Fracture Of Distal Humerus: Mipo Technique With Visualization Of The Radial Nerve.

To evaluate the outcomes in patients treated for humerus distal third fractures with MIPO technique and visualization of the radial nerve by an accessory approach, in those without radial palsy before surgery. The patients were treated with MIPO technique. The visualization and isolation of the radial nerve was done by an approach between the brachialis and the brachiorradialis, with an oblique incision, in the lateral side of the arm. MEPS was used to evaluate the elbow function. Seven patients were evaluated with a mean age of 29.8 years old. The average follow up was 29.85 months. The radial neuropraxis after surgery occurred in three patients. The sensorial recovery occurred after 3.16 months on average and also of the motor function, after 5.33 months on average, in all patients. We achieved fracture consolidation in all patients (M=4.22 months). The averages for flexion-extension and prono-supination were 112.85° and 145°, respectively. The MEPS average score was 86.42. There was no case of infection. This approach allowed excluding a radial nerve interposition on site of the fracture and/or under the plate, showing a high level of consolidation of the fracture and a good evolution of the range of movement of the elbow. Level of Evidence IV, Case Series.

Scaphoid Fracture Nonunion: Correlation Of Radiographic Imaging, Proximal Fragment Histologic Viability Evaluation, And Estimation Of Viability At Surgery: Diagnosis Of Scaphoid Pseudarthrosis.

The purpose of this study was to correlate the pre-operative imaging, vascularity of the proximal pole, and histology of the proximal pole bone of established scaphoid fracture non-union. This was a prospective non-controlled experimental study. Patients were evaluated pre-operatively for necrosis of the proximal scaphoid fragment by radiography, computed tomography (CT) and magnetic resonance imaging (MRI). Vascular status of the proximal scaphoid was determined intra-operatively, demonstrating the presence or absence of puncate bone bleeding. Samples were harvested from the proximal scaphoid fragment and sent for pathological examination. We determined the association between the imaging and intra-operative examination and histological findings. We evaluated 19 male patients diagnosed with scaphoid nonunion. CT evaluation showed no correlation to scaphoid proximal fragment necrosis. MRI showed marked low signal intensity on T1-weighted images that confirmed the histological diagnosis of necrosis in the proximal scaphoid fragment in all patients. Intra-operative assessment showed that 90% of bones had absence of intra-operative puncate bone bleeding, which was confirmed necrosis by microscopic examination. In scaphoid nonunion MRI images with marked low signal intensity on T1-weighted images and the absence of intra-operative puncate bone bleeding are strong indicatives of osteonecrosis of the proximal fragment.

Influence of different catilever extensions and glass or polyamaramid reinforcement fibers on fracture strength of implant-supported temporary

In long-term oral rehabilitation treatments, resistance of provisional crowns is a very important factor, especially in cases of an extensive edentulous distal space. The aim of this laboratorial study was to evaluate an acrylic resin cantilever-type prosthesis regarding the flexural strength of its in-balance portion as a function of its extension variation and reinforcement by two types of fibers (glass and polyaramid), considering that literature is not conclusive on this subject. Each specimen was composed by 3 total crowns at its mesial portion, each one attached to an implant component (abutment), while the distal portion (cantilever) had two crowns. Each specimen was constructed by injecting acrylic resin into a two-part silicone matrix placed on a metallic base. In each specimen, the crowns were fabricated with either acrylic resin (control group) or acrylic resin reinforced by glass (Fibrante, Angelus) or polyaramide (Kevlar 49, Du Pont) fibers. Compression load was applied on the cantilever, in a point located 7, 14 or 21 mm from the distal surface of the nearest crown with abutment, to simulate different extensions. The specimen was fixed on the metallic base and the force was applied until fracture in a universal test machine. Each one of the 9 sub-groups was composed by 10 specimens. Flexural strength means (in kgf) for the distances of 7, 14 and 21 mm were, respectively, 28.07, 8.27 and 6.39 for control group, 31.89, 9.18 and 5.16 for Kevlar 49 and 30.90, 9.31 and 6.86 for Fibrante. Data analysis ANOVA showed statistically significant difference (p<0.05) only regarding cantilever extension. Tukey's test detected significantly higher flexural strength for the 7 mm-distance, followed by 14 and 21 mm. Fracture was complete only on specimens of non-reinforced groups.

