Influence of cervical preflaring on determination of apical file size in the palatal roots of maxillary molars

PURPOSE: The aim of this study was to investigate the influence of cervical preflaring in determining the initial apical file (IAF) in the palatal roots of maxillary molars, and to determine the morphologic shape of the canal 1 mm short of the apex. METHODS: After preparing standard access cavities the group 1 received the IAF without cervical preflaring (WCP). In groups 2 to 5, preflaring was performed with Gates-Glidden (GG), Anatomic Endodontics Technology (AET), GT Rotary Files (GT) and LA Axxes (LA), respectively. Each canal was sized using manual K-files, starting with size 08 files, and making passive movements until the WL was reached. File sizes were increased until a binding sensation was felt at the WL. The IAF area and the area of the root canal were measured to verify the percentage occupied by the IAF inside the canal in each sample by SEM. The morphologic shape of the root canal was classified as circular, oval or flattened. Statistical analysis was performed by ANOVA/Tukey test (P < 0.05). RESULTS: The decreasing percentages occupied by the IAF inside the canal were: LA>GT=AET>GG>WCP. The morphologic shape was predominantly oval. CONCLUSION: The type of cervical preflaring used interferes in the determination of IAF.

Cementum, apical morphology and hypercementosis: a probable adaptive response of the periodontal support tissues and potential orthodontic implications

Information about orthodontic movement of teeth with hypercementosis is scarce. As cementum deposition continues to occur, cementum is expected to change the shape of the root and apex over time, but this has not yet been demonstrated. Nor has it ever been established whether it increases or decreases the prevalence of root resorption during orthodontic treatment. The unique biological function of the interconnected network of cementocytes may play a role in orthodontic movement and its associated root resorptions, but no research has ever been conducted on the topic. Unlike cementum thickness and hypercementosis, root and apex shape has not yet been related to patient age. A study of the precise difference between increased cementum thickness and hypercementosis is warranted. Hypercementosis refers to excessive cementum formation above and beyond the extent necessary to fulfill its normal functions, resulting in abnormal thickening with macroscopic changes in the tooth root, which may require the delivery of forces that are different from conventional mechanics in their intensity, direction and distribution. What are the unique features and specificities involved in moving teeth that present with hypercementosis? Bodily movements would be expected to occur, since inclination might prove difficult to achieve, but would the root resorption index be higher or lower?

Plug apical com MTA em dente adjacente à área da fissura labiopalatina

O tratamento endodôntico de dentes com forame apical amplo requer consideração especial, devido ao risco de extravasamento do material obturador nos tecidos periapicais durante a obturação, de maneira relevante em áreas próximas às fissuras labiopalatinas. A criação de uma barreira apical é indicada em casos de difícil travamento do cone principal e consequente deficiência do selamento apical. O MTA em decorrência de suas excelentes propriedades biológicas, é o material de escolha para permanecer em contato com tecidos periodontais e periapicais, fazendo parte do arsenal endodôntico especificamente nestes casos de ápice aberto para a confecção de plug apical. Relato clínico: Indivíduo do gênero feminino, com fissura labiopalatina bilateral transforame, a distal dos dentes 11 e 21; compareceu no setor de endodontia do Hospital de Reabilitação de Anomalias Craniofaciais (HRAC-USP), apresentando necrose pulpar do dente 21. Na primeira sessão foi realizado o acesso cirúrgico, neutralização do conteúdo séptico/tóxico em sentido corono-apical, odontometria, biomecânica, curativo intracanal (pasta Calen) selamento provisório com cimento de ionômero de vidro. Na segunda sessão, foi realizada a obturação onde ocorreu extravasamento de material obturador, verificado através da radiografia comprobatória; justificando sua remoção e nova obturação, com prévia confecção de plug apical com MTA. Foi realizada proservação aos 6 meses pós tratamento endodôntico. Conclusão: neste caso, o plug apical com MTA possibilitou a obturação final do canal radicular com segurança, pela confecção de um anteparo apical, evitando extravasamento de material obturador e preservando a área de fissura labiopalatina.

The third language in English guidebooks and its translation into Spanish

[EN] This article focuses on a specific feature found in tourist guidebooks –the recurrent use of foreign expressions or “third language”. It presents the findings of a comparative analysis of a parallel corpus made up of twenty guidebooks: ten guidebooks originally written in English and their corresponding translated versions in Spanish, describing different countries and cities (all of them published by Lonely Planet), focusing on those chapters in which the writer includes practical information. The purpose of the study is to analyze the use of the third language in the English and Spanish versions and to determine and identify the translation strategies used by the translators to transfer these linguistic elements from one language to the other.

