T-Bar clasp-retained removable partial denture as an alternative to implant-based prosthetic treatment

This article reports the case of a 55-year-old female patient who presented with unsatisfactory temporary crowns in the right mandibular premolars and molars, and a premolar-to-molar fixed partial denture in the left side. The clinical and radiographic examinations revealed a fracture of the left first premolar that was a retainer of the fixed partial denture and required extraction. Initially, the acrylic resin crowns were replaced by new ones, and a provisional RPD was made using acrylic resin and orthodontic wire clasps to resolve the problem arising from the loss of the fixed partial denture. Considering the patient's high esthetic demands, the treatment options for the definitive prosthetic treatment were discussed with her and rehabilitation with implant-supported dentures was proposed because the clinical conditions of the residual alveolar ridge were suitable for implant installation, and the patient's general health was excellent. However, the patient did not agree because she knew of a failed case of implant-retained denture in a diabetic individual and was concerned. The patient was fully informed that implant installation was the best indication for her case, but the arguments were not sufficient to change her decision. The treatment possibilities were presented and the patient opted for a clasp-retained removable partial denture (RPD) associated with the placement of crowns in the pillar teeth. The temporary RPD was replaced by the definitive RPD constructed subsequently. Although RPD was not the first choice, satisfactory esthetic and functional outcomes were achieved, overcaming the patient's expectations. This case report illustrates that the dentist must be prepared to deal with situations where, for reasons that cannot be managed, the patient does not accept the treatment considered as the most indicated for his/her case. Alternatives must be proposed and the functional and esthetic requirements must be fulfilled in the best possible manner.

Computed tomography and scintigraphy exams for diagnosis and treatment planning of the condylar osteochondroma: a case report

PURPOSE: To report an uncommon case of osteochondroma affecting the mandibular condyle of a young patient and to illustrate the important contributions of different imaging resources to the diagnosis and treatment planning of this lesion. CASE DESCRIPTION: A 24-year-old female patient with the chief complaint of an increasing facial asymmetry and pain in the left pre-auricular region, revealing a reduced mouth opening, mandibular deviation and posterior cross-bite over a period of 18 months. Panoramic radiography revealed an enlargement of the left condyle, whereas computed tomography (CT) sections and three-dimensional CT showed a well-defined bone growth arising from condylar neck. The scintigraphy exam showed an abnormal osteogenic activity in the left temporomandibular joint. The condyle was surgically removed and after 18 months follow-up the panoramic radiography and CT scans showed no signs of recurrence. CONCLUSION: Although osteochondroma is a benign bone tumor that rarely arises in cranial and maxillofacial region, it should be considered in the differential diagnosis of slow-growing masses of the temporomandibular area and the use of different imaging exams significantly contribute to the correct diagnosis and treatment planning of this pathological condition.

Factors associated with stages of change for red meat and vegetable intake by Japanese-Brazilians

Stages of change assess individual motivation for lifestyle changes, contributing to the development of more effective intervention strategies. The objective of the present study was to identify factors associated with stages of change for lower intake of red meat and higher intake of vegetables in a cross-sectional analysis of 578 Japanese-Brazilians aged 30-90 years. In adjusted logistic regression models, the odds ratios for women (OR = 1.89; 95%CI: 1.154; 3.103) and physically active individuals (OR = 1.00; 95%CI: 1.000; 1.001) were positively associated with stage of "action" for the higher intake of vegetables. Inverse associations were observed between central obesity (OR = 0.5; 95%CI: 0.351; 0.887) and highest tertile of red meat intake (OR = 0.50; 95%CI: 0.302; 0.817), as well as a positive association between age (OR = 1.04; 95%CI: 1.020; 1.070) and the stage of "action" to the lower intake of meat were verified. Motivation for Japanese-Brazilians to change their food intake was linked to lifestyle. Stage of change is an important factor in mediating food intake behavior change.

Estudo clínico da aplicação de matriz inorgânica de osso associado a peptídeo sintético de adesão celular (MIO/P-15), PepGen P-15®, em lesões periodontais avançadas de cães

