56-month clinical performance of Class I and II resin composite restorations

Objective: This study evaluated the 56-month clinical performance of Class I and II resin composite restorations. Filtek P60 was compared with Filtek Z250, which are both indicated for posterior restorations but differ in terms of handling characteristics. The null hypothesis tested was that there is no difference in the clinical performance of the two resin composites in posterior teeth. Material and Methods: Thirty-three patients were treated by the same operator, who prepared 48 Class I and 42 Class II cavities, which were restored with Single Bond/Filtek Z250 or Single Bond/Filtek P60 restorative systems. Restorations were evaluated by two independent examiners at baseline and after 56 months, using the modified USPHS criteria. Data were analyzed statistically using Chi-square and Fisher's Exact tests (alpha=0.05). Results: After 56 months, 25 patients (31 Class I and 36 Class II) were analyzed. A 3% failure rate occurred due to secondary caries and excessive loss of anatomic form for P60. For both restorative systems, there were no significant differences in secondary caries and postoperative sensitivity. However, significant changes were observed with respect to anatomic form, marginal discoloration, and marginal adaptation. Significant decreases in surface texture were observed exclusively for the Z250 restorations. Conclusions: Both restorative systems can be used for posterior restorations and can be expected to perform well in the oral environment.

The Poisson-exponential regression model under different latent activation schemes

In this paper, a new family of survival distributions is presented. It is derived by considering that the latent number of failure causes follows a Poisson distribution and the time for these causes to be activated follows an exponential distribution. Three different activation schemes are also considered. Moreover, we propose the inclusion of covariates in the model formulation in order to study their effect on the expected value of the number of causes and on the failure rate function. Inferential procedure based on the maximum likelihood method is discussed and evaluated via simulation. The developed methodology is illustrated on a real data set on ovarian cancer.

Retrospective Clinical Study of 988 Dual Acid-Etched Implants Placed in Grafted and Native Bone for Single-Tooth Replacement

Purpose: To evaluate the influence of sex, implant characteristics, and bone grafting on the survival rate of dual acid-etched (DAE) implants. Materials and Methods: Patients treated with internal-hex DAE implants for single-tooth replacement in a military dental clinic between January 2005 and December 2010 were included in this study. Clinical data related to implant characteristics, implant location, presence of grafted bone, and implant failures were collected. The primary outcome was implant loss. The survival rate was analyzed using the Kaplan-Meier method. Cox regression modeling was used to determine which factors would predict implant failure. Results: DAE implants were evaluated in a total of 988 patients (80.3% men). Twenty-four (2.4%) implants failed, most were cylindric (54.2%) with regular platforms (70.8%) and were 10 mm long (58.3%). The failure rate was 2.4% for the anterior maxilla, 3.3% for the posterior maxilla, 1.6% for the anterior mandible, and 2.0% for posterior mandible. The cumulative survival rate was 97.6%. The failure rate was 8.8% in implants placed after sinus augmentation, 7.3% in bone block-grafted areas, and 1.6% in native bone. Based on multivariable analysis (Cox regression), sinus augmentation and bone block grafting had a statistically significant effect on implant failure; the hazard ratios were 5.5 and 4.6, respectively. Conclusion: The results revealed that DAE implants had high survival rates, and no influence of sex, location, shape, diameter, or length on failure rates could be observed. However, a significant association was observed between failure and presence of bone graft in the implant area. Int J Oral Maxillofac Implants 2012;27:1243-1248

Synthetic phosphoethanolamine a precursor of membrane phospholipids reduce tumor growth in mice bearing melanoma B16-F10 and in vitro induce apoptosis and arrest in G2/M phase

