Evaluation of the accuracy of direct intraoral scanner impressions for digital post and core in various post lengths: An in-vitro study.

STATEMENT OF PROBLEM: Despite the growing utilization of direct intraoral scanners (IOSs) in dentistry, there is a scarcity of research investigating their accuracy, specifically in post and core. Few studies have conducted comprehensive three-dimensional assessments and comparisons of IOSs with the conventional impression technique, particularly in different post space lengths. PURPOSE: The purpose of this in vitro study was to digitally assess the accuracy of direct intraoral scanner (IOS) impressions for different post space lengths, specifically 6, 8, and 10 mm. MATERIALS AND METHODS: A total of 45 typodont teeth (maxillary central incisors) were selected for this study. The teeth underwent endodontic treatment and were divided into three subgroups, each with 15 teeth, based on the desired post space lengths: 6, 8, and 10 mm. Intraoral scans of all specimens were acquired directly using the CEREC Primescan intraoral scanners by two trained examiners. The obtained scan data were compared with conventional impressions obtained using light and heavy bodies of polyvinyl siloxane (PVS). As a control, the conventional impressions were subsequently scanned using an inEos X5a lab scanner. The accuracy of the digital scans was evaluated in the coronal, middle, and apical thirds using the Geomagic Control X software. Statistical analysis was performed using Bonferroni Post-hoc and One-way ANOVA tests to analyze the data. RESULTS: The overall mean root mean square (RMS) deviations for the different post lengths across the three thirds groups were 58, 81, and 101 µm for the 6, 8, and 10 mm subgroups, respectively. There were no statistically significant differences in the accuracy of the coronal and middle thirds among all subgroups (p > 0.5). However, in the apical third, the 10 mm subgroup exhibited a significantly lower accuracy (163 µm) compared to the 6 mm (96 µm) and 8 mm (131 µm) subgroups (p < 0.05). These results suggest that while the accuracy of intraoral scans using direct IOS impressions was consistent in the coronal and middle thirds regardless of the post length, there was a noticeable decrease in accuracy in the apical third, particularly with longer post lengths. CONCLUSION: Considering the limitations of this in vitro study, chairside direct IOS impressions offer a viable and clinically acceptable alternative to the conventional impression technique for post space lengths of 6 and 8 mm. However, as the post space length preparation increases, the accuracy of IOS decreases. CLINICAL SIGNIFICANCE: The Chairside direct IOS enables expedited and efficient digital impression capture within the root canal, ensuring acceptable accuracy for intracanal post length preparation of up to 8 mm.

The Effect of Resin Bonding on Long-Term Success of High-Strength Ceramics.

Digital manufacturing, all-ceramics, and adhesive dentistry are currently the trendiest topics in clinical restorative dentistry. Tooth- and implant-supported fixed restorations from computer-aided design (CAD)/computer-aided manufacturing (CAM)-fabricated high-strength ceramics-namely, alumina and zirconia-are widely accepted as reliable alternatives to traditional metal-ceramic restorations. Most recent developments have focused on high-translucent monolithic full-contour zirconia restorations, which have become extremely popular in a short period of time, due to physical strength, CAD/CAM fabrication, and low cost. However, questions about proper resin bonding protocols have emerged, as they are critical for clinical success of brittle ceramics and treatment options that rely on adhesive bonds, specifically resin-bonded fixed dental prostheses or partial-coverage restorations such as inlays/onlays and veneers. Resin bonding has long been the gold standard for retention and reinforcement of low- to medium-strength silica-based ceramics but requires multiple pretreatment steps of the bonding surfaces, increasing complexity, and technique sensitivity compared to conventional cementation. Here, we critically review and discuss the evidence on resin bonding related to long-term clinical outcomes of tooth- and implant-supported high-strength ceramic restorations. Based on a targeted literature search, clinical long-term studies indicate that porcelain-veneered alumina or zirconia full-coverage crowns and fixed dental prostheses have high long-term survival rates when inserted with conventional cements. However, most of the selected studies recommend resin bonding and suggest even greater success with composite resins or self-adhesive resin cements, especially for implant-supported restorations. High-strength ceramic resin-bonded fixed dental prostheses have high long-term clinical success rates, especially when designed as a cantilever with only 1 retainer. Proper pretreatment of the bonding surfaces and application of primers or composite resins that contain special adhesive monomers are necessary. To date, there are no clinical long-term data on resin bonding of partial-coverage high-strength ceramic or monolithic zirconia restorations.

