and Cenani Lenz syndactyly. The suggestion of a developmental relationship between posterior dislocation of the radial head and proximal radioulnar fusion is supported by the fact that both anomalies

The role of computed tomography in evaluation of subchondral osseous lesions in seven horses with chronic synovitis

International Nuclear Information System (INIS)

Hanson, J.A.; Seeherman, H.J.; Kirker-Head, C.A.; O'Callaghan, M.W.

1996-01-01

Seven horses with severe, persistent lameness of sudden onset were evaluated with scintigraphy and/or computed tomography. The lameness was localised to the front fetlock joint in 2 horses and to the tibiotarsal joint in 5 horses. Five of the horses had a history of intra-articular injections of the involved joint prior to presentation. All horses had effusion of the affected joint and were positive to flexion tests. Intraarticular anaesthesia eliminated or improved the lameness in 4 cases and a nerve conduction block proximal to the affected joint improved the lameness in another. Cytology examination of fluid from affected joints identified normal joint fluid (one horse) or elevations in nucleated cell counts of 0.9 x 10(9)/l-36.8 x 10(9)/l and total protein 20-42 g/l (6 horses). The joint fluid of 2 of these horses cultured positive for bacteria. Initial radiographs were either normal (4 cases) or the changes seen were not sufficient to explain the degree of lameness. In the 6 cases where scintigraphy was performed, intense focal isotope uptake was found in the suspected region, which corresponded to the proximal portion of the first phalanx (2 cases), distal tibia (2 cases), or talus (3 cases). Computed tomography (CT) was performed because occult fracture or osteomyelitis was suspected; and knowledge of the precise anatomical location of the lesion was considered necessary to assess the need for surgery and to plan the surgical approach. Hypodense focal lesions with hyperdense haloes were found in the subchondral bone deep to the sagittal groove of the first phalanx (P1) (2 cases) in the cochlea of the distal tibia (2 cases), and in the intertrochlear portion of the talus (3 cases). Communication between the lesion and the joint space was demonstrated by CT in 5 cases. Post mortem examination of one case revealed synovitis and a chronic bone abscess (Brodie's abscess) communicating with the joint space

Susceptibility of porcine ileal enterocytes to the cytotoxin of Serpulina hyodysenteriae and the resolution of the epithelial lesions: an electron microscopic study.

Science.gov (United States)

Bland, A P; Frost, A J; Lysons, R J

1995-01-01

The cytotoxin from Serpulina hyodysenteriae was injected into ileal loops of eight germ-free pigs, and the effects on the villi were observed after 1, 3, and 18 hours of exposure. The mature vacuolated villus enterocytes of the proximal part of the absorptive villi were most susceptible to the lethal effects of the cytotoxin and were extensively exfoliated. The enterocytes at the base of the villi, the goblet cells, and the follicle-associated epithelium of the dome villi, particularly the M cells, were less affected. As the enterocytes were shed, the villi progressively shortened and the basement membrane became extensively folded. The absorptive villi were markedly stunted at 3 hours, and flattened globlet cells predominated at the site of restitution of the lesion. The myofibroblasts were also damaged, apparently subsequent to the exfoliation of the enterocytes. There was no further damage at 18 hours. The absorptive villi were stunted and were devoid of the large interstitial spaces of the normal lamina propria; the enterocytes were generally columnar, and at the apex of each villus there was an accumulation of goblet cells. There was a preponderance of M cells at the apices of the dome villi. Restitution of the lesions was not as rapid as observed in in vitro systems. The changes observed indicated that as the proximal enterocytes of the absorptive villi were shed, the loss of hydrostatic forces in the lamina propria allowed the myofibroblasts to collapse the villi by progressively retracting the basement membrane. This reduced the surface area to be covered during restitution. Resolution of the lesions was still incomplete after 18 hours.