Phosphoethanolamine (Pho-s) is a compound involved in phospholipid turnover, acting as a substrate for many phospholipids of the cell membranes, especially phosphatidylcholine. We recently reported that synthetic Pho-s has potent effects on a wide variety of tumor cells. To determine if Pho-s has a potential antitumor activity, in this study we evaluated the activity of Pho-s against the B16-F10 melanoma both in vitro and in mice bearing a dorsal tumor. The treatment of B16F10 cells with Pho-s resulted in a dose-dependent inhibition of cell proliferation. At low concentrations, this activity appears to be involved in the arrest of the cell cycle at G2/M, while at high concentrations Pho-s induces apoptosis. In accordance with these results, the loss of mitochondrial potential and increased caspase-3 activity suggest that Phos has dual antitumor effects; i.e. it induces apoptosis at high concentrations and modulates the cell cycle at lower concentrations. In vivo, we evaluated the effect of Pho-s in mice bearing B16-F10 melanoma. The results show that Pho-s reduces the tumoral volume increasing survival rate. Furthermore, the tumor doubling time and tumor delays were substantially reduced when compared with untreated mice. Histological analyses reveal that Pho-s induces changes in cell morphology, typical characteristics of apoptosis, in addition the large areas of necrosis correlating with a reduction of tumor size. The results presented here support the hypothesis that Pho-s has antitumor effects by the induction of apoptosis as well as the inhibition of cell proliferation by arrest at G2/M. Thus, Pho-s can be regarded as a promising agent for the treatment of melanoma. Published by Elsevier Masson SAS.

Clinical Performance of Porcelain Laminate Veneers: Outcomes of the Aesthetic Pre-evaluative Temporary (APT) Technique

This article evaluates the long-term clinical performance of porcelain laminate veneers bonded to teeth prepared with the use of an additive mock-up and aesthetic pre-evaluative temporary (APT) technique over a 12-year period. Sixty-six patients were restored with 580 porcelain laminate veneers. The technique, used for diagnosis, esthetic design, tooth preparation, and provisional restoration fabrication, was based on the APT protocol. The influence of several factors on the durability of veneers was analyzed according to pre- and postoperative parameters. With utilization of the APT restoration, over 80% of tooth preparations were confined to the dental enamel. Over 12 years, 42 laminate veneers failed, but when the preparations were limited to the enamel, the failure rate resulting from debonding and microleakage decreased to 0%. Porcelain laminate veneers presented a successful clinical performance in terms of marginal adaptation, discoloration, gingival recession, secondary caries, postoperative sensitivity, and satisfaction with restoration shade at the end of 12 years. The APT technique facilitated diagnosis, communication, and preparation, providing predictability for the restorative treatment. Limiting the preparation depth to the enamel surface significantly increases the performance of porcelain laminate veneers. (Int J Periodontics Restorative Dent 2012;32:625-635.)

