Nonlinear optomechanical measurement of mechanical motion.

Precision measurement of nonlinear observables is an important goal in all facets of quantum optics. This allows measurement-based non-classical state preparation, which has been applied to great success in various physical systems, and provides a route for quantum information processing with otherwise linear interactions. In cavity optomechanics much progress has been made using linear interactions and measurement, but observation of nonlinear mechanical degrees-of-freedom remains outstanding. Here we report the observation of displacement-squared thermal motion of a micro-mechanical resonator by exploiting the intrinsic nonlinearity of the radiation-pressure interaction. Using this measurement we generate bimodal mechanical states of motion with separations and feature sizes well below 100 pm. Future improvements to this approach will allow the preparation of quantum superposition states, which can be used to experimentally explore collapse models of the wavefunction and the potential for mechanical-resonator-based quantum information and metrology applications.

Histomorphometric comparison of implant anchorage for two types of dental implants after 3 and 6 months' healing in baboon jaws.

STATEMENT OF PROBLEM: A complete understanding of dental implant prognosis requires better knowledge of the bone anatomy after implant healing. Such baseline data are necessary to compare against load-induced changes in anatomy. PURPOSE: The purpose of this article is to describe and compare measures of implant support (percentage [%] integration and percentage [%] bone area) for various implants in baboon jaws after healing times of 3 and 6 months. MATERIAL AND METHODS: Commercially pure titanium (cpTi) and titanium alloy (Ti-alloy) screw-shaped implants were placed in the posterior jaws of 9 female baboons after 2 months of postextraction healing. Specimens were harvested after 3 months (5 baboons: 8 cpTi, 7 Ti-alloy) and after 6 months (4 baboons: 8 cpTi, 8 Ti-alloy). Each implant provided 6 polished horizontal sections for data collection, which was accomplished from digitized images with the IMAGE analysis system (reliability at 1.6%). Three- and six-month data for each parameter were compared with the use of ANOVA (P<.01). RESULTS: The results revealed a significant increase in the % integration (cpTi 39.1 to 56.2; Ti-alloy 40.0 to 55.2) and the % bone area (cpTi 38.8 to 47.9; Ti-alloy 38.9 to 49.2) from 3 to 6 months for both implants. This significant increase was also true for comparisons by jaw for each implant material (P<.01 for overall and by jaw comparisons). CONCLUSION: A time-dependent increase in jawbone anchorage was measured in this nonhuman primate population, and it was shown that the 6-month maxillary data were comparable to the 3-month mandibular data. These results lend support to the clinical strategy of waiting longer to load implants in the maxilla.

Vertical ramus osteotomy allows exposure of the distal internal carotid artery to the base of the skull.

Exposure of the distal internal carotid artery (ICA) above the level of the second cervical vertebra can be difficult and often require maneuvers such as division of the digastric muscle or mandibular subluxation. These techniques increase exposure but may not provide adequate access. We report a series of eight cases in which vertical division of the mandibular ramus provided access of the ICA up to the base of the skull. Over the last 10 years, eight patients underwent vertical ramus osteotomy (VRO) to aid in distal ICA exposure. Preoperative arteriography revealed ICA lesions within 1.5 cm of the skull base. Indications for surgery were compelling and included gunshot wounds to zone III of the neck (n = 2), transient ischemic attack (n = 2), and preocclusive stenosis (n = 4). VRO was performed through a standard vertical neck incision and was created from the depth of the sigmoid notch to the angle of the mandible after elevating the masseter muscle from the bone. Miniature titanium plates were used to reapproximate the mandible after endarterectomy (n = 5), bypass (n = 2), or arterial repair (n = 1). We found that VRO provides reliable exposure of the distal ICA up to the base of the skull. Unlike mandibular subluxation, it requires no pre-incision preparation, thus mandibulotomy can be performed after carotid artery dissection has begun, and may even be avoided. VRO is especially useful when carotid artery pathology unexpectedly extends beyond the usual field of exposure. Work on the carotid artery at the skull base is associated with significant complications and should be reserved for compelling indications.

Histomorphometric analysis of implant anchorage for 3 types of dental implants following 6 months of healing in baboon jaws.