INVESTIGATING THE MANAGEMENT OF CARIOUS PRIMARY TEETH IN GENERAL DENTAL PRACTICE: AN OVERVIEW OF THE DEVELOPMENT AND CONDUCT OF THE FICTION TRIAL.

Science.gov (United States)

Stewart, Matthew; Keightley, Alexander; Maguire, Anne; Chadwick, Barbara; Vale, Luke; Homer, Tara; Douglas, Gail; Deery, Chris; Marshman, Zoe; Ryan, Vicky; Innes, Nicola

2015-11-01

The management of carious primary teeth is a challenge for patients, parents and clinicians. Most evidence supporting different management strategies originates from a specialist setting and therefore its relevance to the primary care setting is questionable. The UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) has commissioned the FiCTION (Filling Children's Teeth: Indicated Or Not?) trial; a multi-centre primary dental care randomised controlled trial (RCT) to determine the most clinically and cost- effective approach to managing caries in the primary dentition in the UK. This large trial began in 2012, is due to be completed in late 2017 and involves 72 practices and 1,124 children initially aged three to seven years with dentine caries, following randomisation to one of three caries management strategies. Clinical, radiographic, quality of life, treatment acceptability and health economics data are collected during the three-year follow up period. This article provides an overview of the development and conduct of FiCTION and discusses some approaches adopted to manage challenges and achieve the patient recruitment target.

Mass-like Dieulafoy's lesion associated with advanced gastric cancer at the antrum of stomach: a case report and literature review.

Science.gov (United States)

Huang, Hsi-Lan; Leung, Chi Yan; Cheng, Chien-Jui

2017-10-10

Dieulafoy's lesion, also known as a caliber-persistent artery, is a shallow, small, and rare lesion that occurs along the lesser curvature of proximal stomach. It is rare for a Dieulafoy's lesion to present as a mass-like lesion that coexists with gastric cancer. To our best knowledge, we report the first case and histopathological pictures of a mass-like Dieulafoy's lesion coexisting with advanced gastric cancer in the antrum of the stomach. A 57-year-old female presented with a 6-month history of intermittent epigastric dull pain and dyspepsia. Subsequent upper gastrointestinal endoscopy revealed a friable mass that was located between the distal antrum and the pyloric ring. Biopsy revealed it to be an intestinal type adenocarcinoma. Subtotal gastrectomy was performed after neoadjuvant chemotherapy. Grossly, a large irregular plaque-like tumor lesion was noted at the anterior wall of the distal antrum and pylorus ring near the lesser curvature, measuring 5.6 × 4.8 × 1.0 cm. Histopathological examination of the resected stomach revealed that the plaque-like lesion largely consisted of numerous abnormally large-caliber and tortuous arteries in the submucosa. The increased fibrosis of the submucosa resulted in the formation of elevated plaque. The intestinal type adenocarcinoma was noted to be largely confined to the mucosa layer, with focal submucosal and muscular propria involvement. The patient was discharged one week after the subtotal gastrectomy, and she was alive and well 17 months after discharge, with no major complications. This is the first case of a mass-like Dieulafoy's lesion coexisting with advanced gastric cancer at the distal antrum area. This case highlights the possibility of life-threatening gastric bleeding after mucosal resection or biopsy that could be encountered by endoscopists.

An anatomical study of the proximal aspect of the medial femoral condyle to define the proximal-distal condylar length

Directory of Open Access Journals (Sweden)