Erosione e sollevamento nell'arco calabro-peloritano

The Calabrian-Peloritani arc represents key site to unravel evolution of surface processes on top of subducting lithosphere. During the Pleistocene, in fact the arc uplifted at rate of the order of about 1mm/yr, forming high-standing low-relief upland (figure 2). Our study is focused on the relationship between tectonic and land evolution in the Sila Massif, Messina strait and Peloritani Mts. Landforms reflect a competition between tectonic, climatic, and surficial processes. Many landscape evolution models that explore feedbacks between these competing processes, given steady forcing, predict a state of erosional equilibrium, where the rates of river incision and hillslope erosion balance rock uplift. It has been suggested that this may be the final constructive stage of orogenic systems. Assumptions of steady erosion and incision are used in the interpretation of exhumation and uplift rates from different geologic data, and in the formulation of fluvial incision and hillslope evolution models. In the Sila massif we carried out cosmogenic isotopes analysis on 24 samples of modern fluvial sediments to constrain long-term (~103 yr) erosion rate averaged on the catchment area. 35 longitudinal rivers profiles have been analyzed to study the tectonic signal on the landscape evolution. The rivers analyzed exhibit a wide variety of profile forms, diverging from equilibrium state form. Generally the river profiles show at least 2 and often 3 distinct concave-up knickpoint-bounded segments, characterized by different value of concavity and steepness indices. River profiles suggest three main stages of incision. The values of ks and θ in the lower segments evidence a decrease in river incision, due probably to increasing uplift rate. The cosmogenic erosion rates pointed out that old landscape upland is eroding slowly at ~0.1 mm/yr. In the contrary, the flanks of the massif is eroding faster with value from 0.4 to 0.5 mm/yr due to river incision and hillslope processes. Cosmogenic erosion rates mach linearly with steepness indices and with average hillslope gradient. In the Messina area the long term erosion rate from low-T thermochronometry are of the same order than millennium scale cosmogenic erosion rate (1-2 mm/yr). In this part of the chain the fast erosion is active since several million years, probably controlled by extensional tectonic regime. In the Peloritani Mts apatite fission-track and (U-Th)/He thermochronometry are applied to constraint the thermal history of the basement rock. Apatite fission-track ages range between 29.0±5.5 and 5.5±0.9 Ma while apatite (U-Th)/He ages vary from 19.4 to 1.0 Ma. Most of the AFT ages are younger than the overlying terrigenous sequence that in turn postdates the main orogenic phase. Through the coupling of the thermal modelling with the stratigraphic record, a Middle Miocene thermal event due to tectonic burial is unravel. This event affected a inner-intermediate portion of the Peloritani belt confined by young AFT data (<15 Ma) distribution. We interpret this thermal event as due to an out-of–sequence thrusting occurring in the inner portion of the belt. Young (U-Th)/He ages (c. 5 Ma) record a final exhumation stage with increasing rates of denudation since the Pliocene times due to postorogenic extensional tectonics and regional uplift. In the final chapter we change the spatial scale to insert digital topography analysis and field data within a geodynamic model that can explain surface evidence produced by subduction process.

