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Comparison of posttreatment stability after total mandibular arch distalization with mini-implants and mandibular setback surgery
No full textAbstract Objectives
To compare posttreatment stability in skeletal Class III patients between those treated by total mandibular arch distalization (TMAD) with buccal mini-implants and those by mandibular setback surgery (MSS). Materials and Methods
The samples included 40 Class III adults, 20 treated by TMAD using buccal interradicular mini-implants and 20 treated with MSS. Lateral cephalograms were taken at pretreatment, posttreatment, and at least 1-year follow-up, and 24 variables were compared using statistical analysis. Results
Mandibular first molars moved distally 1.9 mm with intrusion of 1.1 mm after treatment in the TMAD group. The mandibular incisors moved distally by 2.3 mm. The MSS group exhibited a significant skeletal change of the mandible, whereas the TMAD group did not. During retention, there were no skeletal or dental changes other than 0.6 mm labial movement of the mandibular incisors (P \u3c .05) in the MSS group. There was 1.4° of mesial tipping (P \u3c .01) and 0.4 mm of mesial movement of the mandibular molars and 1.9° of labial tipping (P \u3c .001) and 0.8 mm of mesial movement of the mandibular incisors in the TMAD group. These dental changes were not significantly different between the two groups. Conclusions
The TMAD group showed a slightly decreased overjet with labial tipping of the mandibular incisors and mesial tipping of the first molars during retention. Posttreatment stability of the mandibular dentition was not significantly different between the groups. It can be useful to plan camouflage treatment by TMAD with mini-implants in mild-to-moderate Class III patients
Growth modification using a modified C-palatal plate in a patient with a Class II hyperdivergent relationship with arthrogryposis multiplex congenita
No full textHighlights A 9-year-old patient presented with a hyperdivergent Class II relationship. The patient also presented with arthrogryposis multiplex congenita. Two-phase treatment using a modified C-palatal plate was performed. It was effective in not only anteroposterior improvement but also in vertical control.
A 9-year-old male patient with arthrogryposis multiplex congenita (AMC) had a history of at least 2 joint contractures in multiple areas of his body. In addition, he had a dentoskeletal Class II malocclusion and a hyperdivergent growth pattern. He was successfully treated with growth modification using a modified C-palatal plate (MCPP) with a 2-phase treatment. An MCPP was applied 3 times throughout treatment, and the patient was observed from age 10 to 20 years. In phase 1, an MCPP was placed twice to induce the headgear effect in the maxilla. In phase 2, an MCPP and fixed appliances were used in the whole dentition to improve the dental Class II relationship and functional occlusion. Phase 1 occurred over 6 years and 9 months, whereas Phase 2 occurred over 20 months. Patient with a Class II hyperdivergent AMC relationship with micrognathia have shown improved anteroposterior discrepancy in dental and skeletal structures and effective vertical control using MCPPs. Therefore, clinicians should consider the application of MCPPs as a treatment modality for patients with a Class II growth modification in AMC
Fibroblasts and osteoblasts behavior after contact with different titanium surfaces used as implant abutment: An in vitro experimental study
Get PDFBackground: The goal of this in vitro study was to compare three different surfaces: two types of implant surfaces commercially available ([a] smooth/machined and [b] acid-treated surface) versus (c) anodized surface. Discs were manufactured with commercially pure titanium (CP) grade IV, which were subsequently analyzed by scanning microscopy and fibroblastic and osteoblastic cell cultures. Methods: Ninety-nine discs (5 × 2 mm) were manufactured in titanium grade IV and received different surface treatments: (i) Mach group: machined; (ii) AA group: double acid etch; and (iii) AN group: anodizing treatment. Three discs from each group were analyzed by Scanning Electron Microscopy (SEM) to obtain surface topography images and qualitatively analyzed by EDS. Balb/c 3T3 fibroblasts and pre-osteoblastic cells (MC3T3-E1 lineage) were used to investigate each group’s biological response (n = 10/cellular type). The data were compared statistically using the ANOVA one-way test, considered as a statistically significant difference p \u3c 0.05. Results: The AA group had numerous micropores with diameters between 5 and 10 μm, while nanopores between 1 and 5 nm were measured in the AN group. The EDX spectrum showed a high titanium concentration in all the analyzed samples. The contact angle and wetting tension were higher in the AA, whereas similar results were observed for the other groups. A lower result was observed for base width in the AA, which was higher in the other two groups. The AN showed the best values in the fibroblast cells, followed by Mach and AA; whereas, in the culture of the MC3T3 cells, the result was precisely the opposite (AA \u3e Mach \u3e AN). There was similar behavior for cell adhesion for the test groups (Mach and AN), with greater adhesion of Balb/c 3T3 fibroblasts compared to MC3T3 cells; in the AA group, there was greater adherence for MC3T3 cells compared to Balb/c 3T3 fibroblasts. Conclusions: The findings suggest that different surface characteristics can produce different biological responses, possibly cell-line dependent. These findings have important implications for the design of implantable medical devices, where the surface characteristics can significantly impact its biocompatibility