Chia-Ming Chang

2017-01-01

Full Text Available Objective: Despite its possible role in knee arthroplasty, the proximal-distal condylar length (PDCL of the femur has never been reported in the literature. We conducted an anatomic study of the proximal aspect of the medial femoral condyle to propose a method for measuring the PDCL. Materials and Methods: Inspection of dried bone specimens was carried out to assure the most proximal condylar margin (MPCM as the eligible starting point to measure the PDCL. Simulation surgery was performed on seven pairs of cadaveric knees to verify the clinical application of measuring the PDCL after locating the MPCM. Interobserver reliability of this procedure was also analyzed. Results: Observation of the bone specimens showed that the MPCM is a concavity formed by the junction of the distal end of the supracondylar ridge and the proximal margin of the medial condyle. This anatomically distinctive structure made the MPCM an unambiguous landmark. The cadaveric simulation surgical dissection demonstrated that the MPCM is easily accessed in a surgical setting, making the measurement of the PDCL plausible. The intraclass correlation coefficient was 0.78, indicating good interobserver reliability for this technique. Conclusion: This study has suggested that the PDCL can be measured based on the MPCM in a surgical setting. PDCL measurement might be useful in joint line position management, selection of femoral component sizes, and other applications related to the proximal-distal dimension of the knee. Further investigation is required.

Evaluation and Management of Proximal Humerus Fractures

Directory of Open Access Journals (Sweden)

Ekaterina Khmelnitskaya

2012-01-01

Full Text Available Proximal humerus fractures are common injuries, especially among older osteoporotic women. Restoration of function requires a thorough understanding of the neurovascular, musculotendinous, and bony anatomy. This paper addresses the relevant anatomy and highlights various management options, including indication for arthroplasty. In the vast majority of cases, proximal humerus fractures may be treated nonoperatively. In the case of displaced fractures, when surgical intervention may be pursued, numerous constructs have been investigated. Of these, the proximal humerus locking plate is the most widely used. Arthroplasty is generally reserved for comminuted 4-part fractures, head-split fractures, or fractures with significant underlying arthritic changes. Reverse total shoulder arthroplasty is reserved for patients with a deficient rotator cuff, or highly comminuted tuberosities.

The Life Saving Effects of Hospital Proximity

DEFF Research Database (Denmark)

Bertoli, Paola; Grembi, Veronica

We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from......) increases the fatality rate by 13.84% on the sample average. This is equal to a 0.92 additional death per every 100 accidents. We show that OLS estimates provide a downward biased measure of the real effect of hospital proximity because they do not fully solve spatial sorting problems. Proximity matters...... more when the road safety is low; the emergency service is not properly organized, and the nearest hospital has lower quality standards....

Localization of lesions in aphasia

International Nuclear Information System (INIS)

Hojo, Kei; Watanabe, Shunzo; Tasaki, Hiroichi; Sato, Tokijiro; Metoki, Hirobumi.

1984-01-01

Using a microcomputer, the locus and extent of the lesions, as demonstrated by computed tomography for 127 cases with various types of aphasia were superimposed onto standardized marices. The relationship between the foci of the lesions and the types of aphasia was investigated. Broca aphasics (n=39) : Since the accumulated site of the lesions highly involved the deep structures of the lower part of the precentral gyrus as well as the insula and lenticular nucleus, only 60% of the Broca aphasics had lesions on these areas. This finding has proved to have little localizing value. Wernicke aphasics (n=23) : The size of the lesion was significantly smaller than Broca's aphasia. At least 70% of the patients had the superior temporal lesions involving Wernicke's area and subcortical lesions of the superior and middle temporal gyri. Amnestic aphasics (n=18) : The size of the lesion was smaller than any other types. While there was some concentration of the lesions (maximum 40%) in the area of the subcortical region of the anterior temporal gyrus adjacent to Wernicke's area and the lenticular nucleus, the lesions were distributed throughout the left hemisphere. Amnestic aphasia was thought to be the least localizable. Conduction aphasics (n=11) : The lesions were relatively small in size. Many patients had posterior speech area lesions involving at least partially Wernicke's area. In particular, more than 80% of the conduction aphasics had lesions of the supramarginal gyrus and it's adjacent deep structures. Global aphasics (n=36) : In general, the size of the lesion was very large and 70% of the global aphasics had extensive lesions involving both Broca's and Wernicke's areas. However, there were observations showing that the lesions can be small and confined. (J.P.N.)

Proximal Focal Femoral Deficiency in Ibadan a Developing ...

