Time-dependent supraimplant mucosa changes: short communication

PURPOSE The aim of this short communication was to analyze time-dependent changes of the supraimplant mucosa architecture in the esthetic zone. MATERIALS AND METHODS Five patients underwent single-tooth replacement with implant crowns in the anterior maxilla. The supraimplant soft tissue was conditioned with fixed provisional crowns. Quadrantlike digital impressions were taken with an intraoral optical scanning device at three time points: t0, immediately after removal of the provisional (baseline); t1, after 5 minutes; and t2, after 10 minutes. To analyze time-dependent mucosal changes, the corresponding digital files were superimposed for each patient, and baseline (t0) scans were compared with t1 and t2 scans, respectively. Wilcoxon rank sum tests were used for statistical calculations with a strict level of significance at P < .01. RESULTS Mean values for supraimplant soft tissue changes were statistically significantly different after 5 minutes (5.5%; standard deviation ± 0.3%) in comparison to the results after 10 minutes (21.7%; standard deviation ± 1.8%). The direction of mucosa shrinkage showed a trend toward palatal sites. CONCLUSION Based on the findings of this analysis, changes in supraimplant mucosa architecture seem to be affected only slightly during the first 5 minutes after removal of soft tissue support.

Partial lateralization of the nasopalatine nerve at the incisive foramen for ridge augmentation in the anterior maxilla prior to placement of dental implants: a retrospective case series evaluating self-reported data and neurosensory testing

The objective of this study was to assess implant therapy after a staged guided bone regeneration procedure in the anterior maxilla by lateralization of the nasopalatine nerve and vessel bundle. Neurosensory function following augmentative procedures and implant placement, assessed using a standardized questionnaire and clinical examination, were the primary outcome variables measured. This retrospective study included patients with a bone defect in the anterior maxilla in need of horizontal and/or vertical ridge augmentation prior to dental implant placement. The surgical sites were allowed to heal for at least 6 months before placement of dental implants. All patients received fixed implant-supported restorations and entered into a tightly scheduled maintenance program. In addition to the maintenance program, patients were recalled for a clinical examination and to fill out a questionnaire to assess any changes in the neurosensory function of the nasopalatine nerve at least 6 months after function. Twenty patients were included in the study from February 2001 to December 2010. They received a total of 51 implants after augmentation of the alveolar crest and lateralization of the nasopalatine nerve. The follow-up examination for questionnaire and neurosensory assessment was scheduled after a mean period of 4.18 years of function. None of the patients examined reported any pain, they did not have less or an altered sensation, and they did not experience a "foreign body" feeling in the area of surgery. Overall, 6 patients out of 20 (30%) showed palatal sensibility alterations of the soft tissues in the region of the maxillary canines and incisors resulting in a risk for a neurosensory change of 0.45 mucosal teeth regions per patient after ridge augmentation with lateralization of the nasopalatine nerve. Regeneration of bone defects in the anterior maxilla by horizontal and/or vertical ridge augmentation and lateralization of the nasopalatine nerve prior to dental implant placement is a predictable surgical technique. Whether or not there were clinically measurable impairments of neurosensory function, the patients did not report them or were not bothered by them.

Dislocated Tongue Muscle Attachment and Cleft Palate Formation

In Pierre Robin sequence, a retracted tongue due to micrognathia is thought to physically obstruct palatal shelf elevation and thereby cause cleft palate. However, micrognathia is not always associated with palatal clefting. Here, by using the Bmp7-null mouse model presenting with cleft palate and severe micrognathia, we provide the first causative mechanism linking the two. In wild-type embryos, the genioglossus muscle, which mediates tongue protrusion, originates from the rostral process of Meckel's cartilage and later from the mandibular symphysis, with 2 tendons positive for Scleraxis messenger RNA. In E13.5 Bmp7-null embryos, a rostral process failed to form, and a mandibular symphysis was absent at E17.5. Consequently, the genioglossus muscle fibers were diverted toward the lingual surface of Meckel's cartilage and mandibles, where they attached in an aponeurosis that ectopically expressed Scleraxis. The deflection of genioglossus fibers from the anterior-posterior toward the medial-lateral axis alters their direction of contraction and necessarily compromises tongue protrusion. Since this muscle abnormality precedes palatal shelf elevation, it is likely to contribute to clefting. In contrast, embryos with a cranial mesenchyme-specific deletion of Bmp7 (Bmp7:Wnt1-Cre) exhibited some degree of micrognathia but no cleft palate. In these embryos, a rostral process was present, indicating that mesenchyme-derived Bmp7 is dispensable for its formation. Moreover, the genioglossus appeared normal in Bmp7:Wnt1-Cre embryos, further supporting a role of aberrant tongue muscle attachment in palatal clefting. We thus propose that in Pierre Robin sequence, palatal shelf elevation is not impaired simply by physical obstruction by the tongue but by a specific developmental defect that leads to functional changes in tongue movements.

