Reconstruction of the Alveolar Buccal Bone Plate in Compromised Fresh Socket after Immediate Implant Placement Followed by Immediate Provisionalization

ObjectiveThe aim of this clinical report was to reestablish the buccal bone wall after immediate implant placement. The socket defect was corrected with autogenous bone, and a connective tissue graft was removed from the maxillary tuberosity to increase the thickness, height, and width of the buccal bone and gingival tissue followed by immediate provisionalization of the crown during the same operation.Clinical ConsiderationsA 66-year-old patient presented with a hopeless maxillary left central incisor with loss of the buccal bone wall. Atraumatic, flapless extraction was performed, and an immediate implant was placed in the extraction socket followed by preparation of an immediate provisional restoration. Subsequently, immediate reconstruction of the buccal bone plate was performed, using the tuberosity as the donor site, to obtain block bone and connective tissue grafts, as well as particulate bone. Finally, immediate provisionalization of the crown followed by simple sutures was performed. Cone-beam computed tomography and periapical radiographs were taken before and after surgery. After 4 months, the final prosthetic crown was made. After a 2-year follow-up, a satisfactory aesthetic result was achieved with lower treatment time and morbidity.ConclusionThis case demonstrates the effective use of immediate reconstruction of the buccal bone wall for the treatment of a hopeless tooth in the maxillary aesthetic area. This procedure efficiently promoted harmonious gingival and bone architecture, recovered lost anatomical structures with sufficient width and thickness, and maintained the stability of the alveolar bone crest in a single procedure.Clinical SignificanceIf appropriate clinical conditions exist, immediate dentoalveolar restoration may be the most conservative means of reconstructing the buccal bone wall after immediate implant placement followed by immediate provisionalization with predictable healing and lower treatment time.

Acute effects of flexible pole exercise on heart rate dynamics

Introduction: Exercise with flexible poles provides fast eccentric and concentric muscle contractions. Although the literature reports significant muscle chain activity during this exercise, it is not clear if a single bout of exercise induces cardiac changes. In this study we assessed the acute effects of flexible pole exercise on cardiac autonomic regulation.Methods: The study was performed on 22 women between 18 and 26 years old. We assessed heart rate variability (HRV) in the time (SDNN, RMSSD and pNN50) and frequency (HF, LF and LF/HF ratio) domains and geometric indices of HRV (RRTri, TINN, SD1, SD2 and SD1/SD2 ratio). The subjects remained at rest for 10 min and then performed the exercises with the flexible poles. Immediately after the exercise protocol, the volunteers remained seated at rest for 60 min and HRV was analyzed.Results: We observed no significant changes in time domain (SDNN: p=0.72; RMSSD: p=0.94 and pNN50: p=0.92) or frequency domain indices (LF [nu]: p=0.98; LF [ms(2)]: p=0.72; HF [nu]: p=0.98; HF [ms(2)]: p=0.82 and LF/HF ratio: p=0.7) or in geometric indices (RRTri: p=0.54; TINN: p=0.77; SD1 p=0.94; SD2: p=0.67 and SD/SD2: p=0.42) before and after a single bout of flexible pole exercise.Conclusion: A single bout of flexible pole exercise did not induce significant changes in cardiac autonomic regulation in healthy women. (C) 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.

Medium effects in the pion-pole mechanism [gamma gamma ->pi(0)->nu(R)(nu)over-bar(L)(nu(L)(nu)over-bar(R))] of neutron star cooling

Nuclear medium effects in the neutrino cooling of neutron stars through the reaction channel γγ→π0 →ν Rν̄L(νLν̄R) are incorporated. Throughout the paper we discuss different possibilities of right-handed neutrinos, massive left-handed neutrinos, and standard massless left-handed neutrinos (reaction is then allowed only with medium modified vertices). It is demonstrated that multiparticle effects suppress the rate of this reaction channel in the dense hadron matter by 6-7 orders of magnitude that does not allow to decrease existing experimental upper limit on the corresponding π0νν̄ coupling. Other possibilities of the manifestation of the given reaction channel in different physical situations, e.g., in the quark color superconducting cores of the most massive neutron stars, are also discussed. We demonstrate that in the color-flavor-locked superconducting phase for temperatures T≲ 0.1-10 MeV (depending on the effective pion mass and the decay width) the process is feasibly the most efficient neutrino cooling process, although the absolute value of the reaction rate is rather small.

