Accuracy of ceramic restorations made using an in-office optical scanning technique: an in vitro study.

The present in vitro study concerns determination of the pre-cementation gap width of all-ceramic crowns made using an in-office digital-impression technique and subsequent computer-aided design/computer-aided manufacturing (CAD/CAM) production. Two chairside video camera systems were used: the Lava Oral scanner and Cadent's iTero scanner. Digital scans were made of a first molar typodont tooth that was suitably prepared for an all-ceramic crown. The digital impressions were sent via the Internet to commercial dental laboratories, where the crowns were made. Also, an impression of the typodont tooth was made, poured, and scanned in order to evaluate the pre-cementation gap of crowns produced from scanning stone dies. These methods and systems were evaluated by creating replicas of the intermediate space using an addition-cured silicone, and the gap widths were determined using a measuring microscope. Hot-pressed leucite-reinforced glass-ceramic crowns were selected as a reference. The mean value for the marginal measuring points of the control was 170 µm, and the values for all the evaluated crowns ranged from 107 to 128 µm. Corresponding figures for the internal measuring points were 141-210 µm and 115-237 µm, respectively. Based on the findings in the present study, an in-office digital-impression technique can be used to fabricate CAD/CAM ceramic single crowns with a marginal and internal accuracy that is on the same level as that of a conventional hot-pressed glass-ceramic crown. In the present study, however, slight differences could be seen between the two types of ceramic crowns studied with respect to the internal fit obtained.

Effects of meal frequency and high-fibre rye-bread diet on glucose and lipid metabolism and ileal excretion of energy and sterols in ileostomy subjects.

OBJECTIVE: To investigate the effect of a rye, high-fibre diet (HFD) vs a wheat, low-fibre diet (LFD), meal frequency, nibbling (Nib, seven times a day) or ordinary (Ord, three times a day), and their combined effects on blood glucose, insulin, lipids, urinary C-peptide and ileal excretion of energy, cholesterol and bile acids in humans. DESIGN: LFD period with Nib or Ord meal frequency followed by an HFD diet with Nib or Ord meal frequency in randomized, crossover design. SETTING: Outpatients of ileostomy volunteers were called for an investigation in research word. SUBJECTS: A total of 10 subjects (two female subjects, age 34 and 51 y; eight males, mean age 54.4 y, range 43-65 y) participated in the experiment. All subjects were proctocolectomized for ulcerative colitis (mean 16.0 y, range 8-29 y before the study). INTERVENTION: In total, 10 ileostomy subjects started with LFD for 2 weeks, the first week on either Nib (five subjects) or Ord (five subjects) and the second week on the other meal frequencies, in a crossover design, followed by a wash-out week, and continued with HFD period for 2 weeks in the same meal frequency manner. All foods consumed in both Nib or Ord regimens were identical and a high-fibre rye bread was used in the HFD period and a low-fibre wheat bread in the LFD period. MAIN OUTCOME MEASURES: Day-profiles of blood glucose, insulin and lipids, blood lipids before and after dietary intervention, and excretion of steroids in the effluents and C-peptide in the urine. RESULTS: During the Nib regimen, plasma glucose and insulin peaks were lower at the end of the day with HFD compared with LFD. Urinary C-peptide excretion was significantly higher in the day-time on LFD compared with HFD (LFD-Ord vs HFD-Ord, P < 0.01; LFD-Nib vs HFD-Nib, P < 0.01). Plasma free-cholesterol, total cholesterol, triglycerides and phospholipids were significantly higher (P < 0.05) after LFD than after HFD with the Nib regimen. A higher excretion of energy (P < 0.05) and chenodeoxycholic acid (P < 0.05) were observed with HFD compared with LFD regardless of meal frequency. A higher daily excretion of cholic acid, total bile acids, cholesterol, net cholesterol and net sterols (P < 0.05) was observed on HFD compared with LFD with the Nib regimen. CONCLUSIONS: An HFD decreased insulin secretion measured as a decreased excretion of C-peptide in urine and as decreased plasma insulin peaks at the end of the day during a Nib regimen. The smoother glycaemic responses at the end of the day during a Nib regimen may be a consequence of a second meal phenomenon, possibly related to the nature of dietary fibre complex.

