Pubertal Development: What's Normal/What's Not.

Onset of puberty, as defined by breast stage 2, appears to be starting at younger ages since the 1940s. There is an ongoing controversy regarding what is normative, as well as what is normal, and the evaluation that is deemed necessary for girls maturing before 8 years of age. There are potential implications of earlier pubertal timing, including psychosocial consequences during adolescence, as well as longer term risks, such as breast cancer and cardiometabolic risks. There are additional consequences derived from slower pubertal tempo, for age of menarche has not decreased as much as age of breast development; these include longer interval between sexual initiation and intentional childbearing, as well as a broadened window of susceptibility to endocrine-related cancers.

A predictable all-digital workflow to retrofit a crown to an existing removable prosthesis.

The task of fabricating a new crown under an existing removable partial denture presents challenges for the dentist, technician, and patient. The main concern is accurately communicating the configuration of the rest, retentive clasps, and reciprocal elements to the laboratory technician without temporarily depriving the patient of the prosthesis. A variety of solutions involving stone cast alterations and elastomeric or resin indexes have been used for this task. However, these methods require significant additional time and technique-sensitive work by the operator and technician. More recent approaches using digital technologies require many of these traditional steps, each of which introduces potential inaccuracy and labor cost. This updated approach eliminates the inaccuracies associated with manual manipulation by the technician by leveraging contemporary intraoral scanning technology and a completely digital workflow to predictably and accurately fabricate a crown under an existing prosthesis.

Removal of Modern Ceramics.

With the overwhelming acceptance of lithium disilicate and zirconia, the frequency with which dentists have to remove these materials is increasing, and this can be difficult. Proper cement usage for full-coverage crowns with preparations that have retention and resistance can be helpful if in the future the restoration needs to be removed. When removing these modern materials, bur and laser techniques are both effective means, with each having specific benefits. Materials selection and preparation design are vital when considering areas of risk each patient exhibits and the potential need for removal.

Clinical and Molecular Perspectives of Reparative Dentin Formation: Lessons Learned from Pulp-Capping Materials and the Emerging Roles of Calcium.

The long-term use of calcium hydroxide and the recent increase in the use of hydraulic calcium-silicate cements as direct pulp-capping materials provide important clues in terms of how reparative dentin may be induced to form a "biological seal" to protect the underlying pulp tissues. In this review article, we discuss clinical and molecular perspectives of reparative dentin formation based on evidence learned from the use of these pulp-capping materials. We also discuss the emerging role of calcium as an odontoinductive component in these pulp-capping materials.

Visual Inspection for Determining Days When Accelerometer Is Worn: Is This Valid?

PURPOSE: Logs have been traditionally used for ascertaining accelerometer wear days in mail study designs, but not all participants complete logs. Visual inspection of accelerometer output may supplement missing logs; however, no data on the validity of this method are available. METHODS: We compared visual inspection with participant logs in 197 women (mean age, 71.0 yr). Women were mailed an accelerometer to be worn during waking hours for 7 d, marking each wear day on a log before returning the accelerometer by mail. For every participant, we created a series of graphs of accelerometer counts by time of day (one chart for each day with accelerometer output, including mail days). Two raters, masked to log wear status, independently inspected these graphs and scored each day as "worn" or "not worn." RESULTS: The median (interquartile range) number of valid wear days using either visual inspection or log was 7 (7-7). For rater 1, the sensitivity and specificity of visual inspection was 99.7% (95% confidence interval, 99.2%-99.9%) and 97.2% (95.2%-98.6%), respectively; for rater 2, the sensitivity and specificity of visual inspection was 99.7% (99.2%-99.9%) and 97.0% (94.9%-98.4%), respectively. Interrater agreement was 99.5%. CONCLUSIONS: Visual inspection of accelerometer data is a valid alternative to missing participant wear logs when determining wear days in mail study designs.

Molecular and phylogenetic analysis of pyridoxal phosphate-dependent acyltransferase of Exiguobacterium acetylicum.

The pyridoxal-5'-phosphate (PLP)-dependent family of enzymes is a very diverse group of proteins that metabolize small molecules like amino acids and sugars, and synthesize cofactors for other metabolic pathways through transamination, decarboxylation, racemization, and substitution reactions. In this study we employed degenerated primer-based PCR amplification, using genomic DNA isolated from the soil bacterium Exiguobacterium acetylicum strain SN as template. We revealed the presence of a PLP-dependent family of enzymes, such as PLP-dependent acyltransferase, and similarity to 8-amino-7-oxononoate synthase. Sequencing analysis and multiple alignment of the thymidine-adenine-cloned PCR amplicon revealed PLP-dependent family enzymes with specific confering codes and consensus amino acid residues specific to this group of functional proteins. Amino acid residues common to the majority of PLP-dependent enzymes were also revealed by the Lasergene MegAlign software. A phylogenetic tree was constructed. Its analysis revealed a close relationship of E. acetylicum to other bacteria isolated from extreme environments suggesting similarities in anabolic adaptability and evolutionary development.