CAD/CAM fabrication accuracy of long- vs. short-span implant-supported FDPs

OBJECTIVE To compare the precision of fit of long-span vs. short-span implant-supported screw-retained fixed dental prostheses (FDPs) made from computer-aided-design/computer-aided-manufactured (CAD/CAM) titanium and veneered with ceramic. The null hypothesis was that there is no difference in the vertical microgap between long-span and short-span FDPs. MATERIALS AND METHODS CAD/CAM titanium frameworks for an implant-supported maxillary FDP on implants with a flat platform were fabricated on one single master cast. Group A consisted of six 10-unit FDPs connected to six implants (FDI positions 15, 13, 11, 21, 23, 25) and group B of six 5-unit FDPs (three implants, FDI positions 21, 23, 25). The CAD/CAM system from Biodenta Swiss AG (Berneck, Switzerland) was used for digitizing (laser scanner) the master cast and anatomical CAD of each framework separately. The frameworks were milled (CAM) from a titanium grade V monobloc and veneered with porcelain. Median vertical distance between implant and FDP platforms from the non-tightened implants (one-screw test on implant 25) was calculated from mesial, buccal, and distal scanning electron microscope measurements. RESULTS All measurements showed values <40 μm. Total median vertical microgaps were 23 μm (range 2-38 μm) for group A and 7 μm (4-24 μm) for group B. The difference between the groups was statistically significant at implant 21 (P = 0.002; 97.5% CI -27.3 to -4.9) and insignificant at implant 23 (P = 0.093; -3.9 to 1.0). CONCLUSIONS CAD/CAM fabrication including laboratory scanning and porcelain firing was highly precise and reproducible for all long- and short-span FDPs. While all FDPs showed clinically acceptable values, the short-span FDPs were statistically more precise at the 5-unit span distance.

Assessment of the nonoperated root after apical surgery of the other root in mandibular molars: a 5-year follow-up study

INTRODUCTION If a surgical approach is chosen to treat a multirooted tooth affected by persistent periapical pathosis, usually only the affected roots are operated on. The present study assessed the periapical status of the nonoperated root 5 years after apical surgery of the other root in mandibular molars. METHODS Patients treated with apical surgery of mandibular molars with a follow-up of 5 years were selected. Patient-related and clinical parameters (sex, age, smoking, symptoms, and signs of infection) before surgery were recorded. Preoperative intraoral periapical radiographs and radiographs 5 years after surgery were examined. The following data were collected: tooth, operated root, type and quality of the coronal restoration, marginal bone level, length and homogeneity of the root canal filling, presence of a post/screw, periapical index (PAI) of each root, and radiographic healing of the operated root. The presence of apical pathosis of the nonoperated root was analyzed statistically in relation to the recorded variables. RESULTS Thirty-seven patients fulfilled the inclusion criteria. Signs of periapical pathosis in the nonoperated root 5 years after surgery (PAI ≥ 3) could be observed in only 3 cases (8.1%). Therefore, statistical analysis in relation to the variables was not possible. The PAI of the nonoperated root before surgery had a weak correlation with signs of apical pathosis 5 years after surgery. CONCLUSIONS Nonoperated roots rarely developed signs of new apical pathosis 5 years after apical surgery of the other root in mandibular molars. It appears reasonable to resect and fill only roots with a radiographically evident periapical lesion.

Long-term Outcome After Monosegmental L4/5 Stabilization for Degenerative Spondylolisthesis With the Dynesys Device.