Bioavailability of selenium from bovine milk as assessed in subjects with ileostomy.

OBJECTIVE: To assess the absorption of dietary selenium in humans, especially of milk selenium. DESIGN: : 1-day meal studies in subjects with ileostomy. SETTING: Hospital outpatient clinics. SUBJECTS: Three subjects in the pilot study and nine subjects in the main study (eight men/ four women). INTERVENTION: Different beverages, 1 l/day, were given in addition to basal diets (soft drink, 1 week; low-fat milk, 3 weeks; fermented low-fat milk, 3 weeks and soft drink, 1 week). Ileostomy effluents were collected during the last 2 days in each of the four periods. RESULTS: On days when the subjects were given 1 l of low-fat milk, the estimated fractional absorption of total dietary selenium was 65.5 (2.3)% (mean (s.d.), n=18), which was similar to the value when fermented low-fat milk was given (64.1 (3.2)%). However, both the calculated amount of milk selenium absorbed (10.9 (2.4) vs 9.4 (1.7) microg selenium) and its fractional absorption (73.3 (16.1) vs 64.1 (11.2)%, n=18) were significantly higher for milk than for fermented milk. CONCLUSIONS: Selenium from milk and other sources is well absorbed in subjects with ileostomy. The real absorption may be even higher than the values shown.

A comparison of iron absorption from single meals and daily diets using radioFe (55Fe, 59Fe).

The purpose of the present study was to compare two measures of Fe absorption, one from single meals and the other from daily diets. Ten ileostomy subjects were given the same low-fibre composite diet for all three meals each day for five consecutive days. After 3 weeks the experiment was repeated with a high-fibre diet. The morning meal constituted one-seventh of the total daily diet intake, the mid-day meal two-sevenths and the evening meal four-sevenths of the total daily diet intake. On days 4 and 5 of each diet period the morning meal was labelled with 55Fe and all three meals were labelled with 59Fe. The activities retained in the subjects 19 d later showed the Fe absorption from the low-fibre diet measured from the morning meals to be almost 80% greater than the average Fe absorption measured from all meals during the same 2 d. With the high-fibre diet the absorption from the morning meals was less than 50% greater than the average for all meals but the difference was not significant. We suggest that all meals of the day should be labelled with radioFe in order to avoid inflating the measures of Fe absorption.

Effect of milk and fermented milk on iron absorption in ileostomy subjects.

This study was undertaken to determine whether milk with its high calcium content adversely affects the absorption of nonheme iron from the diet as greatly as single-meal studies indicate. Nine ileostomy subjects ate a low-fiber, low-phytate diet for 8 consecutive weeks. During the first and eight weeks they drank a 250-mL soft drink with three main meals and an evening snack each day (0.16 g Ca/d). During the two intervening 3-wk periods, they drank the same amount of low-fat milk or fermented low-fat milk (Verum; Hälsofil, Norrmejerier, Umeä, Sweden) according to a formally randomized crossover design (1.4 g Ca/d). During the last 2 d in each of the four periods, apparent iron absorption (balance) from a test diet together with that period's beverage was measured and the plasma ferritin concentration was determined. There was no decrease in apparent iron absorption during the milk diet periods.

Starch and dietary fiber components are excreted and degraded to variable extents in ileostomy subjects consuming mixed diets with wheat- or oat-bran bread.