Influence of intraradicular post and crown ferrule on the fracture strength of endodontically treated teeth

The aim of this study was to investigate the fracture strength of endodontically treated teeth restored with different posts and variable ferrule heights. Sixty freshly extracted human canines were treated endodontically and randomly assigned to 6 groups (n=10), being restored with custom-made cast post-and-core (CP0 and CP3 groups), prefabricated post and composite resin core (PF0 and PF3 groups), and composite resin (CR0 and CR3 groups). The CP0, PF0 and CR0 groups presented no ferrule and the CP3, PF3 and CR3 presented 3 mm of coronal structure. All teeth were restored with full metal crowns. The fracture strength was measured in a universal testing machine at 45o to the long axis of the tooth until failure. Data were analyzed statistically by 2-way ANOVA and Tukey's test (?=0.05). When the mean fracture strength values were compared (CP0 group - 820.20 N, CP3 group - 1179.12 N; PF0 group - 561.05 N; PF3 group - 906.79 N; CR0 group - 297.84 N; and CR3 group - 1135.15 N) there was statistically significant among the groups (p<0.05), except for the three groups with 3 mm of coronal remaining, which were similar to each other. The results of this study showed that the ferrule in crowns promoted significantly higher fracture strength in the endodontically treated teeth.

Fracture resistance of weakened roots restored with composite resin and glass fiber post

This study evaluated the fracture resistance of weakened roots restored with glass fiber posts, composite resin cores and complete metal crowns. Thirty maxillary canines were randomly divided into 3 groups of 10 teeth each: teeth without weakened roots (control); teeth with partially weakened roots (PWR) and teeth with and largely weakened roots (LWR). The control group was restored with glass fiber posts and a composite resin core. Teeth in the PWR and LWR groups were flared internally to standardized dimensions in order to simulate root weakness. Thereafter, the roots were partially filled with composite resin and restored in the same way as in the control group. The specimens were exposed to 250,000 cycles in a controlled chewing simulator. All intact specimens were subjected to a static load (N) in a universal testing machine at 45 degrees to the long axis of the tooth until failure. Data were analyzed by one-way ANOVA and Dunnett's test for multiple comparisons (p=0.05). There were statistically significant difference differences (p<0.01) among the groups (control group = 566.73 N; PWR = 409.64 N; and LWR = 410.91 N), with significantly higher fracture strength for the control group. There was no statistically significant difference (p>0.05) between the weakened groups. The results of this study showed that thicker root dentin walls significantly increase the fracture resistance of endodontically treated teeth.

Effect of different ferrule designs on the fracture resistance and failure pattern of endodontically treated teeth restored with fiber posts and all-ceramic crowns

OBJECTIVE: This study investigated the effect of different ferrule heights on endodontically treated premolars. MATERIAL AND METHODS: Fifty sound mandibular first premolars were endodontically treated and then restored with 7-mm fiber post (FRC Postec Plus #1 Ivoclar-Vivadent) luted with self-polymerized resin cement (Multilink, Ivoclar Vivadent) while the coronal section was restored with hybrid composite core build-up material (Tetric Ceram, Ivoclar-Vivadent), which received all-ceramic crown. Different ferrule heights were investigated: 1-mm circumferential ferrule without post and core (group 1 used as control), a circumferential 1-mm ferrule (group 2), non-uniform ferrule 2-mm buccally and 1-mm lingually (group 3), non-uniform ferrule 3-mm buccally and 2-mm lingually (group 4), and finally no ferrule preparation (group 5). The fracture load and failure pattern of the tested groups were investigated by applying axial load to the ceramic crowns (n=10). Data were analyzed statistically by one-way ANOVA and Tukey's post-hoc test was used for pair-wise comparisons (α=0.05). RESULTS: There were no significant differences among the failure load of all tested groups (P<0.780). The control group had the lowest fracture resistance (891.43±202.22 N) and the highest catastrophic failure rate (P<0.05). Compared to the control group, the use of fiber post reduced the percentage of catastrophic failure while increasing the ferrule height did not influence the fracture resistance of the restored specimens. CONCLUSIONS: Within the limitations of this study, increasing the ferrule length did not influence the fracture resistance of endodontically treated teeth restored with glass ceramic crowns. Insertion of a fiber post could reduce the percentage of catastrophic failure of these restorations under function.

Influence of ferrule preparation with or without glass fiber post on fracture resistance of endodontically treated teeth

OBJECTIVE: This study evaluated the effect of ferrule preparation (Fp) on the fracture resistance of endodontically treated teeth, restored with composite resin cores with or without glass fiber posts. MATERIAL AND METHODS: Forty-four bovine teeth were sectioned 19 or 17 mm (2 mm ferrule) from the apex, endodontically treated and assigned to four groups (n = 11): Group 1: Fp and post; Group 2: Fp and without post; Group 3: without Fp and with post; Group 4: without Fp and without post. All specimens were restored with composite resin core and metal crown. Specimens were subjected to fracture resistance testing in a universal testing machine at a crosshead speed of 0.5 mm/min. The data were analyzed by two-way ANOVA and Tukey's tests (α=0.05). RESULTS: The mean fracture resistance values were as follows: Group 1: 573.3 N; Group 2: 552.5 N; Group 3: 275.3 N; Group 4: 258.6 N. Significantly higher fracture resistance was found for the groups with Fp (p<0.001). CONCLUSION: There was no statistically significant interaction between the "Fp" and "post" factors (p = 0.954). The ferrule preparation increased the fracture resistance of endodontically treated teeth. However, the use of glass fiber post showed no significant influence on the fracture resistance.

