The relationship between interimplant distances and vascularization of the interimplant bone

Background Long-term success of the implant restorations is based upon the biology and vasculature of the bone surrounding the implants, especially for the bone between two implants. Purpose The aim of this study was to evaluate how loaded implants placed 2 or 3 mm apart influence bone vessel organization. Material and methods Six mongrel dogs were used for the study. The four mandibular premolars were extracted and 3 months later, four 4.5 x 10 mm implants were placed on each side of the mandible. The implants were placed so that two adjacent implants were 2 mm (group 1) or 3 mm (group 2) distant from each other. After 12 weeks, the implants were loaded with provisional prostheses, then metallic crowns were placed 4 weeks later. Both temporary and metallic restorations were made so that the distance between the contact point and the bone crest was 5 mm. The animals were sacrificed after 8 weeks. The hemi-mandibles were removed and prepared for analysis. The interimplant bone vasculature of the two groups was studied using scanning electron microscopic images fractal analysis. The fractal dimension (D(f)) was calculated using the box-counting method. Results The values of the D(f) for the blood vessels were significantly higher (P <.05) in the specimens of the group 2 (1.969 +/- 0.169) than the group 1 (1.556 +/- 0.246). Conclusion The presence of more blood vessels in the group 2 is another indication that 3 mm is a preferable distance for contiguous implants than the 2 mm distance. To cite this article:Traini T, Novaes AB, Piattelli A, Papalexiou V, Muglia VA. The relationship between interimplant distances and vascularization of the interimplant bone.Clin. Oral Impl. Res. 21, 2010; 822-829.doi: 10.1111/j.1600-0501.2010.01926.x.

Influence of interimplant distances and placement depth on peri-implant bone remodeling of adjacent and immediately loaded Morse cone connection implants: a histomorphometric study in dogs

Objectives The aim of this study was to histomorphometrically evaluate the influence of interimplant distances (ID) and implant placement depth on bone remodeling around contiguous Morse cone connection implants with `platform-shifting` in a dog model. Material and methods Bilateral mandibular premolars of six dogs were extracted, and after 12 weeks, each dog received 8 implants, four placed 1.5 mm subcrestally (SCL) on one side of the mandible and four placed equicrestally (ECL) on the other side, alternating the ID of 2 and 3 mm. The experimental groups were SCL with IDs of 2 mm (2 SCL) and 3 mm (3 SCL) and ECL with IDs of 2 mm (2 ECL) and 3 mm (3 ECL). Metallic crowns were immediately installed. After 8 weeks, the animals were euthanized and histomorphometric analyses were performed to compare bone remodeling in the groups. Results The SCL groups` indices of crestal bone resorption were significantly lower than those of ECL groups. In addition, the vertical bone resorption around the implants was also numerically inferior in the SCL groups, but without statistical significance. No differences were obtained between the different IDs. All the groups presented similar good levels of bone-to-implant contact and histological bone density. Conclusion The subcrestal placement of contiguous Morse cone connection implants with `platform shifting` was more efficient in preserving the interimplant crestal bone. The IDs of 2 and 3 mm did not affect the bone remodeling significantly under the present conditions. To cite this article:Barros RRM, Novaes AB Jr., Muglia VA, Iezzi G, Piattelli A. Influence of interimplant distances and placement depth on peri-implant bone remodeling of adjacent and immediately loaded Morse cone connection implants: a histomorphometric study in dogs.Clin. Oral Impl. Res. 21, 2010; 371-378.doi: 10.1111/j.1600-0501.2009.01860.x.