Paleoclimate Reconstruction Along The Pole-Equator-Pole Transect of the Americas (PEP 1)

Examples are presented of inter-hemispheric comparison of instrumental climate and paleoclimate proxy records from the Americas for different temporal scales. Despite a certain symmetry of seasonal precipitation patterns along the PEP 1 transect, decadal variability of winter precipitation shows different characteristics in terms of amplitude and frequency in both the last 100 and last 1000 years. Such differences in variability are also seen in a comparison of time series of different El Nino/Southern Oscillation proxy records from North and South America, however, these differences do not appear to affect the spatial correlation with Pacific sea surface temperature patterns. Local and regional differences in response to climate change are even more pronounced for records with lower temporal resolution, and inter-hemispheric synchroneity may or may not be indicative of the same forcing. This aspect is illustrated in an inter-hemispheric comparison of the last 1000 years of glacier variability, and of the full- and late-glacial lake level history.

EREMOPHYGUS BICOLOR (GUTIÉRREZ) (COLEOPTERA: SCARABAEIDAE: RUTELINAE: RUTELINI): A NEW TRIBAL AND GENERIC PLACEMENT FOR THE BOLIVIAN SCARAB PLATYCOELIA BICOLOR (GUTIÉRREZ) (ANOPLOGNATHINI)

Platycoelia bicolor (Gutiérrez) (Scarabaeidae: Rutelinae) is transferred from the tribe Anoplognathini, subtribe Platycoeliina, to the tribe Rutelini. Platycoelia bicolor is placed in the genus Eremophygus Ohaus and the taxonomic history of the species is discussed. The transfer creates a new combination, Eremophygus bicolor (Gutiérrez) and places the generic name Heterocallichloris Gutiérrez as a junior synonym of Eremophygus (new synonymy). Morphological characters that warrant the transfer are discussed. Se transfiere Platycoelia bicolor (Gutiérrez) (Scarabaeidae: Rutelinae) de la tribu Anoplognathini, subtribe Platycoeliina, a la tribu Rutelini. Se transfiere Platycoelia bicolor al género Eremophygus Ohaus y se discute su historia taxonómica. La transferencia crea una nueva combinación, Eremophygus bicolor (Gutiérrez) y ubica al nombre genérico Heterocallichloris Gutiérrez como un sinónimo junior de Eremophygus. Se discuten los caracteres morfológicos que justifican la transferencia.

An algorithm for the strip packing problem using collision free region and exact fitting placement

The irregular shape packing problem is approached. The container has a fixed width and an open dimension to be minimized. The proposed algorithm constructively creates the solution using an ordered list of items and a placement heuristic. Simulated annealing is the adopted metaheuristic to solve the optimization problem. A two-level algorithm is used to minimize the open dimension of the container. To ensure feasible layouts, the concept of collision free region is used. A collision free region represents all possible translations for an item to be placed and may be degenerated. For a moving item, the proposed placement heuristic detects the presence of exact fits (when the item is fully constrained by its surroundings) and exact slides (when the item position is constrained in all but one direction). The relevance of these positions is analyzed and a new placement heuristic is proposed. Computational comparisons on benchmark problems show that the proposed algorithm generated highly competitive solutions. Moreover, our algorithm updated some best known results. (C) 2012 Elsevier Ltd. All rights reserved.

