Oncologic outcomes of surgically managed primary pelvic soft tissue sarcoma; tumour biology or surgical constraints of the true pelvis?

BACKGROUND: Pelvic soft tissue sarcomas are rare. Potentially curative resection remains challenging due to anatomical constraints of true pelvis and tumour spread through various anatomical hiatus. We sought to review the oncological outcomes of surgically managed cases at our centre and determine whether outcomes differ for patients with localised (limited to pelvis) versus extensive disease (with extra-pelvic extension). METHODS: Sixty-seven patients who underwent surgical resection with curative intent at the centre for primary, non-metastatic, WHO intermediate to high-grade soft tissue sarcoma of the true pelvis from January 2012 through January 2020 were analysed. Establishment of the extent of disease was made by review of pre-treatment imaging and surgical notes. Oncologic endpoints examined were resection margin, recurrence rate, disease-free and overall survival. RESULTS: Rates of complete oncological resection and disease control were similar for tumours with localised or extensive disease. On logistic regression analysis, tumour grade, and a negative resection margin (R0) correlated with the risk of recurrence (p=<0.05). On further multinomial analysis, R0 resection was associated with improved local control, but not metastatic relapse (p = 0.003). 5-year local recurrence-free and distant metastasis-free survival were 61.3% and 67.1%, respectively. Five and 10-year overall survival were 64% and 36%, respectively. Age >50 years and high tumour grade were associated with a worse outcome (p < 0.05). CONCLUSIONS: When potentially curative surgery is performed for pelvic sarcoma, disease-extent does not influence oncologic outcomes. While a complete oncologic resection determines the risk of local recurrence, tumour grade and metastatic relapse remain primary prognostic determinants for overall survival.

Cavity Disinfection With a 445 nm Diode Laser Within the Scope of Restorative Therapy - A Pilot Study.

Introduction: Cavity disinfection is necessary to prevent a progressive infection of the crown dentin and pulp. Increasing intolerance and resistance to antiseptics and antibiotics as well as the controversy over the effects of those on the dental hard tissue and composite have prompted the investigation of alternative treatment options. The objective of this pilot study is to evaluate the antibacterial potential of a diode laser with a wavelength of 445 nm in the cavity preparation using the bacterium Streptococcus salivarius associated with caries in conjunction with the characteristics and influences of dentin on light transmission. Methods: The bactericidal effect of the laser irradiation was determined in culture experiments by using caries-free human dentin samples on bacteria-inoculated agar. For this, dentin discs (horizontally cut coronal dentin) of 500 µm and 1000 µm thicknesses were produced and irradiated with the laser with irradiation parameters of 0.7-1 W in a cw-mode and exposure times of between 5-30 s. Based on the different sample thicknesses, the penetration depth effect of the irradiation was ascertained after the subsequent incubation of the bacteria-inoculated agar. Additional influential parameters on the irradiation transmission were investigated, including surface moisture, tooth color as well as the presence of a smear layer on the dentin surface. Results: The optical transmission values of the laser radiation for dentin were significantly dependent on the sample thickness (P = 0.006) as well as its moisture content (P = 0.013) and were independent of the presence of a smear layer. There was a 40% reduction in bacteria after the radiography of the 500-µm-thick dentin samples, which was shown as the lowest laser dose (443 J/cm2). Conclusion: These findings indicate that the diode laser with light emission at a wavelength of 445 nm is interesting for the supportive cavity disinfection within the scope of caries therapy and show potential for clinical applications.

Comparison of force loss due to friction of different wire sizes and materials in conventional and new self-ligating orthodontic brackets during simulated canine retraction.

