Dimensional stability of a novel polyvinyl siloxane impression technique

AIM: To introduce a modification of the reline impression technique (MRIT), and compare the dimensional changes of impressions obtained by MRIT and by conventional reline impression technique (CRIT). METHODS: An acrylic resin tablet was milled by a CAD-CAM system to simulate three abutments (A, B and C) with different distances among them. The abutments were molded using both impression techniques. For MRIT, before completing the putty silicone polymerization, the relieve procedure was made by compression and it was immediately repositioned to complete the polymerization. Impressions were stored dry at room temperature for different periods (immediately, 1 h, 2 days and 7 days). The distances were obtained by scanning. The differences between the impressions and their respective matrix reference measurements were calculated to determine the dimensional changes. Data were subjected to ANOVA and Tukey's test (p<0.05). RESULTS: For AB and BC distances, there was no statistically significant difference between CRIT and MRIT (p=0.0597 and p=0.2167, respectively). For AC, there was statistically significant difference between the techniques for the immediate storage time (p=0.006). In general, for CRIT the material showed expansion, while for MRIT it showed contraction. CONCLUSIONS: It was verified that the addition silicon impressions obtained by both impression techniques showed dimensional stability, except for the immediate time-point...

Transcatheter arterial embolization of acute gastrointestinal tumor hemorrhage with Onyx.

BACKGROUND: Endovascular embolization has been used to control gastrointestinal tumor bleeding. Lots of embolic agents have been applied in embolization, but liquid embolic materials such as Onyx have been rarely used because of concerns about severe ischemic complications. AIM: To evaluate the clinical efficacy and safety of transcatheter arterial embolization (TAE) with Onyx for acute gastrointestinal tumor hemorrhage. MATERIALS AND METHODS: Between September 2011 and July 2013, nine patients were diagnosed as acute gastrointestinal tumor hemorrhage by clinical feature and imaging examination. The angiographic findings were extravasation of contrast media in the five patients. The site of hemorrhage included upper gastrointestinal bleeding in seven cases and lower gastrointestinal bleeding in two cases. TAE was performed using Onyx in all the patients, and the blood pressure and heart rate were monitored, the angiographic and clinical success rate, recurrent bleeding rate, procedure related complications and clinical outcomes were evaluated after therapy. The clinical parameters and embolization data were studied retrospectively. RESULTS: All the patients (100%) who underwent TAE with Onyx achieved complete hemostasis without rebleeding and the patients were discharged after clinical improvement without a second surgery. No one of the patients expired during the hospital course. All the patients were discharged after clinical improvement without a second surgery. Postembolization bowel ischemia or necrosis was not observed in any of the patients who received TAE with Onyx. CONCLUSIONS: TAE with Onyx is a highly effective and safe treatment modality for acute gastrointestinal tumor hemorrhage, even with pre‑existing coagulopathy.

Avaliação do efeito de implantes subgengivais do polímero ELVAX com equistatina. Estudo microscópico em dentes de ratos extraídos e reimplantados / Evaluation of the effect of subgingival implants of polymer ELVAX with echistatin: microscopic study on rats' extracted and reimplanted teeth

