Chamber Obliteration Research Articles

Left ventricular geometry during unloading and the end-systolic pressure volume relationship: Measurement with a modified real-time MRI-based method in normal sheep.

The left ventricular (LV) end-systolic (ES) pressure volume relationship (ESPVR) is the cornerstone of systolic LV function analysis. We describe a 2D real-time (RT) MRI-based method (RTPVR) with separate software tools for 1) semi-automatic level set-based shape prior method (LSSPM) of the LV, 2) generation of synchronized pressure area loops and 3) calculation of the ESPVR. We used the RTPVR method to measure ventricular geometry, ES pressure area relationship (ESPAR) and ESPVR during vena cava occlusion (VCO) in normal sheep. 14 adult sheep were anesthetized and underwent measurement of LV systolic function. Ten of the 14 sheep underwent RTMRI and eight of the 14 underwent measurement with conductance catheter; 4 had both RTMRI and conductance measurements. 2D cross sectional RTMRI were performed at apex, mid-ventricle and base levels during separate VCOs. The Dice similarity coefficient was used to compare LSSPM and manual image segmentation and thus determine LSSPM accuracy. LV cross-sectional area, major and minor axis length, axis ratio, major axis orientation angle and ESPAR were measured at each LV level. ESPVR was calculated with a trapezoidal rule. The Dice similarity coefficient between LSSPM and manual segmentation by two readers was 87.31±2.51% and 88.13±3.43%. All cross sections became more elliptical during VCO. The major axis orientation shifted during VCO but remained in the septo-lateral direction. LV chamber obliteration at the apical level occurred during VCO in 7 of 10 sheep that underwent RTMRI. ESPAR was non-linear at all levels. Finally, ESPVR was non-linear because of apical collapse. ESPVR measured by conductance catheter (EES,Index = 2.23±0.66 mmHg/ml/m2) and RT (EES,Index = 2.31±0.31 mmHg/ml/m2) was not significantly different. LSSPM segmentation of 2D RT MRI images is accurate and allows calculation of LV geometry, ESPAR and ESPVR during VCO. In the future, RTPVR will facilitate determination of regional systolic material parameters underlying ESPVR.

The Use of a Novel Approach for the Instrumentation of a Cone-beam Computed Tomography–discernible Lateral Canal in an Unusual Maxillary Incisor: Case Report

Lateral and apical ramifications of the main root canal create potential pathways through which bacteria can spread and remain unaffected by treatment procedures. It is a challenge for the specialty to find techniques that can predictably reach, disinfect, and obturate these ramifications. Here, we report the use of a novel instrumentation approach to aid in the negotiation and management of a lateral canal discernible on cone-beam computed tomography (CBCT) in an unusual maxillary central incisor. A 23-year-old female patient was referred for evaluation and possible treatment of tooth 9. The periapical radiographic examination revealed pulp chamber obliteration, existence of a lateral lesion, and a possible complex internal root canal anatomy. The CBCT evaluation revealed the existence of a lateral lesion, a periapical lesion, an additional distopalatal canal, and a lateral canal exiting at the lateral lesion. The diagnosis of asymptomatic apical and lateral periodontitis of tooth 9 was reached. CBCT-aided access cavity preparation and scouting resulted in the successful negotiation of all canals, main and lateral. A novel instrumentation technique with precurved controlled memory files was used for the mechanical preparation of the lateral canal to a 25/04 enlargement. Obturaton of the lateral canal was achieved with a single gutta-percha cone and AH Plus Root Canal Sealer. At the 2-year follow-up, the patient was asymptomatic, and the 2-dimensional radiographic examinations revealed resolution of both the periapical and the lateral lesions. This case report describes the application of a novel instrumentation technique for the mechanical debridement of an infected lateral canal discernible on CBCT and reinforces the importance of treating the root canals as systems that possesses anatomic intricacies that need to be addressed.

Dentin Dysplasia Type I: Report of Two Cases

ABSTRACTObjectivesIn this article, we report two cases of type I dentin dysplasia (DD): the first case is subtype “d” DD and second case is severe form of DD type I, which presents all of four subtypes and describes characteristics and the management of this type of teeth anomalies.Materials and methodsDentin dysplasia is a rare abnormality of dentin that involves both primary and permanent dentition. The normal shape of crown, short roots or its total absence, pulp chamber obliteration, crescent-shaped pulp, pulp stone, and periapical radiolucencies are the characteristics of DD type I.ConclusionThere are many problems in the management of a patient with DD. Depending on root development and pulp canal situation, endodontic treatment and tooth extraction are applied in teeth with pulp necrosis and periapical abscess. The prognosis of DD largely depends upon the age at which the diagnosis is made, and the quality of the treatment provided.How to cite this articleElmi R Z, Azimi S, Jafari S, Farzanegan A. Dentin Dysplasia Type I: Report of Two Cases. Int J Experiment Dent Sci 2017;6(1):44-47.

