Buccal Area Research Articles

Review of Brazilian jawfishes of the genus Opistognathus with descriptions of two new species (Teleostei, Opistognathidae)

A new species of jawfish, Opistognathusthionyisp. n., is described from the Vitória-Trindade Chain and Fernando de Noronha Archipelago off Brazil, a disjunct distribution of ca. 1,800 km. Opistognathusthionyi and its allopatric Caribbean sister-species, Opistognathusmaxillosus, both have a wide, fan-like upper margin of the subopercular flap and mostly over-lapping meristic data. The new species differs from O.maxillosus in having the darkest spot on the spinous dorsal fin, when present, between spines 2–5, versus always present between spines 6–9, the buccal area surrounding the esophageal opening pale versus very dark and fewer oblique scale rows in longitudinal series (45–52 vs. 69–85). A second new species, Opistognathusvicinussp. n., known from Brazil’s mainland, has completely over-lapping meristic values with its allopatric Caribbean sister-species O.whitehursti, but differs in lacking vomerine teeth and a supramaxilla and retaining the juvenile color pattern of the latter species in adults. Diagnoses, photographs, an identification key, and distributional maps are given for all Brazilian species of Opistognathus.Molecular phylogenetic analysis of partial cytochrome c oxidase subunit-I sequences indicates that specimens of the two allopatric pairs, O.thionyi – O.maxillosus and O.vicinus – O.whitehursti, form reciprocally monophyletic groups that differ from each other on average by 9 to 11%, with less than 1% average pair-wise genetic distance within-species. Similar patterns of phylogenetic structure were observed between reciprocally monophyletic (predominately allopatric) groups within nominal species of Opistognathusaurifrons, suggesting the possibility of at least two additional undescribed species from the Brazilian Province.

SMAS Plication in Superficial Plane & Bichectomy in Facial Lifting

The facial lifting show a favorable evolution in the last years; some technical modifications and the mixture with another procedures can make a more favorable results, with predictability and low morbidity. The aim of this paper is to show a mixture of two surgical techniques to obtain complimentary results in facial lifting. The technique of facial lifting with SMAS plication and bichectomy are frequently used in facial plastic surgery; the combined work of both procedures allow a reduction in the adipose tissue in the lateral and middle side of the buccal area, showing better esthetical results with a low morbidity.

Periimplant soft tissue volume changes after connective tissue grafting. The autologous connective tissue graft vs. the porcine collagen matrix. A clinical follow‐up case series

Background The thickness of peri-implant soft tissue is very important in the high risk esthetic area. Especially in advanced cases, i.e. high lip line, thin gingival biotype, loss of soft or hard tissues or bony atrophy, soft tissue grafting can be indicated in order to avoid gingival recession and periimplantitis. Gold standard is the autologous subepithelial connective tissue graft (SCTG) of the palate. To avoid tissue removal, porcine collagen matrices have been introduced as possible alternatives. Aim/Hypothesis This clinical study evaluates a porcine collagen matrix (CM) in comparison to the subepithelial connective tissue graft (SCTG) from the palate for soft tissue thickening around implants with a 3D follow- up. Material and Methods Patients (n = 12) were included after implant placement in the esthetic area with buccal tissue deficit. At the time point of implant exposure, buccal soft tissue were either thickened with the CM (n = 6) or the SCTG (n = 6). Impressions with a scan optimized vinylsiloxanether (Identium® Scan, Kettenbach GmbH, Eschenburg, Germany) were taken before augmentation (i), after surgery (ii), after 10 (iii), 30 (iv), 90 (v) and 180 days (vi). The impressions were optically scanned with a high precision scanner (Atos II Triple Scan, GOM GmbH, Braunschweig, Germany). The acquired data was visualized and superimposed with the ATOS Professional software (GOM GmbH, Braunschweig, Germany). The region of interest (ROI) was defined at the buccal area from the margin of the suprastructure to the mucogingival junction at the implant site and to the 2 adjacent teeth (primary outcome variable- volume increase in mm3+ secondary outcome variables- volume increase in%, mean and maximum thickness increases in mm. Results The evaluation of the region of interest at the different time points showed that there was a volume increase in both groups after surgery. After ten days, volume further increased in the SCTG group (183.88 mm3 = 139.03%) compared to the CM group (80.74 mm3 = 71.03%). This was a thickness increase (mm) of 2.31 mm in the SCT group and 1.12 mm in the CM group. Volume and thickness decreased in both groups over time (6 months- SCTG- 61.75 mm3 = 43.61%+ CM- 19.56 mm3 = 18.24%). This resulted in a thickness increase of 0.3 mm in the CM and 0.8 mm in the SCTG group with statistically significant difference after 6 months. Conclusions and Clinical Implications After 6 months, soft tissues thickness gain with the use of the porcine collagen matrix was significantly lower than with the use of the autologous subepithelial connective tissue graft. The SCTG still remains the gold standard for such procedures.