O presente trabalho investigou microscopicamente o efeito da equistatina sobre o processo reabsortivo de dentes incisivos superiores de ratos, extraídos e reimplantados. Foram utilizados 42 animais, divididos em grupos com e sem equistatina. Os tempos extra-alveolares dos dentes foram de 30 e 60 minutos e os períodos experimentais pós-cirúrgicos foram 15, 60 e 90 dias. Os espécimes obtidos foram processados e corados em H.E. para observar os processos biológicos presentes. Os eventos microscópicos foram avaliados por dois examinadores, de modo quantitativo histomorfométrico e descritivo, de acordo com o tipo de infiltrado e intensidade da reação inflamatória; com o tipo, extensão e localização de reabsorção dentária; e presença de anquilose alveolodentária. O nível de concordância entre examinadores, determinado pelo índice Kappa, revelou-se quase perfeito para todas as variáveis avaliadas. A comparação entre os grupos testes e controle para as variáveis apresentadas foi feita por meio do teste Mann-Whitney e mostrou não haver diferença estatística entre a administração de equistatina e tempo extra-alveolar em relação à intensidade inflamatória nas diferentes porções radiculares. Quanto ao tipo de reabsorção estabelecida, notou-se que a presença de reabsorção inflamatória foi significativamente maior (p<0,05) no grupo controle nos tempos de 30 e 60 minutos no período pós-cirúrgico de 15 dias. A anquilose alveolodentária também esteve significativamente mais presente no grupo tratado com equistatina com 30 minutos extra-alveolar e 15 dias de período experimental. Houve, ainda, mais anquilose alveolodentária no grupo controle de 60 minutos extra-alveolar, com o período experimental de 60 dias. No período experimental de 90 dias todos os espécimes avaliados apresentaram processos reabsortivos inflamatórios e ausência de anquilose alveolodentária. O teste Kruskall-Wallis avaliou as diferenças significantes entre grupos, em relação à intensidade inflamatória por...

This study aimed to microscopically investigate the effect on the dental resorptive process of subgingival implants of ELVAX polymer with peptide echistatin in reimplantation of upper incisors in rats. For this purpose, 42 animals were used and divided into groups with and without echistatin. Extra alveolar socket period was 30 and 60 minutes and post-surgical experimental periods were 15, 60 and 90 days. Specimens were processed and stained with H.E. to observe the biological processes in the area. The microscopic events were evaluated by two examiners. Quantitative histomorphometric and descriptive evaluation of the events were performed according to the presence, type and location of the inflammatory response, incidence of resorptions or dental ankylosis. The level of agreement between examiners determined by the Kappa index, proved to be almost perfect for all variables. The comparison between the experimental and control groups for the variables presented was performed using the Mann-Whitney test and showed no statistical difference between the administration of echistatin and extra alveolar socket period relative to the inflammatory intensity in different portions of the root. Regarding the type of resorption established, it was noted that the presence of inflammatory resorption was significantly higher (p<0.05) in the control group on days 30 and 60 minutes in the postoperative period of 15 days. Dental ankylosis was also significantly more prevalent in the group treated with echistatin in extra alveolar socket period of 30 minutes and 15-day trial period. There was even more dental ankylosis in control group with 60 minutes of extra alveolar socket, with the trial period of 60 days. In the trial period of 90 days all specimens studied featured inflammatory resorptives processes and absence of dental ankylosis. The Kruskal-Wallis test assessed significant differences between groups in relation to the intensity of...

Avaliação do efeito de implantes subgengivais do polímero ELVAX com equistatina. Estudo microscópico em dentes de ratos extraídos e reimplantados / Evaluation of the effect of subgingival implants of polymer ELVAX with echistatin: microscopic study on rats' extracted and reimplanted teeth

O presente trabalho investigou microscopicamente o efeito da equistatina sobre o processo reabsortivo de dentes incisivos superiores de ratos, extraídos e reimplantados. Foram utilizados 42 animais, divididos em grupos com e sem equistatina. Os tempos extra-alveolares dos dentes foram de 30 e 60 minutos e os períodos experimentais pós-cirúrgicos foram 15, 60 e 90 dias. Os espécimes obtidos foram processados e corados em H.E. para observar os processos biológicos presentes. Os eventos microscópicos foram avaliados por dois examinadores, de modo quantitativo histomorfométrico e descritivo, de acordo com o tipo de infiltrado e intensidade da reação inflamatória; com o tipo, extensão e localização de reabsorção dentária; e presença de anquilose alveolodentária. O nível de concordância entre examinadores, determinado pelo índice Kappa, revelou-se quase perfeito para todas as variáveis avaliadas. A comparação entre os grupos testes e controle para as variáveis apresentadas foi feita por meio do teste Mann-Whitney e mostrou não haver diferença estatística entre a administração de equistatina e tempo extra-alveolar em relação à intensidade inflamatória nas diferentes porções radiculares. Quanto ao tipo de reabsorção estabelecida, notou-se que a presença de reabsorção inflamatória foi significativamente maior (p<0,05) no grupo controle nos tempos de 30 e 60 minutos no período pós-cirúrgico de 15 dias. A anquilose alveolodentária também esteve significativamente mais presente no grupo tratado com equistatina com 30 minutos extra-alveolar e 15 dias de período experimental. Houve, ainda, mais anquilose alveolodentária no grupo controle de 60 minutos extra-alveolar, com o período experimental de 60 dias. No período experimental de 90 dias todos os espécimes avaliados apresentaram processos reabsortivos inflamatórios e ausência de anquilose alveolodentária. O teste Kruskall-Wallis avaliou as diferenças significantes entre grupos, em relação à intensidade inflamatória por...

