Comparison of the effects of pilocarpine and cevimeline on salivary flow

Objective: The aim of the present study was to compare the effect of low-dose pilocarpine and cevimeline as stimulants for salivary flow in healthy subjects. Methods: In this cross-over clinical trial with a 1-week washout period, 40 male volunteers were submitted to an oral dose of pilocarpine 1% (Salagen (TM)) -60 mu g kg(-1) body-weight (Group 1) or Cevimeline (Evoxac (TM)) -30 mg (Group 2). Saliva samples were collected and the salivary flow rate was measured (ml min(-1)) at baseline and 20, 40, 60, 80, 140 and 200 min after administration of drugs. In addition, salivary secretion was also measured under mechanical stimulation to observe salivary gland function. Results: The data were analyzed by Friedman and Wilcoxon signed-rank tests (significance level = 5%). Pilocarpine and cevimeline significantly increased salivary flow 140 min after intake. There was a significant higher secretion with cevimeline 140 and 200 min after administration. There were no differences seen among subjects in the salivary glands function by mechanical stimulation. Conclusion: Both drugs showed efficacy in increasing the salivary flow in healthy volunteers, but cevimeline was more effective than pilocarpine.

The effects of occlusal loading on the margins of cervical restorations

Background. Researchers have proposed the restoration of abfraction lesions, but limited information is available about the effects of occlusal loading on the margins of such restorations. Because abfraction is a well-recognized problem, the authors conducted a study to assess the effects of occlusal loading on the margins of cervical restorations. Methods. The authors prepared 40 wedge-shaped cavities in extracted premolars and restored them with a resin-based composite. They subjected specimens to occlusal loading (150 newtons, 101 cycles) on the buccal cusp, on the central fossa or on the lingual cusp, and they stored 1 the control group, specimens in deionized water. The authors used fluorescein to delimit marginal defects and evaluated the defects by using laser scanning confocal microscopy. Results. Results of chi(2) and Kruskal-Wallis tests (P < .05) showed that specimens subjected to occlusal loading had a higher percentage of marginal gaps (53.3 percent) than did the control specimens (10.0 percent). There were no differences between groups in marginal defect formation or in defect location, length or width. Conclusions. Occlusal loading led to a significant increase in gap formation at the margins of cervical resin-based composite restorations. Clinical Implications. The clinician cannot underestimate the effects of occlusal loading When restoring teeth with cervical wedge-shaped lesions. If occlusal loading is the main factor contributing to lesion formation, the clinician should identify and treat it before placing the restoration or otherwise run the risk that the restorative treatment will fail because of marginal gap formation.

Influence of differently oriented dentin surfaces and the regional variation of specimens on adhesive layer thickness and bond strength

Statement of the Problem: Adhesive systems can spread differently onto a substrate and, consequently, influence bonding. Purpose: The purpose of this study was to evaluate the effect of differently oriented dentin surfaces and the regional variation of specimens on adhesive layer thickness and microtensile bond strength (MTBS). Materials and Methods: Twenty-four molars were sectioned mesiodistally to expose flat buccal and lingual halves. Standardized drop volumes of adhesive systems (Single Bond [SB] and Prime & Bond 2.1 [PB2.1]) were applied to dentin according to the manufacturer`s instructions. Teeth halves were randomly divided into groups: 1A-SB/parallel to gravity; 1B-SB/perpendicular to gravity; 2A-PB2.1/parallel to gravity; and 2B-PB2.1/perpendicular to gravity. The bonded assemblies were stored in 37 degrees C distilled water for 24 hours and then sectioned to obtain dentin sticks (0.8 mm(2)). The adhesive layer thickness was determined in a light microscope (x200), and after 48 hours the specimens were subjected to MTBS test. Data were analyzed by one-way and two-way analysis of variance and Student-Newman-Keuls tests. Results: Mean values (MPa +/- SD) of MTBS were: 39.1 +/- 12.9 (1A); 32.9 +/- 12.4 (1B); 52.9 +/- 15.2 (2A); and 52.3 +/- 16.5 (2B). The adhesive systems` thicknesses (mu m +/- SD) were: 11.2 +/- 2.9 (1A); 18.1 +/- 7.3 (1B); 4.2 +/- 1.8 (2A); and 3.9 +/- 1.3 (2B). No correlation between bond strength and adhesive layer thickness for both SB and PB2.1 (r = -0.224, p = 0.112 and r = 0.099, p = 0.491, respectively) was observed. Conclusions: The differently oriented dentin surfaces and the regional variation of specimens on the adhesive layer thickness are material-dependent. These variables do not influence the adhesive systems` bond strength to dentin. CLINICAL SIGNIFICANCE Adhesive systems have different viscosities and spread differently onto a substrate, influencing the bond strength and also the adhesive layer thickness. Adhesive thickness does not influence dentin bond strength, but it may impair adequate solvent evaporation, polymer conversion, and may also determine water sorption and adhesive degradation over time. In the literature, many studies have shown that the adhesive layer is a permeable membrane and can fail over timebecause ofits continuous plasticizing and degradation when in contact with water. Therefore, avoiding thick adhesive layers may minimize these problems and provide long-term success for adhesive restorations.