Accessory auricle: Classification according to location, protrusion pattern and body shape.

BackgroundAccessory auricles (AAs) are common congenital anomalies. We present a new classification according to location and shape, and propose a system for coding the classifications.MethodsThis study was conducted by reviewing the records of 502 patients who underwent surgery for AA. AAs were classified into three anatomical types: intraauricular, preauricular, and buccal. Intraauricular AAs were divided into three subtypes: intracrural, intratragal, and intralobal. Preauricular AAs were divided into five subtypes: precrural, superior pretragal, middle pretragal, inferior pretragal, and prelobal. Buccal AAs were divided into two subtypes: anterior buccal and posterior buccal. AAs were also classified according to their protrusion pattern above the surrounding surface: pedunculated, sessile, areolar, remnant, and depressed.Pedunculated and sessile AAs were subclassified as spherical, ovoid, lobed, and nodular, according to their body shape. Cartilage root presence and family history of AA were reviewed. A coding system for these classifications was also proposed.ResultsThe total number of AAs in the 502 patients was 1,003. Among the locations, the superior pretragal subtype (27.6%) was the most common. Among the protrusion patterns and shapes, pedunculated ovoid AAs were the most common in the preauricular (27.8%) and buccal areas (28.0%), and sessile lobed AAs were the most common in the intraauricular area (48.7%). The proportion of AAs with a cartilage root was 78.4%, and 11% of patients had a family history. The most common type of preauricular AA was the superior pretragal pedunculated ovoid AA (13.2%) with a cartilage root.ConclusionsThis new system will serve as a guideline for classifying and coding AAs.

Smith\u2013Lemli\u2013Opitz syndrome presenting as acute adrenal crisis in a child: a case report

BackgroundSmith–Lemli–Opitz syndrome is a rare autosomal recessive disorder of cholesterol biosynthesis which is characterized by multiple congenital malformations and global developmental delay. Here we report the case of a 3-year-old, previously undiagnosed, child with Smith–Lemli–Opitz syndrome presenting with acute adrenal crisis, which is an extremely rare and atypical presentation of this disease.Case presentationA 3-year-old Sri Lankan Sinhalese boy without evidence of infection presented with circulatory collapse. He had a normal perinatal period; however, his early infancy was complicated by poor feeding, episodes of loose stools, failure to thrive, and several episodes of unexplained drowsiness. His weight, height, and occipitofrontal circumference were well below the third percentile. He had soft dysmorphic features that included microcephaly, bitemporal narrowing, upward slanting eyes, epicanthal folds, partial ptosis, broad nasal bridge, low set posteriorly rotated ears, high arched palate, and short neck. Marked hyperpigmentation was noted in perioral, buccal, and palmar areas. His pulses were rapid and low in volume and his systolic blood pressure was low. Initial resuscitation was performed by administering multiple crystalloid fluid boluses. A septic screen was negative. His blood glucose and serum bicarbonate levels were low and serum electrolytes revealed hyponatremia with hyperkalemia. Serum spot cortisol level was low normal and 17-hydroxyprogesterone level was low. Diagnosis of Smith–Lemli–Opitz syndrome and associated adrenal crisis was made based on clinical and biochemical features. Intravenously administered hydrocortisone was commenced to which he showed a marked clinical response.ConclusionsThis case describes a rare and atypical presentation of Smith–Lemli–Opitz syndrome and highlights the importance of making early and accurate syndromic diagnoses in children with dysmorphism to avoid sudden and life-threatening complications.