This study aimed to microscopically investigate the effect on the dental resorptive process of subgingival implants of ELVAX polymer with peptide echistatin in reimplantation of upper incisors in rats. For this purpose, 42 animals were used and divided into groups with and without echistatin. Extra alveolar socket period was 30 and 60 minutes and post-surgical experimental periods were 15, 60 and 90 days. Specimens were processed and stained with H.E. to observe the biological processes in the area. The microscopic events were evaluated by two examiners. Quantitative histomorphometric and descriptive evaluation of the events were performed according to the presence, type and location of the inflammatory response, incidence of resorptions or dental ankylosis. The level of agreement between examiners determined by the Kappa index, proved to be almost perfect for all variables. The comparison between the experimental and control groups for the variables presented was performed using the Mann-Whitney test and showed no statistical difference between the administration of echistatin and extra alveolar socket period relative to the inflammatory intensity in different portions of the root. Regarding the type of resorption established, it was noted that the presence of inflammatory resorption was significantly higher (p<0.05) in the control group on days 30 and 60 minutes in the postoperative period of 15 days. Dental ankylosis was also significantly more prevalent in the group treated with echistatin in extra alveolar socket period of 30 minutes and 15-day trial period. There was even more dental ankylosis in control group with 60 minutes of extra alveolar socket, with the trial period of 60 days. In the trial period of 90 days all specimens studied featured inflammatory resorptives processes and absence of dental ankylosis. The Kruskal-Wallis test assessed significant differences between groups in relation to the intensity of...

Comparison of 2% chlorhexidine and 5.25% sodium hypochlorite irrigating solutions on postoperative pain: A randomized clinical trial.

Aim: To compare the levels of postoperative pain after cleaning and shaping of root canals using two different root canal irrigants for debridement. Materials and Methods: Forty patients with irreversible pulpitis, pulp necrosis and non-vital teeth exhibiting acute apical periodontitis requiring root canal treatment were included. At random, canals were cleaned and shaped with the following protocols. 2% chlorhexidine solution in group I and 5.25% sodium hypochlorite solution in group II were used as an irrigants. Access cavities were closed with a sterile cotton pellet and cavit. The patients recorded degree of pain at various time intervals after cleaning and shaping on a visual analogue scale for 1 week. Results: The mean pain score for group I was between 0.65 and 3.35 and for group II was between 0.95 and 4.50. There was significant difference in the pain level between the two groups only at 6 th hour postoperatively (P<0.05) and the pain was more in sodium hypochlorite group. Conclusions: More pain was present in teeth irrigated using 5.25% sodium hypochlorite when compared to that in teeth irrigated using 2% chlorhexidine solution. Significant difference in pain level was present only at 6th hour postoperatively, and at all other periods (24 th hour, 4 th and 7 th days) there was no significant difference in pain level between the two groups.

