Conservative approach to restore the first molar with extensive destruction: a 30-month follow-up

The available options for restoring multiple surface cavities are: amalgam, composite resin, or indirect restorations. Adhesive system and intradentinal pin-retained composite resin restorations should have a similar performance to pin-retained amalgam, regarding resistance to support occlusal forces. Polymerization shrinkage is a major concern when performing direct posterior composite resin restorations and the incremental insertion technique can provide less stress and outstanding margin behavior. Intradentinal pins can potentially enhance composite resin's retention, while reducing gaps caused by polymerization shrinkage. This article reports a clinical case involving an extensive restoration on a posterior tooth with cusp loss that was successfully treated using an intradentinal pin and direct nano-hybrid composite resin restoration.

SEM analysis and push-out bond strength of fiberglass posts luted with different cements of glass-ionomer in humid environment: pilot test

The objective of this study was to evaluate the push-out bond strength of fiberglass resin reinforced bonded with five ionomer cements. Also, the interface between cement and dentin was inspected by means of SEM. Fifty human canines were chose after rigorous scrutiny process, endodontically treated and divided randomly into five groups (n = 3) according to cement tested: Group I – Ionoseal (VOCO), Group II – Fugi I (GC), Group III – Fugi II Improved (GC), Group IV – Rely X Luting 2 (3M ESPE), Group V – Ketac Cem (3M ESPE). The post-space was prepared to receive a fiberglass post, which was tried before cementation process. No dentin or post surface pretreatment was carried out. After post bonding, all roots were cross-sectioned to acquire 3 thin-slices (1 mm) from three specific regions of tooth (cervical, medium and apical). A Universal test machine was used to carry out the push-out test with cross-head speed set to 0.5mm/mim. All failed specimens were observed under optical microscope to identify the failure mode. Representative specimens from each group was inspected under SEM. The data were analyzed by Kolmogorov-Smirnov and Levene’s tests and by two-way ANOVA, and Tukey’s port hoc test at a significance level of 5%. It was compared the images obtained for determination of types of failures more occurred in different levels. SEM inspection displayed that all cements filled the space between post and dentin, however, some imperfections such bubles and voids were noticed in all groups in some degree of extension. The push-out bond strength showed that cement Ketac Cem presented significant higher results when compared to the Ionoseal (P = 0.02). There were no statistical significant differences among other cements.

Experimental and numerical analysis of dry contact in the pin on disc test

The reduction of friction and wear in systems presenting metal-to-metal contacts, as in several mechanical components, represents a traditional challenge in tribology. In this context, this work presents a computational study based on the linear Archard's wear law and finite element modeling (FEM), in order to analyze unlubricated sliding wear observed in typical pin on disc tests. Such modeling was developed using finite element software Abaqus® with 3-D deformable geometries and elastic–plastic material behavior for the contact surfaces. Archard's wear model was implemented into a FORTRAN user subroutine (UMESHMOTION) in order to describe sliding wear. Modeling of debris and oxide formation mechanisms was taken into account by the use of a global wear coefficient obtained from experimental measurements. Such implementation considers an incremental computation for surface wear based on the nodal displacements by means of adaptive mesh tools that rearrange local nodal positions. In this way, the worn track was obtained and new surface profile is integrated for mass loss assessments. This work also presents experimental pin on disc tests with AISI 4140 pins on rotating AISI H13 discs with normal loads of 10, 35, 70 and 140 N, which represent, respectively, mild, transition and severe wear regimes, at sliding speed of 0.1 m/s. Numerical and experimental results were compared in terms of wear rate and friction coefficient. Furthermore, in the numerical simulation the stress field distribution and changes in the surface profile across the worn track of the disc were analyzed. The applied numerical formulation has shown to be more appropriate to predict mild wear regime than severe regime, especially due to the shorter running-in period observed in lower loads that characterizes this kind of regime.

