Staged Approach Involving Orthodontic Implant Site Development with Labial Root Torque and Guided Bone Regeneration; 3-Year Follow-up Case Report.

Restoring periodontally compromised teeth in aesthetic zones through dental implant rehabilitation poses significant challenges due to the loss of supporting tissues. This case report describes a staged treatment strategy designed for a 48-year-old woman with advanced chronic periodontitis of the aesthetic zone. This approach combined various advanced techniques, including periodontal regeneration, orthodontic implant site development with labial root torque, guided bone regeneration, and soft tissue augmentation. The innovative orthodontic implant site development with labial root torque technique was employed to harness healthy palatal periodontal ligament cells by strategically applying labial root torque in the horizontal labial-palatal direction. This technique uses healthy palatal periodontal ligament cells, which benefits overall periodontal health. The procedure involved gradually shifting hopeless teeth at a rate of 2 mm per month using nickel-titanium wires, thereby maintaining overcorrection for two months before extraction. Following successful orthodontic implant site development with labial root torque, the next phase involved guided bone regeneration using a honeycomb-structured titanium membrane. This set the stage for implant placement six months later, ensuring a stable foundation for subsequent prosthetic intervention. Soft tissue augmentation was then meticulously performed using an artificial collagen dermis infused with fibroblast growth factor-2, contributing to the overall aesthetic outcome. Final prosthesis integration revealed a harmonious blend with the adjacent teeth and gums, underscoring the success of this multidisciplinary approach. This case report provides valuable insights into severe periodontitis in the aesthetic field. Our findings highlight the importance of continuously researching and improving procedures for optimal patient care.

Orthodontic Implant Site Development Using Labial Root Torque: A Case Series with CBCT Analysis.

This case series assessed the efficacy of Orthodontic Implant Site Development with Labial Root Torque (OISD-LRT) as a nonsurgical technique for addressing labial bone deficiencies in seven patients. The procedure involved strategically placing a multi-bracket of 2-3 mm apically on the hopeless teeth, gradually shifting them with Ni-Ti wires at the rate of 2 mm per month and maintaining overcorrection for 2 months before extraction. OISD-LRT consistently augmented tissue for flapless guided implant surgery, with an average treatment duration of 404Å}311.7 days. Cone-beam computed tomography (CBCT) scans at various stages revealed increases in both vertical and horizontal bone dimensions, especially in the sockets with complete labial bone loss. Despite inevitable post-extraction reductions in bone height and width, sufficient dimensions were maintained to ensure long-term implant stability. This case series highlights the effectiveness of OISD-LRT as a valuable method for horizontal bone augmentation, particularly in patients with labial bone deficiency. This approach provides a robust foundation for subsequent implant placement, showcasing its success in addressing challenging anatomical conditions and contributing to the broader field of implant dentistry.

[Analysis of Preventive Cases Using Resilience Engineering in Radiotherapy Department].

PURPOSE: Resilience engineering is the ability of a system to adjust its own functions and maintain the required behavior in the face of changes and disturbances, and resilience potential is a necessary requirement. We aimed to clarify the relationship between resilience potential and error prevention cases. METHOD: Based on the error cases reported in our department, we aggregated the relationship with resilience potential for each radiation treatment process. RESULT: As a result of tabulating the relationship, we were able to recognize and prevent errors by taking preventive measures from past cases. On the other hand, in cases that slipped through the check mechanism, errors were discovered because of a sense of discomfort in unusual situations, and some error cases could be prevented by increasing the resilience potential. CONCLUSION: This study found that preparation, observation, coping, and utilization of past experiences are related to resilience potential in preventive cases.

Resorbable Membrane Pouch Technique for Single-Implant Placement in the Esthetic Zone: A Preliminary Technical Case Report.

The conventional protocol for lateral guided bone regeneration (GBR) in esthetic areas requires the securing of resorbable collagen membranes using titanium cortical bone pins to immobilize bone grafts. These procedures are highly invasive and can increase patient morbidity and discomfort. Herein, we introduce a minimally invasive novel resorbable membrane pouch technique, wherein collagen membranes can be immobilized by securing them to the periosteum without the need of titanium pins. We describe 11 cases of single-immediate- or delayed-implant placement in the atrophic maxilla esthetic zone. All implants were successful and functional without pain or inflammation and with optimal soft-tissue health and esthetics. Radiographic evaluation with cone-beam computed tomography (CBCT) and esthetic assessment using the pink esthetic score (PES) were performed. At the time of implant placement, the average augmented bone width was 2.8 ± 0.6 mm on CBCT analysis. In all cases, resorption of the augmented bone was confirmed with an average of -1.3 ± 0.8 mm. Soft-tissue outcomes were scored 1 year after permanent restoration. The PES score 1 year after treatment was 11.9 ± 1.4. The resorbable membrane pouch technique with immediate or delayed implant placement for buccal dehiscence in the esthetic area can be predictable and is minimally invasive.