Dural arteriovenous fistulas with direct cortical venous drainage treated with Onyx®: a case series / Fístulas arteriovenosas durais com drenagem cortical direta tratadas com Onyx®: casuística

Dural arteriovenous fistulas (DAVFs) may have aggressive symptoms, especially if there is direct cortical venous drainage. We report our preliminary experience in transarterial embolization of DAVFs with direct cortical venous drainage (CVR) using Onyx®. METHOD: Nine patients with DAVFs with direct cortical venous drainage were treated: eight type IV and one type III (Cognard). Treatment consisted of transarterial embolization using Onyx-18®. Immediate post treatment angiographies, clinical outcome and late follow-up angiographies were studied. RESULTS: Complete occlusion of the fistula was achieved in all patients with only one procedure and injection in only one arterial pedicle. On follow-up, eight patients became free from symptoms, one improved and no one deteriorated. Late angiographies showed no evidence of recurrent DAVF. CONCLUSION: We recommend that transarterial Onyx® embolization of DAVFs with direct cortical venous drainage be considered as a treatment option, while it showed to be feasible, safe and effective.

As fistulas arteriovenosas durais (FAVDs) podem se manifestar com sintomas agressivos, especialmente se existe drenagem cortical direta. Relatamos nossa experiência preliminar na embolização transarterial de FAVDs com drenagem cortical direta usando Onyx®. MÉTODO: Nove pacientes com FAVDs com drenagem cortical direta foram tratados: oito do tipo IV e uma do tipo III (Cognard). O tratamento consistiu na embolização transarterial usando Onyx-18®. Angiografias imediatas pós-tratamento, evolução clínica e angiografias de controle tardias foram estudadas. RESULTADOS: A oclusão completa da fístula foi alcançada em todos pacientes através de um só procedimento e injeção em apenas um pedículo arterial. No seguimento, oito pacientes ficaram livres de sintomas, um melhorou e nenhum deteriorou. Angiografias tardias de controle não mostraram evidência de FAVD recorrente. CONCLUSÃO: Nós recomendamos que a embolização transarterial com Onyx® das FAVDs com drenagem cortical direta, seja considerada como uma opção terapêutica, uma vez que mostrou ser factível, segura e efetiva.

Effect of immediate and delayed post space preparation on the apical seal of root canals obturated with different sealers and techniques

During mechanical preparation of the post space, the root canal filling may be twisted or vibrated, depending on several factors associated with the preparation technique and quality of filling. OBJECTIVE: The purpose of this study was to investigate the effect of immediate and delayed post space preparation on the integrity of the apical seal. MATERIAL AND METHODS: Sixty-four extracted human incisors were biomechanically prepared using the step-back technique. Sixty roots were randomly assigned to 6 experimental groups of 10 teeth each and the remaining 4 roots served as positive and negative controls (n=2). The root canals in the different groups were obturated with cold lateral and warm vertical condensation of gutta-percha and one of two sealers (Sealapex and Diaket). Post space was prepared either individually or simultaneously. An insulated copper wire was cut into 10-cm-long pieces. In each canal, one piece was inserted to maintain contact with gutta-percha and extended to the outside as one of two working electrodes. A stainless steel wire with the same dimensions of those of the copper wire, used as the other working electrode, was immersed into the background electrolyte from the center of the bottle. The electrical current between standard and experimental electrodes in canals was measured over a period of 10 days applying a conductivity meter. The Kruskal-Wallis test (p=0.05) determined whether there was a significant difference in microleakage among the groups and the Mann-Whitney U test (p=0.01) was used for multiple comparison grouping variables. RESULTS: The results suggest that only the differences between the root canal filling techniques were statistically significant (p<0.01). There were no statistically significant difference in the sealers and the times of filling removal for post space preparation (p>0.01). CONCLUSION: The quality of the root canal filling is important for the integrity of the apical seal.