Diseño e implementación de un prototipo de enchufe inteligente mediante la placa Arduino

[ES] Este trabajo detalla las diferentes etapas del desarrollo de construcción del prototipo Clever Socket, abarcando desde su análisis, a su diseño e implementación.
Clever Socket es un conjunto hardware y software que facilita el control del encendido y el apagado de los aparatos electrónicos conectados a él a través de redes de comunicación LAN y WAN. Para lograr este propósito, el artefacto se apoya en la placa de desarrollo electrónico Arduino UNO y la placa Arduino WiFi Shield –que posibilita su conexión inalámbrica a la red–.
El dispositivo cuenta con cuatro bases de enchufe controladas a través de relés, que permiten la gestión de hasta cuatro dispositivos electrónicos de manera simultánea.
 En el lado del software se presentan tres componentes:
Un servicio web de bajo nivel destinado a la gestión de la placa Arduino. Permite la comunicación con la placa, la lectura y escritura de sus pines.
 Un servicio web específico del dispositivo Clever Socket. Facilita la comunicación con el prototipo hardware, permitiendo así la gestión de diferentes operaciones que se llevan a cabo sobre los aparatos conectados a sus enchufes.
 Una aplicación web. Actúa como interfaz entre el usuario y el servicio web de Clever Socket, permitiendo la gestión del dispositivo. El diseño de la aplicación es responsive, lo que posibilita su correcta visualización en todo tipo de dispositivos, tanto móviles como de escritorio.

Il trattamento delle fratture e lussazioni vertebrali nei piccoli animali

Treatment of spinal fracture and luxation in small animals Traumatic spinal injuries usually result from a mechanic trauma. Spinal facture and luxations generally occur in the junction between and more mobile parts of the spinal column: close to the skull, thorax and pelvis. Fractures may occur alone or in combination with luxation as fracture/luxation. When the fractures are not stable the best solution is the surgical fixation. Internal and external fixation are the surgical methods for the treatment of vertebral fractures and luxations. The authors report the treatment of 12 cases of thoracic and lumbar vertebral fractures and luxations in small animals using the screws/pins and Polymethylmethacrylate technique. The analysis of results is a contribute I the valutation of surgical technique and complications in the post-surgical period.

Progettazione e realizzazione di prove meccaniche comparative su un fissatore esterno articolato per correzioni angolari

La fissazione esterna ha subito una forte evoluzione nel corso degli anni, passando dall’essere una tecnica utilizzata esclusivamente nella stabilizzazione delle fratture, fino a diventare una risorsa importante in ortopedia ricostruttiva per il trattamento di molte patologie ossee e dei tessuti molli. Il prototipo di fissatore esterno monolaterale articolato Kore (Citieffe S.r.l.), oggetto di questo studio, consente di effettuare correzione di deformità angolari e piccoli allungamenti su ossa lunghe. Il lavoro sperimentale si è concentrato sul testare le prestazioni meccaniche del dispositivo e della sua componentistica, con l'obiettivo di mettere in evidenza eventuali problemi. I risultati sono stati confrontati con quelli ottenuti in prove realizzate precedentemente in azienda, e con quelli ricavati su dispositivi concorrenti da altri autori. Sono state svolte una prova di compressione assiale statica, una prova a fatica di compressione assiale, una prova a flessione a quattro punti ed una prova di regolazione dinamometrica sul meccanismo di attuazione del dispositivo. E’ stata poi progettata una configurazione per studiare le principali caratteristiche dei morsetti. Nel caso del morsetto a compensazione si è verificata l'effettiva capacità di scorrimento del morsetto, mentre nel morsetto a traliccio, dotato di un meccanismo di snodo, ne viene accertata la tenuta. Al termine dei test, in base ai risultati raccolti dalle prove meccaniche e dalle prove svolte su osso artificiale, sono state fatte valutazioni riguardanti alcune modifiche da apportare al prototipo. Per quanto riguarda il dispositivo dovrà essere ridotta la dimensione del corpo centrale, al fine di avere un dispositivo più duttile, leggero e vicino al corpo. Questa modifica inoltre limiterà l'influenza della flessione delle pins sul comportamento meccanico del fissatore, migliorandone le prestazioni. Relativamente al morsetto a traliccio dovrà essere ridotta la lunghezza dello snodo, per limitare lo sforzo sulla vite di serraggio del meccanismo. Nel morsetto a compensazione dovrà essere modificato il profilo, per garantire un migliore scorrimento.