Structuring of polymer surface by evaporation of sessile microdrops

In this thesis, we investigated the evaporation of sessile microdroplets on different solid substrates. Three major aspects were studied: the influence of surface hydrophilicity and heterogeneity on the evaporation dynamics for an insoluble solid substrate, the influence of external process parameters and intrinsic material properties on microstructuring of soluble polymer substrates and the influence of an increased area to volume ratio in a microfluidic capillary, when evaporation is hindered. In the first part, the evaporation dynamics of pure sessile water drops on smooth self-assembled monolayers (SAMs) of thiols or disulfides on gold on mica was studied. With increasing surface hydrophilicity the drop stayed pinned longer. Thus, the total evaporation time of a given initial drop volume was shorter, since the drop surface, through which the evaporation occurs, stays longer large. Usually, for a single drop the volume decreased linearly with t1.5, t being the evaporation time, for a diffusion-controlled evaporation process. However, when we measured the total evaporation time, ttot, for multiple droplets with different initial volumes, V0, we found a scaling of the form V0 = attotb. The more hydrophilic the substrate was, the more showed the scaling exponent a tendency to an increased value up to 1.6. This can be attributed to an increasing evaporation rate through a thin water layer in the vicinity of the drop. Under the assumption of a constant temperature at the substrate surface a cooling of the droplet and thus a decreased evaporation rate could be excluded as a reason for the different scaling exponent by simulations performed by F. Schönfeld at the IMM, Mainz. In contrast, for a hairy surface, made of dialkyldisulfide SAMs with different chain lengths and a 1:1 mixture of hydrophilic and hydrophobic end groups (hydroxy versus methyl group), the scaling exponent was found to be ~ 1.4. It increased to ~ 1.5 with increasing hydrophilicity. A reason for this observation can only be speculated: in the case of longer hydrophobic alkyl chains the formation of an air layer between substrate and surface might be favorable. Thus, the heat transport to the substrate might be reduced, leading to a stronger cooling and thus decreased evaporation rate. In the second part, the microstructuring of polystyrene surfaces by drops of toluene, a good solvent, was investigated. For this a novel deposition technique was developed, with which the drop can be deposited with a syringe. The polymer substrate is lying on a motorized table, which picks up the pendant drop by an upward motion until a liquid bridge is formed. A consecutive downward motion of the table after a variable delay, i.e. the contact time between drop and polymer, leads to the deposition of the droplet, which can evaporate. The resulting microstructure is investigated in dependence of the processes parameters, i.e. the approach and the retraction speed of the substrate and the delay between them, and in dependence of the intrinsic material properties, i.e. the molar mass and the type of the polymer/solvent system. The principal equivalence with the microstructuring by the ink-jet technique was demonstrated. For a high approach and retraction speed of 9 mm/s and no delay between them, a concave microtopology was observed. In agreement with the literature, this can be explained by a flow of solvent and the dissolved polymer to the rim of the pinned droplet, where polymer is accumulated. This effect is analogue to the well-known formation of ring-like stains after the evaporation of coffee drops (coffee-stain effect). With decreasing retraction speed down to 10 µm/s the resulting surface topology changes from concave to convex. This can be explained with the increasing dissolution of polymer into the solvent drop prior to the evaporation. If the polymer concentration is high enough, gelation occurs instead of a flow to the rim and the shape of the convex droplet is received. With increasing delay time from below 0 ms to 1s the depth of the concave microwells decreases from 4.6 µm to 3.2 µm. However, a convex surface topology could not be obtained, since for longer delay times the polymer sticks to the tip of the syringe. Thus, by changing the delay time a fine-tuning of the concave structure is accomplished, while by changing the retraction speed a principal change of the microtopolgy can be achieved. We attribute this to an additional flow inside the liquid bridge, which enhanced polymer dissolution. Even if the pendant drop is evaporating about 30 µm above the polymer surface without any contact (non-contact mode), concave structures were observed. Rim heights as high as 33 µm could be generated for exposure times of 20 min. The concave structure exclusively lay above the flat polymer surface outside the structure even after drying. This shows that toluene is taken up permanently. The increasing rim height, rh, with increasing exposure time to the solvent vapor obeys a diffusion law of rh = rh0  tn, with n in the range of 0.46 ~ 0.65. This hints at a non-Fickian swelling process. A detailed analysis showed that the rim height of the concave structure is modulated, unlike for the drop deposition. This is due to the local stress relaxation, which was initiated by the increasing toluene concentration in the extruded polymer surface. By altering the intrinsic material parameters i.e. the polymer molar mass and the polymer/solvent combination, several types of microstructures could be formed. With increasing molar mass from 20.9 kDa to 1.44 MDa the resulting microstructure changed from convex, to a structure with a dimple in the center, to concave, to finally an irregular structure. This observation can be explained if one assumes that the microstructuring is dominated by two opposing effects, a decreasing solubility with increasing polymer molar mass, but an increasing surface tension gradient leading to instabilities of Marangoni-type. Thus, a polymer with a low molar mass close or below the entanglement limit is subject to a high dissolution rate, which leads to fast gelation compared to the evaporation rate. This way a coffee-rim like effect is eliminated early and a convex structure results. For high molar masses the low dissolution rate and the low polymer diffusion might lead to increased surface tension gradients and a typical local pile-up of polymer is found. For intermediate polymer masses around 200 kDa, the dissolution and evaporation rate are comparable and the typical concave microtopology is found. This interpretation was supported by a quantitative estimation of the diffusion coefficient and the evaporation rate. For a different polymer/solvent system, polyethylmethacrylate (PEMA)/ethylacetate (EA), exclusively concave structures were found. Following the statements above this can be interpreted with a lower dissolution rate. At low molar masses the concentration of PEMA in EA most likely never reaches the gelation point. Thus, a concave instead of a convex structure occurs. At the end of this section, the optically properties of such microstructures for a potential application as microlenses are studied with laser scanning confocal microscopy. In the third part, the droplet was confined into a glass microcapillary to avoid evaporation. Since here, due to an increased area to volume ratio, the surface properties of the liquid and the solid walls became important, the influence of the surface hydrophilicity of the wall on the interfacial tension between two immiscible liquid slugs was investigated. For this a novel method for measuring the interfacial tension between the two liquids within the capillary was developed. This technique was demonstrated by measuring the interfacial tensions between slugs of pure water and standard solvents. For toluene, n-hexane and chloroform 36.2, 50.9 and 34.2 mN/m were measured at 20°C, which is in a good agreement with data from the literature. For a slug of hexane in contact with a slug of pure water containing ethanol in a concentration range between 0 and 70 (v/v %), a difference of up to 6 mN/m was found, when compared to commercial ring tensiometry. This discrepancy is still under debate.