African Journals Online (AJOL)

The cultural aversion to amputation in our environment makes it difficult to employ that option of treatment. Proximal focal femoral deficiency in Ibadan a developing country's perspective and a review of the literature. Keywords: Proximal focal femoral deficiency , congenital malformations , limb malformations , lower limb ...

Analysis of pulmonary coin lesions

International Nuclear Information System (INIS)

Kim, O; Kim, K. H.; Oh, K. K.; Park, C. Y.

1979-01-01

For A long time the solitary pulmonary nodule has remained a difficult problem to solve and has attracted a great deal of attension in recent years. Circumscribed coin lesions of the lung were generally peripheral in location with respect to the pulmonary hilus. Because of this, important clinical problem in management and diagnosis arise. Such a lesion is discovered through roentgenologic examination. So the roentgenologists is the first be in a position to offer advise. This presentation is an attempt to correlate a useful diagnosis with roentgenologic findings of pulmonary coin lesion which enables us to get differential diagnosis of benign and malignant lesion. Histologically proven 120 cases of the pulmonary coin lesion during the period of 8 years were reviewed through plain film, tomogram, bronchoscopy, variable laboratory findings, and clinical history. The results are as follows: 1. Male to female sex ratio was 3 : 1. In age distribution, most of the malignant pulmonary coin lesion appeared in 6th decade (39%) and 5th decade (27%). In benign lesion, the most cases were in 3 rd decade. 2. Pathological cell type are as follows: Primary bronchogenic cancer 43.3%, tuberculoma 25.8%, inflammatory lesion 17.5%, benign tumor 10%, and bronchial adenoma, harmartoma, A.V. malformation, mesothelioma, are 1 case respectively. As a result benign and malignant lesion showed equal distribution (49.1% : 50.3%). 3. In symptom analysis ; cough is the most common (43.5%) symptom in malignant lesion, next follows hemoptysis (20.9%) and chest pain (14.5%). In benign lesion, most of the patient (32.7%) did not complain any symptom. 4. In malignant lesion, the most common nodular size was 4 cm (32.3%), and in benign lesion 2 cm sized coin was most common (39.3%). 5. In general, margin of nodule was very sharp and well demarcated in benign lesion (83.3%), and in malignant lesion that was less demarcated and poorly defined. 6. Most case of calcification (82.7%) was seen in benign

[Avulsion of the Proximal Hamstring Insertion. Case Reports].

Science.gov (United States)

Mizera, R; Harcuba, R; Kratochvíl, J

2016-01-01

Proximal hamstring avulsion is an uncommon muscle injury with a lack of consensus on indications and the timing and technique of surgery. Poor clinical symptoms and difficulties in the diagnostic process can lead to a false diagnosis. The authors present three cases of proximal hamstring avulsion, two complete and one partial ruptures of the biceps femoris muscle. MRI and ultrasound scans were used for optimal treatment alignment. Acute surgery reconstruction (hamstring strength. Two interesting systematic reviews published on the treatment of proximal hamstring avulsion are discussed in the final part of the paper. Key words: hamstring, rupture, avulsion.

A dual-mode proximity sensor with integrated capacitive and temperature sensing units

International Nuclear Information System (INIS)