Biocompatibility Evaluation of Epiphany/Resilon Root Canal Filling System in Subcutaneous Tissue of Rats

Introduction: The purpose of this study was to evaluate the biocompatibility of the root canal filling system Epiphany/Resilon in connective tissue of rats. Methods: Fifteen rats were used, separated into 3 groups in accordance with its period of death (7, 21, 42 days). Four filled dentin tubes were implanted with the tested materials as follows: ERSP group, Epiphany/Resilon with Self-etch Primer; ER group, Epiphany/Resilon without primer; EG group, Endofill/gutta-percha points; and ET group, empty tube. After 7, 21, and 42 days, animals were killed, obtaining 5 samples per group. A grade from I-IV was used to graduate the inflammatory reaction. Results: Results showed that Epiphany/Resilon (ERSP and ER groups) induced a slight (II) inflammatory reaction after 42 days. However, in ER group, in which the self-etch primer was not applied, severe (IV) to moderate (III) inflammatory reactions were observed between 7 and 21 days. When compared with the EG and ET groups, it was observed that these groups presented tissue reaction ranging from slight (II, 7 and 21 days) to no inflammation (I, 42 days). Conclusions: Epiphany/Resilon root canal filling system presented satisfactory tissue reaction. It was biocompatible when tested in connective tissue of rats. (J Endod 2010;36:110-114)

Effect of recombinant human bone morphogenetic protein-2 on bone formation in the acute distraction osteogenesis of rat mandibles

Background Distraction osteogenesis (DO) is a method of producing new bone directly from the osteotomy site by gradual traction of the divided bone fragments. Aim The purpose of the present study was to evaluate histomorphometrically whether acute DO would constitute a viable alternative to the conventional continuous distraction treatment and also to verify the capacity of a recombinant human BMP (rhBMP-2) associated with monoolein gel to stimulate bone formation in the acute distraction process. Materials and methods Forty-eight Wistar rats were assigned to three groups: Group 1, treated at a conventional continuous distraction rate (0.5 mm/day), Group 2, treated with acute distraction of 2.5 mm at the time of the surgical procedure, and Group 3, subjected to acute distraction associated with rhBMP-2. The animals from each experimental group were killed at the end of the second or fourth post-operative weeks and the volume fraction of newly formed bone trabeculae was estimated in histological images by a differential point-counting method. Results The results showed that after 2 and 4 weeks, bone volumes in the rhBMP-2 group were significantly higher than in the other groups (P < 0.05), but no significant difference was observed in the volume fraction of newly formed bone between the continuous and acute DO groups. Conclusion In conclusion, the study indicates that rhBMP-2 can enhance the bone formation at acute DO, which may potentially reduce the treatment period and complications related to the distraction procedure. To cite this article:Issa JPM, do Nascimento C, Lamano T, Iyomasa MM, Sebald W, de Albuquerque Jr RF. Effect of recombinant human bone morphogenetic protein-2 on bone formation in the acute distraction osteogenesis of rat mandibles.Clin. Oral Impl. Res. 20, 2009; 1286-1292.doi: 10.1111/j.1600-0501.2009.01799.x.

Mental evolution and development: Evidence for secondary representation in children, great apes, and other animals

Recent interest in the development and evolution of theory of mind has provided a wealth of information about representational skills in both children and animals, According to J, Perrier (1991), children begin to entertain secondary representations in the 2nd year of life. This advance manifests in their passing hidden displacement tasks, engaging in pretense and means-ends reasoning, interpreting external representations, displaying mirror self-recognition and empathic behavior, and showing an early understanding of mind and imitation. New data show a cluster of mental accomplishments in great apes that is very similar to that observed in 2-year-old humans. It is suggested that it is most parsimonious to assume that this cognitive profile is of homologous origin and that great apes possess secondary representational capacity. Evidence from animals other than apes is scant. This analysis leads to a number of predictions for future research.