Adhesive bonding of Ti-6Al-7Nb alloy and component metals with acidic primers and a tri-n-butylborane initiated resin.

PURPOSE: To evaluate the effects of acidic functional monomers on the bond strength and durability of an acrylic resin joined to Ti-6Al-7Nb alloy and component metals. MATERIALS AND METHODS: Disk specimens of two different sizes (10 and 8 mm in diameter and 2.5 mm in thickness) were prepared from uncast Ti-6Al-7Nb alloy, titanium, aluminum, and niobium. The specimens were ground with abrasive paper and divided into 8 groups: unprimed control, primed with Acryl Bond, Alloy Primer, All Bond II Primer B, Estenia Opaque Primer, M.L. Primer, MR. Bond, and Super-Bond Liquid. The disks were bonded with tri-n-butylborane (TBB)-initiated acrylic resin, and shear bond strengths were determined both before and after thermocycling. RESULTS: The Alloy Primer and Estenia Opaque Primer agents, which contain a hydrophobic phosphate monomer (MDP), and Super-Bond Liquid demonstrated a durable bond with Ti-6Al-7Nb alloy. MDP was also effective in bonding Ti, Al, and Nb. CONCLUSION: The two primers containing MDP were effective for treating Ti-6Al-7Nb alloy and Ti. Al and Nb showed bonding behavior similar to Ti-6Al-7Nb alloy and Ti when the two metals were treated with acidic primers and bonded with the TBB-initiated acrylic resin.

Bonding and wear characteristics of a tri-n-butylborane initiated adhesive resin filled with pre-polymerized composite particles.

This study evaluated the wear characteristics and bonding to silver-palladium-copper-gold (Ag-Pd-Cu-Au) alloy of an acrylic resin that was filled with pre-polymerized composite particles and initiated with tri-n-butylborane (TBB) derivative (Bondfill). Three methyl methacrylate (MMA)-based resins (Bondfill, Super-Bond, and Multi-Bond II) and a microfilled composite restorative material (Metafil C) were assessed. Disk specimens were cast from the alloy and were air-abraded with alumina. The disks were bonded with nine bonding systems selected from two priming and three luting agents. Shear bond strengths were measured before and after thermocycling. Bond strength varied from 2.2 MPa to 28.2 MPa. Three systems based on thione primers (Metaltite and V-Primer) and TBB-initiated resins (Bondfill and Super-Bond) had the highest bond strength after thermocycling (15.9-20.4 MPa). The toothbrush-dentifrice abrasion test showed that the Metafil C material was the most wear-resistant, followed by Bondfill and Super-Bond. In conclusion, Bondfill resin is an alternative to Super-Bond resin for luting metallic restorations and for restoring tooth defects. However, care is required in selecting appropriate clinical cases.

Effects of triazine dithione and hydrophobic phosphate monomers on bonding to Ag-Pd-Cu-Au alloy and titanium with a methacrylic resin-based luting agent.

PURPOSE: The purpose of the current study was to evaluate the effects of thione and phosphate functional monomers on bond strength and durability of a methacrylic resin luting agent joined to silver-palladium based alloy and titanium. MATERIALS AND METHODS: Disk specimens of two different sizes (10 mm and 8 mm in diameter by 2.5 mm thickness) were prepared from silver-palladium-copper-gold (Ag-Pd-Cu-Au) alloy and titanium. The specimens were ground with abrasive paper, and divided into four groups based on the following conditions: 1) unprimed control; 2) priming with Alloy Primer (thione and phosphate); 3) priming with Estenia Opaque Primer (phosphate); and 4) priming with VPrimer (thione). The disks were bonded with tri-n-butylborane (TBB)-initiated resin, and shear bond strengths were determined both before and after thermocycling. RESULTS: The Alloy Primer and V-Primer agents containing a triazine dithione monomer (VTD) bonded the Ag-Pd-Cu-Au alloy, whereas the Alloy Primer and Estenia Opaque Primer agents containing a hydrophobic phosphate monomer (MDP) bonded titanium. The reduction in bond strength after 20,000 thermocycles was not remarkable for the two groups (Alloy Primer and Ag-Pd-Cu-Au alloy; V-Primer and Ag-Pd-Cu-Au alloy). CONCLUSION: The thione monomer was effective in bonding the Ag-Pd-Cu-Au alloy, whereas the phosphate monomer was useful for bonding titanium. The thione did not interfere with the bonding of MDP to titanium, and MDP did not negatively affect bonding of VTD to the Ag-Pd-Cu-Au alloy. The combinations of two thione primers and the Ag-Pd-Cu- Au alloy exhibited the best adhesive performance within the limitations of the current experiment.