Qiu, Shihua; Huang, Ying; He, Xiaoyue; Sun, Zhiguang; Liu, Ping; Liu, Caixia

2015-01-01

The proximity sensor is one of the most important devices in the field of robot application. It can accurately provide the proximity information to assistant robots to interact with human beings and the external environment safely. In this paper, we have proposed and demonstrated a dual-mode proximity sensor composed of capacitive and resistive sensing units. We defined the capacitive type proximity sensor perceiving the proximity information as C-mode and the resistive type proximity sensor detecting as R-mode. Graphene nanoplatelets (GNPs) were chosen as the R-mode sensing material because of its high performance. The dual-mode proximity sensor presents the following features: (1) the sensing distance of the dual-mode proximity sensor has been enlarged compared with the single capacitive proximity sensor in the same geometrical pattern; (2) experiments have verified that the proposed sensor can sense the proximity information of different materials; (3) the proximity sensing capability of the sensor has been improved by two modes perceive collaboratively, for a plastic block at a temperature of 60 °C: the R-mode will perceive the proximity information when the distance d between the sensor and object is 6.0–17.0 mm and the C-mode will do that when their interval is 0–2.0 mm; additionally two modes will work together when the distance is 2.0–6.0 mm. These features indicate our transducer is very valuable in skin-like sensing applications. (paper)

The effect of two different renal denervation strategies on blood pressure in resistant hypertension: Comparison of full-length versus proximal renal artery ablation.

Science.gov (United States)

Chen, Weijie; Ling, Zhiyu; Du, Huaan; Song, Wenxin; Xu, Yanping; Liu, Zengzhang; Su, Li; Xiao, Peilin; Yuan, Yuelong; Lu, Jiayi; Zhang, Jianhong; Li, Zhifeng; Shao, Jiang; Zhong, Bin; Zhou, Bei; Woo, Kamsang; Yin, Yuehui

2016-11-01

Renal denervation (RDN) is used to manage blood pressure (BP) in patients with resistant hypertension (rHT), but effectiveness is still a concern, and key arterial portion for successful RDN is not clear. The aim of this study was to investigate the efficacy and safety of proximal versus full-length renal artery ablation in patients with resistant hypertension (rHT). Forty-seven patients with rHT were randomly assigned to receive full-length ablation (n = 23) or proximal ablation (n = 24) of the renal arteries. All lesions were treated with radiofrequency energy via a saline-irrigated catheter. Office BP was measured during 12 months of follow-up and ambulatory BP at baseline and 6 months (n = 15 in each group). Compared with full-length ablation, proximal ablation reduced the number of ablation points in both the right (6.1 ± 0.7 vs. 3.3 ± 0.6, P renal arteries (6.2 ± 0.7 vs. 3.3 ± 0.8, P  0.5). Similar office BPs was reduced by -39.4 ± 11.5/-20.9 ± 7.1 mm Hg at 6 months and -38.2 ± 10.3/-21.5 ± 5.8 mm Hg at 12 months in the full-length group (P efficacy and safety profile compared with full-length RDN, and propose the proximal artery as the key portion for RDN. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Multiple bony lesions other than femoral heads on 99mTc-MDP bone scan in patients with avascular necrosis of the femoral head

International Nuclear Information System (INIS)

Choi, Yun Young; Yang, Seoung Oh; Moon, Dae Hyuk; Ryu, Jin Sook; Weon, Young Cheol; Shin, Myung Jin; Lee, Soo Ho; Lee, Hee Kyung; Chun, Hae Kyung

1997-01-01

To evaluate the clinical significance of the multiple increased uptake lesions other than in femoral heads as seen on whole body bone scan in patients with avascular necrosis of femoral heads. One hundred and seventy three patients with clinical diagnosis of avascular necrosis of the emoral head underwent a bone scan using Tc-99m MDP. Increased uptake lesions other than in femoral heads were evaluated, including frequency and common sites of in volvement, and correlated with clinical information and plain radiographic findings. Two hundred patients without AVN, who had undergone a bone scan, were included as a control group. Increased uptake lesions in extrafemoral head locations were found in 36 of 173 patients(20.8%;the location of 79 lesions was other than the femoral head, This result is statistically different from patients without avascular necrosis of femoral head(p<0.0001). The most common site of involvement was the knee joint area(62.5%). Other lesions were located in the mid-shafts of the long bones of the lower extremities, calcaneus, proximal humerus, etc., in order of decreasing frequency. Plain radiographs of 17 lesions were nonspecific, except for three lesions showing definite changes associated with avascular necrosis. The risk factors included alcoholism, the prolonged use of steroids, renal transplantation, herbal medication and working as a working as deep-sea diver. Most patients did not complain of pain, except for two with irreversible osteonecrotic changes as seen on plain radiograph. in patients with avascular necrosis of the femur, increased uptake lesions other than in the femoral head as seen on bone scan, may represent the early stage of osteonecrosis, which shows a characteristic appearance on bone scan. In order to aveid possible misdiagnoses of multiple extrafemoral lesions as bony metastasis or traumatic lesions, in patients with avascular necrosis of the femur these should be carefully evaluated

Skeletal and dental pathology of free-ranging mountain gorillas.

