Photo-elastic stress analysis of initial alignment archwires.
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Photo-elastic models replicating a lower arch with a moderate degree of lower incisor crowding and a palatally displaced maxillary canine were used to evaluate the stresses transmitted to the roots of the teeth by initial alignment archwires. Six initial alignment archwires were compared, two multi-strand stainless steel wires, two non-super-elastic (stabilized martensitic form) nickel titanium wires, and two stress-induced super-elastic (austenitic active) nickel titanium wires. Three specimens of each archwire type were tested. Analysis of the photo-elastic fringe patterns, in the medium supporting the teeth, revealed that the non-super-elastic nickel titanium archwires produced the highest shear stresses (P = 0.001). However, the shear stresses generated by the super-elastic alignment archwires and the multi-strand stainless steel archwires were very similar (P = 1.00). These results show that even in situations where large deflections of initial alignment archwires are required, super-elastic archwires do not appear to have any marked advantage over multi-strand stainless steel alignment archwires in terms of the stresses transferred to the roots of the teeth. (+info)
Safety of inhaled corticosteroids delivered by plastic and metal spacers.
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BACKGROUND: Because of its non-electrostatic properties the metal Nebuchamber (NC) valved holding chamber (VHC) delivers a greater mass of aerosol to the mouth than the polypropylene Aerochamber (AC) VHC. Delivery of more aerosol to the lungs may also increase systemic absorption of inhaled corticosteroids (ICS) and hypothalamo-pituitary-adrenal (HPA) suppression. METHODS: Thirty children (mean 4.3 (SD 0.3) years) received 200 micro g budesonide twice daily by NC or AC, both with the mask provided, in a randomised, two month crossover trial. Twenty four hour urinary free cortisol (UFC) was determined as a measure of HPA suppression. RESULTS: UFC decreased from 42.3 (7.8) nmol UFC/nmol creatinine control to 26.2 (2.4) (p = 0.06 v control) after AC, and to 24.5 (2.5) (p = 0.04 v control) after NC (p = 0.4 AC v NC). CONCLUSIONS: Despite a greater total dose delivered to the mouth, NC is not associated with greater HPA suppression when using 400 micro g/day budesonide under real life conditions in young children. (+info)
Zirconia and alumina ceramics in comparison with stainless-steel heads. Polyethylene wear after a minimum ten-year follow-up.
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Although alumina has been used in orthopaedic surgery since the 1970s, the long-term clinical results of zirconia have not been well documented in vivo. We studied hips with these two different ceramics during the same period and with a minimum follow-up of ten years. Because the size of the alumina and zirconia heads was different, hips with 32 mm alumina heads and those with 28 mm zirconia heads were compared with control hips with stainless-steel heads of the same size. Our aim was to compare the two ceramics. There was an increased linear rate of penetration of the femoral heads into the liner between years five and 12 for the zirconia and the stainless-steel groups. This was severe in the zirconia group (0.4 mm/year compared with 0.13 mm/year for the stainless-steel group). During the same 12-year period there was, however, no significant change in the rate of wear in the alumina group (0.07 mm/year). The mean wear at the most recent follow-up was 1360 mm3 for the 28 mm zirconia group, 683 mm3 for the 28 mm stainless-steel group, 755 mm3 for the 32 mm alumina group and 1314 mm3 for the 32 mm stainless-steel group. The monoclinic content rose on the surface of three zirconia heads which were retrieved at revision. This change was associated with an increase in the surface roughness. A change in the roundness with an increase in the sphericity deviation was also observed both in the articular and non-articular parts of the femoral heads. The increase in rate of wear in the zirconia group was only evident after eight years and may be linked to a long-term biodegradation of zirconia in vivo, associated with the altered roughness and roundness which was observed on the retrieved heads. (+info)
Randomized evaluation of polytetrafluoroethylene-covered stent in saphenous vein grafts: the Randomized Evaluation of polytetrafluoroethylene COVERed stent in Saphenous vein grafts (RECOVERS) Trial.
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BACKGROUND: Treatment of lesions located in saphenous vein grafts (SVGs) is associated with increased procedural risk and a high rate of restenosis. METHODS AND RESULTS: We conducted a randomized, multicenter trial to evaluate the usefulness of a polytetrafluoroethylene (PTFE)-covered stent compared with a bare stainless steel (SS) stent for prevention of restenosis and major adverse cardiac events (MACE) in patients undergoing SVG treatment. The primary end point was angiographic restenosis at 6 months. Secondary end points were 30-day and 6-month MACE rates, defined as the cumulative of death, myocardial infarction (MI), and target lesion revascularization. Between September 1999 and January 2002, 301 patients with SVG lesions were randomized to either the PTFE-covered JoStent coronary stent graft (PTFE group, n=156) or the SS JoFlex stent (control group, n=145). Angiographic and procedural success rates were similar between the 2 groups (97.4% versus 97.9% and 87.3% versus 93.8%, respectively). The incidence of 30-day MACE was higher in the PTFE group (10.9% versus 4.1%, P=0.047) and was mainly attributed to MI (10.3% versus 3.4%, P=0.037). The primary end point, the restenosis rate at 6-month follow-up, was similar between the 2 groups (24.2% versus 24.8%, P=0.237). Although the 6-month non-Q-wave MI rate was higher in the PTFE group (12.8% versus 4.1%, P=0.013), the cumulative MACE rate was not different (23.1% versus 15.9%, P=0.153). CONCLUSIONS: The study did not demonstrate a difference in restenosis rate and 6-month clinical outcome between the PTFE-covered stent and the SS stent for treatment of SVG lesions. However, a higher incidence of nonfatal myocardial infarctions was found in patients treated with the PTFE-covered stent. (+info)
In vivo evaluation of two new moisture-resistant orthodontic adhesive systems: a comparative clinical trial.