[Intramedullary claw for stabilization of proximal humerus fractures: a comparison with other semirigid techniques]

Proximal humerus fractures (pHF) are common. In this retrospective study intra-operative and postoperative data and complications of patients stabilized with conventional semirigid techniques (pins, n=30; helix wire, n=19) or a novel semirigid technique, the intramedullary claw (IMC, n=82) were compared. The type and frequency of postoperative complications differed between the groups (p<0.001). The IMC is a novel semirigid technique to stabilize pHF and seems to result in fewer complications than pins or helix wire. The frequency and relevance of a loss of repositioning in patients after IMC implantation need to be elucidated in long-term studies.

Ridge augmentation by applying bioresorbable membranes and deproteinized bovine bone mineral: a report of twelve consecutive cases

OBJECTIVE: Lateral ridge augmentations are traditionally performed using autogenous bone grafts to support membranes for guided bone regeneration (GBR). The bone-harvesting procedure, however, is accompanied by considerable patient morbidity. AIM: The aim of the present study was to test whether or not resorbable membranes and bone substitutes will lead to successful horizontal ridge augmentation allowing implant installation under standard conditions. MATERIAL AND METHODS: Twelve patients in need of implant therapy participated in this study. They revealed bone deficits in the areas intended for implant placement. Soft tissue flaps were carefully raised and blocks or particles of deproteinized bovine bone mineral (DBBM) (Bio-Oss) were placed in the defect area. A collagenous membrane (Bio-Gide) was applied to cover the DBBM and was fixed to the surrounding bone using poly-lactic acid pins. The flaps were sutured to allow for healing by primary intention. RESULTS: All sites in the 12 patients healed uneventfully. No flap dehiscences and no exposures of membranes were observed. Nine to 10 months following augmentation surgery, flaps were raised in order to visualize the outcomes of the augmentation. An integration of the DBBM particles into the newly formed bone was consistently observed. Merely on the surface of the new bone, some pieces of the grafting material were only partly integrated into bone. However, these were not encapsulated by connective tissue but rather anchored into the newly regenerated bone. In all of the cases, but one, the bone volume following regeneration was adequate to place implants in a prosthetically ideal position and according to the standard protocol with complete bone coverage of the surface intended for osseointegration. Before the regenerative procedure, the average crestal bone width was 3.2 mm and to 6.9 mm at the time of implant placement. This difference was statistically significant (P<0.05, Wilcoxon's matched pairs signed-rank test). CONCLUSION: After a healing period of 9-10 months, the combination of DBBM and a collagen membrane is an effective treatment option for horizontal bone augmentation before implant placement.

Experimental model to evaluate in vivo and in vitro cartilage MR imaging by means of histological analyses