Clinical observation of anterior chamber obliteration after silicone oil tamponade

Objective To investigate the relevant factors and treatment methods of anterior chamber obliteration (obliteratio camerae anterior) after silicone oil tamponade in vitrectomy surgery. Methods A total of 2560 eyes of 2560 patients who received vitrectomy and silicone oil tamponade were retrospectively analyzed, including 1476 cases who underwent lensectomy and inferior peripheral iridectomy. Anterior chamber obliteration after silicone oil tamponade occurred in 19 eyes of 19 cases, accounting for 0.74% among all of the 2560 eyes, and accounting for 1.29% among the patients who received vitrectomy, lensectomy and silicone oil tamponade. All those 19 eyes received lensectomy and inferior peripheral iridectomy. The peripheral lens capsule was completely removed in 16 eyes, and it remained in 3 eyes. If the anterior chamber disappeared after silicone oil tamponade, local mydriatic and miotic eyedrops was used alternatively. If anterior chamber could not form, the surgery of pressing iris and anterior chamber forming was performed. The intraocular pressure after the operation was observed closely. Results After the treatment with local mydriatic and miotic eyedrops, anterior chamber formed in 13 eyes (68.42%). The other 6 eyes (31.58%) accepted surgery, in which anterior chamber formed in 5 eyes after once operation, and it formed after twice operations and partly removing silicone oil in one eye. Conclusion Anterior chamber obliteration after vitrectomy and silicone oil tamponade may be associated with weaker function of iris sphincter. Long duration of fluid-gas exchange, and the complete removal of lens capsule might be risk factors. It is effective to apply mydriatic and miotic eyedrops alternatively for this situation. If necessary, the surgery of pressing iris and forming anterior chamber should be performed. Key words: Vitrectomy; Silicone oil tamponade eye; Lensectomy; Anterior chamber obliteration

Determination of the Frequency of Second Mesiobuccal Canal in Permanent Maxillary First Molar Teeth with Magnification Loupes (×3.5)

introduction: The mesiobuccal root of the maxillary first molar has generated more research and clinical investigation than any root. An inability to detect and treat a second mesiobuccal (MB2) canal is a reason for endodontic failure in maxillary first molars. Modifications in the endodontic access and detection techniques, along with advancements in illumination and magnification technology, have aided in the location and treatment with the second mesiobuccal canal of maxillary first molars. OBJECTIVE: To determine the frequency of the second mesiobuccal canal in the permanent maxillary first molars with magnification loupes (× 3.5). materialS and methods: A total of 53 teeth were assessed using a moderate magnification for second mesiobuccal canal in mesiobuccal root of first permanent maxillary molars in vivo. Detection of this canal in maxillary first molars was done through a clinical access cavity preparation under magnification loupes (× 3.5). Data was analyzed using SPSS 15.0. Frequency distribution of variables was determined and the level of significance was kept at 0.05. RESULTS: We were able to detect second mesiobuccal canal in 27 out of 53 (50.9%) of the permanent maxillary first molars that were studied. It was found that the males tend to have a higher proportion of second mesiobuccal canals (up to 31%) as compared to the females in whom the second mesiobuccal canals could be identified only 19% of the time. Whilst, there was no association found between age, gender and chamber obliteration with the presence of second mesiobuccal canal. CONCLUSIONS: In conclusion, within its limitations, this study suggested that the use of magnification loupes enhanced both the detection (50.9%) and negotiation (86.8%) of the second mesiobuccal canals in the permanent maxillary first molars beyond what could be achieved with naked eye.