Percepción del médico y paciente de la gravedad de la psoriasis, su impacto en la calidad de vida y satisfacción con la atención y el tratamiento recibido. Estudio observacional en España / Physician and Patient Perception of Disease Severity, Quality of Life, and Treatment Satisfaction in Psoriasis: An Observational Study in Spain

Introducción: El objetivo de este estudio fue evaluar el impacto de la psoriasis en la calidad de vida del paciente, las diferencias entre médicos y pacientes en las percepciones sobre la calidad de vida, los tratamientos y las necesidades de los pacientes y la relación médico-paciente. Material y métodos: Estudio observacional, multicéntrico, de corte transversal, en el cual un grupo de dermatólogos representativos de toda la geografía española, con ejercicio tanto en el ámbito hospitalario como ambulatorio, y de pacientes con diagnóstico de psoriasis, cumplimentaron una encuesta especialmente diseñada para el estudio. La encuesta incluía preguntas sobre datos demográficos del paciente, características de la enfermedad, impacto de esta sobre la calidad de vida, manejo terapéutico de la psoriasis y relación paciente-dermatólogo. Resultados: Un total de 151 dermatólogos de toda España incluyeron una media de 5 pacientes cada uno. Se incluyeron en el análisis un total de 771 encuestas cumplimentadas por los dermatólogos y 732 encuestas cumplimentadas por los pacientes. Dos terceras partes de los pacientes presentaban una enfermedad moderada a grave con una importante repercusión en la calidad de vida, en especial sobre el estado emocional. No obstante, la calidad de vida sóloe ra evaluada de forma sistemática y rutinaria por el 19,9% de los dermatólogos. El 47% de los pacientes estaba muy satisfecho o bastante satisfecho con el tratamiento que recibía. No se encontraron diferencias relevantes entre las percepciones del paciente y del médico sobre los aspectos evaluados. Conclusiones: Nuestros resultados señalan el importante impacto que tiene la psoriasis sobre la calidad de vida del paciente y la necesidad de evaluar este parámetro de forma sistemática. Los pacientes refieren un buen grado de satisfacción con la atención recibida por los dermatólogos y los tratamientos administrados. Existe bastante concordancia entre los pacientes y los dermatólogos en la valoración de los parámetros evaluados (AU)

Objectives: The aims of this study were to determine the impact of psoriasis on patient quality of life, to analyze differences in perception between patients and physicians regarding quality of life, treatment satisfaction, and patient needs, and to assess the physician—patient relationship. Material and methods: A multicenter, observational, cross-sectional study was undertaken in which a representative group of dermatologists—–working in hospitals and outpatient clinics throughout Spain—–and their patients with a diagnosis of psoriasis completed specifically designed questionnaires. The questionnaires covered patient demographics, disease characteristics, impact of the disease on quality of life, treatment of psoriasis, and the relationship between patient and dermatologist. Results: A total of 151 dermatologists from throughout Spain included a mean of 5 patients each. The analysis included 771 questionnaires completed by dermatologists and 732 completed by patients. Two-thirds of patients had moderate-to-severe psoriasis with a major impact on quality of life, particularly in relation to emotional wellbeing. Nevertheless, quality of life was only assessed routinely and systematically by 19.9% of dermatologists. Overall, 47% of patients reported being quite satisfied or very satisfied with the treatment they received. No significant differences were observed between patients and dermatologists on the aspects analyzed. Conclusions: Our results highlight the substantial impact of psoriasis on patient quality of life and the consequent need for systematic quality-of-life assessment in affected patients. Patients reported a high level of satisfaction with the care provided by dermatologists and the treatment received. There was good agreement between patients and dermatologists in their assessment of the variables analyzed (AU)

[Physician and patient perception of disease severity, quality of life, and treatment satisfaction in psoriasis: an observational study in Spain]. / Percepción del médico y paciente de la gravedad de la psoriasis, su impacto en la calidad de vida y satisfacción con la atención y el tratamiento recibido. Estudio observacional en España.