Do Implant Surgical Guides Allow an Adequate Zone of Keratinized Tissue for Flapless Surgery?

A major advantage of guided implant surgery using 3-dimensionally printed guides is the ability to perform accurate flapless surgery.A drawback of a flapless technique is the inability to manipulate soft tissue to ensure sufficient gingiva around the implant. The purpose of this study was to determine how often flapless surgery using surgical guides results in less than 2mm of keratinized tissue surrounding the implant. This retrospective analysis included 27 maxillary and 27 mandibular implant sites that underwent treatment planning for implant-guided surgery using 3Shape Implant Studio (3Shape, Copenhagen, Denmark).Intraoral scan images were used to measure the width of the keratinized tissue on the buccal aspect of each implant site in both arches and the lingual aspect in the mandibular arch. Three examiners measured the amount of buccal and lingual keratinized tissue in millimeters at each implant site. Analysis of variance (P<.05) and correlation coefficients were used to determine statistically significant differences in keratinized tissue among sites. No statistically significant difference was found either between the widths of buccal keratinized tissue in the maxillary anterior (4.06±1.42mm) and posterior (4.93±2.54mm) areas (P=.293) or between the amounts of buccal and lingual keratinized tissue in the mandible (P=.995). The keratinized tissue width in the maxillary buccal area was significantly different (4.48±2.04mm) from that in the mandibular posterior buccal (1.98±1.41mm) and lingual (1.98±1.23mm) areas (P<.001). Over 77% of maxillary implant sites had greater than 3mm of gingiva, and just over 20% had sufficient gingiva in the mandible. Adequate keratinized tissue was found in most of the planned maxillary implant sites, whereas most of the mandibular posterior implant sites had inadequate keratinized tissue. Therefore, elevation of a flap to preserve and reposition existing keratinized tissue around implants should be considered when planning to use tooth-borne surgical guides in the posterior mandible.

Three new Troglodytella and a new Gorilloflasca ciliates (Entodiniomorphida) from mountain gorillas (Gorilla beringei beringei) in Rwanda

Four new species, Troglodytella gracilis, T. virunga, T. dolium, and Gorilloflasca longior were described from the mountain gorillas in Rwanda. The three Troglodytella species share a retractable adoral ciliary zone, four non-retractable ciliary arches, two broad skeletal plates, a skeletal rod plate, numerous longitudinal cortical grooves, and four contractile vacuoles. The anterior ciliary arch is the longest of the four arches, extending transversely on the left body surface. T. gracilis and T. virunga are characterized by an elongated body, a tail flap, and a wedge-shaped macronucleus. T. virunga can be distinguished from T. gracilis by a trifurcate dorsal lobe, three right lobes, and two ventral spines. T. dolium has a barrel-shaped body and a rod-shaped or boomerang-shaped macronucleus. The buccal infraciliature of the three Troglodytella is composed of an adoral polybrachykinety, a perivestibular polybrachykinety, and paralabial kineties. G. longior has a long flask-shaped body, a vestibulum, a frontal lobe, a posterior cavity, an ellipsoidal or peanut-shaped macronucleus, a contractile vacuole, non-retractable adoral and vestibular ciliary zones in buccal area, a cavity ciliary zone, and two longitudinal dorsal ciliary zones. The infraciliature of G. longior is the same as that of G. africana.