Os mecanismos biológicos desenvolvidos para aumentar a qualidade da regeneração óssea e da reparação tecidual de sítios periodontais específicos continuam a ser um desafio e têm sido complementado pela capacidade de adesão celular do colágeno do tipo I, promovida por um peptídeo sintético de adesão celular (P-15), associado a uma matriz inorgânica de osso (MIO) para formar MIO/P-15. O objetivo deste estudo foi avaliar a perda do nível clínico de inserção e a resposta da bolsa periodontal em dentes após 3 e 6 meses da aplicação de enxerto com MIO/P-15. Vinte e um cães do Hospital Veterinário da Universidade de São Paulo foram anestesiados para realização de tratamento periodontal e 132 faces dentais com perda de nível clínico de inserção foram tratadas, sendo que 36,4% (48 faces) receberam o peptídeo de adesão celular e 63,6% (84 faces) compuseram o grupo controle que recebeu tratamento convencional (retalho muco-gengival e aplainamento radicular). O procedimento foi documentado através de radiografia intra-oral e todas as sondagens de bolsas periodontais foram fotografadas. Depois de 3 e de 6 meses, os animais foram re-anestesiados a fim de se obter novas avaliações, radiografias, fotografias e sondagens periodontais. As 48 faces com perda de nível clínico de inserção que receberam material de enxertia apresentaram taxa de 40% de recuperação do nível clínico de inserção após 6 meses. O grupo controle de faces dentais não apresentou alteração do nível clínico de inserção. A face palatina foi a que apresentou melhor taxa de regeneração (40%) e os dentes caninos e molares mostraram as melhores respostas (57,14% e 65%, respectivamente). Não houve sinais de infecção pós-cirúrgica relacionadas à falta de higienização oral dos animais. Pode-se concluir que o MIO/P-15 auxilia na regeneração e re-aderência das estruturas periodontais, incluindo osso alveolar. Sua aplicação mostrou-se fácil e prática e a incidência de complicações pós-cirúrgicas foi baixa. Ainda assim, mais estudos e pesquisas são necessários para que se avalie a quantidade e a qualidade do osso e do ligamento periodontal formados.

The bubbles or the boiling pot?: an ecosystemic approach to culture, environment and quality of life

For the diagnosis and prognosis of the problems of quality of life, a multidisciplinary ecosystemic approach encompasses four dimensions of being-in-the-world, as donors and recipients: intimate, interactive, social and biophysical. Social, cultural and environmental vulnerabilities are understood and dealt with, in different circumstances of space and time, as the conjugated effect of all dimensions of being-in-the-world, as they induce the events (deficits and assets), cope with consequences (desired or undesired) and contribute for change. Instead of fragmented and reduced representations of reality, diagnosis and prognosis of cultural, educational, environmental and health problems considers the connections (assets) and ruptures (deficits) between the different dimensions, providing a planning model to develop and evaluate research, teaching programmes, public policies and field projects. The methodology is participatory, experiential and reflexive; heuristic-hermeneutic processes unveil cultural and epistemic paradigms that orient subject-object relationships; giving people the opportunity to reflect on their own realities, engage in new experiences and find new ways to live better in a better world. The proposal is a creative model for thought and practice, providing many opportunities for discussion, debate and development of holistic projects integrating different scientific domains (social sciences, psychology, education, philosophy, etc.)

Change and Aging Senescence as an Adaptation

Understanding why we age is a long-lived open problem in evolutionary biology. Aging is prejudicial to the individual, and evolutionary forces should prevent it, but many species show signs of senescence as individuals age. Here, I will propose a model for aging based on assumptions that are compatible with evolutionary theory: i) competition is between individuals; ii) there is some degree of locality, so quite often competition will be between parents and their progeny; iii) optimal conditions are not stationary, and mutation helps each species to keep competitive. When conditions change, a senescent species can drive immortal competitors to extinction. This counter-intuitive result arises from the pruning caused by the death of elder individuals. When there is change and mutation, each generation is slightly better adapted to the new conditions, but some older individuals survive by chance. Senescence can eliminate those from the genetic pool. Even though individual selection forces can sometimes win over group selection ones, it is not exactly the individual that is selected but its lineage. While senescence damages the individuals and has an evolutionary cost, it has a benefit of its own. It allows each lineage to adapt faster to changing conditions. We age because the world changes.

Visual Feedforward Control in Human Locomotion During Avoidance of Obstacles that Change Size

The purpose of the current study was to understand how visual information about an ongoing change in obstacle size is used during obstacle avoidance for both lead and trail limbs. Participants were required to walk in a dark room and to step over an obstacle edged with a special tape visible in the dark. The obstacle's dimensions were manipulated one step before obstacle clearance by increasing or decreasing its size. Two increasing and two decreasing obstacle conditions were combined with seven control static conditions. Results showed that information about the obstacle's size was acquired and used to modulate trail limb trajectory, but had no effect on lead limb trajectory. The adaptive step was influenced by the time available to acquire and process visual information. In conclusion, visual information about obstacle size acquired during lead limb crossing was used in a feedforward manner to modulate trail limb trajectory.