OBJECTIVES: The aims of this study were to determine the impact of psoriasis on patient quality of life, to analyze differences in perception between patients and physicians regarding quality of life, treatment satisfaction, and patient needs, and to assess the physician-patient relationship. MATERIAL AND METHODS: A multicenter, observational, cross-sectional study was undertaken in which a representative group of dermatologists-working in hospitals and outpatient clinics throughout Spain-and their patients with a diagnosis of psoriasis completed specifically designed questionnaires. The questionnaires covered patient demographics, disease characteristics, impact of the disease on quality of life, treatment of psoriasis, and the relationship between patient and dermatologist. RESULTS: A total of 151 dermatologists from throughout Spain included a mean of 5 patients each. The analysis included 771 questionnaires completed by dermatologists and 732 completed by patients. Two-thirds of patients had moderate-to-severe psoriasis with a major impact on quality of life, particularly in relation to emotional wellbeing. Nevertheless, quality of life was only assessed routinely and systematically by 19.9% of dermatologists. Overall, 47% of patients reported being quite satisfied or very satisfied with the treatment they received. No significant differences were observed between patients and dermatologists on the aspects analyzed. CONCLUSIONS: Our results highlight the substantial impact of psoriasis on patient quality of life and the consequent need for systematic quality-of-life assessment in affected patients. Patients reported a high level of satisfaction with the care provided by dermatologists and the treatment received. There was good agreement between patients and dermatologists in their assessment of the variables analyzed.

Reflexiones acerca de la oclusión funcional y su aplicación en ortodoncia / Reflections on functional occlusion dogma and clinical application in orthodontia

Estas reflexiones surgen del interés de un ortodoncista experimentado por reevaluar su experiencia sobre oclusión funcional y de otro novel por sintetizar conceptos y aplicarlos a la clínica cotidiana. Se revisan las bases científicas y la evolución que han experimentado las diferentes teorías sobre oclusión. De igual modo, se estudian las relaciones entre oclusión y disfunción temporomandibular, profundizando en los conceptos de guía anterior y desplazamiento céntrico en pacientes con y sin potencial de crecimiento. Para finalizar, proponemos nuestro proceder en relación con diferentes puntos: exploración y toma de registros; control del deslizamiento céntrico en pacientes en crecimiento; esquema oclusal de finalización del tratamiento; estabilidad, y recidiva. Se destaca la necesidad de colaboración con otros especialistas en un gran número de casos y sobre todo, la de seguir investigando acerca de un tema que aún hoy en día presenta una grave falta de solidez en los resultados de sus investigaciones

These reflections arise from the interest of an experienced orthodontist in reevaluating his experience in functional occlusion, and of an inexpirienced one in synthesizing concepts and applying them in his daily duties. In this article we review the scientific basis and the evolution of the different theories about occlusion. In the same way, we study the relation between occlusion and temporomandibular dysfunction, detailing the concepts of anterior guidance and slides between centric relation and habitual occlusion in patients with or without potential growth. Finally, we propose our course of action in relation to the following points: the keeping of records, control of slides between centric relation and habitual occlusion in the development of patients, occlusion of the conclusion of treatment, stability and relapse. It will be necessary in a great number of cases to collaborate with other specialists. It will be also necessary to investigate further this subject, which even nowadays presents a serious lack of solidity in the results of investigations

Acrosome reaction in fertile and subfertile boar sperm.

The main purpose of sperm evaluation is to predict its fertilizing ability. However, basic sperm test results show a low correlation with fertilizing ability. The purpose of this study was to determine whether there is an association between acrosome reaction (AR) and the incidence of subfertility of normal sperm boar. The production records of 22 farms were analyzed to identify boars with low fertility and/or prolificity, classified as subfertile. Twenty-two subfertile boar semen samples were analyzed and compared with 51 samples of fertile boars. Sperm were capacitated during 4 h at 39 degrees C. viability was determined by bisbenzimide (Hoechst-33258) staining. Acrosome reaction was assessed with fluorescein isothiocyanate conjugated Pisum sativum agglutinin. The percentage of spontaneous acrosome reaction (SAR) was not significantly different in fertile (4.5%) and subfertile boars (4.75%) (p > .05). Nevertheless, the percentage of progesterone-induced acrosome reaction (IAR) was significantly lower in subfertile boars (5.75%) as compared with fertile boars (10%) (p < .01). These results suggest that assessment of IAR in vitro may be a useful parameter to identify subfertility in boars.