Effectiveness of bipaddled anterolateral thigh perforator flap in repair of through-and-through maxillofacial defect after oral cancer ablation

To investigate the effectiveness of bipaddled anterolateral thigh perforator flap in repair of through-and-through maxillofacial defect following oral cancer ablation. Between January 2008 and December 2016，42 patients with oral cancer were treated. There were 31 males and 11 females with an average age of 44.5 years (range, 31-68 years). There were 28 cases of buccal mucosa carcinoma, 10 cases of basal cell carcinoma of buccal skin, 3 cases of gingiva carcinoma, and 1 case of recurrent parotidduct carcinoma. The disease duration ranged from 1 to 24 months (mean, 13.5 months). The size of through-and-through maxillofacial defect ranged from 6.0 cm×4.5 cm to 9.0 cm×7.0 cm. All defects were repaired with the bipaddled anterolateral thigh perforator flap. The paddles were adjusted to repair the buccal area. And the size of flap ranged from 7 cm×5 cm to 10 cm×8 cm. The donor sites were closed directly. The operation time was 4.5-7.5 hours (mean, 5.5 hours). All flaps healed and the wounds of recipient and donor sites healed by first intention. All patients were followed up 9-60 months (mean, 22 months). All patients were satisfied with their facial appearance and the speech function. The range of mouth opening was 3-5 cm. Three patients died of recurrence during the follow-up period and the other patients were alive. The bipaddled anterolateral thigh perforator flap is flexible and reliable for the through-and-through maxillofacial defect reconstruction following oral cancer ablation.

Fracture resistance of veneers in premolars.

Objective:The purpose of the study was to compare the fracture resistance of ceramic veneers and composite resin veneers with and without dental preparation.Materials and Methods:Forty freshly extracted mandibular premolars were selected and randomly assigned into four groups (n = 10): Group NPR = no dental preparation and direct veneer with 0.2 mm thick composite resin (Amelogen Plus, Ultradent); Group NPC = no dental preparation and 0.2 mm thick lithium disilicate ceramic veneer (IPS e.max Press, Ivoclar Vivadent); Group P2C = Tooth preparation of 0.2 mm and 0.2 mm thick ceramic veneer (IPS e.max Press); and Group P5C = Tooth preparation of 0.5 mm and 0.5 mm-thick ceramic veneer (IPS e.max Press). In all groups, the restorations covered 1 mm of the occlusal surface of the buccal cusp, and the thickness of this area was the same of the buccal area (0.2 mm or 0.5 mm). After the luting procedure, all groups were thermocycled (10,000 cycles, 5°C–55°C) and subjected to fracture resistance test under compression (Instron 4444 with a crosshead speed of 0.5 mm/min). The mode of failure analysis was performed under a ×10 magnification. Data were subjected to one-way ANOVA and Duncan's post hoc test (P < 0.05).Results:The mean fracture resistance (men ± standard deviation) was NPR = 690.33 ± 233, NPC = 790.52 ± 408, P2C = 1131.34 ± 341, and P5C = 983.56 ± 202. There were significant differences of the fracture resistance values between all groups (P = 0.013). NPR and NPC groups showed mean values of fracture resistance significantly lower than P2C. However, P5C presented intermediate values without a significant difference from the other groups. The mode of failure for all groups was mixed (60%), cohesive failures (20%), root failures (15%), and adhesive failures (5%).Conclusion:Minimally invasive tooth preparation (0.2-mm) allowed to achieve higher fracture resistance in premolars restored with lithium disilicate ceramic veneers. Attention should be given to the 0.5 mm preparation since catastrophic fractures only happened when this preparation depth was performed.