Potential Correlation between Statins and Pulp Chamber Calcification

Introduction3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) are the first-line pharmaceuticals for the prevention and treatment of dyslipidemia. A recent investigation has shown that statins induced odontoblastic differentiation of dental pulp stem cells. Statins enhance the differentiation of human dental pulp cells by up-regulating mineralization nodules and odontogenic markers. This study tested the hypothesis that the systemic administration of statins results in increased dental pulp calcification. MethodsThis retrospective case-control study used digital bitewing radiographs of mandibular molars. Subjects (N = 90) aged ≥60 years were assigned to either test (n = 45) or control (n = 45) groups based on the systemic use of statins. The dimensions of the pulp chambers were measured using a standardized method for height and mesiodistal distances. The chi-square test was used to analyze the data. Multiple linear regression model analysis was performed to explore the association between statin intake and pulp calcification. ResultsThree of the 45 mandibular molars in the test group exhibited almost complete pulp chamber obliteration. There was a significant reduction in pulp chamber height ratio shown in the statin group compared with the control group (P < .0001). When the mesiodistal width was compared between the 2 groups, there was no significant difference (P = .3730). ConclusionsThe significant increase of calcification and loss of vertical height of the pulp chamber observed in mandibular molars in patients on statin medication indicated a possible increased odontoblastic activity. Therefore, systemic statins could be a contributing factor for pulp chamber calcification.

Ocular Anterior Segment Dysgenesis upon Ablation of p120 Catenin in Neural Crest Cells

Development of the ocular anterior segment depends largely on periocular mesenchyme cells, which are derived predominantly from neural crest cells (NCC). Specific and differential cell adhesion is expected to be instrumental in induction, migration, and differentiation of NCC. As p120 catenin (ctn) is an important component of cadherin-catenin cell adhesion complexes, we assessed its role in development of the anterior segment structure. We generated conditional p120ctn(fl/fl);Wnt1Cre knockout mice and studied the effect of this gene ablation on eye development in vivo. In addition, p120ctn was knocked down in vitro. Wnt1Cre-mediated deletion of floxed p120ctn alleles in NCC resulted in serious ocular anterior segment dysgenesis (ASD), including iridocorneal angle closure, complete anterior chamber obliteration, iris and ciliary body hypoplasia, corneal malformation and opacity, and glaucoma-like defects. A completely penetrant phenotype was visible approximately three weeks after birth, but histologic defects were obvious at embryonal day 18.5 (E18.5). Neither migration of NCC nor expression of key transcription factors appeared to be affected. In contrast, the N-cadherin expression pattern was changed significantly in iridocorneal angle cells and corneal endothelium. A human trabecular meshwork cell line in which p120ctn was knocked down also showed decreased expression levels of N-cadherin and β-catenin at the plasma membrane, but no defect in cell migration. p120ctn has a critical role in ocular mesenchyme development. Loss of p120ctn and the associated N-cadherin downregulation in NCC leads to ASD without affecting cell migration. p120ctn abnormalities might have a role in the pathophysiology of mammalian eye development.

Clinical study on secondary glaucoma after traumatic cataract with obliteratio camerae anterior

Objective To study the treatment of the anterior chamber obliteration of traumatic cataract with secondary glaucoma after the eyeball perforation wound.Method 12 cases (12 eyes) with traumatic cataract with secondary glaucoma after eye perforation wound were following the cataract phacoemulsification immediately and (or) vitrectomy,after the surgery,follow-up for 6 - 24 months.Results The anterior chamber formed,the intraocular pressure (IOP) contralled after surgery.Postoperative visual acuity improved obviously than preoperation,with no decompensation of corneal endothelium.Conclusion To the traumatic cataract with secondary glaucoma after the eyeball perforates the wound partner and the anterior chamber vanishing,Removing the pupillary blocking by phacoemulsification cataract surgery is key factor to form anterior chamber,and can get good results. Key words: Eyeball penetrating wound; Cataract,traumatic; Glaucoma,secondary; Obliteratio camerae anterior; Phacoemulsification

Variation of dentin dysplasia type I: report of atypical findings in the permanent dentition

Dentin dysplasia is a rare defect of dentin development with an autosomal dominant pattern of inheritance, which is generally divided into 2 main classes based on the clinical and radiographic appearance of the affected dental tissues: type I, which affects the root portion and type II, which affects the coronal portion of the tooth. This paper reports the case of a child aged 10 years and 8 months with both classic and atypical features of dentin dysplasia type I in the permanent dentition. Only few mandibular teeth were affected and presented clinically normal appearing crowns, moderate to severe mobility, short, blunt or almost absent roots. However, no evidence of pulp chamber obliteration or periapical radiolucencies was found. The clinical and radiographic characteristics observed in this patient are different from those reported in the literature, which suggests that this may be a variation of dentin dysplasia type I expression.

Significance of Left Ventricle Chamber Obliteration in Dobutamine Stress Echocardiography

Significance of Left Ventricle Chamber Obliteration in Dobutamine Stress Echocardiography