Syndecan-1 expression is up-regulated in pancreatic but not in other gastrointestinal cancers.

Syndecan-1 belongs to the syndecan family of cell surface transmembrane heparan-sulfate proteoglycans, which participate in cell proliferation, cell migration and cell-matrix interactions. Decreased expression of syndecan-1 has been observed in some gastrointestinal malignancies, and it is thought that high levels of syndecan-1 correlate with the maintenance of epithelial morphology and inhibition of invasiveness. In our study, we characterized the expression of syndecan-1 in normal, chronic pancreatitis and primary and metastatic human pancreatic cancer tissues, in cultured pancreatic cancer cell lines and in esophageal, gastric, colon, and liver cancers. Pancreatic cancer cell lines expressed syndecan-1 mRNA and protein at variable levels. In addition, these cells also released syndecan-1 into the culture medium. Pancreatic cancer tissues markedly over-expressed syndecan-1 mRNA in comparison with both chronic pancreatitis (2.4-fold increase, p < 0.01) and normal pancreatic samples (10.6-fold increase, p < 0.01). There was no difference in syndecan-1 mRNA expression between early and advanced tumors. By in situ hybridization and immunohistochemistry, syndecan-1 expression was evident at relatively low levels in the ductal cells and less frequently in acinar cells of the normal pancreas. In chronic pancreatitis, syndecan-1 was present at low to moderate levels in areas with atrophic acinar cells and ductular complexes. In contrast, in pancreatic cancer tissues, syndecan-1 was present at moderate to high levels in the majority of the cancer cells within the tumor mass and also in metastatic lesions of pancreatic tumors. Syndecan-1 mRNA levels in other gastrointestinal malignancies (esophageal, gastric, colon and liver cancers) were not significantly different from the levels observed in the corresponding normal samples. Together, our findings suggest that syndecan-1 expression by pancreatic cancer cells may be of importance in the pathobiology of this disorder and that its role in pancreatic cancer seems to be different from that in other gastrointestinal malignancies.

CDKN2A mutations in Spanish cutaneous malignant melanoma families and patients with multiple melanomas and other neoplasia.

The CDKN2A gene has been implicated in cutaneous malignant melanoma (CMM) in about 40% of families with linkage to chromosome 9p21, while a small proportion of families have mutations in the CDK4 gene. In order to estimate the importance of these genes in the predisposition to CMM in Spanish families and patients we have analysed, by SSCA, a total of 56 subjects belonging to 34 CMM families, and nine patients with multiple CMM and other neoplasia. We have detected germline CDKN2A mutations in six out of the 34 families (17%). A frameshift mutation (358delG) and four missense mutations (G59V, G101W (two cases), D84Y, and R87W) were identified. Five CMM patients from different families (14%) carried the A148T variant, which is known not to affect p16 activity. No mutations were detected in the patients with multiple CMM or other neoplasms. We have not found mutations either in exon 1 beta of the CDKN2A gene or in exon 2A of CDK4. Linkage analysis of the 9p21 region showed exclusion for one of the families for CMM and for four families for CMM/dysplastic naevi. This study indicates a small role for CDKN2A in Spanish CMM families and suggests that other genes are also responsible for CMM predisposition.

Cyclosporine increases local glomerular synthesis of reactive oxygen species in rats: effect of vitamin E on cyclosporine nephrotoxicity.