In an effort to better understand the supporting anatomy for unloaded endosseous dental implants, this study focused on the histomorphometric analysis of 3 different types of implants placed into non-human primate jaws and allowed to heal for 6 months. This report describes data from 24 screw-type dental implants placed in edentulated (2 months healing time) posterior arches of 4 adult female baboons. Three different implants were placed and allowed to heal for 6 months prior to processing for evaluation: commercially pure titanium (n = 8), titanium alloy (n = 8), and titanium plasma-sprayed (n = 8). Circumferential bone-implant interface sampling from 6 regions along the entire length of each implant was obtained for evaluation of percent bone-implant contact (%BIC) and percent bone area (%BA), within 3 mm of the implant. Data were collected (reliability of 1.6% for both parameters) and analyzed by an observer blinded to implant material using IMAGE analysis software for differences between jaws, implant biomaterials, and jaw/biomaterial (analysis of variance, pairwise comparison using least squares method with Bonferroni adjustment). The results indicated that the overall mean %BIC was 55.8 and mean %BA was 48.1. Maxillary and mandibular differences for both parameters were statistically significantly different: %BIC in maxilla 50.8, in mandible 60.8; %BA in maxilla 43.6, in mandible 52.6 (both significant at the P < .05 level). The biomaterial analyses revealed no significant differences between the different implants for %BIC or %BA. The trend observed--that mandibular values were greater than maxillary values for the overall jaw comparisons--was found to be consistent at the jaw/biomaterial level, although the small sample size limited statistical power. These data, along with data from a previous 3-month study, provide insight into baseline supporting anatomy for dental implants.

Distraction osteogenesis of the mandible with a modified intraoral appliance: a pilot study in miniature pigs.

The purpose of this study was to evaluate an intraoral, nontooth-borne, submucosal distraction appliance in the pig mandible from a clinical, radiographic, and histologic perspective. Intraoral distraction appliances were fabricated, tested for strength, and then adapted and rigidly fixated to the mandibles of three growing miniature Yucatan pigs. A bicortical osteotomy was performed on the right side of the mandible, and a buccal and lingual corticotomy on the left. Two amalgam markers were placed on each side of the osteotomy/corticotomy sites as references. Measurements were taken to evaluate the length and vector of the distraction site, and radiographs were obtained perioperatively. After a latency period of 5 days, distraction was commenced and continued for 13 days at a rate of 1 mm/day. Clinical evidence of distraction was apparent in all cases, with resulting Class III skeletal deformities. Distraction progressed further for the corticotomy sides than the osteotomy sides because of distraction device failure. Radiographic examination revealed increased bone density at the periphery of the distracted callus, with less density apparent centrally. Histologic examination showed fibrous connective tissue in the center of the callus, with cartilage and osteoid formation at the periphery. Bone formation was parallel to the vectors of distraction in all cases. This study confirms that the use of a modified intraoral appliance for distraction osteogenesis is feasible. Use of this device overcomes many of the problems associated with extraoral devices and may have clinical applications.

Reverse-torque failure of screw-shaped implants in baboons after 6 months of healing.

Mechanical testing of the implant-tissue interface has been the focus of numerous investigations concerning the anchorage capacity of implants. The purpose of this study was to measure reverse-torque failure after 6 months of healing for three different biomaterials in the posterior jaws of four adult female baboons. The animals had all of their posterior teeth surgically extracted and, following 10 weeks of healing, 7 implants were placed in each quadrant. The biomaterials included titanium plasma-sprayed surfaces, titanium-aluminum-vanadium surfaces (both 3.8 mm x 10 mm), and a commercially pure titanium surface (3.75 mm x 10 mm). After 6 months, torque data were collected using a counterclockwise computerized torque driver and were analyzed by repeated measures analysis of variance for differences related to biomaterial, jaw, and biomaterial/jaw. Post-hoc Tukey Kramer analysis was also performed for within-group differences (alpha = .05 level). The biomaterial comparison revealed a significant difference between the titanium plasma-sprayed and the combined commercially pure titanium/titanium -aluminum-vanadium groups (analysis of variance, Tukey Kramer, P < .05). The jaw comparison showed no significant difference, although the data suggest that higher forces may be required for mandibular torsional failure. The biomaterial/jaw comparison revealed that jaw differences for the mean values of commercially pure titanium and titanium-aluminum-vanadium implants were greater than jaw differences for mean values of titanium plasma-sprayed implants, although these differences were not statistically significant. Because of the lack of correlation between single-cycle biomechanical tests and clinical performance, it is necessary to be selective in assigning usefulness to data of this type.

Isolation of isoflavones from soy-based fermentations of the erythromycin-producing bacterium Saccharopolyspora erythraea.