Supernova-Detektion mit dem IceCube-Neutrinoteleskop

IceCube, ein Neutrinoteleskop, welches zur Zeit am Südpol aufgebaut und voraussichtlich 2011 fertiggestellt sein wird, kann galaktische Kernkollaps-Supernovae mit hoher Signifikanz und unübertroffener statistischer Genauigkeit der Neutrinolichtkurve detektieren. Derartige Supernovae werden begleitet von einem massiven Ausbruch niederenergetischer Neutrinos aller Flavour. Beim Durchfliegen des Detektormediums Eis entstehen Positronen und Elektronen, welche wiederum lokale Tscherenkowlichtschauer produzieren, die in ihrer Summe das gesamte Eis erleuchten. Ein Nachweis ist somit, trotz der Optimierung IceCubes auf hochenergetische Teilchenspuren, über eine kollektive Rauschratenerhöhung aller optischen Module möglich. Die vorwiegende Reaktion ist der inverse Betazerfall der Antielektronneutrinos, welcher über 90,% des gesamten Signals ausmacht.rnrnDiese Arbeit beschreibt die Implementierung und Funktionsweise der Supernova-Datennahme-Software sowie der Echtzeitanalyse, mit welcher die oben genannte Nachweismethode seit August 2007 realisiert ist. Die Messdaten der ersten zwei Jahre wurden ausgewertet und belegen ein extrem stabiles Verhalten des Detektors insgesamt sowie fast aller Lichtsensoren, die eine gemittelte Ausfallquote von lediglich 0,3,% aufweisen. Eine Simulation der Detektorantwort nach zwei unterschiedlichen Supernova-Modellen ergibt eine Sichtweite IceCubes, die im besten Falle bis zur 51,kpc entfernten Großen Magellanschen Wolke reicht. Leider ist der Detektor nicht in der Lage, die Deleptonisierungsspitze aufzulösen, denn Oszillationen der Neutrinoflavour innerhalb des Sterns modifizieren die Neutrinospektren ungünstig. Jedoch können modellunabhängig anhand des frühesten Signalanstiegs die inverse Massenhierarchie sowie $sin^2 2theta_{13} > 10^{-3}$ etabliert werden, falls die Entfernung zur Supernova $leq$,6,kpc beträgt. Gleiches kann durch Auswertung eines möglichen Einflusses der Erdmaterie auf die Neutrinooszillation mit Hilfe der Messung eines zweiten Neutrinodetektors erreicht werden.

Ergebnisse der Behandlung mit Kortikalisschrauben

Im Rahmen der vorliegenden Dissertation wurden 106 Minipins bei 62 Patienten (29 Männer und 33 Frauen)untersucht.rnÜberlebensrate betrug 76,4%. Misserfolge, die zum Verlust der Minipins führten wie Mukositis, Lockerung oder Wurzelperforation, stellten sich in 23,7 % (n=25) der Fälle ein. Dabei gingen beim Auftreten von Mukositis 9 von 14 (8,5 %), bei der Lockerung der Minischrauben 8 von 10 (7,5 %) der Minischrauben verloren. Eine Wurzelperforation trat in einem Fall auf. rnDie einzige lingual im Unterkiefer implantierte Schraube ging verloren. Implantation palatinal im Oberkiefer führte in zwei von vier Fällen zum Verlust. rnDie Sofortbelastung der kieferorthopädischen Kortikalisschrauben erscheint ein praktikables Belastungskonzept zu sein.rnDie Verlustraten bei der vestibulären Implantation betrugen 3,8 % (n=4) für den Oberkiefer und 15,1 % (n=16) für den Unterkiefer.rnBei der Implantation in befestigte bzw. unbefestigte Mukosa betrug die Überlebensrate entsprechend 83,3 % (n=72) und 62,3 % (n=22). rn