Renal Artery Embolization Using a New Liquid Embolic Material Obtained by Partial Hydrolysis of Polyvinyl Acetate (Embol):Initial Experience in Six Patients

OBJECTIVE: To evaluate the therapeutic efficacy of a new liquid embolic materi-al,Embol, in embolization of the renal artery. MATERIALS AND METHODS: Embol is a new embolic material obtained by partial hydrolysis of polyvinyl acetate mixed in absolute ethanol and Iopromide 370 and manufactured by Schering Korea, Kyonggido, Korea. Six patients who underwent embolization of the renal artery using Embol were evaluated. Four were male and two were female and their ages ranged from 11 to 70 (mean, 53) years. Clinical and radiologic diagnoses referred for renal artery embolization were renal cell carcinoma (n = 3), renal angiomyolipoma (n = 2) and pseudoaneurysm of the renal artery (n = 1). After selective renal angiography, Embol was injected through various catheters, either with or without a balloon occlusion catheter. Changes in symptoms and blood chemistry which may have been related to renal artery embolization with Embol were analyzed. RESULTS: The six patients showed immediate total occlusion of their renal vas-cular lesions. One of the three in whom renal cell carcinoma was embolized with Embol underwent radical nephrectomy, and the specimen thus obtained revealed 40% tumor necrosis. In the two patients with angiomyolipomas, the tumors decreased in size and abdominal pain subsided. Bleeding from pseudoaneurysm of the renal artery was successfully controlled. Four patients showed symptoms of post-embolization syndrome, and one of these also showed increased levels of blood urea nitrogen and creatinine. One patient experienced transient hyperten-sion. CONCLUSION: Embol is easy to use, its radiopacity is adequate and it is a safe and effective embolic material which provides immediate and total occlusion of renal vascular lesions.

Utilidad del catéter transcístico en la cirugía biliar laparoscópica / Usefulness, of trancystic drainage in laparoscopic biliary surgery

Antecedentes: Si bien la Colecistectomía Laparoscópica es universalmente aceptada, no hay acuerdo unánime acerca de como tratar los cálculos de la vía biliar principal, detectados por colangiografía operatoria. Objetivo: Averiguar la utilidad, ventajas e inconvenientes del drenaje transcístico en la cirugía biliar laparoscópica. Lugar de aplicación: Clínica privada.Diseño: Trabajo retrospectivo de casuística. Población: Se analizan 32 drenajes transcísticos ("drain d'Escat") colocados por vía laparoscópica en un total de 1.232 colecistectomías laparoscópicas realizadas entre octubre de 1990 y agosto de 1997. Método: Se indicó la colocación del "drain d'Escat", en todos los casos en que se descartó la conversión o la exploración laparoscópica de la VBP, frente a hallazgos colangiográficos que sugerían litiasis, escaso pasaje a duodeno, o colédoco dilatado sin cálculos. Resultados: De los 32 drenajes, 10 aportaron débito nulo, certificando su ineficacia para drenar la VBP. En 2 casos el catéter provocó falsa vía, causando morbilidad. La litiasis fue descartada en 12 pacientes, y confirmada en 18. 3 enfermos tenían más cálculos de lo previsto. 5 litiasis fueron resueltas con lavajes a través del drenaje en el postoperatorio, y 11 con papilotomía endoscópica postoperatoria, en las cuales el tubo fue de utilidad para guiar al endoscopista y comprobar la eficacia de la sección. Conclusiones: El "drain d'Escat", si bien no es inocuo, es un eficaz auxiliar de la Colecistectomía Laparoscópica seguida de Colangiografía Operatoria Sistemática, frente al hallazgo o sospecha de litiasis coledociana, cuando no se dispone de tecnología o entrenamiento para explorar la Vía Biliar Principal por laparoscopia, o no se opata por la conversión

Obturadores para defectos palatinos: Un nuevo método de elaboración / Obturators for palatine defects: A new elaboration process

Las prótesis para obturar defectos palatinos son hechas con metil metacrilato de termopolimerización y retenedor de acero forjado que se fijan a los dientes remanentes. Este proceso es largo, costoso y laborioso. El objetivo de este trabajo es presentar nuestra experiencia con un método alternativo de elaboración con polivinil acetato polietileno son una excelente alternativa a los obturarodores tradicionales