AIMS: The aim of this study was to compare force loss due to friction (Fr) during simulated canine retraction using different archwire dimensions and materials between conventional and new self-ligating brackets. METHODS: The tested brackets were (1) conventional brackets (Victory series, GAC twin and FLI twin), (2) self-ligating brackets (Damon-Q, FLI-SL, new/improved FLI-SL (I FLI-SL), SPEED, GAC innovation (R) and Ortho Classic) and (3) a low-friction bracket (Synergy). All brackets had a 0.022″ slot size. The tested archwires were stainless steel (0.018″; 0.016″x0.022″; 0.017″x0.025″; 0.018″x0.025″ and 0.019″x0.025″); nickel titanium (NiTi; 0.016″x0.022″; 0.017″x0.025″; 0.018″x0.025″ and 0.019″x0.025″) and titanium molybdenum alloy (TMA; 0.016″x0.022″; 0.017″x0.025″; 0.018″x0.025″ and 0.019″x0.025″). Canine retraction was experimentally simulated in a biomechanical set-up using a NiTi coil spring that delivered a force of 1 N. The simulated retraction path was up to 4 mm. Force loss due to friction was compared between groups using the Welch t­test. RESULTS: Force loss due to friction increased with increasing archwire size. Also, TMA showed the highest and stainless steel the lowest force loss due to friction. FLI-SL brackets showed the lowest Fr (31%) and Ortho Classic showed the highest (67%). CONCLUSIONS: Increasing wire size generally showed increasing force loss due to friction. FLI-SL brackets showed the lowest, while Ortho Classic showed the highest friction.

Time-dependent behavior of porcine periodontal ligament: A combined experimental, numeric in-vitro study.

INTRODUCTION: The aim of this study was to analyze the time-dependent in-vitro behavior of the periodontal ligament (PDL) by determining the material parameters using specimens of porcine jawbone. Time-dependent material parameters to be determined were expected to complement the results from earlier biomechanical studies. METHODS: Five mandibular deciduous porcine premolars were analyzed in a combined experimental-numeric study. After selecting suitable specimens (excluding root resorption) and preparing the measurement system, the specimens were deflected by a distance of 0.2 mm at loading times of 0.2, 0.5, 1, 2, 5, 10, and 60 seconds. The deflection of the teeth was determined via a laser optical system, and the resulting forces and torques were measured. To create the finite element models, a microcomputed tomography scanner was used to create 3-dimensional x-ray images of the samples. The individual structures (tooth, PDL, bone) of the jaw segments were reconstructed using a self-developed reconstruction program. A comparison between experiment and simulation was conducted using the results from finite element simulations. Via iterative parameter adjustments, the material parameters (Young's modulus and Poisson's ratio) of the PDL were assessed at different loading velocities. RESULTS: The clinically observed effect of a distinct increase in force during very short periods of loading was confirmed. Thus, a force of 2.6 N (±1.5 N) was measured at the shortest stress duration of 0.2 seconds, and a force of 1.0 N (±0.5 N) was measured at the longest stress duration of 60 seconds. The numeric determination of the material parameters showed bilinear behavior with a median value of the first Young's modulus between 0.06 MPa (2 seconds) and 0.04 MPa (60 seconds), and the second Young's modulus between 0.30 MPa (10 seconds) and 0.20 MPa (60 seconds). The ultimate strain marking the transition from the first to the second Young's modulus remained almost unchanged with a median value of 6.0% for all loading times. CONCLUSION: A combined experimental-numeric analysis is suitable for determining the material properties of the PDL. Microcomputed tomography allows high-precision recordings with only minimum effort. This study confirms the assumption of time dependency and nonlinearity of previous studies.

Comparison of the force levels among labial and lingual self-ligating and conventional brackets in simulated misaligned teeth.