Contribution margin model applied to the marketing planning of a container liner carrier

The implementation of confidential contracts between a container liner carrier and its customers, because of the Ocean Shipping Reform Act (OSRA) 1998, demands a revision in the methodology applied in the carrier's planning of marketing and sales. The marketing and sales planning process should be more scientific and with a better use of operational research tools considering the selection of the customers under contracts, the duration of the contracts, the freight, and the container imbalances of these contracts are basic factors for the carrier's yield. This work aims to develop a decision support system based on a linear programming model to generate the business plan for a container liner carrier, maximizing the contribution margin of its freight.

A Paradigm Shift in Predoctoral Dental Curricula in Brazil: Evaluating the Process of Change

In 2002, the Brazilian Ministry of Education approved the official curricular guidelines for undergraduate courses in Brazil to be adopted by the nation's 188 dental schools. In 2005-06, the Brazilian Dental Education Association (BDEA) promoted workshops in forty-eight of the schools to verify the degree of transformation of the curriculum based on these guidelines. Among the areas analyzed were course philosophy (variables were v1: knowledge production based on the needs of the Brazilian Public Health System [BPHS]; v2: health determinants; and v3: postgraduate studies and permanent education); pedagogical skills (v4: curricular structure; v5: changes in pedagogic and didactic skills; and v6: course program orientation); and dental practice scenarios (v7: diversity of the scenarios for training/learning; v8: academic health care centers opened to the BPHS; and v9: participation of students in health care delivery for the population). The subjects consisted of faculty members (n=711), students (n=228), and employees (n=14). The results showed an incipient degree of curriculum transformation. The degree of innovation was statistically different depending on the type of university (public or private) for variables I, 2, 4, 5, 6, and 7. Private schools reported a higher level of innovation than public institutions. Resistance to transforming the dental curriculum according to the official guidelines may be linked to an ideological conception that supports the private practice model, continues to have faculty members direct all classroom activities, and prevents students from developing an understanding of professional practice as targeted towards the oral health needs of all segments of society.

Large change in the predicted number of small halos due to a small amplitude oscillating inflaton potential

A smooth inflaton potential is generally assumed when calculating the primordial power spectrum, implicitly assuming that a very small oscillation in the inflaton potential creates a negligible change in the predicted halo mass function. We show that this is not true. We find that a small oscillating perturbation in the inflaton potential in the slow-roll regime can alter significantly the predicted number of small halos. A class of models derived from supergravity theories gives rise to inflaton potentials with a large number of steps and many trans-Planckian effects may generate oscillations in the primordial power spectrum. The potentials we study are the simple quadratic (chaotic inflation) potential with superimposed small oscillations for small field values. Without leaving the slow-roll regime, we find that for a wide choice of parameters, the predicted number of halos change appreciably. For the oscillations beginning in the 10(7)-10(8) M(circle dot) range, for example, we find that only a 5% change in the amplitude of the chaotic potential causes a 50% suppression of the number of halos for masses between 10(7)-10(8) M(circle dot) and an increase in the number of halos for masses <10(6) M(circle dot) by factors similar to 15-50. We suggest that this might be a solution to the problem of the lack of observed dwarf galaxies in the range 10(7)-10(8) M(circle dot). This might also be a solution to the reionization problem where a very large number of Population III stars in low mass halos are required.

Effective coordination concept applied for phase change (GeTe)(m)(Sb(2)Te(3))(n) compounds

In this work, we employed the effective coordination concept to study the local environments of the Ge, Sb, and Te atoms in the Ge(m)Sb(2n)Te(m+3n) compounds. From our calculations and analysis, we found an average effective coordination number (ECN) reduction of 1.59, 1.42, and 1.37, for the Ge, Sb, Te atoms in the phase transition from crystalline, ECN=5.55 (Ge), 5.73 (Sb), 4.37 (Te), to the amorphous phase, ECN=3.96 (Ge), 4.31 (Sb), 3.09 (Te), for the Ge(2)Sb(2)Te(5) composition. Similar changes are observed for other compositions. Thus, our results indicate that the coordination changes from the crystalline to amorphous phase are not large as previously assumed in the literature, i.e., from sixfold to fourfold for Ge, which can contribute to obtain a better understanding of the crystalline to amorphous phase transition. (C) 2011 American Institute of Physics. [doi:10.1063/1.3533422]

LATENT RANK CHANGE DETECTION FOR ANALYSIS OF SPLICE-JUNCTION MICROARRAYS WITH NONLINEAR EFFECTS

Alternative splicing of gene transcripts greatly expands the functional capacity of the genome, and certain splice isoforms may indicate specific disease states such as cancer. Splice junction microarrays interrogate thousands of splice junctions, but data analysis is difficult and error prone because of the increased complexity compared to differential gene expression analysis. We present Rank Change Detection (RCD) as a method to identify differential splicing events based upon a straightforward probabilistic model comparing the over-or underrepresentation of two or more competing isoforms. RCD has advantages over commonly used methods because it is robust to false positive errors due to nonlinear trends in microarray measurements. Further, RCD does not depend on prior knowledge of splice isoforms, yet it takes advantage of the inherent structure of mutually exclusive junctions, and it is conceptually generalizable to other types of splicing arrays or RNA-Seq. RCD specifically identifies the biologically important cases when a splice junction becomes more or less prevalent compared to other mutually exclusive junctions. The example data is from different cell lines of glioblastoma tumors assayed with Agilent microarrays.