The study was conducted to determine if the excretion of starch and dietary fiber components varies in ileostomy subjects consuming diets high or low in dietary fiber. Excretion of starch, enzyme-resistant starch and dietary fiber components was studied in nine human subjects with ileostomies, who consumed (in a crossover design) a wheat bread-based diet (daily intake 274 g starch, 2.4 g enzyme-resistant starch and 14.4 g total dietary fiber) and a high fiber diet based on oat-bran bread (daily intake 243 g starch, 2.7 g enzyme-resistant starch and 40.2 g total dietary fiber). Food and excreta were collected on d 3 and 17. No significant differences in excretion of starch, enzyme-resistant starch or dietary fiber components were found on these 2 d in each dietary period. When subjects consumed the wheat bread-based diet they excreted (mean +/- SD) 3.3 +/- 1.7 g starch and 2.4 +/- 0.4 g enzyme-resistant starch daily, whereas when consuming the oat bran-based diet they excreted 4.5 +/- 3.1 g starch and 2.5 +/- 0.4 g enzyme-resistant starch. During both dietary periods subjects excreted significantly greater amounts of certain dietary fiber polysaccharide residues (fucose, galactose and uronic acid) than they ingested. This indicates a contribution of endogenous and/or microbial material to the dietary fiber value in ileostomy effluents. However, significantly less excretion of some dietary fiber polysaccharide residues, especially glucose residues, during the oat-bran bread-based dietary period was also noted. This was presumably caused by a degradation of mixed-linked (1,3),(1,4)-beta-D-glucans.

A 2-year clinical follow-up study of IPS Empress ceramic inlays.

This study evaluated the clinical quality of 62 Empress restorations placed for 18 patients. Patients were evaluated for caries and fracture by two investigators at 7 and 26 months using the CDA quality evaluation criteria in additional to periodontal criteria. The results indicated a large number of excellent ratings for color and surface, but lower ratings for anatomic form and marginal integrity.

Excretion of amino acid residues from diets based on wheat flour or oat bran in human subjects with ileostomies.

OBJECTIVES: The effect of consumption of a wheat-flour bread-based low-fibre diet (7.8 g/day fibre; 1.0 portion) or the same diet in which the wheat bread was exchange for a bread based on oat bran with a high fibre content (31.9 g/day fibre; 1.0 portion) on the ileal excretion of amino acid residues and crude protein was studied. DESIGN: The study was performed as a cross-over design. SETTING: The subjects were studied as outpatients except on the sampling days when all subjects were admitted to the research ward and stayed in a nearby patient hotel overnight. SUBJECTS: Seven men and three women, all proctocolectomised for ulcerative colitis, volunteered to participate in the study. One female subject was withdrawn from the study because of inflammation of the ileal stoma. INTERVENTIONS: During each dietary period of 3 weeks, food and excreta were collected and analysed on days 3 and 17. RESULTS: No significant differences in excretion of crude protein or amino acids (free and bound) were found between the two sampling days. Intake as well as excretion of all analysed amino acids was higher during the high-fibre diet period, although the relative proportion of amino acids was comparable in the two diets and their corresponding ileal effluents. Aspartic acid, glycine, threonine, alanine and serine were found in considerably higher relative proportions in the effluents from the subjects when they consumed each of the two diets than their concentrations in the diets. The apparent digestibilities were significantly (P < 0.05) lower for all analysed amino acids during the high-fibre diet period. Aspartic acid (10.7%), alanine (9.9%) and glycine (8.5%) showed a more pronounced decrease than the mean decrease in amino acid digestibility (6.6%) when subjects consumed the high-fibre diet. CONCLUSION: Intake of the oat bran high-fibre diet resulted in significantly lower amino acid and crude protein digestibility. The relative amino acid proportions in the diets and their corresponding excretas were, however, comparable for the two diets.

Effects of low-fat milk and fermented low-fat milk on cholesterol absorption and excretion in ileostomy subjects.