Rare enlargement of the genial tubercles Enlargement of genial tubercles

Genial tubercles usually are small bony protuberances on the lingual aspect of the mandible symphysis. Conversely, this case shows 3D tomographic reconstruction images of genial tubercles as an oversized projection causing pain and discomfort to the patient.

Tooth abnormalities and soft tissue changes in patients with velocardiofacial syndrome

Objective. The objective of this study was to investigate the prevalence of tooth abnormalities and soft tissue changes in patients with velocardiofacial syndrome. Study design. Twenty-six patients with velocardiofacial syndrome were examined to investigate the presence of tooth abnormalities and soft tissue alterations. The occurrence of tooth agenesis and supernumerary teeth was compared to patients without morphofunctional alterations, matched for gender and age. Results. Of all patients, 76.92% exhibited at least one tooth abnormality, with predominance of hypoplastic alterations, especially represented by hypodevelopment of the lingual cusp of mandibular first premolars and enamel opacities. The occurrence of tooth agenesis and supernumerary teeth was similar in both study and control groups. Conclusion. the present results suggest an association between hypodevelopment of the lingual cusp of mandibular first premolars and enamel opacities, yet these findings still require corroboration. Future studies should further investigate these aspects in larger samples compared to control groups, as well as employing molecular genetics techniques.

Warthin Tumor of the Upper Lip: An Unusual Location of a Benign Salivary Gland Tumor

Warthin tumor (papillary cystadenoma lymphomatosum) is a benign salivary gland tumor involving almost exclusively the parotid gland. The lip is a very unusual location for this type of tumor, which develops only rarely in minor salivary glands. The case of 42-year-old woman with Warthin tumor arising in minor salivary glands of the upper lip is reported.

Reliability and Failure Modes of Implant-Supported Y-TZP and MCR Three-Unit Bridges

Purpose: Chipping within veneering porcelain has resulted in high clinical failure rates for implant-supported zirconia (yttria-tetragonal zirconia polycrystals [Y-TZP]) bridges. This study evaluated the reliability and failure modes of mouth-motion step-stress fatigued implant-supported Y-TZP versus palladium-silver alloy (PdAg) three-unit bridges. Materials and Methods: Implant-abutment replicas were embedded in polymethylmethacrylate resin. Y-TZP and PdAg frameworks, of similar design (n = 21 each), were fabricated, veneered, cemented (n = 3 each), and Hertzian contact-tested to obtain ultimate failure load. In each framework group, 18 specimens were distributed across three step-stress profiles and mouth-motion cyclically loaded according to the profile on the lingual slope of the buccal cusp of the pontic. Results: PdAg failures included competing flexural cracking at abutment and/or connector area and chipping, whereas Y-TZP presented predominantly cohesive failure within veneering porcelain. Including all failure modes, the reliability (two-sided at 90% confidence intervals) for a ""mission"" of 50,000 and 100,000 cycles at 300 N load was determined (Alta Pro, Reliasoft, Tucson, AZ, USA). No difference in reliability was observed between groups for a mission of 50,000. Reliability remained unchanged for a mission of 100,000 for PdAg, but significantly decreased for Y-TZP. Conclusions: Higher reliability was found for PdAg for a mission of 100,000 cycles at 300 N. Failure modes differed between materials.