The Amazon Frontier of Land-Use Change: Croplands and Consequences for Greenhouse Gas Emissions

The Brazilian Amazon is one of the most rapidly developing agricultural frontiers in the world. The authors assess changes in cropland area and the intensification of cropping in the Brazilian agricultural frontier state of Mato Grosso using remote sensing and develop a greenhouse gas emissions budget. The most common type of intensification in this region is a shift from single-to double-cropping patterns and associated changes in management, including increased fertilization. Using the enhanced vegetation index (EVI) from the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor, the authors created a green-leaf phenology for 2001-06 that was temporally smoothed with a wavelet filter. The wavelet-smoothed green-leaf phenology was analyzed to detect cropland areas and their cropping patterns. The authors document cropland extensification and double-cropping intensification validated with field data with 85% accuracy for detecting croplands and 64% and 89% accuracy for detecting single-and double-cropping patterns, respectively. The results show that croplands more than doubled from 2001 to 2006 to cover about 100 000 km(2) and that new double-cropping intensification occurred on over 20% of croplands. Variations are seen in the annual rates of extensification and double-cropping intensification. Greenhouse gas emissions are estimated for the period 2001-06 due to conversion of natural vegetation and pastures to row-crop agriculture in Mato Grosso averaged 179 Tg CO(2)-e yr(-1),over half the typical fossil fuel emissions for the country in recent years.

Influence of land-use change on near-surface hydrological processes: Undisturbed forest to pasture

Soil compaction that follows the clearing of tropical forest for cattle pasture is associated with lower soil hydraulic conductivity and increased frequency and volume of overland flow. We investigated the frequency of perched water tables, overland flow and stormflow in an Amazon forest and in an adjacent 25-year-old pasture cleared from the same forest. We compared the results with the frequencies of these phenomena estimated from comparisons of rainfall intensity and soil hydraulic conductivity. The frequency of perched water tables based on rainfall intensity and soil hydraulic conductivity was expected to double in pasture compared with forest. This corresponded closely with an approximate doubling of the frequency of stormflow and overland flow in pasture. In contrast, the stormflow volume in pasture increased 17-fold. This disproportional increase of stormflow resulted from overland flow generation over large areas of pasture, while overland flow generation in the forest was spatially limited and was observed only very near the stream channel. In both catchments, stormflow was generated by saturation excess because of perched water tables and near-surface groundwater levels. Stormflow was occasionally generated in the forest by rapid return flow from macropores, while slow return flow from a continuous perched water table was more common in the pasture. These results suggest that deforestation for pasture alters fundamental mechanisms of stormflow generation and may increase runoff volumes over wide regions of Amazonia. (C) 2009 Elsevier B.V. All rights reserved.

Implications of long-term land-use change for the hydrology and solute budgets of small catchments in Amazonia

The replacement of undisturbed tropical forest with cattle pasture has the potential to greatly modify the hydrology of small watersheds and the fluxes of solutes. We examined the fluxes of water, Cl(-), NO(3)(-)-N: SO(4)(2--)-S, NH(4)(+)-N, Na(+), K(+), Mg(2+) and Ca(2+) in different flow paths in similar to 1 ha catchments of undisturbed open tropical rainforest and a 20 year-old pasture established from forest in the southwestern Brazilian Amazon state of Rondonia. Storm flow discharge was 18% of incident rainfall in pasture, but only 1% in forest. Quickflow predominated over baseflow in both catchments and in both wet and dry seasons. In the pasture, groundwater and quickflow were important flow paths for the export of all solutes. In the forest, quickflow was important for NO(3)(-)-N export, but all other solutes were exported primarily by groundwater outflow. Both catchments were sinks for SO(4)(2-)-S and Ca(2+), and sources of Na(+). The pasture catchment also lost K(+) and Mg(2+) because of higher overland flow frequency and volume and to cattle excrement. These results show that forest clearing dramatically influences small watershed hydrology by increasing quickflow and water export to streams. They also indicate that tropical forest watersheds are highly conservative for most solutes but that pastures continue to lose important cations even decades after deforestation and pasture establishment. (c) 2008 Elsevier B.V. All rights reserved.