BACKGROUND: We report an investigation of the effects of cyclosporine (CsA) on kidney function, the glomerular synthesis of reactive oxygen species, the peroxidation of lipids, and the levels of thromboxane B2 (TXB2). The effect of the simultaneous administration of the antioxidant vitamin E (Vit E) and CsA in rats was also evaluated. METHODS: Adult male Wistar rats were treated for 30 days with CsA (30 mg/kg/day), with Vit E (0.05 mg/ml), with CsA plus Vit E, or with the vehicle used for administration of CsA, namely 12.6% ethanol. RESULTS: CsA induced kidney failure and increased the glomerular synthesis of superoxide anion, H2O2, malonyldialdehyde, and TXB2. Vit E minimized the adverse effects of CsA on kidney function and the glomerular synthesis of these compounds. CONCLUSIONS: Our results suggest that the acute decrease in glomerular filtration rate induced by CsA might be mediated by the synthesis of reactive oxygen species and subsequent peroxidation of lipids, which increases the levels of TXB2. Treatment with Vit E prevented these effects, suggesting a possible role for antioxidants in the prevention of CsA nephrotoxicity.

Diagnostic value of three tumor markers determined in pleural effusions.

In order to discriminate between malignant and benign effusions, the values of tissue polypeptide specific antigen,carcinoembryonic antigen and squamous cell carcinoma associated antigen were measured in the pleural fluid of 30 patients with neoplasm, 10 with tuberculous pleurisy, 10 with transudates due to congestive heart failure or cirrhosis, 29 with parapneumonic effusions and 23 with benign diseases other than tuberculosis and pneumonia. Carcinoembryonic antigen and tissue poly-peptide specific antigen levels in effusions due to neoplasms were significantly higher than those in effusions due to other diseases. The areas under Receiver Operating Characteristic curves for carcinoembryonic antigen and tissue polypeptide specific antigen determinations were 0.69 and 0.67, respectively. No significant differences were found in the pleural fluid squamous cell carcinoma associated antigen levels between neoplasms and other diseases. The ability of tissue polypeptide specific antigen and carcinoembryonic antigen to discriminate between benign and malignant effusions may be considered comparable. Although both carcinoembryonic antigen and tissue polypeptide specific antigen showed a low accuracy (the number of undiagnosed pleural effusions is considerably high), both tissue polypeptide specific antigen and carcinoembryonic antigen determinations may contribute to a correct diagnostic classification. Moreover, the combination of these markers provides a specificity of 97.2%. However, the low number of positivities obtained for tissue polypeptide specific antigen and carcinoembryonic antigen together (13 cases in our series) reveals the need for further investigations.

Evaluation of zone electrophoresis of serum proteins performed on the Helena Laboratories rapid electrophoresis analyser.

Zone electrophoresis of serum proteins is still widely performed as a routine procedure in clinical laboratories. It is used in the diagnosis and management of many disorders, e.g. monoclonal gammopathies, cirrhosis, nephrotic syndrome, acute-phase reaction, immunoglobulin deficiency and others. The aim of this work is to evaluate the analytical performance of zone electrophoresis of serum proteins carried out in the Helena Laboratories Rapid Electrophoresis analyser (REP) comparing the results with those obtained in the Olympus Hite System 200 (HS-200). The REP system employs agarose gel as support medium, the HS-200 system employs cellulose acetate and it is the routine method in our laboratory. To date, we have not found any paper that deals with the assessment of a system for performing zone electrophoresis of serum proteins in terms of comparison with another.

A monoclonal antibody, GR7A4, reacting with the T10 antigen.

The monoclonal antibody GR7A4 was produced against a human lymphoblastic leukemia (ALL-B). Biochemical characterization of GR7A4 was carried out with Raji cells in SDS-PAGE studies. GR7A4 precipitated a 43 kd molecule. The tissue distribution and molecular weight were similar to the T10 antigen. Modulation and capping of GR7A4 antigen reduced its binding ability to cells with either GR7A4 or OKT10. However, the cell surface distribution pattern observed was somewhat different from other similar monoclonal antibodies. Thus GR7A4 reacted greatly with pre-B-cell lines, Burkitt cell lines, EBV cell lines and activated PHA, ConA and PWM lymphocytes, however reactivity with leukemic cells was very limited. The kinetics of appearance of GR7A4 antigen on PWM blasts show that this molecule seems to represent an intermediate stage in lymphocytic activation. The differences in comparison with other similar MAbs are discussed and correlated with the peculiar discontinous pattern of appearance of this antigen.