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OBJECTIVE: To evaluate and compare the clinical performance of two new moisture-resistant orthodontic adhesive systems: a chemically-cured composite resin (Unite, 3M Unitek, Monrovia, California, USA) in conjunction with a special moisture-resistant primer (Transbond MIP, 3M Unitek, Monrovia, California, USA); and a fluoride-releasing light-cured compomer (Assure, Reliance Orthodontic Products, Inc., Itasca, Illinois, USA). DESIGN: Randomized controlled clinical trial using the 'split-mouth' technique. SETTING: Department of Orthodontics, Aristotle University of Thessaloniki. SUBJECTS (MATERIALS) AND METHODS: Twenty-five consecutively started patients (13 females and 12 males) requiring fixed appliance orthodontic treatment. INTERVENTIONS: Four-hundred-and-thirty-six stainless steel brackets bonded to all teeth except molars using two different moisture-resistant orthodontic adhesive systems. MAIN OUTCOME MEASURES: Bond failure rates during a period of 9 months were estimated for each adhesive system and the corresponding bracket survival curves were plotted using the Kaplan- Meier product-limit estimate. Bracket survival distributions with respect to adhesive material, tooth location, patient's gender and operator, were then compared by means of a log-rank test. Bond failure interface was determined using the Adhesive Remnant Index. RESULTS: Assure recorded a higher bond failure rate (13.8 per cent) than Unite & MIP (7.3 per cent). The corresponding bracket survival curves were found to be significantly different (P < 0.05). Premolars exhibited higher bond failures than incisors and canines (P < 0.001), while half (49.8 per cent) of the total bond failures occurred during the first 2 months of treatment. The predominant mode of failure was within the bonding material. CONCLUSION: The new moisture-resistant adhesive systems under study were found to be clinically efficient, though Assure exhibited a significantly higher bond failure rate than Unite and Transbond MIP. The higher frequency of adhesive failures observed with Assure might indicate a possible weak point at the adhesive-bracket interface. (+info)
Nickel allergy and orthodontics.
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Nickel is the most common metal to cause contact dermatitis in orthodontics. Nickel-containing metal alloys, such as nickel-titanium and stainless steel, are widely used in orthodontic appliances. Nickel-titanium alloys may have nickel content in excess of 50 per cent and can thus potentially release enough nickel in the oral environment to elicit manifestations of an allergic reaction. Stainless steel has a lower nickel content (8 per cent). However, because the nickel is bound in a crystal lattice it is not available to react. Stainless steel orthodontic components are therefore very unlikely to cause nickel hypersensitivity. This article discusses the diagnosis of nickel allergy in orthodontics and describes alternative products that are nickel free or have a very low nickel content, which would be appropriate to use in patients diagnosed with a nickel allergy. (+info)
Inactivation of vegetative cells, but not spores, of Bacillus anthracis, B. cereus, and B. subtilis on stainless steel surfaces coated with an antimicrobial silver- and zinc-containing zeolite formulation.
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Stainless steel surfaces coated with paints containing a silver- and zinc-containing zeolite (AgION antimicrobial) were assayed in comparison to uncoated stainless steel for antimicrobial activity against vegetative cells and spores of three Bacillus species, namely, B. anthracis Sterne, B. cereus T, and B. subtilis 168. Under the test conditions (25 degrees C and 80% relative humidity), the zeolite coating produced approximately 3 log(10) inactivation of vegetative cells within a 5- to 24-h period, but viability of spores of the three species was not significantly affected. (+info)
Effect of processing variables (different compression packing processes and investment material types) and time on the dimensional accuracy of polymethyl methacrylate denture bases.
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In this study we determined the effect of different compression packing processes, investment materials (a hemihydrate and dental stone) and time on the dimensional accuracy of polymethyl metacrylate denture bases. Square stainless steel plates (15 mm x 15 mm x 5 mm) were prepared to make an acrylic resin specimen. The linear dimensional changes of acrylic resin were determined by measuring the distances of fix points. Measurements were made at 24 hours, 48 hours, 12 days and 30 days after setting with a digital compass. Dimensional changes of test specimens that were obtained with three different flasks and two press techniques were compared by univariate analysis. Measurements of the linear dimensions of specimens cured by different compression packing techniques suggested that differences existed. The time interval differences were not significant. According to the results; flask and investment material types affect the dimensional accuracy of test specimens (p < 0.05). The least dimensional change observed in the specimens was obtained with Type 1 flask-dental stone-manual press combinations. (+info)