Efficient Placement of Fault Indicators in an Actual Distribution System Using Evolutionary Computing

This paper proposes an evolutionary computing strategy to solve the problem of fault indicator (FI) placement in primary distribution feeders. More specifically, a genetic algorithm (GA) is employed to search for an efficient configuration of FIs, located at the best positions on the main feeder of a real-life distribution system. Thus, the problem is modeled as one of optimization, aimed at improving the distribution reliability indices, while, at the same time, finding the least expensive solution. Based on actual data, the results confirm the efficiency of the GA approach to the FI placement problem.

A study of effectiveness of midazolam sedation for prevention of myocardial arrhythmias in endosseous implant placement

Purpose: The study aimed to assess electrocardiographic alterations during oral implant placement surgeries under local anesthesia (lidocaine chlorhydrate with epinephrine), using 15 mg of midazolam as an anxiolytic premedication. Material and methods: The study randomly selected 20 patients, aged 21-50 years old, requiring bilateral mandibular dental implants. Each patient was assessed using placebo on one side and midazolam on the contralateral side, with random, double-blinded distribution. The electrocardiogram recorded 12 static leads every 2 min, while D2 derivations were recorded continuously. Results: No statistically significant differences were observed between the placebo and midazolam when analyzing the morphological behavior of the electrocardiographic wave and the presence of arrhythmias during the experiment. However, under sedation, assessment of the behavior of electrocardiographic parameters during different stages of the procedure revealed statistically significant differences (P<0.05) for heart rate, P-wave amplitude and duration of the RR and QTc intervals. The arrhythmias detected were considered low risk for patients without systemic alterations and were observed in 53.3% of patients. The most frequently occurring alterations were tachycardia, bradycardia, supraventricular and ventricular extrasystoles and blocked atrial extrasystole, which were similar for both placebo and midazolam, with the greatest incidence during the initial, incision and bone drilling stages. Conclusion: The use of 15 mg of midazolam made no difference compared with the placebo. The use of 15 mg of midazolam did not show an advantage in the incidence of arrhythmias The anxiolytic premedication does not prevent myocardial arrhythmias in endosseous implant placement. The clinical significance of the arrhythmias may not represent serious risks.

Buccal Bone Plate Remodeling After Immediate Implant Placement With and Without Synthetic Bone Grafting and Flapless Surgery: Radiographic Study in Dogs

Recent studies in animals have shown pronounced resorption of the buccal bone plate after immediate implantation. The use of flapless surgical procedures prior to the installation of immediate implants, as well as the use of synthetic bone graft in the gaps represent viable alternatives to minimize buccal bone resorption and to favor osseointegration. The aim of this study was to evaluate the healing of the buccal bone plate following immediate implantation using the flapless approach, and to compare this process with sites in which a synthetic bone graft was or was not inserted into the gap between the implant and the buccal bone plate. Lower bicuspids from 8 dogs were bilaterally extracted without the use of flaps, and 4 implants were installed in the alveoli in each side of the mandible and were positioned 2.0 mm from the buccal bone plate (gap). Four groups were devised: 2.0-mm subcrestal implants (3.3 x 8 mm) using bone grafts (SCTG), 2.0-mm subcrestal implants without bone grafts (SCCG), equicrestal implants (3.3 x 10 mm) with bone grafts (EGG), and equicrestal implants without bone grafts (ECCG). One week following the surgical procedures, metallic prostheses were installed, and within 12 weeks the dogs were sacrificed. The blocks containing the individual implants were turned sideways, and radiographic imaging was obtained to analyze the remodeling of the buccal bone plate. In the analysis of the resulting distance between the implant shoulder and the bone crest, statistically significant differences were found in the SCTG when compared to the ECTG (P = .02) and ECCG (P = .03). For mean value comparison of the resulting linear distance between the implant surface and the buccal plate, no statistically significant difference was found among all groups (P > .05). The same result was observed in the parameter for presence or absence of tissue formation between the implant surface and buccal plate. Equicrestally placed implants, in this methodology, presented little or no loss of the buccal bone. The subcrestally positioned implants presented loss of buccal bone, even though synthetic bone graft was used. The buccal bone, however, was always coronal to the implant shoulder.