STUDY DESIGN Retrospective analysis of prospectively collected clinical data. OBJECTIVE To assess the long-term outcome of patients with monosegmental L4/5 degenerative spondylolisthesis treated with the dynamic Dynesys device. SUMMARY OF BACKGROUND DATA The Dynesys system has been used as a semirigid, lumbar dorsal pedicular stabilization device since 1994. Good short-term results have been reported, but little is known about the long-term outcome after treatment for degenerative spondylolisthesis at the L4/5 level. METHODS A total of 39 consecutive patients with symptomatic degenerative lumbar spondylolisthesis at the L4/5 level were treated with bilateral decompression and Dynesys instrumentation. At a mean follow-up of 7.2 years (range, 5.0-11.2 y), they underwent clinical and radiographic evaluation and quality of life assessment. RESULTS At final follow-up, back pain improved in 89% and leg pain improved in 86% of patients compared with preoperative status. Eighty-three percent of patients reported global subjective improvement. Ninety-two percent would undergo the surgery again. Eight patients (21%) required further surgery because of symptomatic adjacent segment disease (6 cases), late-onset infection (1 case), and screw breakage (1 case). In 9 cases, radiologic progression of spondylolisthesis at the operated segment was found. Seventy-four percent of operated segments showed limited flexion-extension range of <4 degrees. Adjacent segment pathology, although without clinical correlation, was diagnosed at the L5/S1 (17.9%) and L3/4 (28.2%) segments. In 4 cases, asymptomatic screw loosening was observed. CONCLUSIONS Monosegmental Dynesys instrumentation of degenerative spondylolisthesis at L4/5 shows good long-term results. The rate of secondary surgeries is comparable to other dorsal instrumentation devices. Residual range of motion in the stabilized segment is reduced, and the rate of radiologic and symptomatic adjacent segment degeneration is low. Patient satisfaction is high. Dynesys stabilization of symptomatic L4/5 degenerative spondylolisthesis is a possible alternative to other stabilization devices.

A 3-D CT assisted Monte Carlo evaluation of intracavitary brachytherapy implants

Intracavitary brachytherapy (ICB) combined with external beam irradiation for treatment of cervical cancer is highly successful in achieving local control. The M.D. Anderson Cancer Center employs Fletcher Suit Delclos (FSD) applicators. FSD applicators contain shields to limit dose to critical structures. Dosimetric evaluation of ICB implants is limited to assessing dose at reference points. These points serve as surrogates for treatment intensity and critical structure dose. Several studies have mentioned that the ICRU38 reference points inadequately characterize the dose distribution. Also, the ovoid shields are rarely considered in dosimetry. ^ The goal of this dissertation was to ascertain the influence of the ovoid shields on patient dose distributions. Monte Carlo dosimetry (MCD) was applied to patient computed tomography(CT) scans. These data were analyzed to determine the effect of the shields on dose to standard reference points and the bladder and rectum. The hypothesis of this work is that the ICRU38 bladder and rectal points computed conventionally are not clinically acceptable surrogates for the maximum dose points as determined by MCD. ^ MCD was applied to the tandem and ovoids. The FSD ovoids and tandem were modeled in a single input file that allowed dose to be calculated for any patient. Dose difference surface histograms(DDSH) were computed for the bladder and rectum. Reference point doses were compared between shielded and unshielded ovoids, and a commercial treatment planning system. ^ The results of this work showed the tandem tip screw caused a 33% reduction in dose. The ovoid shields reduced the dose by a maximum of 48.9%. DDSHs revealed on average 5% of the bladder surface area was spared 53 cGy and 5% of the rectal surface area was spared 195 cGy. The ovoid shields on average reduced the dose by 18% for the bladder point and 25% for the rectal point. The Student's t-test revealed the ICRU38 bladder and rectal points do not predict the maximum dose for these organs. ^ It is concluded that modeling the tandem and ovoid internal structures is necessary for accurate dose calculations, the bladder shielding segments may not be necessary, and that the ICRU38 bladder point is irrelevant. ^