Receptor for Fc on the surfaces of schistosomes

Schistosoma mansoni masks its surface with adsorbed host proteins including erythrocyte antigens, immunoglobulins, major histocompatibility complex class I, and beta (2)-microglobulin (beta (2)m), presumably as a means of avoiding host immune responses, How this is accomplished has not been explained. To identify surface receptors for host proteins, we biotinylated the tegument of live S, mansoni adults and mechanically transformed schistosomula and then removed the parasite surface with detergent, Incubation of biotinylated schistosome surface extracts witt l human immunoglobulin G (IgG) Fc-Sepharose resulted in purification of a 97-kDa protein that was subsequently identified as paramyosin (Pmy), using antiserum specific for recombinant Pmy, Fc also bound recombinant S. mansoni Pmy and native S. japonicum Pmy, Antiserum to Pmy decreased the binding of Pmy to Fc-Sepharose, and no proteins bound after removal of Pmy from extracts. Fluoresceinated human Fe bound to the surface, vestigial penetration glands, and nascent oral cavity of mechanically transformed schistosomula, and rabbit anti-Pmy Fab fragments ablated the binding of Fc to the schistosome surface, Pmy coprecipitated with host IgG from parasite surface extracts, indicating that complexes formed on the parasite surface as well as in vitro. Binding of Pmy to Fe was not inhibited by soluble protein A, suggesting that Pmy does not bind to the region between the CH2 and CH3 domains used by many other Fc-binding proteins. beta (2)m did not bind to the schistosome Fc receptor (Pmy), a finding that contradicts reports from earlier workers but did bind to a heteromultimer of labeled schistosomula surface proteins, This is the first report of the molecular identity of a schistosome Fc receptor; moreover it demonstrates an additional aspect of the unusual and multifunctional properties of Pmy from schistosomes and other parasitic flatworms.

Failure modes of Y-TZP crowns at different cusp inclines

Objectives To compare the reliability of the disto-facial (DF) and mesio-lingual (ML) cusps of an anatomically correct zirconia (Y-TZP) crown system The research hypotheses tested were (1) fatigue reliability and failure mode are similar for the ML and DF cusps, (2) failure mode of one cusp does not affect the failure of the other Methods The average dimensions of a mandibular first molar crown were imported into CAD software, a tooth preparation was modelled by 1 5 mm marginal high reduction of proximal walls and occlusal surface by 2 0 mm The CAD-based tooth preparation was milled and used as a die to fabricate crowns (n = 14) with porcelain veneer on a 0 5 mm Y-TZP core. Crowns were cemented on composite reproductions of the tooth preparation The crowns were step-stress mouth motion fatigued with sliding (0 7 mm) a tungsten-carbide indenter of 6 25 mm diameter down on the inclines of either the DF or ML cusps Use level probability Weibull curve with use stress of 200 N and the reliability for completion of a mission of 50,000 cycles at 200 N load were calculated Results Reliability for a 200 N at 50,000 cycles mission was not different between tested cusps SEM imaging showed large cohesive failures within the veneer for the ML and smaller for the DF Fractures originated from the contact area regardless of the cusp loaded Conclusion No significant difference on fatigue reliability was observed between the DF compared to the ML cusp Fracture of one cusp did not affect the other (c) 2010 Elsevier Ltd All rights reserved

Thermal/mechanical simulation and laboratory fatigue testing of an alternative yttria tetragonal zirconia polycrystal core-veneer all-ceramic layered crown design