A search for an abundant and economical source of isoflavones, particularly genistein, led to the discovery that the erythromycin-producing organism Saccharopolyspora erythraea also produces this promising new cancer-prevention agent. Erythromycin fermentation is a large-scale, soybean-based process used world-wide for the commercial production of this medically important antibiotic. Results from this study indicate that genistin (the glucoside form of genistein), which is added to the fermentation in the soybean media, was converted to genistein through the action of a beta-glucosidase produced by the organism. Genistein was co-extracted with erythromycin from the fermentation broth, then separated from erythromycin during the second step of the purification process for the production of erythromycin.

Effect of prosthetic superstructure accuracy on the osteointegrated implant bone interface.

OBJECTIVE: This study evaluated the biologic result of forces induced by a misfitting prosthetic superstructure on implants placed in a New Zealand white rabbit tibia model. STUDY DESIGN: Nine rabbits had two dental implants placed in both right and left proximal tibias. After 6 weeks, one animal was sacrificed for baseline integration data, and the remaining animals had fitting or misfitting prosthetic superstructures attached to the implants for 12 weeks. Implants were evaluated clinically, radiographically, and histomorphometrically at the scanning electron microscopic level. RESULTS: No clinical, radiographic, or histomorphometric evidence exists of integration failure with implants subjected to superstructure strain, although bone remodeling is noted. CONCLUSIONS: Given the limitations of sample size, animal model used, duration of prosthetic superstructure attachment, and loading confounders possible, the study of prosthetic framework misfit must be evaluated with another animal model, such as an intraoral primate model, to determine the relationship between clinical performance and histologic findings.

Quantitative histomorphometric description of implant anchorage for three types of dental implants following 3 months of healing in baboons.

Important to the understanding of the dynamics associated with dental implant anchorage over time is a knowledge of the supporting anatomy for common endosseous implants prior to being placed into function. This study followed 20 screw-shaped dental implants placed in edentulated (2 months' healing time) posterior jaws of five adult female baboons. Implants made of three biomaterials were placed and allowed to heal for 3 months prior to processing for evaluation. Percentage integration and bone area data from six horizontal sections along the entire length of each implant were collected and analyzed for differences between jaws, implant biomaterials, jaw/biomaterial, and sections of the implants (ANOVA, pairwise comparison using LSM with Bonferroni adjustment). The results indicated that overall mean percentage integration was 46.5 and mean percentage bone area was 39.9. Maxillary and mandibular differences for both parameters were statistically different (integration: maxillary = 38.1%, mandibular = 56.7%; bone area: maxillary = 35.8%, mandibular = 44.9%; both were significant at the P < .05 level). The biomaterial analyses revealed significant differences for percentage integration between the metal implants and the hydroxyapatite-coated implant (commercially pure titanium = 39.1%, titanium-aluminum-vanadium = 40.0%, hydroxyapatite-coated = 61.5%), but no such difference was noted for percentage bone area (commercially pure titanium = 38.8%, titanium-aluminum-vanadium = 38.9%, hydroxyapatite-coated = 42.3%). Discussion of the relative importance of the two parameters highlights the fact that resistance to functional loads requires establishing and then maintaining an adequate volume of bone, which may have a functionally specific structure based on the mechanical properties of the local jaw environment.

The response of bone in primates around unloaded dental implants supporting prostheses with different levels of fit.

Implant failure as a consequence of prosthetic loading following clinical determination of successful stage I healing is poorly understood. A basic premise of accepted prosthetic protocol is passive connection of multiunit prostheses to the implant support. To better understand mechanical factors related to implant failure, this basic passivity premise was experimentally tested prior to study of functional loading research. The purpose of this preliminary study was to measure the bone response around implants placed in the mandible of baboons that supported prostheses exhibiting two levels of fit and not loaded occlusally. Screw-retained prostheses that exhibited a mean linear distortion of 38 microns and 345 microns made up the fit and misfit groups respectively. The results failed to distinguish a difference in bone response between the two levels of prosthetic fit. Although the finding can be argued as a sample size limitation, the data strongly suggest an opposite response than is clinically expected and, consequently, does not warrant the use of additional animals in this initial study. Because the design of this study does not mimic the clinical application of misfitting prostheses (where dynamic functional loads are superimposed with misfit loads), it cannot be inferred that, in clinical application, fit does not alter the osseointegrated interface. Ongoing investigation of failure due to nonpassive connections under dynamic loading conditions of mastication will help clarify the clinical significance of passivity.