Science.gov (United States)

Lovell, N C

1990-03-01

The mountain gorillas of the central Virungas have been the subject of field study for the last 30 years; however, our understanding of morbidity and mortality in these apes is limited. This paper describes pathological conditions of the skeleton and dentition of these animals and evaluates lesions in relation to behavioral and environmental data. The skeletal remains of 31 mountain gorillas from the Karisoke Research Center were examined for enamel wear, carious lesions, abscesses, periodontal disease, antemortem tooth loss, trauma, inflammation, arthritis, neoplasia, and developmental anomalies. Two infants, three juveniles, 13 adult males, and 13 adult females form the sample. Enamel wear in the permanent posterior dentition is moderate. Six periapical abscesses were seen; three are associated with antemortem tooth breakage. No carious lesions were observed. Pronounced calculus buildup and alveolar resorption are the most notable pathological conditions of the dentition and affect all adult animals. The primary affliction of the skeleton is arthritis, which affects 14 animals. Vertebral degenerative disease predominates, but there is also temporomandibular joint involvement. Fractures occur at seven locations in the postcranium. In addition, there are five cranial injuries, including a fractured sagittal crest, and a penetrating wound to the vault, which is believed to result from a bite. Also thought to result from a bite is a case of cranial osteomyelitis. The only other inflammatory responses are two cases of idiopathic periostitis and one idiopathic lytic lesion. Button osteomas affect two animals and are the only neoplastic conditions observed. Two animals are afflicted by developmental abnormalities: one animal by idiopathic vertebral fusion and the other by spinal scoliosis.

Emerging technologies for diagnosis of dental caries: The road so far

Science.gov (United States)

Amaechi, Bennett T.

2009-05-01

It is now universally recognized that the development of new technologies for early detection and quantitative monitoring of dental decay at an early stage of formation could provide health and economic benefits ranging from timely preventive interventions to reduction in the time required for clinical trials of anticaries agents. The use of technologies as adjunct to clinical visual examination for caries diagnosis will facilitate preventive care in dentistry to lower treatment cost as well as reduce the cost and time for testing potential anticaries agents. This article describes the various technologies available to aid the dental practitioners in detecting dental caries at the earliest stage of its formation, assessing the activities of the detected carious lesion, and quantitatively or qualitatively monitoring of the lesion over time. The need and the importance of these technologies were also discussed. The data discussed are primarily based on published scientific studies and reviews from case reports, clinical trials, and in vitro and in vivo studies. References have been traced manually by MEDLINE® or through manufacturer's websites. While some of the devices are fully developed and commercially available, others are still under development. The devices vary in their modes of action as well as their capability as caries diagnostic aids. It is clear that the differences in caries presentations and behavior in different anatomical sites make it unlikely that any one diagnostic modality will have adequate sensitivity and specificity of detection of carious lesions for all sites; a combination of diagnostic tools will help us diagnose lesions earlier and detect failing restorations sooner, all to avoid more costly, destructive dental procedures and truly take dentistry into the preventive rather than the reactive mode.

A Regularized Algorithm for the Proximal Split Feasibility Problem

Directory of Open Access Journals (Sweden)

Zhangsong Yao

2014-01-01

Full Text Available The proximal split feasibility problem has been studied. A regularized method has been presented for solving the proximal split feasibility problem. Strong convergence theorem is given.