BACKGROUND/OBJECTIVE: The aim of this study was to evaluate force levels exerted by levelling arch wires with labial and lingual conventional and self-ligating brackets. MATERIALS/METHODS: The tested orthodontic brackets were of the 0.022-in slot size for labial and 0.018-in for lingual brackets and were as follows: 1. Labial brackets: (i) conventional bracket (GAC-Twin, Dentsply), (ii) passive self-ligating (SL) brackets (Damon-Q®, ORMCO; Ortho classic H4™, Orthoclassic; FLI®SL, Rocky Mountain Orthodontics) and (iii) active SL brackets (GAC In-Ovation®C, DENTSPLY and SPEED™, Strite). 2. Lingual brackets: (i) conventional brackets (Incognito, 3M and Joy™, Adenta); (ii) passive SL bracket (GAC In-Ovation®LM™, Dentsply and (iii) active SL bracket (Evolution SLT, Adenta). Thermalloy-NiTi 0.013-in and 0.014-in arch wires (Rocky Mountain Orthodontics) were used with all brackets. The simulated malocclusion represented a maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis). RESULTS: Lingual bracket systems showed higher force levels (2.4 ± 0.2 to 3.8 ± 0.2 N) compared to labial bracket systems (from 1.1 ± 0.1 to 2.2 ± 0.4 N). However, the differences between SL and conventional bracket systems were minor and not consistent (labial brackets: 1.2 ± 0.1 N for the GAC Twin and 1.1 ± 0.1 to 1.6 ± 0.1 N for the SL brackets with 0.013-in thermalloy; lingual brackets: 2.5 ± 0.2 to 3.5 ± 0.1 N for the conventional and 2.7 ± 0.3 to 3.4 ± 0.1 N for the SL brackets with 0.013-in Thermalloy). LIMITATIONS: This is an in vitro study with different slot sizes in the labial and lingual bracket systems, results should be interpreted with caution. CONCLUSIONS/IMPLICATIONS: Lingual bracket systems showed higher forces compared to labial bracket systems that might be of clinical concern. We recommend highly flexible nickel titanium arch wires lower than 0.013-in for the initial levelling and alignment especially with lingual appliances.

Influence of tooth dimension on the initial mobility based on plaster casts and X-ray images : A numerical study.

AIMS: The goal was to determine the influence of different geometric parameters of the tooth on the initial tooth mobility and the position of the center of resistance employing numerical models based on scaled X-ray images and plaster casts. METHODS: The dimensions of tooth 21 were measured in 21 patients, using radiographs and dental casts. Length and mesiodistal width of the tooth were obtained from the X-ray image and the orovestibular diameter from the plaster cast. Finite element models were generated. Cortical and cancellous bone and the periodontal ligament were simulated to create realistic models. Root length (11-17 mm), mesiodistal width (6-10 mm) and orovestibular thickness (7-9 mm) were varied in 1-mm steps to generate 105 models. In the simulation, each model was loaded with a force of 10 N in vestibulopalatinal direction and with a torque of 10 Nmm to determine tooth displacements and center of resistance. RESULTS: Initial tooth displacement and thus mobility increased with decreasing total root surface. The shortest, slimmest and thinnest tooth showed a total deflection of 0.14 mm at the incisal edge, while the longest, widest and thickest tooth showed a total deflection of 0.10 mm. Changes in mesiodistal width had the greatest influence on initial tooth mobility and changes in orovestibular thickness the least. The teeth's center of resistance was positioned between 37 and 43% of the root length measured from the cervical margin of the alveolar bone. The center of resistance of the longest dental root investigated was located around 6% more cervically compared to the one of the shortest dental root. The influence of root width and thickness on the position of the center of resistance was significantly lower than root length. CONCLUSION: Geometric parameters significantly impact initial tooth mobility and position of the center of resistance. Thus, tooth dimensions should be considered in orthodontic treatment planning. Dental radiographs represent a sufficient validation tool to estimate the quality of a pure dental tipping during orthodontic treatment, as the orovestibular thickness has little influence. However, for three-dimensional tooth displacements all geometric parameters should be determined accurately using plaster casts or DVT.

Mechanical properties of different esthetic and conventional orthodontic wires in bending tests : An in vitro study.