Stress distribution pattern in roots of incisors with various root resorptions: A finite element study

Objectives Root resorption is a dangerous side effect in orthodontics, and maxillary incisors are at the highest risk for root resorption. It is important to understand optimal force considerations for patients with altered root lengths.The purpose of this study was to investigate the effects of root length on stress distribution on roots by means of three-dimensional finite element method (FEM).Methods Three dimensional FEM models of maxillary central and lateral incisors were made. Then, root length of the incisors was changed in the increments of 1 mm from 0-4 mm. Applying 50 g (0.5 N) of force perpendicular to the tooth crown simulated uncontrolled tipping. Stresses and strains for each model were calculated and Pearson correlation coefficient was used to analysis the data.Results There were significant correlations between root length of incisors and maximum stress in PDL. In the centrals with various root lengths, maximum stress was between 0.010884 and 0.056520 MPa, and in the laterals, it was between 0.027297 and 0.221040 MPa. By reducing root length of incisors, the maximum stress in buccal apical (r= 0.933,p<0.001 and 0.995, p<0.001 prospectively) and lingual crestal areas (r= 0.974 p=0.005 and 0.992, p=0.001 respectively) were reduced.Conclusion Although in lateral incisors, stress at the lingual crestal area was more than buccal apical area, in central incisors with more than 2 mm resorption, the stress distribution of buccal apical was higher. Therefore, in maxillary central incisors with more root resorption, force control might be even more critical.

An ecomorphospace for the Ammonoidea

AbstractThe fossil conchs of ammonoids provide valuable information about the life habits of this extinct group. A new conch measurement, the apertural surface area (ASarea), is introduced here along with modeled sizes of the buccal mass and the hyponome, based on ratios of these organs in comparison with the aperture height from the RecentNautilus pompilius. A principal components analysis was performed using the three main characters: (1) apertural surface area index (i.e., the ratio of the apertural surface and the conch diameter), (2) buccal mass area index (i.e., the ratio between the buccal mass area and the ASarea), and (3) coiling rate of the conch. It revealed an ecomorphospace where life history traits can be tentatively assigned to species of the Ammonoidea. In this morphospace, RecentNautilushas a marginal position, being one of the ectocochleate cephalopods with best properties for active life (capacity for handling large food items, rather good mobility). In contrast, most ammonoids possessed, at comparable conch sizes, much smaller buccal apparatuses and hyponomes, suggesting a more passive life history with reduced mobility potential and reduced capacities for larger prey items.

Anthelmintic efficacy of cranberry vine extracts on ovine Haemonchus contortus

The discovery that plant secondary compounds, including proanthocyanidins (PAC), suppress gastrointestinal nematode (GIN) infection has provided promise for alternative methods of GIN control in small ruminants. This investigation is the first to examine the anthelmintic potential of cranberry vine (CV) against the GIN Haemonchus contortus. The purpose of this study was to explore the anti-parasitic activity of CV in the form of a specific organic proanthocyanidin extract (CV-PAC) and an aqueous extract (CV-AqE) containing PAC and other compounds. In vitro egg hatching, first (L1) and third (L3) stage larval and adult worm motility and L3 exsheathment were evaluated after a 24-h incubation with CV products. In addition, CV treated worms were observed via scanning electron microscopy, and a preliminary investigation of the efficacy of CV powder against an experimental infection of H. contortus was conducted. The in vivo effect on an experimental infection was determined by administering 21.1 g CV powder to lambs (n = 9 per group) for three consecutive days, and collecting fecal egg count data for four weeks post-treatment. The effect of CV-PAC on egg hatching, L3 motility and exsheathment was limited. However, a substantial effect was observed on motility of post-hatch L1 (EC50 0.3 mg PAC/mL) and adults (EC50 0.2 mg PAC/mL). The CV-AqE showed more effect on egg hatching (EC50 5.3 mg/mL containing 0.6 mg PAC/mL) as well as impacting motility of L1 (EC50 1.5 mg/mL with 0.2 mg PAC/mL) and adults (EC50 3.4 mg/mL with 0.4 mg PAC/mL), but like CV-PAC, did not substantially effect L3 motility or exsheathment. Scanning electron microscopy revealed an accumulation of aggregate on the cuticle around the buccal area of adult worms incubated in CV-AqE and CV-PAC. In the preliminary in vivo study, there was a significant effect of treatment over time (p = .04), although differences in individual weeks were not significant. In summary, both extracts inhibited motility of L1 and adult worms. The higher efficacy of CV-AqE than CV-PAC at levels that contained the same concentrations of PAC tested alone, suggest that other secondary compounds in the CV-AqE contributed to the observed effects on the parasites. This first study of the in vitro and in vivo effects of CV suggest that this readily available plant product may have utility in integrated control of H. contortus and support the need for additional testing to provide further information.

