Opportunities for reducing morbidity and mortality due to leading cancers in a developing country.

BACKGROUND: Malignancies are a leading cause of chronic non-communicable disease deaths in Jamaica. However, little or no data is available on integration of cancer screening guidelines in clinics. METHODS: A cross-sectional survey of 88 consecutive patients with diabetes mellitus (DM) and/or hypertension (HTN) was conducted at major health centers in Jamaica between September and December 2011. RESULTS: Eighty percent respondents were women; 20% were men. The mean age was 57 years old. Forty persons (45.5%) had high cholesterol, 62 (71%) had DM and 62 (71%) had HTN. Of 66 women, 27% reported never having a pap smear and 66% had no pap smear within the last 12 months. 49% women over 40 years never had a mammogram and 74% did not have a mammogram in the last 12 months. Among men over 40 years old, at least 25% never had a prostate examination and 19% never had a prostate-specific antigen blood test. Most participants (>90%) received counseling about diet and exercise, but self-reported compliance with recommendations was low. CONCLUSIONS: Cancer screening among chronic disease patients is suboptimal in our population. Improved implementation of guidelines for cancer in chronic disease clinics have the potential to impact on morbidity and mortality.

Synthesis and NaOTf mediated self-assembly of monodendritic crown ethers.

The synthesis of ten benzyl ether based self-assembling monodendrons containing benzo[15]crown-5 at their focal point is presented. These dendritic building blocks self-assemble either directly or via complexation with NaOTf in two-dimensional smectic B, smectic A, and p6mm hexagonal columnar (Phi(h)) and three-dimensional Pm3n cubic lattices. Retrostructural analysis of these lattices and of the lattices generated from the same monodendrons containing various other functional groups at their focal point by X-ray diffraction experiments provided for the first time a correlation between the molecular structure and the shape of the monodendron, the shape of the supramolecular dendrimer and the symmetry of the lattice. It has been shown that complexation with NaOTf provides the following five different trends: a) stabilization of the three-dimensional Pm3n cubic lattice self-organized from spherical dendrimers that are self-assembled from conic monodendrons; b) stabilization of the two-dimensional S(A) phase generated from parallel-piped monodendrons; c) no effect on the stability of the two-dimensional S(B) phase generated from parallel-piped monodendrons; d) stabilization of the two-dimensional p6mm hexagonal columnar phase self-organized from cylindrical supramolecular dendrimers that are self-assembled from tapered monodendrons; and e) destabilization of the two-dimensional p6mm hexagonal columnar phase self-organized from cylindrical supramolecular dendrimers self-assembled from half-disc monodendrons. Mechanisms of NaOTf mediated self-assembly processes were suggested. These monodendritic crown ethers and their NaOTf complexes provide the largest diversity of liquid crystalline phases encountered so far in any library of supramolecular dendrimers.

Exploring and expanding the three-dimensional structural diversity of supramolecular dendrimers with the aid of libraries of alkali metals of their AB(3) minidendritic carboxylates.

The synthesis of the alkali metal salts of 3,4,5-tris(n-alkan-1-yloxy)benzoic acid [(3,4,5)nG1-CO(2)M, where n is the number of methylenic units in the alkane group for n=12, 14, 16, 18 and M=Li, Na, K, Rb, Cs] is described. The structural analysis of these AB(3) molecules by a combination of methods which includes X-ray diffraction experiments was performed. These experiments have demonstrated that (3,4,5)nG1-CO(2)M self-assemble at low temperatures into supramolecular cylinders and at high temperatures into spheres which subsequently self-organize into two-dimensional c2mm rectangular columnar, p6mm hexagonal columnar, three-dimensional Pm(-)3n and Im(-)3m cubic lattices. In addition a novel unidentified liquid crystalline lattice was also discovered. The dependence between the symmetry of the lattice and the molecular structure of (3,4,5)nG1-CO(2)M was established. (3,4,5)nG1-CO(2)M represents one of the AB(3) minidendrons (i.e., first-generation monodendron attached to the periphery of larger generation dendrons) that is responsible for the control of the three-dimensional structures created from libraries of larger generations of dendrimers. Therefore, the molecular structure-lattice dependence elaborated here will aid the rational design of the three-dimensional shapes from larger generations of supramolecular dendrimers and of their lattices. In addition, the temperature responsive shape change of these supramolecular objects may generate new supramolecular concepts and technological applications.

Teaching an abbreviated impression technique for complete dentures in an undergraduate dental curriculum.