Novel gene therapies for sickle cell disease, Duchenne muscular dystrophy, and hemophilia A
No full textThis article discusses novel genetic therapies for sickle cell disease, Duchenne muscular dystrophy, and hemophilia A. Gene therapies have the potential to deliver more targeted and effective approaches to treatment, especially for rare diseases for which the availability of approved therapies is limited. This article describes the first FDA-approved crispr/ Cas9 treatment and the treatment protocols, indications, warnings, precautions, cost, and contraindications of four novel genetic therapies
Fracture resistance, marginal and internal adaptation of innovative 3D-printed graded structure crown using a 3D jet printing technology
No full textPurpose: This in vitro study aimed to create a graded structured dental crown using 3D printing technology and investigate the fracture resistance and the adaptation of this new design. Materials and Methods: A dental crown with a uniform thickness of 1.5 mm was designed, and the exported stereolithography file (STL) was used to manufacture 30 crowns in three groups (n = 10), solid (SC), bilayer (BL), and multilayer (ML) crowns using 3D jet printing technology. Marginal and internal gaps were measured using the silicone replica technique. Crowns were then luted to a resin die using a temporary luting agent and the fracture resistance was measured using a universal testing machine. One-way ANOVA and Tukey post hoc tests were used to compare the fracture resistance and the adaptation of crowns at a significance level of 0.05. Results: Mean marginal and internal gap of the ML group were 80 and 82 mm, respectively; which were significantly (p \u3c 0.05) smaller than BL (203 and 183 mm) and SC (318 and 221 mm) groups. The SC group showed the highest mean load at fracture (2330 N) which was significantly (p \u3c 0.05) higher than the BL (1716 N) and ML (1516 N) groups. Conclusion: 3D jet printing technology provides an opportunity to manufacture crowns in a graded structure with various mechanical properties. This study provided an example of graded structured crowns and presented their fracture resistance. SC group had the highest fracture resistance; however, ML had the best marginal and internal adaptation
Did the COVID-19 pandemic impact antibiotic prescribing patterns among dentists?: Oral health
No full textData sources: Patient records from Wits Oral Health Centre were collected over two years (March 2019–March 2021). The records were divided into two groups: pre-COVID-19 (March 2019–March 2020) and COVID-19 (March 2020–March 2021). The total sample size was 698 systematically selected patient records who received antibiotics. Study selection: A systematic random sampling method was used to select a sample of patients who received prescriptions for antibiotics. Patients were included based on their treatment time and need for antibiotic prescription. Patients whose records were missing information or treated by independent private practitioners for whom records access was not feasible were excluded. Data extraction and synthesis: The extracted data contained information regarding the patients’ demographics, medical histories, dental condition, dental procedure, antibiotic type, frequency, dosage, duration of use, and prescribers’ disciplines. The information was categorized and captured in Microsoft Excel to analyze and create figures and tables. Analysis was performed using descriptive statistics, chi-squared, and z-tests to compare pre-COVID-19 and COVID-19 prescription patterns in RStudio. Results: From an initial pool of 44,067 patient consultations, a systematic random sample of 698 records met the eligibility criteria for inclusion in this study. The sample was divided between pre-COVID-19 (n = 350) and COVID-19 (n = 348). A significant increase in antibiotic prescriptions was found during COVID-19 (1571 prescriptions) compared to pre-COVID-19 (1109 prescriptions). The most commonly prescribed antibiotics were amoxicillin and metronidazole. Specifically, amoxicillin was used in most cases before and during COVID-19. The combination of amoxicillin with metronidazole increased from 16.6% pre-COVID-19 to 24.4% COVID-19. It was found that many of the antibiotics prescribed from both periods were not clinically indicated (53.1% pre-COVID-19 and 54.3% COVID-19). Conclusions: The authors concluded that the COVID-19 pandemic significantly increased antibiotic prescriptions despite fewer in-person consultations. This was likely due to insufficient surgical intervention and reliance on antibiotics to treat dental conditions. The lack of proper antibiotic use raises concerns regarding dental practitioners’ appropriate use of antibiotics. There is an urgent need for improved antibiotic stewardship to prevent the misuse and growing public health issue of antimicrobial resistance
Nonextraction anterior open bite treatment with distalization and intrusion
No full textThis case report describes successful orthodontic retreatment for vertical control with nonextraction orthodontic therapy. A 31-year-old woman complained of anterior open bite and crowding. She had slightly protrusive lips but wanted to correct her malocclusion without extraction. Two palatal temporary skeletal anchorage devices were used for the distalization of the maxillary arch along with posterior intrusion. Mandibular distalization was performed with Class III elastics. The duration of active treatment was 22 months. The plain and efficient mechanics used contributed to the effective distalization of both arches, the intrusion of the maxillary posterior teeth, and favorable profile changes. The results were still stable at the five-year follow-up period
