Subclinical subretinal fluid detectable only by optical coherence tomography in choroidal naevi-the SON study.

BACKGROUND: Subretinal fluid is a risk factor for growth and malignant transformation of choroidal naevi, however it is unclear if this applies to subclinical fluid that is only detectable by optical coherence tomography (OCT). The objective of this study was to determine the prevalence and associations of subclinical but OCT-detectable subretinal fluid over choroidal naevi. METHODS: Cross-sectional study of 309 consecutive cases of choroidal naevi imaged by OCT between July 2017 to January 2019. Multicentre international study involving ten retinal specialist centres. All patients presenting to retinal specialists had routine clinical examination and OCT imaging. The prevalence of subclinical OCT-detectable subretinal fluid over choroidal naevi and its associations with other features known to predict growth and malignant transformation were noted and analysed. RESULTS: Of 309 identified consecutive cases, the mean patient age was 65 years, 89.3% of patients were Caucasian and 3.9% were Asian. The prevalence of subclinical but OCT-detectable subretinal fluid associated with choroidal naevi was 11.7% (36/309). Naevi with fluid were associated with larger basal diameters, greater thickness, presence of a halo, orange pigmentation, hyperautofluorescence, and hypodensity on B-scan ultrasonography. CONCLUSION AND RELEVANCE: Of choroidal naevi where subretinal fluid is not visible on clinical examination, 11.7% demonstrate subretinal fluid on OCT scans. These naevi more commonly exhibit features known to be associated with growth and transformation to melanoma. The presence of subclinical OCT-detectable fluid over choroidal naevi may assist in their risk stratification.

The biomechanics of posterior maxillary arch expansion using fixed labial and lingual appliances.

OBJECTIVE: To compare the biomechanics of straight labial, straight lingual, and mushroom lingual archwire systems when used in posterior arch expansion. MATERIALS AND METHODS: An electro-mechanical orthodontic simulator allowing for buccal-lingual and vertical displacements of individual teeth and three-dimensional force/moment measurements was instrumented with anatomically shaped teeth for the maxillary arch. In-Ovation L brackets were bonded to lingual surfaces, and Carriere SLX brackets were bonded to labial surfaces to ensure consistency of slot dimensions. Titanium molybdenum archwires were bent to an ideal arch form, and the teeth on the orthodontic simulator were set to a passive position. Posterior teeth from the canine to second molar were moved lingually to replicate a constricted arch. From the constricted position, the posterior teeth were simultaneously moved until the expansive force decreased below 0.2 N. Initial force/moment systems and the amount of predicted expansion were compared for posterior teeth at a significance level of α = 0.05. RESULTS: Archwire type affected both the expected expansion and initial force/moment systems produced in the constricted position. In general, the lingual systems produced the most expansion. The archwire systems were not able to return the teeth to their ideal position, with the closest system reaching 41% of the intended expansion. CONCLUSIONS: In general, lingual systems were able to produce greater expansion in the posterior regions when compared with labial systems. However, less than half of the intended arch expansion was achieved with all systems tested.

Photo-polymerisation variables influence the structure and subsequent thermal response of dental resin matrices.

OBJECTIVE: The structure of the polymer phase of dental resin-based-composites is highly sensitive to photo-polymerisation variables. The objective of this study was to understand how different polymer structures, generated with different photo-polymerisation protocols, respond to thermal perturbation. METHODS: Experimental resins were prepared from a series of Bis-GMA/TEGDMA blends (40/60, 50/50 and 60/40 wt.%), with either Camphorquinone/DMAEMA or Lucirin TPO as the photo-initiator system. Resins were photo-polymerised, in a disc geometry, at either relatively 'high' (3000 mW cm-2 for 6 s) or 'low' (300 mW cm-2 for 60 s) irradiances ensuring matched radiant exposures (18 J cm-2). Specimens were heated, from 20-160 °C at a rate of 5 °C min-1, whilst simultaneous synchrotron X-ray scattering measurements were taken at 5 °C increments to determine changes in polymer chain segment extension and medium-range order as a function of temperature. For each unique resin composition (n = 3), differential scanning calorimetry was used to measure glass transition temperatures using the same heating protocol. A paired t-test was used to determine significant differences in the glass transition temperature between irradiance protocols and photo-initiator chemistry at ɑ = 0.05. RESULTS: Resins pre-polymerised through the use of TPO and or high irradiances demonstrated a reduced rate of chain extension indicative of lower thermal expansion and a larger decrease in relative order when heated below the glass transition temperature. Above the transition temperature, differences in the rate of chain extension were negligible, but slower converted systems showed greater relative order. There was no significant difference in the glass transition temperature between different photo-initiator systems or irradiance protocols. SIGNIFICANCE: The evolution of chain extension and medium-range order during heating is dependent on the initial polymer structure which is influenced by photo-polymerisation variables. Less ordered systems, generated at faster rates of reactive group conversion displayed reduced chain extension below the glass transition temperature and maintained lower order throughout heating.

Repeatability of strain magnitude and strain rate measurements in the periodontal ligament using fibre Bragg gratings: An ex vivo study in a swine model.

Measurement of periodontal ligament (PDL) strain in an ex vivo or in vivo setting of a complete tooth-PDL-bone complex (TPBC) has yet to be achieved in the literature. The objective of this study was to investigate inter- and intra-TPBC PDL strain measurement using fibre Bragg grating (FBG) strain sensors. Second and third premolars from the left and the right side of four swine mandibles were removed to yield sixteen TPBC samples. Samples were secured in a miniature load-frame equipped with a digital actuator used to apply apical-directed displacement to the tooth. The same tooth on left and right sides of the mouth were exposed to the same loading condition over ten trials allowing for comparisons in a split-mouth study. Displacements of 0.2 and 0.3mm were considered along with displacement rates of 0.025, 0.05, and 0.1mm/s, yielding six loading combinations. Hypothesis testing between left and right teeth revealed FBGs did not always measure the same strain between left and right TPBCs. For all strain measures, the average coefficient of variation (CV) (all data collected) was 2.16 (range: 0.274-10.71). For repeated measures in single TPBCs, the minimum CV ranged from 0.037 to 0.449, and generally coincided with the time of maximum strain measured over the test duration. Based on the findings of this study, it is suggested that FBGs can provide repeatable ex vivo strain measures in the PDL of complete TPBCs.