Effects of the condylar process fracture on facial symmetry in rats submitted to protein undernutrition

PURPOSE: To investigate the facial symmetry of rats submitted to experimental mandibular condyle fracture and with protein undernutrition (8% of protein) by means of cephalometric measurements. METHODS: Forty-five adult Wistar rats were distributed in three groups: fracture group, submitted to condylar fracture with no changes in diet; undernourished fracture group, submitted to hypoproteic diet and condylar fracture; undernourished group, kept until the end of experiment, without condylar fracture. Displaced fractures of the right condyle were induced under general anesthesia. The specimens were submitted to axial radiographic incidence, and cephalometric mensurations were made using a computer system. The values obtained were subjected to statistical analyses among the groups and between the sides in each group. RESULTS: There was significative decrease of the values of serum proteins and albumin in the undernourished fracture group. There was deviation of the median line of the mandible relative to the median line of the maxilla, significative to undernutrition fracture group, as well as asymmetry of the maxilla and mandible, in special in the final period of experiment. CONCLUSION: The mandibular condyle fracture in rats with proteic undernutrition induced an asymmetry of the mandible, also leading to consequences in the maxilla.

Fracture strength of teeth restored with ceramic inlays and overlays

This study evaluated the fracture strength of teeth restored with bonded ceramic inlays and overlays compared to sound teeth. Thirty sound human maxillary premolars were assigned to 3 groups: 1- sound/unprepared (control); 2- inlays and 3- overlays. The inlay cavity design was Class II MOD preparation with an occlusal width of 1/2 of the intercuspal distance. The overlay cavity design was similar to that of the inlay group, except for buccal and palatal cusp coverage The inlay and overlay groups were restored with feldspathic porcelain bonded with adhesive cement. The specimens were subjected to a compressive load until fracture. Data were analyzed statistically by the Kruskal-Wallis test at 5% significance level. The fracture strength means (KN) were: Sound/unprepared group = 1.17, Inlay group= 1.17, and Overlay group = 1.14. There were no statistically significant differences (p>0.05) among the groups. For inlays and overlays, the predominant fracture mode involved fragments of one cusp (70% of simple fractures). The fracture strength of teeth restored with inlay and overlay ceramics with cusp coverage was similar to that of intact teeth.

Comparison of the fracture torque of different Brazilian mini-implants

This study evaluated fracture torque by torsion, in relation to the length and diameter of orthodontic mini-implants, to demonstrate their viability for clinical and experimental use based on the torque recommended by the manufacturers. The fractures at the moment of insertion, whose incidence in the literature is around 4%, are principally due to excessive force and the inability of the implant to resist rotational forces. Thirty orthodontic mini-implants of three commercial brands available in Brazil (Neodent 1.6 x 9 mm, Dentoflex 1.6 x 9 mm and Kopp 1.6 x 9 mm) were attached to a device made specifically for this research, leaving the mini-implants with sufficient stability. The miniimplants were submitted to torsion torque, using a digital torque wrench, until their breaking point. The values obtained with the test were submitted to analysis of variance and the Tukey test. The mean values of mini-implant ruptures were 26 N.cm for group A (Dentoflex), 25.4 N. cm for group B (Kopp) and 32.8 N.cm for group C (Neodent). From the Tukey test we could observe that the relationships between the means of the Dentoflex and Neodent groups, and between the Kopp and Neodent groups, were significant. Between the Dentoflex and Kopp groups, significance was nonexistent. All the values found in our research for fracture torque were higher than the limits recommended by the manufacturers for clinical use in orthodontics. The highest values were found in the Neodent group.

The influence of microstructure on the maximum load and fracture energy of refractory castables

Refractory castables are composed of fractions of fine to fairly coarse particles. The fine fraction is constituted primarily of raw materials and calcium aluminate cement, which becomes hydrated, forming chemical bonds that stiffen the concrete during the curing process. The present study focused on an evaluation of several characteristics of two refractory castables with similar chemical compositions but containing aggregates of different sizes. The features evaluated were the maximum load, the fracture energy, and the ""relative crack-propagation work"" of the two castables heat-treated at 110, 650, 1100 and 1550 degrees C. The results enabled us to draw the following conclusions: the heat treatment temperature exerts a significant influence on the matrix/aggregate interaction, different microstructures form in the castables with temperature, and a relationship was noted between the maximum load and the fracture energy. (C) 2009 Elsevier Ltd and Techna Group S.r.l. All rights reserved.