Effect of electromagnetic field on bone regeneration around dental implants after immediate placement in the dog mandible: a pilot study

Background: Accelerating bone healing around dental implants can reduce the long-term period between the insertion of implants and functional rehabilitation. Objective: This in vivo study evaluated the effect of a constant electromagnetic field (CEF) on bone healing around dental implants in dogs. Materials and methods: Eight dental implants were placed immediately after extraction of the first premolar and molar teeth on the mandible of two male dogs and divided into experimental (CEF) and control groups. A CEF at magnetic intensity of 0.8 mT with a pulse width of 25 mu s and frequency of 1.5 MHz was applied on the implants for 20 min per day for 2 weeks. Result and conclusion: After qualitative histological analysis, a small quantity of newly formed bone was observed in the gap between the implant surface and alveolar bone in both groups.

TOMOGRAPHIC ANALYSIS FOR C2 SCREW PLACEMENT IN RHEUMATOID ARTHRITIS PATIENTS

Objective: A morphological analysis of the bone structure of 02 in patients with rheumatoid arthritis in order to enhance the security of the stabilization procedures for this vertebra. Methods: We retrospectively analyzed 20 CT scans of the cervical spine performed in patients with rheumatoid arthritis; the following parameters were measured: spinolaminar angle, thickness and length of C2 lamina. Results: The mean values are: 5.92mm and 5.87mm for thickness of right and left laminae retrospectively, 27.75mm for right lamina length and 27.94mm for left lamina length, and 44.7 degrees for spinolaminar angle. Conclusion: The values obtained are consistent with studies in normal subjects published by other groups, with no apparent need for change in the screw placement technique. Level of Evidence IV, Case Series.

Retrolabyrinthine approach for surgical placement of auditory brainstem implants in children

Conclusion: The extended retrolabyrinthine approach (RLA) is a safe and reliable approach for auditory brainstem placement in children. The surgical landmarks to reach cochlear nucleus are adequately exposed by this approach. Objective: To describe a new approach option for auditory brainstem implants (ABIs) in children, highlighting the anatomical landmarks to appropriately expose the foramen of Luschka. Methods: Three prelingually deafened children consecutively operated for ABIs via the RLA. Results: ABI placement via the RLA was successfully performed in all children without any further complications except multidirectional nystagmus in one child. The RLA we employed differed from that used for vestibular schwannoma only in the removal of the posterior semicircular canal. The lateral and superior semicircular canals and the vestibule remained intact, and there was no need to expose the dura of the internal auditory meatus. The jugular bulb was completely exposed to allow adequate visualization of the ninth cranial nerve and cerebellar flocculus.

Modeling the gluon propagator in Landau gauge: Lattice estimates of pole masses and dimension-two condensates

We present an analytic description of numerical results for the Landau-gauge SU(2) gluon propagator D(p(2)), obtained from lattice simulations (in the scaling region) for the largest lattice sizes to date, in d = 2, 3 and 4 space-time dimensions. Fits to the gluon data in 3d and in 4d show very good agreement with the tree-level prediction of the refined Gribov-Zwanziger (RGZ) framework, supporting a massive behavior for D(p(2)) in the infrared limit. In particular, we investigate the propagator's pole structure and provide estimates of the dynamical mass scales that can be associated with dimension-two condensates in the theory. In the 2d case, fitting the data requires a noninteger power of the momentum p in the numerator of the expression for D(p(2)). In this case, an infinite-volume-limit extrapolation gives D(0) = 0. Our analysis suggests that this result is related to a particular symmetry in the complex-pole structure of the propagator and not to purely imaginary poles, as would be expected in the original Gribov-Zwanziger scenario.