AIMS: The goal of this study was to determine the mechanical properties of different esthetic and conventional orthodontic wires in three-point and four-point bending tests, and in a biomechanical test employing three bracket systems. METHODS: The behavior of round wires with a diameter of 0.46 mm (0.018″) were investigated: uncoated nickel titanium (NiTi) wires, surface modified NiTi wires; FLI® Orthonol Wire® and glass fiber reinforced plastic wires. The biomechanical bending test was performed using the following bracket types: metal brackets (Discovery®, Dentaurum), ceramic brackets (Fascination®, Dentaurum), and plastic brackets (Elegance®, Dentaurum). All bending tests were performed in the orthodontic measurement and simulation system (OMSS) at a temperature of 37 °C. The classical three-point bending test was performed according to an ISO standard (DIN EN ISO 15841:2007) using the appropriate thrust die and supports with a predefined span of 10 mm. In the other tests the supports or interbracket distances were chosen such that the free wire length was also 10 mm (5 mm between adjacent brackets). All wires were loaded centrally to a maximum of 3.1 and 3.3 mm in the biomechanical test, respectively. The force was measured upon unloading with a loading velocity of 1 mm/min. Each specimen was loaded twice and a total of 10 specimens tested for each product. Weighted means and the error of the weighted mean were calculated for each product. RESULTS: Fiber reinforced wires displayed lowest forces in three-point bending with values of 0.4 N at a displacement of 1 mm and 0.7 N at a 2 mm displacement. In four-point bending the forces were 0.9 N and 1.4 N, respectively, at the same displacements. Almost all of the translucent wires showed fracture upon bending at displacements greater than 3 mm, independent of the bending test and bracket type. The different investigated NiTi wires, surface modified or conventional, only showed minor variation, e.g., 2.2 N for rematitan® Lite White and 2.0 N for rematitan®, 2.1 N for FLI® Coated Orthonol® and 1.7 N for Orthonol® in four-point bending. The rhodinized wire generated forces between these values (2.1 N). CONCLUSION: The translucent wires had the lowest forces in all three bending tests; however, displacements above 3 mm resulted in increased risk of fracture. Forces of investigated NiTi wires were very high and in part above clinically recommended values.

Clinical and radiological investigations of mandibular overdentures supported by conventional or mini-dental implants: A 2-year prospective follow-up study.

STATEMENT OF PROBLEM: Conventional dental implants are not applicable in the mandibular interforaminal region if bone volume is limited. Mini-dental implants offer an alternative means of supporting mandibular overdentures in a narrow residual ridge, without additional surgery. PURPOSE: The purpose of this nonrandomized clinical trial was to compare the ability of mini-dental implants with that of conventional dental implants in supporting mandibular overdentures during a 2-year clinical follow-up. Bone quality, bone resorption, implant stability, and oral health were assessed radiographically. MATERIAL AND METHODS: A total of 32 participants with edentulism were included. Twenty-two participants (99 implants) received 4 to 5 mini-dental implants (diameter: 1.8-2.4 mm; length: 13-15 mm, study group), and 10 participants (35 implants) received 2 to 4 conventional dental implants (diameter: 3.3-3.7 mm; length: 11-13 mm, control group). The selection of the participants in the study or control group was based on the available bone volume in the mandible. The selection was not randomized. The density of cortical bone thickness was measured in Hounsfield units (HU) from computed tomography data, and patients were followed for 2 years. The participants were examined 3, 6, 12, and 24 months after surgery. Primary stability immediately after the insertion of dental implants (Periotest), secondary stability 6 months after implantation, modified plaque, bleeding on probing indices, and probing depth were measured and analyzed statistically (α=.05). RESULTS: The mean HU value 6 months after implantation in the participants who received mini-dental implants was significantly (P=.035) higher (1250 HU) than that in the participants who received conventional dental implants (1100 HU). The probing depths around the conventional dental implants (1.6 and 1.8 mm, respectively) were significantly higher than those around the mini-dental implants (1.3 and 1.2 mm, respectively) 12 and 24 months after surgery, respectively (P<.001). The mean primary and secondary stability values for conventional dental implants were -4.0 and -4.9, respectively. The primary and secondary stability values for the mini-dental implants were -0.3 and -1.4, respectively. The Periotest values of the primary (measured immediately after implant insertion) and secondary implant stabilities (measured 6 months after implant insertion) were significantly higher for the conventional dental implants than for the mini-dental implants (P<.001). CONCLUSIONS: Based on this 2-year clinical trial, patients receiving mini-dental implants had clinical outcomes similar to those of patients receiving conventional dental implants to support overdenture prostheses.