This study evaluated the stress levels at the core layer and the veneer layer of zirconia crowns (comprising an alternative core design vs. a standard core design) under mechanical/thermal simulation, and subjected simulated models to laboratory mouth-motion fatigue. The dimensions of a mandibular first molar were imported into computer-aided design (CAD) software and a tooth preparation was modeled. A crown was designed using the space between the original tooth and the prepared tooth. The alternative core presented an additional lingual shoulder that lowered the veneer bulk of the cusps. Finite element analyses evaluated the residual maximum principal stresses fields at the core and veneer of both designs under loading and when cooled from 900 degrees C to 25 degrees C. Crowns were fabricated and mouth-motion fatigued, generating master Weibull curves and reliability data. Thermal modeling showed low residual stress fields throughout the bulk of the cusps for both groups. Mechanical simulation depicted a shift in stress levels to the core of the alternative design compared with the standard design. Significantly higher reliability was found for the alternative core. Regardless of the alternative configuration, thermal and mechanical computer simulations showed stress in the alternative core design comparable and higher to that of the standard configuration, respectively. Such a mechanical scenario probably led to the higher reliability of the alternative design under fatigue.

Evaluation of distances between the mandibular teeth and the alveolar process in Brazilians with normal occlusion

Introduction: The aims of this study were to evaluate the distances between the mandibular permanent teeth and the alveolar process in Brazilians with normal occlusion and to compare them with normal American values. Methods: We used 59 mandibular casts from untreated subjects who had permanent dentition and the 6 keys to normal occlusion. A computer program was used to calculate the distances between the dental reference points and the alveolar process for each tooth. The mean values were then compared to the normal values by applying the Student t test at a significance level of 0.05. Results: The results showed a progressive increase of these distances from the anterior region (incisors) to the posterior region (molars), from 0.00 to 2.49 mm. All measurements had statistically significant differences from the American sample, except for the values for canines and first premolars. Conclusions: Brazilians with normal occlusion have more lingual crown positions for the incisors, second premolars, and molars compared with Americans with normal occlusion. Although these findings were statistically significant, they are unlikely to be clinically significant. (Am J Orthod Dentofacial Orthop 2010; 137: 308.e1-308.e4)

Effect of framework design on crown failure

This study evaluated the effect of core-design modification on the characteristic strength and failure modes of glass-infiltrated alumina (In-Ceram) (ICA) compared with porcelain fused to metal (PFM). Premolar crowns of a standard design (PFMs and ICAs) or with a modified framework design (PFMm and ICAm) were fabricated, cemented on dies, and loaded until failure. The crowns were loaded at 0.5 mm min(-1) using a 6.25 mm tungsten-carbide ball at the central fossa. Fracture load values were recorded and fracture analysis of representative samples were evaluated using scanning electron microscopy. Probability Weibull curves with two-sided 90% confidence limits were calculated for each group and a contour plot of the characteristic strength was obtained. Design modification showed an increase in the characteristic strength of the PFMm and ICAm groups, with PFM groups showing higher characteristic strength than ICA groups. The PFMm group showed the highest characteristic strength among all groups. Fracture modes of PFMs and of PFMm frequently reached the core interface at the lingual cusp, whereas ICA exhibited bulk fracture through the alumina core. Core-design modification significantly improved the characteristic strength for PFM and for ICA. The PFM groups demonstrated higher characteristic strength than both ICA groups combined.

Evaluation of several protocols for the application of ultrasound during the removal of cast intraradicular posts cemented with zinc phosphate cement