OBJECTIVES: Implementation of an experimental model to compare cartilage MR imaging by means of histological analyses. MATERIAL AND METHODS: MRI was obtained from 4 patients expecting total knee replacement at 1.5 and/or 3T prior surgery. The timeframe between pre-op MRI and knee replacement was within two days. Resected cartilage-bone samples were tagged with Ethi((R))-pins to reproduce the histological cutting course. Pre-operative scanning at 1.5T included following parameters for fast low angle shot (FLASH: TR/TE/FA=33ms/6ms/30 degrees , BW=110kHz, 120mmx120mm FOV, 256x256 matrix, 0.65mm slice-thickness) and double echo steady state (DESS: TR/TE/FA=23.7ms/6.9ms/40 degrees , BW=130kHz, 120x120mm FOV, 256x256 matrix, 0.65mm slice-thickness). At 3T, scan parameters were: FLASH (TR/TE/FA=12.2ms/5.1ms/10 degrees , BW=130kHz, 170x170mm FOV, 320x320, 0.5mm slice-thickness) and DESS (TR/TE/FA=15.6ms/4.5ms/25 degrees , BW=200kHz, 135mmx150mm FOV, 288x320matrix, 0.5mm slice-thickness). Imaging of the specimens was done the same day at 1.5T. MRI (Noyes) and histological (Mankin) score scales were correlated using the paired t-test. Sensitivity and specificity for the detection of different grades of cartilage degeneration were assessed. Inter-reader and intra-reader reliability was determined using Kappa analysis. RESULTS: Low correlation (sensitivity, specificity) was found for both sequences in normal to mild Mankin grades. Only moderate to severe changes were diagnosed with higher significance and specificity. The use of higher field-strengths was advantageous for both protocols with sensitivity values ranging from 13.6% to 93.3% (FLASH) and 20.5% to 96.2% (DESS). Kappa values ranged from 0.488 to 0.944. CONCLUSIONS: Correlating MR images with continuous histological slices was feasible by using three-dimensional imaging, multi-planar-reformat and marker pins. The capability of diagnosing early cartilage changes with high accuracy could not be proven for both FLASH and DESS.

Funktionsintegration im Werkzeugbau durch laseradditive Fertigung

Werkzeugbauer stellen anspruchsvolle Spritzgießwerkzeuge als Einzelanfertigung oder in kleiner Stückzahl her. Dabei unterliegen sie einem hohen Zeit- und Kostendruck durch die Forderung der Kunden nach einer kurzen Time-to-Market und der Konkurrenz aus Niedriglohnländern. Eine Innovation des Werkzeugbaus zur Reduzierung von Zeit und Kosten ist die Integration von zusätzlichen Funktionen in bestehende Komponenten. Am Institut für Laser- und Anlagensystemtechnik der TU Hamburg-Harburg wurde in Zusammenarbeit mit Werkzeugbau Siegfried Hofmann und Concept Laser ein Druckluftauswerfersystem für Spritzgießwerkzeuge entwickelt. Dieses System kann klassische Auswerferstifte vollständig ersetzen. Die Integration von Druckluftauswerfern in laseradditiv gefertigte Werkzeugeinsätze mit konturnaher Kühlung erfolgt kostenneutral, da sich die Fertigungszeit des Einsatzes durch das zusätzliche System nicht verlängert und eine Druckluftsteuerung bereits in Spritzgießmaschinen vorhanden ist. Zusätzlich entfällt durch das Druckluftauswerfersystem das komplette mechanische Auswerferpaket. Durch diese Einsparungen reduzieren sich Zeit und Kosten für das Werkzeug.

Minimal-invasive percutaneous reduction and transsacral screw fixation for U-shaped fractures