Friction behavior of ceramic injection-molded (CIM) brackets.

OBJECTIVES: Bracket material, bracket design, archwire material, and ligature type are critical modifiers of friction behavior during archwire-guided movement of teeth. We designed this in vitro study to compare the friction losses of ceramic injection-molded (CIM) versus pressed-ceramic (PC) and metal injection-molded (MIM) brackets-used with different ligatures and archwires-during archwire-guided retraction of a canine. METHODS: Nine bracket systems were compared, including five CIM (Clarity™ and Clarity™ ADVANCED, both by 3M Unitek; discovery(®) pearl by Dentaurum; Glam by Forestadent; InVu by TP Orthodontics), two PC (Inspire Ice by Ormco; Mystique by DENTSPLY GAC), and two MIM (discovery(®) and discovery(®) smart, both by Dentaurum) systems. All of these were combined with archwires made of either stainless steel or fiberglass-reinforced resin (remanium(®) ideal arch or Translucent pearl ideal arch, both by Dentaurum) and with elastic ligatures or uncoated or coated stainless steel (all by Dentaurum). Archwire-guided retraction of a canine was simulated with a force of 0.5 N in the orthodontic measurement and simulation system (OMSS). Friction loss was determined by subtracting the effective orthodontic forces from the applied forces. Based on five repeated measurements performed on five brackets each, weighted means were calculated and evaluated by analysis of variance and a Bonferroni post hoc test with a significance level of 0.05. RESULTS: Friction losses were significantly (p < 0.05) higher (58-79 versus 20-30 %) for the combinations involving the steel versus the resin archwire in conjunction with the elastic ligature. The uncoated steel ligatures were associated with the lowest friction losses with Clarity™ (13 %) and discovery(®) pearl (16 %) on the resin archwire and the highest friction losses with Clarity™ ADVANCED (53 %) and Mystique (63 %) on the steel archwire. The coated steel ligatures were associated with friction losses similar to the uncoated steel ligatures on the steel archwire. Regardless of ligature types, mild signs of abrasion were noted on the resin archwire. CONCLUSIONS: The lowest friction losses were measured with rounded ceramic brackets used with a stainless-steel ligature and the resin archwire. No critical difference to friction behavior was apparent between the various manufacturing technologies behind the bracket systems.

Friction behavior of self-ligating and conventional brackets with different ligature systems.