The association between parity and selected structural birth defects

BACKGROUND: Parity is a risk factor in neonatal morbidity and mortality. This dissertation examined the association between first births and selected birth defects. The first aim was to assess the risk of 66 birth defects among first births and third or greater births. The second aim was to determine if maternal race, maternal age, infant sex or infant birth weight modify the association between first births and selected birth defects. METHODS: The Texas Birth Defects Registry provided data for 1999-2009. For the first aim, odds ratios were calculated for each birth defect. For the second aim, analysis was restricted to the ten birth defects significantly associated with first births. Stratified analyses were conducted and interaction terms were added to logistic regression models to assess whether differences in the odds ratios for the effect of first birth were statistically significant across strata. RESULTS: Findings for the first aim showed that first births had significantly increased odds of having an infant with 24 of the 66 birth defects. Third or greater births had significantly increased odds of having four of the 66 birth defects. For the second aim, a number of significant effect modifiers were observed. For patent ductus arteriosis, obstructive urinary defects and gastroschisis, the effect of first births was significantly modified by black or U.S.-born Hispanic mothers. The effect of first birth was also significantly modified among mothers ≥30 years for mitral valve insufficiency, atrial septal defect and congenital hip dislocation. The effect of first births was significantly modified among infants with low birth weight for hypospadias, congenital hip dislocation and gastroschisis. CONCLUSIONS: First births were associated with an elevated risk of 24 categories of birth defects. For some of the birth defects studied, the effect of first birth is modified by maternal age, maternal race and low birth weight. Knowledge of the increased risk for birth defects among women having their first birth allows physicians and midwives to provide better patient care and spur further research into the etiology of associated birth defects. This knowledge may bring about interventions prior to conception in populations most likely to conceive.^

Tensiones sociales y políticas en la campaña bonaerense : El caso de San Isidro durante el Rosismo

Abordamos la conflictividad social en San Isidro durante el Rosismo para analizar, a nivel micro, conflictos resultantes de procesos fragmentación política, dislocación del espacio económico, politización y militarización de la población en la postindependencia. Nuestro enfoque desde una infrahistoria de la conflictividad social, imbricándose tensiones sociales y políticas en nivel local, recobra la agencia histórica de sujetos subalternos para la reconstrucción de su experiencia en los pequeños acontecimientos cotidianos. Mostraremos cómo la conflictividad social podía expresarse en el terreno de lo político, aunque no se formulara en términos expresamente políticos

The increasing role of career guidance at the turn of the centuries

At the beginning this paper sketches trends of the rapid changes of nearly all life issues, especially in society, work behaviours, labour environment and demands for adjustment under new social values. As main factors which influence worldwide the economic development and the labour market are elaborated the globalization and liberalization process and the labour market aspects of feminization, ageing labour force, migration, unemployment as a global phenomenon and general changes in labour demand by occupations and skill level. A well-developed and highly qualified career guidance service is seen as one of the most effective instruments in solving these problems which are raised by the described developements. The personal and psychological effects of uncertainty and dislocation of people and the new requirements of the expected qualification standard make career guidance an important cornerstone to cope with these social aspects. Thus, the nature and structure of guidance and counselling are described under the new challenges. The international co-operation in the guidance sector has accompanied this process in delivering two important documents. The Mission Statement and the Ethical Standards of IAEVG, adopted by the General Assembly of IAEVG in 1995, show in what direction guidance services have to be developed.

Tensiones sociales y políticas en la campaña bonaerense : El caso de San Isidro durante el Rosismo

Abordamos la conflictividad social en San Isidro durante el Rosismo para analizar, a nivel micro, conflictos resultantes de procesos fragmentación política, dislocación del espacio económico, politización y militarización de la población en la postindependencia. Nuestro enfoque desde una infrahistoria de la conflictividad social, imbricándose tensiones sociales y políticas en nivel local, recobra la agencia histórica de sujetos subalternos para la reconstrucción de su experiencia en los pequeños acontecimientos cotidianos. Mostraremos cómo la conflictividad social podía expresarse en el terreno de lo político, aunque no se formulara en términos expresamente políticos