Transport Properties and Novel Sensing Applications of Organic Semiconducting Crystals

The present thesis is focused on the study of Organic Semiconducting Single Crystals (OSSCs) and crystalline thin films. In particular solution-grown OSSC, e.g. 4-hdroxycyanobenzene (4HCB) have been characterized in view of their applications as novel sensors of X-rays, gamma-rays, alpha particles radiations and chemical sensors. In the field of ionizing radiation detection, organic semiconductors have been proposed so far mainly as indirect detectors, i.e. as scintillators or as photodiodes. I first study the performance of 4HCB single crystals as direct X-ray detector i.e. the direct photon conversion into an electrical signal, assessing that they can operate at room temperature and in atmosphere, showing a stable and linear response with increasing dose rate. A dedicated study of the collecting electrodes geometry, crystal thickness and interaction volume allowed us to maximize the charge collection efficiency and sensitivity, thus assessing how OSSCs perform at low operating voltages and offer a great potential in the development of novel ionizing radiation sensors. To better understand the processes generating the observed X-ray signal, a comparative study is presented on OSSCs based on several small-molecules: 1,5-dinitronaphthalene (DNN), 1,8-naphthaleneimide (NTI), Rubrene and TIPS-pentacene. In addition, the proof of principle of gamma-rays and alpha particles has been assessed for 4HCB single crystals. I have also carried out an investigation of the electrical response of OSSCs exposed to vapour of volatile molecules, polar and non-polar. The last chapter deals with rubrene, the highest performing molecular crystals for electronic applications. We present an investigation on high quality, millimeter-sized, crystalline thin films (10 – 100 nm thick) realized by exploiting organic molecular beam epitaxy on water-soluble substrates. Space-Charge-Limited Current (SCLC) and photocurrent spectroscopy measurements have been carried out. A thin film transistor was fabricated onto a Cytop® dielectric layer. The FET mobility exceeding 2 cm2/Vs, definitely assess the quality of RUB films.

Gestione pre, intra e post-operatoria del cane sottoposto ad ipofisectomia transfenoidale

L’approccio chirurgico agli adenomi ipofisari ACTH secernenti è la terapia d’elezione nell’uomo. L’ipofisectomia transfenoidale è invece una tecnica poco diffusa in ambito veterinario. La terapia più diffusa nel cane con ipercortisolismo ipofisi dipendente (PDH) è di tipo medico e prevede la somministrazione di farmaci inibitori della sintesi del cortisolo. Gli adenomi ipofisari possono aumentare di volume e determinare una conseguente sintomatologia neurologica; in questi casi le uniche opzioni terapeutiche sono rappresentate dall’asportazione chirurgica della neoplasia e dalla radioterapia. Nella presente tesi vengono descritti 8 interventi di ipofisectomia transfenoidale effettuati su 7 cani con macroadenoma ipofisario presso il Dipartimento di Scienze Mediche Veterinarie dell’Università di Bologna. La difficoltà maggiore per il chirurgo è rappresentata dalla localizzazione della fossa ipofisaria rispetto ai punti di repere visibile in tomografia computerizzata o in risonanza magnetica nucleare, oltre ai problemi di sanguinamento durante la rimozione della neoplasia. Nel periodo post-operatorio maggiori complicazioni si riscontrano in soggetti con adenomi ipofisari di maggiori dimensioni. Al contrario, in presenza di adenomi di dimensioni più contenute, la ripresa post-operatoria risulta più rapida e il tasso di successo maggiore. Al fine di poter eseguire nel cane l’exeresi mirata della sola neoplasia ipofisaria, al pari di quanto avviene nell’uomo, è stato condotto uno studio sulla tomografia computerizzata (TC) in 86 cani con PDH. Il protocollo TC non ha tuttavia permesso di individuare con precisione la posizione della neoplasia per guidare il chirurgo nella sua rimozione. In due casi riportati nel presente lavoro si è verificata una recidiva della neoplasia ipofisaria. In un soggetto si è optato per il reintervento, mentre nell’altro caso per la radioterapia. Entrambe le opzioni hanno garantito una buona qualità di vita per più di un anno dall’intervento terapeutico. Questi casi clinici dimostrano come il reintervento e la radioterapia possano essere considerate valide opzioni in caso di recidiva.