Adverse Drug Events in Puppies Following Treatment with Amoxicillin with or without Clavulanate

This study reports adverse drug events (ADEs) in puppies following treatment with amoxicillin with or without clavulanate. A prospective and observational multicentre study was conducted in five Veterinary clinics in Nigeria where 63 heterogeneous puppies with parvovirus enteritis were used. Puppies in group A (n=36) were treated with amoxicillin alone (n=16), or with clavulanate (n=20) by IV route, whereas group B (n=27) were administered amoxicillin alone by IM route. All puppies were administered a single dose of 15mg/kg, thereafter, observed for ADEs within 3 hours. Those that manifested ADEs were subsequently administered 2mg/kg IV single dose of diphenhydramine. Out of 63 puppies, 12(18.5%) had diarrhoea, hyper-salivation, cutaneous erythema, and swellings around eyelids and buccal areas within 5 minutes post-treatments. These were observed only in puppies treated by IV route, where 5/16(31.3%) of those administered amoxicillin with clavulanate, and 7/20(35%) of those treated with amoxicillin alone showed these signs, which resolved following diphenhydramine administration. No ADEs were observed after subsequent treatment of the affected puppies with amoxicillin alone by IM route. Although amoxicillin is usually well tolerated, this study recommends that veterinarians should be cautious when it becomes neccessary to treat dogs with amoxicillin alone or with clavulanate by IV route to circumvent these ADEs.

Effect of freeze drying on stability, thermo-responsive characteristics, and in vivo wound healing of erythropoietin-loaded trimethyl chitosan/glycerophosphate hydrogel.

Erythropoietin (EPO) was successfully incorporated into a bioadhesive thermosensitive hydrogel based on trimethyl chitosan (TMC)/β-glycerophosphate (GP) for prevention and treatment of oral mucositis in cancerous patients. The aim of the present study was to evaluate the effect of freeze drying on thermo-responsive property of the hydrogel and structural stability of the loaded protein. The freeze-dried EPO-loaded hydrogel were characterized using various methods. Gelation property by rheological analysis, EPO aggregation in formulations by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), protein secondary structure by far ultraviolet-circular dichroism (CD), and the antigenic activity of EPO with ELISA techniques. The healing effects of the freeze-dried formulation was also investigated in Sprague-Dawley rats with chemotherapy-induced mucositis and compared with freshly prepared mixture. Finally, the retention time of the gel in the oral cavity was assessed in healthy volunteers. SDS-PAGE, CD, and ELISA confirmed the stability of conformational structure of loaded and released EPO. Severity of mucositis was markedly reduced in animals treated with freeze-dried EPO hydrogel; whereas the group received normal saline did not show any significant healing. EPO salvia level was decreased rapidly following EPO solution compared to the gel application. Approximately, 40% of EPO was maintained on the buccal areas in patients receiving the hydrogel system after 30 min. Therefore, the TMC/GP could preserve EPO stability after freeze drying and has the potential in the treatment of oral mucositis and other oral or subcutaneous wounds.

Effect of inadequate ferrule segment location on fracture resistance of endodontically treated teeth.