Effect of alumina air-abrasion on mechanical bonding between an acrylic resin and casting alloys.

This study examined the effect of alumina air-abrasion with different pressure on bonding between an acrylic resin and casting alloys. Disk specimens (8 and 10 mm in diameter) were cast from a silver-palladium-copper-gold (Ag-Pd-Cu-Au, Castwell M.C.12) alloy and a titanium-aluminum-niobium alloy (Ti-6Al-7Nb, T-Alloy Tough). The disks were air-abraded with alumina particles (50-70 microm) under different air-pressures (0 unabraded, 0.1, and 0.6 MPa). The disk pairs were bonded together with a tri-n-butylborane (TBB)-initiated acrylic resin, and shear bond strengths were determined both before and after thermocycling. Bond strength varied from a maximum of 37.1 MPa to a minimum of 3.6 MPa for the Ag-Pd-Cu-Au alloy, whereas bond strength to Ti-6Al-7Nb alloy ranged from 34.7 MPa to 0.1 MPa. Specimens abraded with 0.6 MPa pressure recorded the greatest post-thermocycling bond strength (21.7 MPa and 17.9 MPa), and unabraded specimens showed the lowest strength (3.6 MPa and 0.1 MPa) for both alloys. Post-thermocycling bond strength to the Ag-Pd-Cu-Au alloy was higher than that to the Ti-6Al-7Nb alloy under identical air-abrading conditions. It can be concluded that alumina air-abrasion with an air-pressure of 0.6 MPa is effective in enhancing retentive characteristics of the TBB-initiated resin joined to the alloys.

Repulsive guidance molecule b inhibits neurite growth and is increased after spinal cord injury.

Neuronal axons are guided by attractive and repulsive cues in their local environment. Since the identification of the repulsive guidance molecule (RGM) a (RGMa) as an axon repellent in the visual system, diverse functions, as part of the developing and adult central nervous system (CNS), have been ascribed to it. The binding of RGMa to its receptor neogenin has been shown to induce RhoA activation, leading to inhibitory/repulsive behavior and the collapse of the neuronal growth cone. In this paper, we provide evidence to suggest the involvement of RGMb, another member of the RGM family, in the rat CNS. RGMb inhibits neurite outgrowth in postnatal cerebellar granule neurons (CGNs) in vitro. RGMb is expressed by oligodendrocytes and neurons in the adult rat CNS, and the expression of this molecule is upregulated around the site of spinal cord injury. RGMb is present in myelin isolated from an adult rat brain. RGMb and neogenin are coexpressed in CGNs and entorhinal cortex neurons. These findings suggest that RGMb is a myelin-derived inhibitor of axon growth in the CNS. Inhibition of RGMb may provide an alternative approach for the treatment of spinal injuries.

Therapeutic potential of a specific chymase inhibitor in atopic dermatitis.

A novel therapeutic mechanism may be the key to improving the chief symptoms and signs of atopic dermatitis (AD), which are persistent pruritus and high serum IgE. We demonstrate here that mast cell chymase may be a possible initiating factor and that the orally active specific inhibitor Y-40613 may have a therapeutic potential in the treatment of AD. We found that Y-40613 (2-[5-amino-2-(4-fluorophenyl)-1,6-dihydro-6-oxo-1-pyrimidinyl]-N-[1-[(5-methoxycarbonyl-2-benzoxazolyl)carbonyl]-2-phenylethyl]acetamide) dose-dependently suppressed the scratching response in a mouse pruritus model, with inhibitory efficacy enhanced by combination with conventional drugs, suggesting that chymase contributes to the development of pruritus by a unique mechanism or mechanisms. In fact, chymase injected in the model induced the scratching response. In vitro IgE production from mouse B cells was increased by purified rat chymase and suppressed by Y-40613. Increased serum IgE observed in Brown Norway rats injected with mercury chloride was suppressed by Y-40613. Furthermore, Y-40613 lowered ear thickness as well as serum IgE level in a mouse contact dermatitis model. Taken together, these findings suggest that the specific chymase inhibitor Y-40613 may ameliorate symptoms of AD through the dual inhibition of the chymase-dependent IgE production pathway and itching sensation.