Polymer toughening using residue of recycled windshields: PVB film as impact modifier

In this work, poly(vinyl butyral) (PVB) film originated from the mechanical separation of windshields was tested as all impact modifier of Polyamide-6 (PA-6). The changes undergone by PVB film during the recycling process and the blend manufacturing were evaluated by thermal analyses, infrared spectroscopy and loss oil ignition. Blends of PA-6/original PVB film and PA-6/recovered PVB film were obtained in concentrations ranging from 90/10 to 60/40. The mechanical properties of the blends were investigated and explained in light of the blends morphologies, which in turns were correlated to the changes undergone by the PVB film during the recycling process. The original film presented a plasticizer content of 33 wt.%, which decreased to as low as 20 wt.%, after the recycling and blend preparation processes. The PA-6/PVB film blends presented lower values of tensile strength and Young`s modulus than Polyamide-6, but all blends presented a dramatic increase in their toughness, with a special feature for the 40 wt.%(, blend, which resulted in a super toughened material (impact strength exceeding 500 J/m). Similar results were obtained with recovered PVB film and super tough blends were also obtained. The use of recovered PVB resulted in a smaller improvement of the impact strength due to the loss of plasticizer undergone during the recycling process. The morphological observations showed that if the interparticle distance is smaller than around 0.2 mu m (critical value), the notched Izod impact strength values increase considerably and the fracture surface of blends exhibit characteristics of tough failure. (C) 2007 Elsevier Ltd. All rights reserved.

Effect of alpha prime due to 475 degrees C aging on fracture behavior and corrosion resistance of DIN 1.4575 and MA 956 high performance ferritic stainless steels

The 475 degrees C embrittlement in stainless steels is a well-known phenomenon associated to alpha prime (alpha`) formed by precipitation or spinodal decomposition. Many doubts still remain on the mechanism of alpha` formation and its consequence on deformation and fracture mechanisms and corrosion resistance. In this investigation, the fracture behavior and corrosion resistance of two high performance ferritic stainless steels were investigated: a superferritic DIN 1.4575 and MA 956 superalloy were evaluated. Samples of both stainless steels (SS) were aged at 475 degrees C for periods varying from 1 to 1,080 h. Their fracture surfaces were observed using scanning electron microscopy (SEM) and the cleavage planes were determined by electron backscattering diffraction (EBSD). Some samples were tested for corrosion resistance using electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization. Brittle and ductile fractures were observed in both ferritic stainless steels after aging at 475 degrees C. For aging periods longer than 500 h, the ductile fracture regions completely disappeared. The cleavage plane in the DIN 1.4575 samples aged at 475 degrees C for 1,080 h was mainly {110}, however the {102}, {314}, and {131} families of planes were also detected. The pitting corrosion resistance decreased with aging at 475 degrees C. The effect of alpha prime on the corrosion resistance was more significant in the DIN 1.4575 SS comparatively to the Incoloy MA 956.

Photodegradation of Thermodegraded Polypropylene/High-Impact Polystyrene Blends: Mechanical Properties

The influence of the addition of high-impact polystyrene (HIPS) on polypropylene (PP) photodegradation was studied with blends obtained by extrusion with and without styrene-butadiene-styrene (SBS) copolymer (10 wt % with respect to the dispersed phase). The concentrations of HIPS ranged from 10 to 30 wt %. The blends and pure materials were exposed for periods of up to 15 weeks of UV irradiation; their mechanical properties (tensile and impact), fracture surface, and melt flow indices were monitored. After 3 weeks of UV exposure, all of the materials presented mechanical properties of the same order of magnitude. However, for times of exposure greater than 3 weeks, an increasing concentration of HIPS resulted in a better photostability of PP. These results were explained in light of morphological observations. This increase of photostability was even greater when SBS was added to the blends. It was more difficult to measure the melt flow index of the binary PP/HIPS blends than that of PP for low concentrations of HIPS; this was most likely due to energy transfer between the blend domains during photodegradation. This phenomenon was not observed for the ternary blends. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 120: 770-779, 2011

Facial Palsy After Blunt Trauma and Without Facial Bone Fracture

A 14-year-old patient had a low-energy facial blunt trauma that evolved to right facial paralysis caused by parotid hematoma with parotid salivary gland lesion. Computed tomography and angiography demonstrated intraparotid collection without pseudoaneurysm and without radiologic signs of fracture in the face. The patient was treated with serial punctures for hematoma deflation, resolving with regression and complete remission of facial paralysis, with no late sequela. The authors discuss the relationship between facial nerve traumatic injuries associated or not with the presence of facial fractures, emphasizing the importance of early recognition and appropriate treatment of such cases.