The increasing role of career guidance at the turn of the centuries

At the beginning this paper sketches trends of the rapid changes of nearly all life issues, especially in society, work behaviours, labour environment and demands for adjustment under new social values. As main factors which influence worldwide the economic development and the labour market are elaborated the globalization and liberalization process and the labour market aspects of feminization, ageing labour force, migration, unemployment as a global phenomenon and general changes in labour demand by occupations and skill level. A well-developed and highly qualified career guidance service is seen as one of the most effective instruments in solving these problems which are raised by the described developements. The personal and psychological effects of uncertainty and dislocation of people and the new requirements of the expected qualification standard make career guidance an important cornerstone to cope with these social aspects. Thus, the nature and structure of guidance and counselling are described under the new challenges. The international co-operation in the guidance sector has accompanied this process in delivering two important documents. The Mission Statement and the Ethical Standards of IAEVG, adopted by the General Assembly of IAEVG in 1995, show in what direction guidance services have to be developed.

Tensiones sociales y políticas en la campaña bonaerense : El caso de San Isidro durante el Rosismo

Abordamos la conflictividad social en San Isidro durante el Rosismo para analizar, a nivel micro, conflictos resultantes de procesos fragmentación política, dislocación del espacio económico, politización y militarización de la población en la postindependencia. Nuestro enfoque desde una infrahistoria de la conflictividad social, imbricándose tensiones sociales y políticas en nivel local, recobra la agencia histórica de sujetos subalternos para la reconstrucción de su experiencia en los pequeños acontecimientos cotidianos. Mostraremos cómo la conflictividad social podía expresarse en el terreno de lo político, aunque no se formulara en términos expresamente políticos

The increasing role of career guidance at the turn of the centuries

At the beginning this paper sketches trends of the rapid changes of nearly all life issues, especially in society, work behaviours, labour environment and demands for adjustment under new social values. As main factors which influence worldwide the economic development and the labour market are elaborated the globalization and liberalization process and the labour market aspects of feminization, ageing labour force, migration, unemployment as a global phenomenon and general changes in labour demand by occupations and skill level. A well-developed and highly qualified career guidance service is seen as one of the most effective instruments in solving these problems which are raised by the described developements. The personal and psychological effects of uncertainty and dislocation of people and the new requirements of the expected qualification standard make career guidance an important cornerstone to cope with these social aspects. Thus, the nature and structure of guidance and counselling are described under the new challenges. The international co-operation in the guidance sector has accompanied this process in delivering two important documents. The Mission Statement and the Ethical Standards of IAEVG, adopted by the General Assembly of IAEVG in 1995, show in what direction guidance services have to be developed.

Chemical composition of basalts and minerals from basalts of the Bouvet triple junction

This study focuses on mafic volcanic rocks from the Bouvet triple junction, which fall into six geochemically distinct groups: (1) N-MORB, the most widespread type, encountered throughout the study area. (2) Subalkaline volcanics, hawaiites and mugearites strongly enriched in lithophile elements and radiogenic isotopes and composing the Bouvet volcanic rise, and compositionally similar basalts and basaltic andesites from the Spiess Ridge, generated in a deeper, fertile mantle region. (3) Relatively weakly enriched basalts, T-MORB derived by the mixing of Type 1 and 2 melts and exposed near the axes of the Mid-Atlantic, Southwest Indian, and America-Antarctic Ridges. (4) Basalts with a degree of trace lithophile element enrichment similar to the Spiess Ridge and Bouvet Island rocks, but higher in K, P, Ti, and Cr. These occur within extensional structures: the rift valley of the Southwest Indian Ridge, grabens of the East Dislocation Zone, and the linear rise between the Spiess Ridge and Bouvet volcano. Their parental melts presumably separated from plume material that spread from the main channels and underwent fluid-involving differentiation in the mantle. (5) A volcanic suite ranging from basalt to rhyolite, characterized by low concentrations of lithophile elements, particularly TiO2, and occurring on the Shona Seamount and other compressional features within the Antarctic and South American plates near the Bouvet triple junction. Unlike Types 1 to 4, which display tholeiitic differentiation trends, this suite is calc-alkaline. Its parental melts were presumably related to the plume material as well but, subsequently, they underwent a profound differentiation involving fluids and assimilated surrounding rocks in closed magma chambers in the upper mantle. Alternatively, the Shona Seamount might be a fragment of an ancient oceanic island arc. (6) Enriched basalts, distinguished from the other enriched rock types in very high P and radiogenic isotope abundances and composing a tectonic uplift near the junction of the three rifts. It thus follows that the main factors responsible for the compositional diversity of volcanic rocks in this region include (i) mantle source heterogeneity, (ii) plume activity, (iii) an intricate geodynamic setup at the triple junction giving rise to stresses in adjacent plate areas, and (iv) the geological prehistory. The slow spreading rate and ensuing inefficient mixing of the heterogeneous mantle material result in strong spatial variations in basaltic compositions.