The circumferential 2 mm ferrule during the fabrication of the crown is strongly advocated for the long-term clinical success. During the routine clinical practice, the dentist encounters the endodontically treated tooth (ETT) with inadequacy of the ferrule in some segment due to caries, abrasion, and erosions. The aim of this in vitro study was to investigate the consequence of inadequate segmental ferrule location on fracture strength of the root canal-treated anterior and posterior teeth. Fifty each maxillary canine and mandibular premolar intact human teeth were root canal treated and sectioned at 2 mm above the cementum-enamel junction. The teeth samples were divided into 5 groups of 10 each. The G-I and G-V samples had the 360° ferrule and complete absence of the ferrule, respectively. The G-II had the inadequate ferrule on the palatal surface, while G-III and G-IV had inadequate ferrule at buccal and proximal area. Teeth samples were subsequently restored with glass-reinforced fiber post, composite core, and full veneer metal crown. The samples were tested with universal testing machine under static load to record the fracture resistance. The acquired data were subjected to ANOVA and Tukey's post hoc statistical analysis. The G-I with circumferential ferrule showed the higher fracture resistance. The teeth samples with lack of the ferrule had the least fracture resistance. Among the segmental absence of ferrule, teeth samples with lack of the proximal ferrule were least affected. Deficiency of a ferrule on the lingual wall significantly affected the fracture strength in both anterior and posterior ETT. The ETT with sectional inadequacy of the ferrule is significantly more effective in resisting the fracture in comparison to the complete absence of the ferrule.

Comparative Evaluation of Marginal Accuracy of Metal Copings Fabricated using Direct Metal Laser Sintering, Computer-Aided Milling, Ringless Casting, and Traditional Casting Techniques: An In vitro Study.

Purpose:The purpose of the study is to determine the amount of marginal discrepancy produced by Co-Cr copings fabricated using various fabrication methods which include direct metal laser sintering (DMLS), computer-aided milling, traditional casting, and ringless casting and compare the values obtained between each fabrication technique and to evaluate if the fabrication technique can produce prosthesis that is within the standards of clinical acceptance of marginal discrepancy.Materials and Methods:Ten metal copings were fabricated by DMLS, computer-aided milling, traditional casting, and ringless casting. Marginal gap at the buccal, lingual, mesial, and distal areas was measured using silicone replica technique. A digital microscope was used to measure the silicone layer. Statistical analysis was done using one-way ANOVA test and post hoc Bonferroni test to test the difference between the fabrication method and categories of measured points, respectively.Results:The values indicate that the marginal gap was least for the copings fabricated using ringless casting followed by traditional casting and DMLS. The widest gap was seen in copings fabricated using computer-aided milling. Analysis of results showed statistically significant difference between copings fabricated using computer-aided milling and traditional casting (P = 0.029 and 0.043 – mesial and distal, respectively) and computer-aided milling and ringless casting (P = 0.002 and 0.001 – mesial and distal, respectively).Conclusion:Even though the marginal gap was found to vary with the fabrication method, all measurements of marginal gap of all groups were well within the standard clinical acceptance of 120 μ.

In vitro and clinical evaluation of optical coherence tomography for the detection of subgingival calculus and root cementum.

This study evaluated the effectiveness of swept-source optical coherence tomography (ss-OCT) for detecting calculus and root cementum during periodontal therapy. Optical coherence tomography (OCT) images were taken before and after removal of subgingival calculus from extracted teeth and compared with non-decalcified histological sections. Porcine gingival sheets of various thicknesses were applied to the root surfaces of extracted teeth with calculus and OCT images were taken. OCT images were also taken before and after scaling and root planing (SRP) in human patients. In vitro, calculus was clearly detected as a white-gray amorphous structure on the root surface, which disappeared after removal. Cementum was identified as a thin, dark-gray layer. The calculus could not be clearly observed when soft tissues were present on the root surface. Clinically, supragingival calculus and cementum could be detected clearly with OCT, and subgingival calculus in the buccal cervical area of the anterior and premolar teeth was identified, which disappeared after SRP. Digital processing of the original OCT images was useful for clarifying the calculus. In conclusion, ss-OCT showed potential as a periodontal diagnostic tool for detecting cementum and subgingival calculus, although the practical applications of subgingival imaging remain limited.