OBJECTIVES: Self-ligating brackets are widely believed to offer better clinical efficiency and, in particular, less friction. Thus, the goal of this in vitro investigation was to assess the friction behavior of different bracket/archwire/ligature combinations during simulated canine retraction. An important aspect of this work was to determine whether conventional bracket systems behave differently in passive or active self-ligating brackets used with a Slide™ ligature, an elastic ligature, or a steel ligature. METHODS: Three conventional (Contour, Class One; Discovery(®), Dentaurum; Mystique MB, GAC) and six self-ligating (Carriere SL, Class One; Clarity™ SL, 3M Unitek; Damon3, Ormco; In-Ovation(®) C, GAC; Speed Appliance, Speed System™; QuicKlear(®), Forestadent(®)) bracket systems were analyzed. All brackets featured a 0.022″ slot (0.56 mm). Each conventional system was tested with a steel ligature (0.25 mm; Remanium(®), Dentaurum), an elastic ligature (1.3 mm in diameter; Dentalastics, Dentaurum), and a modified elastic ligature (Slide™; Leone(®)). Each combination was used with four archwires, including rectangular stainless steel (0.46 × 0.64 mm, 0.018 × 0.025″, Dentaurum), rectangular nickel-titanium with Teflon coating (0.46 × 0.64 mm, 0.018 × 0.025″, Forestadent(®)), round coaxial nickel-titanium (0.46 mm, 0.018″, Speed), and half-round/half-square (D-profile) stainless steel (0.46 mm, 0.018″, Speed). In the orthodontic measurement and simulation system (OMSS), retraction of a canine was simulated on a Frasaco model replicated in resin. Based on the force systems, the respective friction values were determined. For each combination of materials, five brackets of the same type were tested and five single measurements performed. RESULTS: Friction values were found to vary distinctly with the different combinations, modifiers being the ligature systems and the archwire types. Any significant friction differences between the steel-ligated, Slide™-ligated, and self-ligated brackets were sporadic. All three systems were associated with average friction values of 40 %. Active self-ligating brackets and elastic-ligated conventional brackets, by contrast, generally differed significantly from the three above-mentioned bracket systems and showed distinctly higher friction values averaging 59 and 67 %, respectively. CONCLUSIONS: While passive self-ligating bracket systems have frequently been touted as advantageous in the literature, they should not be regarded as the only favorable system. Steel-ligated and Slide™-ligated conventional bracket systems are capable of offering similar friction performance.

Mechanical LUCAS resuscitation is effective, reduces physical workload and improves mental performance of helicopter teams.

BACKGROUND: Physical and mental workload during cardiopulmonary resuscitation (CPR) is challenging under extreme working conditions. We hypothesized that the mechanical chest-compression device Lund University Cardiac Assist System (LUCAS) increases the effectiveness of CPR, decreases the physical workload and improves the mental performance of the emergency medical service (EMS) staff during simulated emergency helicopter flights. METHODS: During simulated helicopter flights, 12 EMS teams performed manual or LUCAS-CPR on a manikin at random order. Compression depth, rate, overall time of compressions, application of drugs and defibrillation were recorded to test the quality of CPR. Heart rate monitoring of EMS members was used as a surrogate of physical workload. Cognitive performance was evaluated shortly after each flight by a questionnaire and a memory test about medical and extraneous items presented to the teams during the flights. RESULTS: Overall times of chest-compressions were similar, compression rate (101.7±9.6/min) was lower and compressions were deeper (3.9±0.2cm) with LUCAS as compared to manual CPR (113.3±19.3/min and 3.7±0.4cm) (P<0.01, respectively). Heart rates of the EMS staff were increased after manual as compared to mechanical CPR (100.1±21.0 vs. 80.4±11.3, P<0.01). Results of the questionnaire (93.6±6.9% vs. 87.0±7.3% correct answers, P<0.01) and memory test (22.4±15.4% vs. 11.3±7.5%, P<0.02) were significantly better after LUCAS resuscitation. Dosing of drugs, application intervals and rate of correct handling of drugs and defibrillation were not different between LUCAS or manual CPR. CONCLUSIONS: During simulated helicopter flights LUCAS-CPR improved the efficacy of chest-compressions, was physically less demanding and provided enhanced cognitive performance of the EMS team as compared to manual CPR.

Histopathological Verification of Osteoimmunological Mediators in Peri-Implantitis and Correlation to Bone Loss and Implant Functional Period.