Identifizierung und Charakterisierung von Intermediärfilament-Organisatoren in Caenorhabditis elegans

Intermediärfilamente (IFs) sind neben Mikrotubuli und Aktinfilamenten die dritte filamentäre Komponente des Zytoskeletts. Sie wirken als mechanische Stabilisatoren, sind außerdem an Zelldifferenzierung, Proliferation und Apoptose beteiligt und tragen zu Zellpolarität bei. IFs sind dynamische Strukturen, die zelltypspezifisch in unterschiedlichen Anordnungen und Abundanzen vorkommen und von Signalkaskaden beeinflusst werden. Die zugrundeliegenden molekularen Mechanismen dieser fein abgestimmten Prozesse sind weitgehend unbekannt. In dieser Arbeit sollte deswegen ein Tiermodell entwickelt werden, um Regulatoren der IF-(Netzwerk)-Organisation in vivo zu untersuchen und zu identifizieren. Dazu wurde C. elegans ausgewählt, da es sich hierbei um einen genetisch gut charakterisierten und leicht manipulierbaren Organismus handelt, in dessen Genom elf Gene für zytoplasmatische IFs kodieren. Zunächst wurden stabil transgene C. elegans-Linien generiert, die fluoreszierende IFs exprimieren. Es konnte gezeigt werden, dass das darmspezifische IFB-2::CFP im Bereich des apikalen Junktionskomplex verankert ist und nahezu vollständig im subapikalen Terminalgeflecht der Enterozyten lokalisiert, das als Teil der endotube besonders stabil und widerstandsfähig ist. Wenn diese Tiere mit dsRNA gegen das ebenfalls im Terminalgeflecht exprimierte IF ifc-2 behandelt wurden, entwickelten sich blasenförmige Ausstülpungen des Darmlumens, die auf eine Schwächung der rigiden und formgebenden endotube hinwiesen und damit einen direkten in vivo-Beweis für die stressprotektive Funktion des intestinalen IF-Netzwerks lieferten. Die leichte Detektierbarkeit des IFB-2::CFP-Musters wurde in einem optischen Screen ausgenutzt, bei dem nach chemischer Mutagenese nach Veränderungen im IF-Muster gefahndet wurde. Hierbei wurden drei Mutanten isoliert. In Komplementationsanalysen stellte sich heraus, dass es sich in zwei Fällen um Allele desselben Gens handelt. Die Identifizierung der betroffenen Gene gelang durch eine PCR-basierte Kartierung von single nucleotide polymorphisms nach Verpaarung mit dem Hawaii-Stamm (snp-mapping) und anschließender RNAi-Analyse der Einzelgene in den identifizierten Chromosomenabschnitten. Im einen Fall handelte es sich um das sma-5-Gen, einer Serin/Threonin-Kinase mit Homologie zu den MAP-Kinasen MAPK7/ERK5 der Säuger. Hier wurden, ebenso wie beim ifc-2 (RNAi)-Phänotyp, progressive blasenförmige Ausstülpungen des Darmlumens beobachtet. Die beiden anderen Allele tragen Mutationen in einem bisher nicht näher charakterisierten Gen. In diesen Würmern kommt es zu einem vollständigen Auflösung des IFB-2::CFP-Netzwerks mit prominenten Akkumulationen um die apikalen Junktionen. Das Darmlumen ist stellenweise geweitet und das elektronendichte Terminalgeflecht fehlt fast vollständig, die Integrität des Darmepithels ist jedoch nicht kompromittiert. Die anderen IFs des Terminalgeflechts sind ebenfalls fehlverteilt, und die intestinale Expression von Aktin ist stark reduziert. Expressionskonstrukte des Gens zeigten weiterhin, dass es darmspezifisch synthetisiert wird und mit den IFs im Terminalgeflecht kolokalisiert. Das Protein ist, ähnlich wie das IF-assoziierte Filaggrin der Säuger ausgesprochen histidinreich. Es enthält außerdem eine Prolin-reiche Domäne, die Teil einer potentiellen Aktin-Bindedomäne ist. Auf Grund all dieser Eigenschaften wird die Bezeichnung IFO-1 (intermediate filament organizer) für das neue Protein vorgeschlagen, das möglicherweise als struktureller Zytoskelett-Linker wirkt. Die vorgestellten Ergebnisse untermauern die Bedeutung von C. elegans für die Identifizierung von Faktoren, die IF-Netzwerke regulieren, und die Möglichkeit, Defekte im lebenden Gesamtorganismus zu bestimmen.