Results from Purgatory Conglomerate investigations

Quartz Crystallographic Preferred Orientation (CPO) patterns are most commonly a result of deformation by dislocation creep. We investigated whether Dissolution-Precipitation Creep (DPC) a process that occur at lower differential stresses and temperatures, may result in CPO in quartz. Within the Purgatory Conglomerate, DPC led to quartz dissolution along cobble surfaces perpendicular to the shortening direction, and quartz precipitation in overgrowths at the ends of the cobbles (strain shadows), parallel to the maximum extension direction. The Purgatory Conglomerate is part of the SE Narragansett basin where strain intensity increases from west to east and is associated with top-to-the-west transport and folding during the Alleghanian orogeny. Quartz c-axis orientations as revealed by Electron Backscatter Diffraction (EBSD) methods, were random in all analyzed domains within the cobbles and strain shadows irrespective of the intensity of strain or metamorphic grade of the sample. Quartz dissolution probably occurred exclusively along the cobbles' margins, leaving the remaining grains unaffected by DPC. The fact that quartz precipitated in random orientations may indicate that the strain shadows were regions of little or no differential stress.

OSIRIS observations of meter-sized exposures of H2O ice at the surface of 67P/Churyumov-Gerasimenko and interpretation using laboratory experiments

Since OSIRIS started acquiring high-resolution observations of the surface of the nucleus of comet 67P/Churyumov-Gerasimenko, over one hundred meter-sized bright spots have been identified in numerous types of geomorphologic regions, but mostly located in areas receiving low insolation. The bright spots are either clustered, in debris fields close to decameter-high cliffs, or isolated without structural relation to the surrounding terrain. They can be up to ten times brighter than the average surface of the comet at visible wavelengths and display a significantly bluer spectrum. They do not exhibit significant changes over a period of a few weeks. All these observations are consistent with exposure of water ice at the surface of boulders produced by dislocation of the weakly consolidated layers that cover large areas of the nucleus. Laboratory experiments show that under simulated comet surface conditions, analog samples acquire a vertical stratification with an uppermost porous mantle of refractory dust overlaying a layer of hard ice formed by recondensation or sintering under the insulating dust mantle. The evolution of the visible spectrophotometric properties of samples during sublimation is consistent with the contrasts of brightness and color seen at the surface of the nucleus. Clustered bright spots are formed by the collapse of overhangs that is triggered by mass wasting of deeper layers. Isolated spots might be the result of the emission of boulders at low velocity that are redepositioned in other regions.

Interstitial defects stability in FeCr alloys vs Cr concentration

Finding adequate materials to withstand the demanding conditions in the future fusion and fission reactors is a real challenge in the development of these technologies. Structural materials need to sustain high irradiation doses and temperatures that will change the microstructure over time. A better understanding of the changes produced by the irradiation will allow for a better choice of materials, ensuring a safer and reliable future power plants. High-Cr ferritic/martensitic steels head the list of structural materials due to their high resistance to swelling and corrosion. However, it is well known that these alloys present a problem of embrittlement, which could be caused by the presence of defects created by irradiation as these defects act as obstacles for dislocation motion. Therefore, the mechanical response of these materials will depend on the type of defects created during irradiation. In this work, we address a study of the effect Cr concentration has on single interstitial defect formation energies in FeCr alloys.