Veterinary drug delivery: Potential for skin penetration enhancement

A range of topical products are used in veterinary medicine. The efficacy of many of these products has been enhanced by the addition of penetration enhancers. Evolution has led to not only a highly specialized skin in animals and humans, but also one whose anatomical structure and skin permeability differ between the various species. The skin provides an excellent barrier against the ingress of environmental contaminants, toxins, and microorganisms while performing a homeostatic role to permit terrestrial life. Over the past few years, major advances have been made in the field of transdermal drug delivery. An increasing number of drugs are being added to the list of therapeutic agents that can be delivered via the skin to the systemic circulation where clinically effective concentrations are reached. The therapeutic benefits of topically applied veterinary products is achieved in spite of the inherent protective functions of the stratum corneum (SQ, one of which is to exclude foreign substances from entering the body. Much of the recent success in this field is attributable to the rapidly expanding knowledge of the SC barrier structure and function. The bilayer domains of the intercellular lipid matrices within the SC form an excellent penetration barrier, which must be breached if poorly penetrating drugs are to be administered at an appropriate rate. One generalized approach to overcoming the barrier properties of the skin for drugs and biomolecules is the incorporation of suitable vehicles or other chemical compounds into a transdermal delivery system. Indeed, the incorporation of such compounds has become more prevalent and is a growing trend in transdermal drug delivery. Substances that help promote drug diffusion through the SC and epidermis are referred to as penetration enhancers, accelerants, adjuvants, or sorption promoters. It is interesting to note that many pour-on and spot-on formulations used in veterinary medicine contain inert ingredients (e.g., alcohols, amides, ethers, glycols, and hydrocarbon oils) that will act as penetration enhancers. These substances have the potential to reduce the capacity for drug binding and interact with some components of the skin, thereby improving drug transport. However, their inclusion in veterinary products with a high-absorbed dose may result in adverse dermatological reactions (e.g., toxicological irritations) and concerns about tissue residues. These a-re important considerations when formulating a veterinary transdermal product when such compounds ate added, either intentionally or otherwise, for their penetration enhancement ability. (C) 2001 Elsevier Science B.V. All rights reserved.

Experimental infections of pigs with Japanese encephalitis virus and closely related Australian flaviviruses

The flavivirus Japanese encephalitis (JE) virus has recently emerged in the Australasian region. To investigate the involvement of infections with related enzootic flaviviruses, namely Murray Valley encephalitis (MVE) virus and Kunjin (KUN) virus, on immunity of pigs to JE virus and to provide a basis for interpretation of serologic data, experimental infections were conducted with combinations of these viruses. Antibody responses to primary and secondary infections were evaluated using panels of monoclonal antibody-based blocking enzyme-link-ed immuno-sorbent assays and microtiter scrum neutralization tests (mSNTs). Identification of the primary infecting virus was possible only using the mSNTs. Following challenge, unequivocal diagnosis was impossible due to variation in immune responses between animals and broadened and/or anamnestic responses. Viremia for JE virus was readily detected in pigs following primary infection, but was not detected following prior exposure to MVE or KUN viruses. Boosted levels of existing cross-neutralizing antibodies to JE virus suggested a role for this response in suppressing JE viremia.

Fluid shifts resulting from exercise in rats as detected by bioelectrical impedance

Purpose: This study was designed to investigate the immediate effect of exercise intensity and duration on body fluid volumes in rats throughout a 3-wk exercise program. Methods: Changes in the extracellular water (ECW) and total body water (TBW) volumes of rats were measured preexercise and postexercise using multiple frequency bioelectrical impedance analysis. Groups of rats were exercised at two intensities (6 m.min(-1) and 12 m.min(-1)) for two exercise times (60 min and 90 min) 5 d.wk(-1) during a 3-wk period. Changes in plasma electrolytes, glucose, and lactate resulting from the exercise were also measured on 3 d of each week. Results: Each group of animals showed significant losses in ECW and TBW as a direct result of daily exercise. The magnitude of fluid loss was directly related to the intensity of the exercise, bur not to exercise duration; although the magnitude of daily fluid loss at the higher intensity exercise (12 m.min(-1)) decreased as the study progressed, possibly indicating a training effect. Conclusion: At low-intensity exercise, there is a small bur significant loss in both TBW and ECW fluids, and the magnitude of these losses does not change throughout a 3-wk exercise program. At moderate levels of exercise intensity, there is a greater loss of both TBW and ECW fluids. However, the magnitudes of these losses decrease significantly during the 3-wk exercise program, thus demonstrating a training effect.