Predominance of blaNDM- and blaIMP-Harboring Escherichia coli Belonging to Clonal Complexes 131 and 23 in a Major University Hospital
No full textAbstract
Background and Objectives: Carbapenem resistance is a growing global challenge for healthcare, and, therefore, monitoring its prevalence and patterns is crucial for implementing targeted interventions to mitigate its impact on patient outcomes and public health. This study aimed to determine the prevalence of carbapenem resistance among Escherichia coli (E. coli) strains in the largest tertiary care hospital of the capital territory of Pakistan and to characterize the isolates for the presence of antimicrobial resistance genes. Additionally, the most prevalent sequence types were analyzed. Materials and Methods: A total of 15,467 clinical samples were collected from November 2020 to May 2022, underwent antimicrobial susceptibility testing, and were analyzed for antimicrobial resistance genes through conventional PCR and sequence typing using MLST. Results: In carbapenem-resistant E. coli (CR-EC), 74.19% of isolates harbored the blaNDM gene, with blaNDM-1 (66.96%), blaNDM-5 (12.17%), and blaNDM-7 (20.87%) variants detected. Additionally, blaIMP was found in 25.81% and blaOXA-48 in 35.48% of isolates. The presence of blaCTX-M15 and blaTEM was identified in 83.87% and 73.55% of CR-EC isolates, respectively, while armA and rmtB were detected in 40% and 65.16% of isolates, respectively. Colistin and tigecycline were the most effective drugs against CR-EC isolates, with both showing an MIC50 of 0.5 µg/mL. The MIC90 for colistin was 1 µg/mL, while for tigecycline, it was 2 µg/mL. MLST analysis revealed that the CR-EC isolates belonged to ST131 (24.52%), ST2279 (23.87%), ST3499 (16.13%), ST8051 (15.48%), ST8900 (9.68%), ST3329 (7.10%), ST88 (1.94%), and ST6293 (1.29%). The ST131 complex (70.97%) was the most prevalent, harboring 95.65% of the blaNDM gene, while the ST23 complex (18.06%) harbored 62.50% of the blaIMP gene. Conclusions: Implementing large-scale surveillance studies to monitor the spread of specific pathogens, along with active infection control policies, is crucial for the effective containment and prevention of future epidemics
On the spinal venous sinus of Alligator mississippiensis
No full textThe epidural space of the American alligator (Alligator mississippiensis) is largely filled by a continuous venous sinus. This venous sinus extends throughout the trunk and tail of the alligator, and is continuous with the dural sinuses surrounding the brain. Segmental spinal veins (sl) link the spinal venous sinus (vs) to the somatic and visceral venous drainage. Some of these sl, like the caudal head vein along the occipital plate of the skull, are enlarged, suggesting more functional linkage. No evidence of venous valves or external venous sphincters was found associated with the vs; the relative scarcity of smooth muscle in the venous wall of the sinus suggests limited physiological regulation. The proatlas (pr), which develops between the occipital plate and C1 in crocodylians, is shaped like a neural arch and is fused to the dorsal surface of the vs. The present study suggests that the pr may function to propel venous blood around the brain and spinal cord. The vs effectively encloses the spinal dura, creating a tube-within-a-tube system with the (smaller volume) spinal cerebrospinal fluid (CSF). Changes in venous blood pressure, as are likely during locomotion, would impact dural compliance and CSF pressure waves propagating along the spinal cord
Unfavorable social determinants of health and risk of mortality in adults with diabetes: findings from the National Health Interview Survey
No full textIntroduction Understanding the role of social determinants of health as predictors of mortality in adults with diabetes may help improve health outcomes in this high-risk population. Using population-based, nationally representative data, this study investigated the cumulative effect of unfavorable social determinants on all-cause mortality in adults with diabetes. Research design and methods We used data from the 2013–2018 National Health Interview Survey, linked to the National Death Index through 2019, for mortality ascertainment. A total of 47 individual social determinants of health were used to categorize participants in quartiles denoting increasing levels of social disadvantage. Poisson regression was used to report age-adjusted mortality rates across increasing social burden. Multivariable Cox proportional hazards models were used to assess the association between cumulative social disadvantage and all-cause mortality in adults with diabetes, adjusting for traditional risk factors. Results The final sample comprised 182 445 adults, of whom 20 079 had diabetes. In the diabetes population, mortality rate increased from 1052.7 per 100 000 person-years in the first quartile (Q1) to 2073.1 in the fourth quartile (Q4). In multivariable models, individuals in Q4 experienced up to twofold higher mortality risk relative to those in Q1. This effect was observed similarly across gender and racial/ethnic subgroups, although with a relatively stronger association for non-Hispanic white participants compared with non-Hispanic black and Hispanic subpopulations. Conclusions Cumulative social disadvantage in individuals with diabetes is associated with over twofold higher risk of mortality, independent of established risk factors. Our findings call for action to screen for unfavorable social determinants and design novel interventions to mitigate the risk of mortality in this high-risk population