STUDY DESIGN Technical note and case series. OBJECTIVE To introduce an innovative minimal-invasive surgical procedure reducing surgery time and blood loss in management of U-shaped sacrum fractures. SUMMARY OF BACKGROUND Despite their seldom appearance, U-shaped fractures can cause severe neurological deficits and surgical management difficulties. According to the nature of the injury normally occurring in multi-injured patients after a fall from height, a jump, or road traffic accident, U-shaped fractures create a spinopelvic dissociation and hence are highly unstable. In the past, time-consuming open procedures like large posterior constructs or shortening osteotomies with or without decompression were the method of choice, sacrificing spinal mobility. Insufficient restoration of sacrococcygeal angle and pelvic incidence with conventional techniques may have adverse long-term effects in these patients. METHODS In a consecutive series of 3 patients, percutaneous reduction of the fracture with Schanz pins inserted in either the pedicles of L5 or the S1 body and the posterior superior iliac crest was achieved. The Schanz pins act as lever, allowing a good manipulation of the fracture. The reduction is secured by a temporary external fixator to permit optimal restoration of pelvic incidence and sacral kyphosis. Insertion of 2 transsacral screws allow fixation of the restored spinopelvic alignment. RESULTS Anatomic alignment of the sacrum was possible in each case. Surgery time ranged from 90 to 155 minutes and the blood loss was <50 mL in all 3 cases. Two patients had very good results in the long term regarding maintenance of pelvic incidence and sacrococcygeal angle. One patient with previous cauda equina decompression had loss of correction after 6 months. CONCLUSIONS Percutaneous reduction and transsacral screw fixation offers a less invasive method for treating U-shaped fractures. This can be advantageous in treatment of patients with multiple injuries.

Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease

Much of the research on visual hallucinations (VHs) has been conducted in the context of eye disease and neurodegenerative conditions, but little is known about these phenomena in psychiatric and nonclinical populations. The purpose of this article is to bring together current knowledge regarding VHs in the psychosis phenotype and contrast this data with the literature drawn from neurodegenerative disorders and eye disease. The evidence challenges the traditional views that VHs are atypical or uncommon in psychosis. The weighted mean for VHs is 27% in schizophrenia, 15% in affective psychosis, and 7.3% in the general community. VHs are linked to a more severe psychopathological profile and less favorable outcome in psychosis and neurodegenerative conditions. VHs typically co-occur with auditory hallucinations, suggesting a common etiological cause. VHs in psychosis are also remarkably complex, negative in content, and are interpreted to have personal relevance. The cognitive mechanisms of VHs in psychosis have rarely been investigated, but existing studies point to source-monitoring deficits and distortions in top-down mechanisms, although evidence for visual processing deficits, which feature strongly in the organic literature, is lacking. Brain imaging studies point to the activation of visual cortex during hallucinations on a background of structural and connectivity changes within wider brain networks. The relationship between VHs in psychosis, eye disease, and neurodegeneration remains unclear, although the pattern of similarities and differences described in this review suggests that comparative studies may have potentially important clinical and theoretical implications.

Textilien und organische Reste

Textiles fund in Bern-Engehalbinsel are dated to the late La Tène period and show similar qualities and pattern. Their function was garments, probably a tunic hold by pins.

Biomechanical comparison between bicortical pin and monocortical screw/polymethylmethacrylate constructs in the cadaveric canine cervical vertebral column.

OBJECTIVE To compare biomechanical stiffness of cadaveric canine cervical spine constructs stabilized with bicortical stainless steel pins and polymethylmethacrylate (PMMA), monocortical stainless steel screws with PMMA, or monocortical titanium screws with PMMA. STUDY DESIGN Biomechanical cadaver study. ANIMALS Eighteen canine cervical vertebral columns (C2-C7) were collected from skeletally mature dogs (weighing 22-32 kg). METHODS Specimens were radiographed and examined by dual energy X-ray absorptiometry. Stiffness of the unaltered C4-C5 intervertebral motion unit was measured in extension, flexion and lateral bending using non-destructive 4-point bend testing. Specimens were then stabilized by (1) bicortical stainless steel pins/PMMA, (2) monocortical stainless steel screws/PMMA, or (3) monocortical titanium screws/PMMA. Mechanical testing was repeated and stiffness data from unaltered specimens and the 3 treatment groups were compared. RESULTS All 3 surgical methods significantly increased stiffness of the C4-C5 motion unit compared with the unaltered specimen (P < .001 for all treatments), but stiffness was not significantly different among the 3 fixation groups (P = .578). CONCLUSIONS In this model, monocortical screw fixation (with stainless steel or titanium screws) was biomechanically equivalent to bicortical fixation.