Static analysis of functionally graded cylindrical and conical shells or panels using the generalized unconstrained third order theory coupled with the stress recovery

A 2D Unconstrained Third Order Shear Deformation Theory (UTSDT) is presented for the evaluation of tangential and normal stresses in moderately thick functionally graded conical and cylindrical shells subjected to mechanical loadings. Several types of graded materials are investigated. The functionally graded material consists of ceramic and metallic constituents. A four parameter power law function is used. The UTSDT allows the presence of a finite transverse shear stress at the top and bottom surfaces of the graded shell. In addition, the initial curvature effect included in the formulation leads to the generalization of the present theory (GUTSDT). The Generalized Differential Quadrature (GDQ) method is used to discretize the derivatives in the governing equations, the external boundary conditions and the compatibility conditions. Transverse and normal stresses are also calculated by integrating the three dimensional equations of equilibrium in the thickness direction. In this way, the six components of the stress tensor at a point of the conical or cylindrical shell or panel can be given. The initial curvature effect and the role of the power law functions are shown for a wide range of functionally conical and cylindrical shells under various loading and boundary conditions. Finally, numerical examples of the available literature are worked out.

Mapping the elastic response of epithelial apical cell membranes suspended across porous array

As the elastic response of cell membranes to mechanical stimuli plays a key role in various cellular processes, novel biophysical strategies to quantify the elasticity of native membranes under physiological conditions at a nanometer scale are gaining interest. In order to investigate the elastic response of apical membranes, elasticity maps of native membrane sheets, isolated from MDCK II (Madine Darby Canine kidney strain II) epithelial cells, were recorded by local indentation with an Atomic Force Microscope (AFM). To exclude the underlying substrate effect on membrane indentation, a highly ordered gold coated porous array with a pore diameter of 1.2 μm was used to support apical membranes. Overlays of fluorescence and AFM images show that intact apical membrane sheets are attached to poly-D-lysine coated porous substrate. Force indentation measurements reveal an extremely soft elastic membrane response if it is indented at the center of the pore in comparison to a hard repulsion on the adjacent rim used to define the exact contact point. A linear dependency of force versus indentation (-dF/dh) up to 100 nm penetration depth enabled us to define an apparent membrane spring constant (kapp) as the slope of a linear fit with a stiffness value of for native apical membrane in PBS. A correlation between fluorescence intensity and kapp is also reported. Time dependent hysteresis observed with native membranes is explained by a viscoelastic solid model of a spring connected to a Kelvin-Voight solid with a time constant of 0.04 s. No hysteresis was reported with chemically fixated membranes. A combined linear and non linear elastic response is suggested to relate the experimental data of force indentation curves to the elastic modulus and the membrane thickness. Membrane bending is the dominant contributor to linear elastic indentation at low loads, whereas stretching is the dominant contributor for non linear elastic response at higher loads. The membrane elastic response was controlled either by stiffening with chemical fixatives or by softening with F-actin disrupters. Overall, the presented setup is ideally suitable to study the interactions of the apical membrane with the underlying cytoskeleton by means of force indentation elasticity maps combined with fluorescence imaging.

Ontogenetic studies on the determination of the apical meristem in racemose inflorescences

This thesis presents a comparative developmental study of inflorescences and focuses on the production of the terminal flower (TF). Morphometric attributes of inflorescence meristems (IM) were obtained throughout the ontogeny of inflorescence buds with the aim of describing possible spatial constraints that could explain the failure in developing the TF. The study exposes the inflorescence ontogeny of 20 species from five families of the Eudicots (Berberidaceae, Papaveraceae-Fumarioideae, Rosaceae, Campanulaceae and Apiaceae) in which 745 buds of open (i.e. without TF) and closed (i.e. with TF) inflorescences were observed under the scanning electron microscope.rnThe study shows that TFs appear on IMs which are 2,75 (se = 0,38) times larger than the youngest lateral reproductive primordium. The shape of these IMs is characterized by a leaf arc (phyllotactic attribute) of 91,84° (se = 7,32) and a meristematic elevation of 27,93° (se = 5,42). IMs of open inflorescences show a significant lower relative surface, averaging 1,09 (se=0,26) times the youngest primordium size, which suggests their incapacity for producing TFs. The relative lower size of open IMs is either a condition throughout the complete ontogeny (‘open I’) or a result from the drastic reduction of the meristematic surface after flower segregation (‘open II’). rnIt is concluded that a suitable bulge configuration of the IM is a prerequisite for TF formation. Observations in the TF-facultative species Daucus carota support this view, as the absence of the TF in certain umbellets is correlated with a reduction of their IM dimensions. A review of literature regarding histological development of IMs and genetic regulation of inflorescences suggests that in ‘open I’ inflorescences, the histological composition and molecular activity at the tip of the IM could impede the TF differentiation. On the other side, in ‘open II’ inflorescences, the small final IM bulge could represent a spatial constraint that hinders the differentiation of the TF. The existence of two distinct kinds of ontogenies of open inflorescences suggests two ways in which the loss of the TF could have occurred in the course of evolution.rn

Clinical results with two different methods of root-end preparation and filling in apical surgery: mineral trioxide aggregate and adhesive resin composite