Reverse torque failure of screw-shaped implants in baboons: baseline data for abutment torque application.

Torque failure for endosseous implants has been used as a biomechanical measure of anchorage, though the significance of such data is not known. A practical understanding of the resistance to torque failure of implant-tissue interfaces at stage 2 surgery would help in assigning torque levels for implant abutment-screw fastening. The purpose of this study was to measure torque failure levels of commercially pure (CP) titanium, Ti-6Al-4V, hydroxyapatite-coated (HA-coated) screw-shaped implants placed into the maxillae and mandibles of baboons. Implants identical in size were placed into the edentulous posterior maxillae and mandibles of six female baboons (n = 37 each group) using a standardized surgical protocol. Reverse-torque data were collected at postinsertion time intervals ranging from 3 to 4 months using a counterclockwise torque driver and the data were analyzed (repeated measures ANOVA) for torque differences related to time, biomaterial, and jaw. The HA-coated implants exhibited significantly greater torque-removal values compared to both metallic implants (HA: 186.0 Ncm [50.1]; Ti-6Al-4V: 78.6 Ncm [18.1]; CP Ti 74.0 Ncm [24.4]). Analysis of torque interactions with jaw showed no significant difference; however, the mandible was found to be greater than the maxilla in torque resistance for all groups tested. Understanding the risks in inferring animal data to human application, the clinical implications of these data suggest that the recommended torque level of 35 Ncm for abutment fastening may provide a margin of safety for most implants of similar design and material as used in this study.(ABSTRACT TRUNCATED AT 250 WORDS)

The relationship of Periotest values, biomaterial, and torque to failure in adult baboons.

A quantitative measure of implant stability would be beneficial to decision-making regarding the status of the bone anchorage around an implant. The Periotest device has been reported to provide such a measure, but the in vivo data are incomplete and inconclusive in support of this claim. The purpose of this study was to determine in an in vivo model the relationship between Periotest values (PTV), three different implant biomaterials, and torque to failure. A total of 79 screw-shape implants made of commericially pure titanium, titanium alloy, and HA-coated alloy were evaluated in the posterior maxillary and mandibular quadrants of six female baboons following healing for 3 to 4 months. At uncovering, the implants were tested with the Periotest device and torqued to failure using an electronic torque driver. Analysis of the PTV-biomaterial relationship revealed no significant difference among the implants based on the biomaterial (P = .7453). Analysis of PTV-torque revealed a significant relationship (P = .0117), however, the association between PTV and torque was not strong and does not explain 92% of the variation between the parameters (Pearson correlation .2823, R2 = .08).

Treatment of Class II division 2 malocclusion with combined bilateral sagittal split osteotomy and total subapical osteotomy.

This paper describes a modification of the combined bilateral sagittal split osteotomy and total subapical osteotomy procedure; a representative case treated with this approach is presented. In addition, diagnostic and treatment planning considerations for the comprehensive surgical-orthodontic therapy of individuals presenting with differential sagittal discrepancy between the mandibular corpus and symphysis are discussed, along with limitations of diagnostic criteria commonly used in cephalometric appraisal of the facial soft tissue outline.

Osteointegration of implants in radiated bone with and without adjunctive hyperbaric oxygen.

A study was undertaken to evaluate the integration of endosseous implants in rabbit tibias that had received a tumoricidal dose of radiation. The effect of hyperbaric oxygen on integration in this compromised situation was also evaluated. Despite clinical and radiographic evidence of success of all implants, there was a significant decrease in amount of histologic bony integration of implants placed in the tibias that had received radiation therapy when compared to contralateral control implants. Adjunctive hyperbaric oxygen therapy significantly improved the amount of histologic integration of implants placed within the radiated tibias evaluated at 10 and 16 weeks after placement. Hyperbaric oxygen was also associated with better soft tissue wound healing in the radiated surgical site. Increased integration time significantly improved the amount of histologic integration in the animals that did not receive hyperbaric oxygen.

A systematic approach to management of high-flow vascular malformations of the mandible.

High-flow vascular malformations of the mandible are associated with significant morbidity and mortality. As these lesions are rare, the experience that a clinician has with treatment may be limited. To facilitate understanding and treatment of such lesions in a controlled and efficient manner, a treatment protocol is presented that includes careful preoperative planning, embolization, and surgery.