Stability of Rapid Maxillary Expansion

Submitted in partial fulfillment of the requirements for a Certificate in Orthodontics, Dept. of Orthodontics, University of Connecticut Health Center, 1993

Radiolarian biostratigraphy in the central Indian Ocean

Identifiable radiolarians of stratigraphic importance were recovered at eight of the sites drilled on Leg 115. The assemblages range in age from Holocene to middle Eocene (Dictyoprora mongolfieri Zone, about 48 Ma). Faunal preservation is particularly good in two stratigraphic intervals: the Holocene through upper Miocene (0-9 Ma), and the lowermost Oligocene to middle Eocene (35-48 Ma). Fluctuating rates of silica accumulation at these drill sites during the Cenozoic reflect changing tectonic and paleoceanographic conditions. In particular, the gradual closure of the Indonesian and Tethyan seaways and the northward migration of the Indian subcontinent severely restricted zonal circulation and silica accumulation in tropical latitudes during the late Oligocene through middle Miocene. By the late Miocene the Indian subcontinent had moved sufficiently north of the equator to allow trans-Indian zonal circulation patterns to become reestablished, and biosiliceous sedimentation resumed. The composition of the radiolarian assemblages in the tropical Indian Ocean is closely comparable with that of the 'stratotype' sequences in the equatorial Pacific. However, there are some notable exceptions in Indian Ocean assemblages: (1) the scarcity of the genera Pterocanium and Spongaster in the Neogene; (2) the absence of the stratigraphically important Podocyrtis lineage, P. diamesa -> P. phyxis -> P. ampla, in the middle Eocene; and (3) the scarcity of taxa of the genus Dorcadospyris, with the exception of D. ateuchus. The succession of radiolarian events was tabulated for those stratigraphic intervals where the assemblages were well preserved. We identified 55 events in the middle Eocene to earliest Oligocene, and 31 events in the late Miocene to Holocene. The succession of events is closely comparable with that of the tropical Pacific. However, there are exceptions that appear to be real, rather than artifacts of sample preservation, mixing, and core disturbance.

Radiolarians from the Southwest Pacific

Radiolarians are very rare in all Leg 90 sites. They are relatively more frequent only in Neogene sediments from Sites 586 and 594, and in Eocene sediments at Site 592. In this chapter radiolarian abundances are recorded as comparative percentages for 92 Neogene morphotypes at Site 586B. Relative abundances only are estimated at Sites 592 and 594, where preservation is poor to moderate. A tentative correlation of radiolarian events at Hole 586B and Site 594 shows that only a few species can be found in both tropical and subantarctic areas. New evolutionary lineages are proposed. 1. Middle Miocene eucyrtids like Eucyrtidium teuscheri group evolved into a widespread species (E. teuscheri teuscheri) ranging from middle Miocene to Holocene and a temperate species (E. teuscheri orthoporus) ranging from middle Miocene to early Pleistocene. 2. Phormostichoartus pitomorphus appears to be a temperate descendant of the cosmopolitan P. fistula and disappears in early Pleistocene time. 3. The discovery of Lamprocyrtis daniellae n.sp. calls into question the lineage L. heteroporos -> L. nigriniae. 4. The evolution of Lamprocyclas maritalis from an ancestor group (L. aff. maritalis) is located in the early part of the Pterocanium prismatium Zone.

Radiolarian biostratigraphy in sediments of ODP Site 202-1237

Site 1237 is located on Nazca Ridge ~140 km off the coast of Peru and thus within the offshore region of the Peru-Chile Current. A total of 83 samples were used to provide an initial radiolarian biostratigraphic framework for Site 1237; radiolarians are present to Sample 202-1237B-19H-2, 58-60 cm (186.45 meters composite depth [mcd]) and are of good to fair abundance and preservation. Site 1237 is influenced by both subtropical and northward-transported southern latitude waters, has 55 ash layers within the uppermost 166 m, and has minimal to gross reworking. Shipboard paleomagnetic results showed that the upper 200 m spanned the last 12 m.y., and in the upper 100 mcd, the paleomagnetic inclination pattern could be directly correlated to the geomagnetic polarity timescale (GPTS). Tropical biostratigraphy was used to establish the zonal boundaries for Site 1237, and the paleomagnetic and radiolarian stratigraphy were well correlated.

Relative abundances of selected radiolarian species in sediments of ODP Leg 199 sites

During Ocean Drilling Program (ODP) Leg 199, sediments were recovered from eight sites in the Central Pacific. Late Oligocene and early Miocene radiolarians are common to abundant and moderately well preserved in Cores 199-1218A-8H through 11H and 199-1219A-5H through 9H. More than 110 radiolarian species were encountered during this study. Of these species, 100 are identifiable forms and the rest are undescribed or unfamiliar forms. This report presents the relative abundances of described forms from the upper Oligocene to lower Miocene sediments.