Medicalgenomics.org : an open source database and retrieval system for biomedical analysis

Die Molekularbiologie von Menschen ist ein hochkomplexes und vielfältiges Themengebiet, in dem in vielen Bereichen geforscht wird. Der Fokus liegt hier insbesondere auf den Bereichen der Genomik, Proteomik, Transkriptomik und Metabolomik, und Jahre der Forschung haben große Mengen an wertvollen Daten zusammengetragen. Diese Ansammlung wächst stetig und auch für die Zukunft ist keine Stagnation absehbar. Mittlerweile aber hat diese permanente Informationsflut wertvolles Wissen in unüberschaubaren, digitalen Datenbergen begraben und das Sammeln von forschungsspezifischen und zuverlässigen Informationen zu einer großen Herausforderung werden lassen. Die in dieser Dissertation präsentierte Arbeit hat ein umfassendes Kompendium von humanen Geweben für biomedizinische Analysen generiert. Es trägt den Namen medicalgenomics.org und hat diverse biomedizinische Probleme auf der Suche nach spezifischem Wissen in zahlreichen Datenbanken gelöst. Das Kompendium ist das erste seiner Art und sein gewonnenes Wissen wird Wissenschaftlern helfen, einen besseren systematischen Überblick über spezifische Gene oder funktionaler Profile, mit Sicht auf Regulation sowie pathologische und physiologische Bedingungen, zu bekommen. Darüber hinaus ermöglichen verschiedene Abfragemethoden eine effiziente Analyse von signalgebenden Ereignissen, metabolischen Stoffwechselwegen sowie das Studieren der Gene auf der Expressionsebene. Die gesamte Vielfalt dieser Abfrageoptionen ermöglicht den Wissenschaftlern hoch spezialisierte, genetische Straßenkarten zu erstellen, mit deren Hilfe zukünftige Experimente genauer geplant werden können. Infolgedessen können wertvolle Ressourcen und Zeit eingespart werden, bei steigenden Erfolgsaussichten. Des Weiteren kann das umfassende Wissen des Kompendiums genutzt werden, um biomedizinische Hypothesen zu generieren und zu überprüfen.

Studio retrospettico sul ruolo della strumentazione nei fallimenti meccanici a seguito di Trattamento Chirurgico nelle Scoliosi dell'adulto

The spinal column performs important functions in the body, including the support of the entire weight of the human body, the ability to orientate the head in space, bending, flexing and rotating the body. Diseases affecting the spine are manifold: the most frequent is scoliosis, which often affects the female population. It is often treated surgically with a very high percentage of failures. The aim of the thesis is to study the role of instrumentation in mechanical failures encountered 12 months after surgery in the treatment of scoliosis. For the purposes of the study, we analyzed specific biomechanical parameters. The pelvic angles determine the position of the pelvis, while the imbalance parameters the structure of the body. We infer other parameters by analyzing the characteristics of the implanted instrumentation. Initially, the anatomy is described of the spine and vertebrae, the equipment used and the possible failures that may occur after surgery. Subsequently, the materials and methods used for the analysis of the above-mentioned parameters for the 61 patients are reported. All data are obtained by the observation of pre and post-operative x-rays with a special program, by reading reports from operators and by medical records. In the fourth chapter, we report the results: the overall failure rate is 60.9%; the types of failures that occurred are rupture of bars and rupture of bars simultaneously to PJK. The most influential parameters on results of the progress of the surgery are the type of material used and the BMI. It is estimated a high percentage of failures in patients treated with implants of cobalt chromium alloys (90.0%). According to the results obtained, it is possible to understand the aspects that in the future should be studied, in order to find a solution to the most frequent surgical failures.