INTRODUCTION: The aim of apical surgery is to hermetically seal the root canal system after root-end resection, thereby enabling periradicular healing. The objective of this nonrandomized prospective clinical study was to report results of 2 different root-end preparation and filling methods, ie, mineral trioxide aggregate (MTA) and an adhesive resin composite (Retroplast). METHODS: The study included 353 consecutive cases with endodontic lesions limited to the periapical area. Root-end cavities were prepared with sonic microtips and filled with MTA (n = 178), or alternatively, a shallow concavity was prepared in the cut root face, with subsequent placement of an adhesive resin composite (Retroplast) (n = 175). Patients were recalled after 1 year. Cases were defined as healed when no clinical signs or symptoms were present and radiographs demonstrated complete or incomplete (scar tissue) healing of previous radiolucencies. RESULTS: The overall rate of healed cases was 85.5%. MTA-treated teeth demonstrated a significantly (P = .003) higher rate of healed cases (91.3%) compared with Retroplast-treated teeth (79.5%). Within the MTA group, 89.5%-100% of cases were classified as healed, depending on the type of treated tooth. In contrast, more variable rates ranging from 66.7%-100% were found in the Retroplast group. In particular, mandibular premolars and molars demonstrated considerably lower rates of healed cases when treated with Retroplast. CONCLUSIONS: MTA can be recommended for root-end filling in apical surgery, irrespective of the type of treated tooth. Retroplast should be used with caution for root-end sealing in apical surgery of mandibular premolars and molars.

Haemostatic effect and tissue reactions of methods and agents used for haemorrhage control in apical surgery

To compare the haemostatic effect and tissue reactions of different agents and methods used for haemorrhage control in apical surgery.

Apical surgery of a maxillary molar creating a maxillary sinus window using ultrasonics: a clinical case

AIM: To describe a method of carrying out apical surgery of a maxillary molar using ultrasonics to create a lateral sinus window into the maxillary sinus and an endoscope to enhance visibility during surgery. SUMMARY: A 37-year-old female patient presented with tenderness to percussion of the maxillary second right molar. Root canal treatment had been undertaken, and the tooth restored with a metal-ceramic crown. Radiological examination revealed an apical radiolucency in close proximity to the maxillary sinus. Apical surgery of the molar was performed through the maxillary sinus, using ultrasonics for the osteotomy, creating a window in the lateral wall of the maxillary sinus. During surgery, the lining of the sinus was exposed and elevated without perforation. The root-end was resected using a round tungsten carbide drill, and the root-end cavity was prepared with ultrasonic retrotips. Root-end filling was accomplished with MTA(®) . An endoscope was used to examine the cut root face, the prepared cavity and the root-end filling. No intraoperative or postoperative complications were observed. At the 12-month follow-up, the tooth had no clinical signs or symptoms, and the radiograph demonstrated progressing resolution of the radiolucency. KEY LEARNING POINTS: When conventional root canal retreatment cannot be performed or has failed, apical surgery may be considered, even in maxillary molars with roots in close proximity to the maxillary sinus. Ultrasonic sinus window preparation allows more control and can minimize perforation of the sinus membrane when compared with conventional rotary drilling techniques. The endoscope enhances visibility during endodontic surgery, thus improving the quality of the case.

Prognostic factors in apical surgery with root-end filling: a meta-analysis

INTRODUCTION: Apical surgery has seen continuous development with regard to equipment and surgical technique. However, there is still a shortage of evidence-based information regarding healing determinants. The objective of this meta-analysis was to review clinical articles on apical surgery with root-end filling in order to assess potential prognostic factors. METHODS: An electronic search of PubMed and Cochrane databases was performed in 2008. Only studies with clearly defined healing criteria were included, and data for at least two categories per prognostic factor had to be reported. Prognostic factors were divided into patient-related, tooth-related, or treatment-related factors. The reported percentages of healed teeth ("the healed rate") were pooled per category. The statistical method of Mantel-Haenszel was applied to estimate the odds ratios and their 95% confidence intervals. RESULTS: With regard to tooth-related factors, the following categories were significantly associated with higher healed rates: cases without preoperative pain or signs, cases with good density of root canal filling, and cases with absence or size < or = 5 mm of periapical lesion. With regard to treatment-related factors, cases treated with the use of an endoscope tended to have higher healed rates than cases without the use of an endoscope. CONCLUSIONS: Although the clinician may be able to control treatment-related factors (by choosing a certain technique), patient- and tooth-related factors are usually beyond the surgeon's power. Nevertheless, patient- and tooth-related factors should be considered as important prognostic determinants when planning or weighing apical surgery against treatment alternatives.

Greenstick fractures of the middle third of the forearm. A prospective multi-centre study

Greenstick fractures suffered during growth have a high risk for refracture and posttraumatic deformity, particularly at the forearm diaphysis. The use of a preemptive completion of the fracture by manipulation of the concave cortex is controversial and data supporting this approach are few.