Peri-implantitis (PI) is characterized by inflammation and bone resorption eventually leading to implant failure, but the characteristic pathologic determinants are undefined to date. This study aims to elucidate the parameters involved in PI pathogenesis, including intraoral implant retention time, extent of bone loss, smoking history, and identification of osteoimmunological markers for inflammation and bone loss. Peri-implant tissues (n = 21) displaying clinically diagnosed PI from patients with vertical bone loss ranging from 0-12 mm and implant function period between 1 and 60 months were evaluated by histochemistry and immunohistochemistry for TRAP, CD3, RANK, RANKL, OPG, and TNF-α. Statistical analyses were performed with the Welch test and correlation coefficients were calculated. Most bone resorption occurred during the first 12 months of implant function and correlated with the extent of inflammation, although histological signs of inflammation strongly varied between samples from minimal appearance of inflammatory cells to extended infiltrates. Implant function period and smoking history did not significantly affect the degree of inflammation. Higher RANK levels emerged in the first 12 months of implant function compared to longer retention times and were negatively correlated to the occurrence of RANKL. Additionally, histological signs of inflammation were about two-fold higher in specimens with bone resorption up from 5 mm compared to under 5 mm. CD3(+) cells were more prevalent in extensive inflammatory infiltrates and samples derived from smokers. Our analyses proved that PI-induced bone loss is differentially influenced by the parameters evaluated in this study, but a distinct interconnection between disease severity and implant retention time can be established.

Pre-breeding blood urea nitrogen concentration and reproductive performance of Bonsmara heifers within different management systems.

This study investigated the association between pre-breeding blood urea nitrogen (BUN) concentration and reproductive performance of beef heifers within different management systems in South Africa. Bonsmara heifers (n = 369) from five herds with different estimated levels of nitrogen intake during the month prior to the commencement of the breeding season were sampled in November and December 2010 to determine BUN concentrations. Body mass, age, body condition score (BCS) and reproductive tract score (RTS) were recorded at study enrolment. Trans-rectal ultrasound and/or palpation was performed 4-8 weeks after a 3-month breeding season to estimate the stage of pregnancy. Days to pregnancy (DTP) was defined as the number of days from the start of the breeding season until the estimated conception date. Logistic regression and Cox proportional hazards survival analysis were performed to estimate the association of pre-breeding BUN concentration with subsequent pregnancy and DTP, respectively. After stratifying for herd and adjusting for age, heifers with relatively higher pre-breeding BUN concentration took longer to become pregnant when compared to those with relatively lower BUN concentration (P = 0.011). In the herd with the highest estimated nitrogen intake (n = 143), heifers with relatively higher BUN were less likely to become pregnant (P = 0.013) and if they did, it was only later during the breeding season (P = 0.017), after adjusting for body mass. These associations were not present in the herd (n = 106) with the lowest estimated nitrogen intake (P > 0.500). It is concluded that Bonsmara heifers with relatively higher pre-breeding BUN concentration, might be at a disadvantage because of this negative impact on reproductive performance, particularly when the production system includes high levels of nitrogen intake.

Retrospective investigation of gingival invaginations: Part II: microbiological findings and genetic risk profile.

BACKGROUND AND OBJECTIVE: Gingival invaginations are a frequent finding during tooth extraction and following orthodontic space closure. Based on the interdental localization and sometimes pronounced depth, it has been suggested that a gingival invagination may impede oral hygiene. In Part I of this series, the time until active tooth movement and the localization of extraction were identified as potential risk factors for the development of gingival invagination. The aims of the present study were the analysis of the microbial spectrum of a gingival invagination in comparison with pool samples of the sulcus of Ramfjord teeth, on the one hand, and the importance of genetic variations of the pro-inflammatory mediator interleukin-1 (IL-1) and its receptor antagonist (IL-1-RN), on the other hand. In addition, a possible role of smoking as a risk factor was evaluated. SUBJECTS AND METHODS: A total of 30 patients with (n=16) and without (n=14) gingival invagination were examined for the presence of eleven periodontal pathogen bacterial species with a commercially available test (micro-IDent®Plus, Hain Lifescience, Nehren, Germany). The genetic evaluation was performed with the GenoType® IL-1 test (Hain Lifescience). RESULTS: The results of the microbiological analysis of gingival invaginations showed that the bacterial flora might differ or even be higher than the pool sample from sulcus regions. The genetic evaluation demonstrated that in the group without gingival invagination only 14% showed an IL-1 polymorphism, whereas this value was twice as high (35%) in the group with gingival invagination. In addition, a combination of both polymorphisms IL-1 and IL-1-RN was only found in patients with gingival invagination (25%). Interestingly, smoking patients showed a significant increase of the severity of the gingival invagination. CONCLUSION: This retrospective study demonstrated that gingival invagination might be accompanied with an altered microbiological bacterial spectrum and a genetic IL-1 polymorphism. In addition, smoking was identified as another potential risk factor for the severity of gingival invaginations.