Ten-year results of a three-arm prospective cohort study on implants in periodontally compromised patients. Part 1: implant loss and radiographic bone loss

OBJECTIVES: The aim of this study was to compare the long-term outcomes of implants placed in patients treated for periodontitis periodontally compromised patients (PCP) and in periodontally healthy patients (PHP) in relation to adhesion to supportive periodontal therapy (SPT). MATERIAL AND METHODS: One hundred and twelve partially edentulous patients were consecutively enrolled in private specialist practice and divided into three groups according to their initial periodontal condition: PHP, moderate PCP and severe PCP. Perio and implant treatment was carried out as needed. Solid screws (S), hollow screws (HS) and hollow cylinders (HC) were installed to support fixed prostheses, after successful completion of initial periodontal therapy (full-mouth plaque score <25% and full-mouth bleeding score <25%). At the end of treatment, patients were asked to follow an individualized SPT program. At 10 years, clinical measures and radiographic bone changes were recorded by two calibrated operators, blinded to the initial patient classification. RESULTS: Eleven patients were lost to follow-up. During the period of observation, 18 implants were removed because of biological complications. The implant survival rate was 96.6%, 92.8% and 90% for all implants and 98%, 94.2% and 90% for S-implants only, respectively, for PHP, moderate PCP and severe PCP. The mean bone loss was 0.75 (+/- 0.88) mm in PHP, 1.14 (+/- 1.11) mm in moderate PCP and 0.98 (+/- 1.22) mm in severe PCP, without any statistically significant difference. The percentage of sites, with bone loss > or =3 mm, was, respectively, 4.7% for PHP, 11.2% for moderate PCP and 15.1% for severe PCP, with a statistically significant difference between PHP and severe PCP (P<0.05). Lack of adhesion to SPT was correlated with a higher incidence of bone loss and implant loss. CONCLUSION: Patients with a history of periodontitis presented a lower survival rate and a statistically significantly higher number of sites with peri-implant bone loss. Furthermore, PCP, who did not completely adhere to the SPT, were found to present a higher implant failure rate. This underlines the value of the SPT in enhancing the long-term outcomes of implant therapy, particularly in subjects affected by periodontitis, in order to control reinfection and limit biological complications.

Limitations of balloon sinuplasty in frontal sinus surgery

Balloon sinuplasty is a tool that is used to treat selected patients with paranasal sinus pathologies. No studies have investigated the aetiology of failed access to the frontal sinus. The aim of our study was to specify the intraoperative technical failure rate and to analyse the aetiology of the failed access to predict potential technical difficulties before surgery. We retrospectively analysed the charts of patients who underwent balloon sinuplasty from November 2007 to July 2010 at three different ENT-Centres. CT-analysis of the patients with failed access was performed. Of the 104 frontal sinuses, dilation of 12 (12%) sinuses failed. The anatomy of all failed cases revealed variations in the frontal recess (frontoethmoidal-cell, frontal-bulla-cell or agger-nasi-cell) or osteoneogenesis. In one patient, a lymphoma was overlooked during a balloon only procedure. The lymphoma was diagnosed 6 months later with a biopsy during functional endoscopic sinus surgery. In complex anatomical situations of the frontal recess, balloon sinuplasty may be challenging or impossible. In these situations, it is essential to have knowledge of classical functional endoscopic sinus surgery of the frontal recess area. The drawbacks of not including a histopathologic exam should be considered in balloon only procedures.