STATEMENT OF PROBLEM: Traditional methods for teaching complete denture fabrication are time-consuming, difficult to master, and not used by many general practitioners. PURPOSE: This study compared the efficacy of traditional denture fabrication techniques with a more abbreviated method in a dental school setting. MATERIAL AND METHODS: A retrospective record review of 80 completely edentulous patients treated by predoctoral dental students was completed. Forty patients were treated with traditional denture techniques; the other 40 patients were treated with an abbreviated method. The data abstracted included the number of visits to completion and the number of postinsertion visits and relines required within the first 3 months after delivery. A Wilcoxon rank sum test was performed to determine statistical significance between the groups with regard to number of visits for fabrication and postinsertion adjustments. A test for a difference in proportions by using the normal approximation to the binomial distribution was performed for statistical analysis of the incidence of relines. RESULTS: The abbreviated denture technique resulted in a statistically significant difference in the number of visits for fabrication (P<.01) and postinsertion adjustments (P<.05.) There was no difference (P=.39) in the number of relines between the 2 groups. CONCLUSION: Teaching the abbreviated complete denture technique in an undergraduate dental clinic decreased the number of appointments necessary to complete denture therapy without increasing the number of adjustments or reline procedures.

Retentiveness of dental cements used with metallic implant components.

There is limited dental literature evaluating the retentive capabilities of luting agents when used between metal components, such as cast metal restorations cemented onto machined metal implant abutments. This study compared the retentive strengths of 5 different classes of luting agents used to cement cast noble metal alloy crowns to 8-degree machined titanium cementable implant abutments from the Straumann ITI Implant System. Sixty prefabricated 5.5-mm solid titanium implant abutments and implants were used; 30 received the standard surface preparation and the other 30 received an anodized surface preparation. Anodized implant components were used to reflect current implant marketing. Sixty castings were fabricated and randomly paired with an abutment and implant. A total of 12 castings were cemented onto the implant-abutment assemblies for each of the 5 different luting agents (zinc phosphate, resin composite, glass ionomer, resin-reinforced glass ionomer, and zinc oxide-non-eugenol). After cementation, the assemblies were stored in a humidor at room temperature prior to thermocycling for 24 hours. Each casting was pulled from its respective abutment, and the force at which bond failure occurred was recorded as retentive strength. A statistically significant difference was found between the 5 cements at P < or = .001. Of the cements used, resin composite demonstrated the highest mean retentive strength. Zinc phosphate and resin-reinforced glass-ionomer cements were the next most retentive, while glass ionomer and zinc oxide-non-eugenol cements demonstrated minimal retention. In addition, retention was not altered by the use of an anodized abutment surface.

Fiber-reinforced composite framework for implant-supported overdentures.

This article presents a new method for fabricating a framework for an implant-supported overdenture using unidirectional fiber-reinforced composite. This procedure eliminates the need for a traditional metal alloy framework. The fiber-reinforced composite framework has the advantages of lower cost, less time and materials needed during fabrication, minimal potential for toxicity to the technician and patient, and a more esthetic metal-free final result.

Retention of parallel-sided titanium posts cemented with six luting agents: an in vitro study.

PURPOSE: This in vitro study compared the effectiveness of 6 luting systems on the retention of prefabricated titanium posts. MATERIAL AND METHODS: A total of 120 single-rooted teeth were sectioned at the cementoenamel junction and treated endodontically. Roots were mounted in copper cylinders, and prefabricated, parallel-sided titanium posts were cemented according to the manufacturer's instructions. Two resin-ionomer hybrid cements and 2 resin cements were tested with corresponding dentin bonding agents. A glass ionomer cement was also tested, and zinc-phosphate cement served as the control. Samples were tested in an Instron universal testing machine to catastrophic tensile failure. RESULTS: Advance cement with Prime and Bond systems was found to be statistically more retentive than all other groups tested (P < .05). Cement It with Bond It and Permalute with Permalute Primers A and B systems demonstrated significantly greater retention than Ketac Cem cement, Resinomer with One-Step system and zinc-phosphate cement (P < .05). There was no statistically significant difference among Ketac Cem cement, Resinomer with One-Step system, and zinc-phosphate cement.

A simple toothbrush modification for easier implant-supported prosthesis hygiene.

The lingual aspect of mandibular anterior implant-supported prostheses is often difficult to reach for adequate hygiene. The following technique describes modification of an end-tufted toothbrush to allow for improved access into to difficult-to-reach areas.

Preimpregnated, fiber-reinforced prostheses. Part I. Basic rationale and complete-coverage and intracoronal fixed partial denture designs.

This is the first of two articles describing the development and use of a continuous fiber-reinforced composite as a framework for the fabrication of fixed partial dentures and splints. The chemical composition and physical structure of the fiber-reinforced composite, along with the progression and development of a variety of fiber-reinforced composite materials, are discussed. Criteria for case selection, tooth preparation, and the clinical and laboratory procedures required for partial- or complete-coverage fixed partial denture fabrication and delivery are described.

Preimpregnated, fiber-reinforced prostheses. Part II. Direct applications: splints and fixed partial dentures.

This article is the second in a series that describes the development, physical properties, and clinical applications of fiber-reinforced composite materials. The development of fiber-reinforced composite technology has opened new avenues for fabricating direct tooth replacements and splints that are esthetic and simple in design and execution and have the potential for excellent durability. Splinting techniques for hypermobile dentitions or postorthodontic retention and the replacement of anterior and posterior teeth using a groove preparation, a denture tooth, and a fiber-reinforced composite framework will be described.