OBJECTIVE: To study small bowel cholesterol absorption and sterol excretion in order to explain possible serum cholesterol-lowering mechanisms of low-fat milk products. DESIGN: Two 24-h sterol balance studies with 1 litre of low-fat milk or one litre of fermented milk, in random order, added to a controlled diet. [3H]Cholesterol absorption was measured during each period. The results were compared to those on two 24-h periods with isocaloric amounts of lemonade given to the same basic diet, before and after the study. One litre of the two milk products was also consumed in addition to their normal diets in a cross-over design of 3 weeks and with run-in and run-out periods of 2 weeks each with 1000 ml of lemonade preceding the balance studies: SETTING: Outpatient clinic, where the subjects were eating their meals during the day and ileostomy bags collected. SUBJECTS: Nine ileostomy subjects, who have earlier participated in similar studies, volunteered for the study. All subjects completed the study. RESULTS: Cholesterol absorption was highest (66%) in the lemonade period, intermediate in the low-fat milk period (61%) and lowest in the fermented low-fat period (55%) (P < 0.05 for differences). Net cholesterol excretion (excretion minus intake) and calculated endogenous cholesterol excretion were significantly (P < 0.05 for differences) higher in the low-fat milk period than in the lemonade period and the fermented low-fat milk period. No significant change in serum cholesterol was, however, seen after 3 weeks on each milk regimen. CONCLUSION: Assimilation of cholesterol by microorganisms could possibly explain the reduced uptake of cholesterol with fermented milk. The mechanism behind the increased endogenous cholesterol excretion, induced by low-fat milk, is unclear.

Dental status, diet and cardiovascular risk factors in middle-aged people in northern Sweden.

The aim of the present study was to compare the dietary intake and the levels of traditional cardiovascular (CVD) risk factors in edentulous middle-aged individuals and individuals of the same age and sex who still had natural teeth. The study was performed within the framework of the MONICA-project. Population registers were used to sample randomly 1287 men and 1330 women aged 25-64 yr. Data were collected from a mailed questionnaire, blood analyses, registrations of blood pressure and anthropometric measures. The estimated daily energy intake did not differ between the two groups, but edentulous men and women ate more sweet snacks compared to those who still had teeth. Edentulous men also ate less fruits, vegetables and fibre and edentulous women ate more fat than dentates. Edentulous men and women were more obese and had lower serum HDL-cholesterol concentrations than those with remaining teeth. Edentulous women also had significantly higher concentrations of total cholesterol and triglycerides in serum than dentate women. Edentulous men and women were more often regular smokers, but not snuff users, than dentates of the same age and sex. Thus, the presence of two or more cardiovascular risk factors was more common in edentulous individuals than in those who still had natural teeth. In summary, these results support the hypothesis that edentulous middle-aged individuals have a more unfavourable risk factor profile for CVD. Counselling on balanced dietary habits and non-smoking given by dental personnel to orally diseased patients--recommendations given to improve resistance to dental caries or periodontitis--might therefore improve general health and possibly also improve risk factors for CVD.

Effect of oat bran on plasma cholesterol and bile acid excretion in nine subjects with ileostomies.

A higher excretion of dry matter, fat, nitrogen, energy, and total bile acids in ileal effluents; a lower plasma low-density-lipoprotein (LDL) and total cholesterols (12.1% and 9.0% lower respectively); but no change in plasma high-density-lipoprotein (HDL) cholesterol or apolipoproteins A-I and B were observed in nine subjects with ileostomies when they consumed an oat-bran, bread-based, high-fiber diet (HFD) as compared with a wheat-flour, bread-based, low-fiber diet (LFD) for 3 wk with a crossover design. Of the nine subjects only the subjects with a low daily excretion of bile acids had an elevated excretion of total bile acids during the HFD compared with the LFD. Total cholesterol, LDL cholesterol, and apolipoprotein B in plasma also decreased by 11.3%, 15.3%, and 10.7%, respectively, after consumption of the HFD for 3 wk.

The extent of coprophagy in rats with differing iron status and its effect on iron absorption.

The purpose of this study was to determine the prevalence of coprophagy in rats with differing iron status and its effect on the measurement of iron absorption from test meals with and without bran. Two experiments were performed using radioisotope-labelled microspheres added as a non-digestible marker for the ingested faeces and the diet and 59Fe added as a marker for the nonhaem iron in the test meal. In this study, coprophagy occurred at group mean rates of between 5 and 22% and was independent of the iron status of the rats or the presence or absence of bran in the diet. The relative absorption of iron, measured as the retention of 59Fe from a single meal, was affected to the same extent in groups with the same iron status, if it was affected at all. Thus comparisons of iron absorption from diets with and without bran should not be affected by coprophagy.