To evaluate several protocols for the application of ultrasound during removal of cast posts with varying core configurations cemented with zinc phosphate. Sixty maxillary canines were distributed into three groups (n = 20): group 1 - core with 5 mm diameter/height and post diameter of 1.3 mm; groups 2 and 3 - core with the same diameter as the post (1.3 mm) and heights of 5 mm and 3 mm, respectively. Posts/cores were cemented using a standard technique with zinc phosphate cement. Each group was divided into two subgroups according to the ultrasonic vibration mode: point vibration - ultrasonic vibration applied to the core surface for 5 s, on each face totalling 25 s; alternate vibration - intermittent application of ultrasonic vibration for 10 s to the labial and lingual surfaces, 10 s to the mesial and distal surfaces and 5 s to the incisal surface, totalling 25 s. The specimens were submitted to the tensile test using an Instron machine (1 mm min(-1)) and results were analysed by anova and t-test. The failure type was also analysed. Statistical analysis showed significant differences between groups relating to the core preparations (P < 0.05). The lowest mean values of traction force were obtained for group 3 (46.1 +/- 7.7 N), followed by group 2 (89.0 +/- 2.7 N) and group 1 (160.4 +/- 7.5 N). Regarding ultrasonic vibration, the lowest mean was observed with alternate vibration (81.1 +/- 10.1 N), which was significantly lower than the point vibration (115.9 +/- 9.5 N) (P < 0.05). Cohesive failure occurred in all cases. A reduction in core diameter/height and intermittent ultrasonic application improved the removal of cast posts cemented with zinc phosphate.

The anatomy of two-rooted mandibular canines determined using micro-computed tomography

P>Aim To investigate the internal and external anatomy of extracted human mandibular canines with two roots and two distinct canals using micro-computed tomography (mu CT). Methodology Fourteen two-rooted human mandibular canines were scanned using a high-resolution mu CT system (SkyScan 1174v2; SkyScan N.V., Kontich, Belgium). The images were processed to evaluate the size of the roots, the furcation regions, the presence of accessory canals, the mean distances between several anatomical landmarks, the position of the apical foramina, the direction of root curvatures, the cross-sectional appearances (SMI index), the volume and surface areas of the root canals. Results Root bifurcation was located in both apical (44%, n = 6) and middle (58%, n = 8) thirds of the root. The size of the buccal and lingual roots was similar in 29% of the sample. From a buccal view, no curvature towards the lingual or buccal direction occurred in either roots. From a proximal view, no straight lingual root occurred. In both views, S-shaped roots were found in 21% of the specimens. Location of the apical foramen varied considerably, tending to the mesio-buccal aspect of both roots. Lateral and furcation canals were observed mostly in the cervical third in 29% and 65% of the sample, respectively. The structure model index (SMI) index ranged from 1.87 to 3.86, with a mean value of 2.93 +/- 0.46. Mean volume and area of the root canals were 11.52 +/- 3.44 mm3 and 71.16 +/- 11.83 mm2, respectively. Conclusions The evaluation of two-rooted mandibular canines revealed that bifurcations occurred in the apical and middle third. S-shaped roots were found in 21% of the specimens. Mean volume, surface area and SMI index of the root canals were 11.52 mm3, 71.16 mm2 and 2.93, respectively.

A comparison of anterior adhesive areas and secretions in Troglocephalus rhinobatidis and Neoheterocotyle rhinobatidis (Monogenea : Monocotylidae) from the gills of the shovelnose ray, Rhinobatos typus (Rhinobatidae)

This study continues the collection of data on the anterior adhesive areas and secretions of monopisthocotylean monogenean (flatworm) parasites and begins an investigation of their phylogenetic usefulness. Here, two species of parasitic worms from an elasmobranch, Troglocephalus rhinobatidis (Monocotylidae: Dasybatotreminae) and Neoheterocotyle rhinobatidis (Monocotylidae: Heterocotylinae), are compared and contrasted. It has been suggested in recent literature that these two taxa are more closely related than is currently recognised. Our data support this view. Both species have multiple apertures on the ventral anterior margin through which adhesive is secreted. Two types of secretion exit from multiple adjacent duct endings terminating in each aperture: rod-shaped (S1) and spherical-shaped (S2) bodies. S1 bodies of both species show nano-banding of similar size and are membrane bound. Ultrastructure of the glands, ducts, duct endings and secreted adhesive is similar for both species, but aperture shape differs. Away from the adhesive areas, tegumental inclusions are found to differ between the two species and another, apparently non-adhesive, secretion is found in N. rhinobatidis.