Stability of secondarily inserted orthodontic miniscrews after failure of the primary insertion for maxillary anchorage: Maxillary buccal area vs midpalatal suture area

Few studies have examined the secondary insertion of orthodontic miniscrews after failure of the first insertion. We investigated both the primary and secondary success rates of miniscrews used for maxillary anchorage and compared the stability of the maxillary buccal area (MB) and the midpalatal suture area (MP). In total, 387 miniscrews were primarily inserted into the MB (between the second premolar and first molar); of these, 81 (20.9%) miniscrews lacked stability and were reinserted into the MB (same position or more distal position) or the MP. Additionally, 84 miniscrews were primarily inserted into the MP; 13 (15.5%) of those lacked stability and were reinserted into the MP. We calculated and compared the primary and secondary success rates in each area. Moreover, we investigated the factors affecting clinical success. Although the success rate of the secondary insertion was significantly lower than that of the primary insertion into the MB, miniscrews inserted into the MP were stable in both primary and secondary insertions. The screw length was significantly associated with the stability of miniscrews inserted into the MB. For secondary insertions, miniscrews placed in the MP may be more stable than those inserted in the MB.

A novel technique in the treatment of post traumatic parotid duct sialocele

&lt;p&gt;Stenson's duct of parotid gland is a major duct which drains saliva into the oral cavity. Deep penetrating wound in the form of cut or crush injury to the buccal area carries the risk of parotid duct injury. It is in the form of ductal exposure, laceration, total severing, or crushing of the duct. These conditions are difficult to diagnose because of complex anatomy and variable nature of injury. Successful management of parotid duct injury depends on early diagnosis and appropriate intervention, failing of which may lead to complications like sialocele or salivary fistula. Many techniques have been proposed for diagnosis and management of parotid duct injuries. This article presents an easy and an innovative technique to diagnose and manage the parotid duct injuries using an "epidural catheter" which is often used for inducing spinal anesthesia. The technique of epidural catheter usage, its advantages, and limitation over other techniques proposed for the management of parotid duct injury are discussed. &lt;/p&gt;

Facial soft tissue volume decreases during metreleptin treatment in patients with partial and generalized lipodystrophy.

Lipodystrophy (LD) patients suffer from loss or maldistribution of subcutaneous adipose tissue accompanied by dysregulation of several adipocyte-secreted factors, e.g., leptin. The effect of recombinant leptin (metreleptin) therapy on facial soft tissue volume in patients with non-human immunodeficiency virus LD has not been quantified to date. Eight LD patients (six female, two male; six familial partial LD [FPLD], two generalized LD) were treated with metreleptin over 1 year. Anthropometric parameters and 3D stereophotogrammetric imaging of the patients´ faces were assessed at baseline and after 1 year of metreleptin treatment. Median fat mass was significantly reduced during metreleptin treatment from 22.3 kg at baseline to 20.0 kg at 1 year (p = 0.031); however, body weight, body mass index, and waist-to-hip ratio were not significantly affected. Five of the six patients with FPLD lost between 4 and 114 cm3 of facial soft tissue volume in the pre-auricular, buccal, and submandibular area during metreleptin treatment whereas a slight volume gain was seen in one FPLD patient. The two patients with generalized LD developed a volume loss of 20 and 8 cm3 in the buccal region between baseline and 1 year of metreleptin therapy, respectively. Metreleptin replacement leads to loss of facial soft tissue volume in FPLD and generalized LD. However, volume changes in most patients are not visible by the naked eye.