The oral medicine of tooth wear

This review illustrates, through a series of case histories, how oral medicine insights aid the diagnosis and management of patients with excessive tooth wear. The cases reviewed are drawn from the records of 500 southeast Queensland patients referred to the author over a 12 year period. Patients most at risk of dental erosion have work and sports dehydration, caffeine addiction, gastro-oesophageal reflux, asthma, diabetes mellitus, hypertension or other systemic diseases or syndromes that predispose to xerostomia. Saliva protects the teeth from the extrinsic and intrinsic acids which cause dental erosion. Erosion, exacerbated by attrition and abrasion, is the main cause of tooth wear. These cases illustrate that teeth, oral mucosa, salivary glands, skin and eyes should be examined for evidence of salivary hypofunction and attendant medical conditions. Based on comprehensive oral medicine, dietary analyses and advice, it would seem patients need self-management plans to deal with incipient chronic tooth wear. The alternative is the expensive treatment of pain, occlusal damage and pulp death required to repair the effects of acute severe tooth wear.

Irradiation-induced oral candidiasis in an experimental murine model

The aim of this experiment was to establish a mouse model of irradiation-induced oral candidiasis and to explore the cellular populations and mechanisms by which the infection is cleared from the oral mucosa. BALB/c mice received irradiation to the head and neck equivalent to 800 Rad using a Cobalt 60 gamma source. Both irradiated and non-irradiated mice were infected orally with 1 X 10(8) Candida albicans yeasts. Compared with untreated controls, irradiated animals developed a more severe infection of longer duration, with hyphae penetrating the oral mucosa. Monoclonal antibody depletion of CD4(+) but not CD8(+) T cells from the systemic circulation prolonged the infection in irradiated mice, but not in controls. Supernatants of submandibular and superficial cervical lymph node cultures from irradiated animals demonstrated significantly higher titers of interleukin-12, but similar levels of interferon-gamma compared with controls. Screening for cytokine production by an RNase protection assay detected only macrophage migration inhibition factor in irradiated and non-irradiated oral tissues from day 8 onwards. The results of this study demonstrate a requirement for CD4(+) T cells in the recovery from oral candidiasis induced by head and neck irradiation in mice, and are consistent with a role for Th-1-type cytokines in host resistance.

An evidence-based medicine fellowship in a children's teaching hospital

This paper reports the introduction of an evidence-based medicine fellowship in a children’s teaching hospital. The results are presented of a self-reported ‘evidence-based medicine’ questionnaire, the clinical questions requested through the information retrieval service are outlined and the results of an information retrieval service user questionnaire are reported. It was confirmed that clinicians have frequent clinical questions that mostly remain unanswered. The responses to four questions with ‘good quality’ evidence-based answers were reviewed and suggest that at least one-quarter of doctors were not aware of the current best available evidence. There was a high level of satisfaction with the information retrieval service; 19% of users indicated that the information changed their clinical practice and 73% indicated that the information confirmed their clinical practice. The introduction of an evidence-based medicine fellowship is one method of disseminating the practice of evidence-based medicine in a tertiary children’s hospital.

Skeletal effects of low-intensity pulsed ultrasound on the ovariectomized rodent

Growing evidence supports low-intensity pulsed ultrasound (US) as an osteogenic mechanical stimulus. Its effects on isolated bone cells and on fractured bone are established. However, its effects on osteoporosis are not clear. This study examined US effects on ovariectomy (OVX) induced bone changes within the rodent hindlimb (distal femur and proximal tibia), and on normal bone in animals following sham-OVX. Animals were exposed to daily unilateral active-US and contralateral inactive-US for 12 weeks. Bone status was assessed using dual energy X-ray absorptiometry and histomorphometry. Ovariectomy resulted in significant bone changes. Low-intensity pulsed US did not influence these changes. These results suggest that the US dose introduced may not be a beneficial treatment for osteoporosis, and that intact bone may be less sensitive to US than fractured bone and isolated bone cells. This may relate to the biophysical mechanisms of action of US, US-bone interactions and tissue level processes taking place.