Retrospective investigation of gingival invaginations : Part I: Clinical findings and presentation of a coding system.

Many orthodontic treatments involve tooth extraction. Gingival invagination is a common side effect after orthodontic extraction space closure leading to compromised oral hygiene and the space closure being hampered. Even the long-term stability of the orthodontic treatment result may be jeopardized. The aim of this study was to identify risk factors for the development of gingival invagination and possible implications on oral health and orthodontic treatment results.A total of 30 patients presenting 101 tooth extractions and subsequent orthodontic space closure were investigated to detect the presence of gingival invagination. The time required until active space closure, the thoroughness of space closure, and probing depths mesial and distal to the extraction site in addition to age, gender and the Periodontal Screening Index were investigated. A new coding system to describe the extent of gingival invagination is introduced for the first time here.Gingival invagination developed more frequently in the lower jaw (50%) than the upper (30%). Complete penetration occurred in the upper jaw in 6% of the patients and in the lower jaw in 25%. All patients without gingival invagination revealed complete space closure, whereas only 70% in the group with gingival invagination did so. The time until initiation of space closure took significantly longer in patients with gingival invagination (7.5 ± 1.4 months) than in patients without (3.3 ± 0.8 months). Probing depths of the adjacent teeth were significantly greater in regions with invaginations.Thus, the time required until space closure was initiated and the extraction site are important risk factors for the development of gingival invagination. The consequences of gingival invagination are instable space closure and deeper probing depths mesial and distal to the extractions. However, no statements concerning the mid- to long-term effects on oral health can be made.

Ethnic Differences in Age of Onset and Prevalence of Disordered Eating Attitudes and Behaviours: a School-Based South African Study

Objectives: To determine the age of onset and prevalence figures for disordered eating for diverse ethnic groups among a sample of South African schoolgirls.Method: A cross-sectional design was implemented. Two questionnaires were used to elicit prevalence figures and attitudes towards eating.Results: The study population (n = 418) consisted of black and white schoolgirls in various educational phases. Black students were found to experience a significant increase in reported bulimia-associated behaviours in grades seven to nine (mean age 13.7 years) but did not report any significant increases in drive for thinness; body dissatisfaction or poor eating attitudes across the different phases. White students reported significant increases in all measured disordered eating attitudes and behaviours in grades 10-12 (mean age 16.7 years). In grades four to six; black and white students did not differ with respect to their reported disordered eating attitudes and behaviours. However; in grades seven to nine; black students were more likely to report bulimia-associated behaviours than their white counterparts. The most apparent differences emerged in grades 10-12. White students reported significantly higher drive for thinness; greater body dissatisfaction and poorer eating attitudes than their black counterparts. Furthermore; the ethnic differences that emerged during grades seven to nine with respect to bulimia disappeared in grades 10-12.Conclusion: This study fills the hiatus in the existing South African literature with respect to age of onset and prevalence of disordered eating attitudes and behaviours across ethnic boundaries. Furthermore; it creates a foundation for developing appropriate strategies to address eating disorders in the multicultural South African context