bluuebunny/crossref_metadata_2025 huggingface dataset:
Executive Dysfunction Is a Significant Predictor of Poor Quality of Life in Children with Epilepsy
Authors: Sherman Elisabeth M. S. , Slick Daniel J. , Eyrl Kim L.
Published: October 2006

Summary:  Purpose: Based on prior research indicating poor health‐related quality of life (HRQOL) in children with attention‐deficit/hyperactivity disorder, we investigated (1) whether executive functioning deficits were related to poor HRQOL in children with epilepsy, (2) how important these variables were in comparison to known predictors of HRQOL such as neurological factors, and (3) the extent to which clinical‐level impairments in executive dysfunction predispose children to low HRQOL.

Method: Data included scores on the Behavior Rating Inventory of Executive Function (BRIEF) and HRQOL scales (The Impact of Childhood Illness Scale [ICI] and Hague Restrictions in Epilepsy Scale [HARCES]) for 121 children (mean age = 11.9, SD = 3.6) from a tertiary center serving children with severe epilepsy.

Results: Correlations between the BRIEF and ICI total and subscore domains (child, parent, family, and treatment) were generally significant and moderate (e.g., r ≥ 0.30, p ≤ 0.001). BRIEF Global Executive Composite, number of antiepileptic drugs (AEDs), number of prior AEDs, and adaptive level all emerged as significant and unique predictors of HRQOL (R2= 0.36, adj. R2= 0.33, p < 0.0001). A clinically elevated BRIEF was associated with a twofold risk of low HRQOL (odds ratio = 2.21, p = 0.03).

Conclusions: Executive dysfunction appears to exert a broad adverse influence on HRQOL in children with epilepsy, with clinical‐level impairments in executive dysfunction contributing to a twofold increase in the likelihood of poor HRQOL. The constellation of executive dysfunction, low adaptive level, high medication load, and a history of several failed AEDs are risk factors for poor HRQOL in children with epilepsy.
The Blood–Brain Barrier and Epilepsy
Authors: Oby Emily , Janigro Damir
Published: October 2006

Summary:  During the past several years, there has been increasing interest in the role of the blood–brain barrier (BBB) in epilepsy. Advances in neuroradiology have enhanced our ability to image and study the human cerebrovasculature, and further developments in the research of metabolic deficiencies linked to seizure disorders (e.g., GLUT1 deficiency), neuroinflammation, and multiple drug resistance to antiepileptic drugs (AEDs) have amplified the significance of the BBB's relationship to epilepsy.

 Prior to 1986, BBB research in epilepsy focused on three main areas: ultrastructural studies, brain glucose availability and transport, and clinical uses of AEDs. However, contrast‐based imaging techniques and medical procedures such as BBB disruption provided a framework that demonstrated that the BBB could be reversibly disrupted by pathologic or iatrogenic manipulations, with important implications in terms of CNS drug delivery to “multiple drug resistant” brain. This concept of BBB breakdown for therapeutic purposes has also unveiled a previously unrecognized role for BBB failure as a possible etiologic mechanism in epileptogenesis. Finally, a growing body of evidence has shown that inflammatory mechanisms may participate in the pathological changes observed in epileptic brain, with increasing awareness that blood‐borne cells or signals may participate in epileptogenesis by virtue of a leaky BBB. In this article we will review the relationships between BBB function and epilepsy. In particular, we will illustrate consensus and divergence between clinical reality and animal studies.
The Evaluation of Thyroid Functions, Thyroid Antibodies, and Thyroid Volumes in Children with Epilepsy during Short‐Term Administration of Oxcarbazepine and Valproate
Authors: Cansu Ali , Serdaroğlu Ayşe , Çamurdan Orhun , Hırfanoğlu Tuğba , Bideci Aysun , Gücüyener Kıvılcım
Published: October 2006

Summary:  Purpose: The aim of this study was to evaluate the effects of short‐term oxcarbazepine (OXC) and valproate (VPA) monotherapy on thyroid functions in children.

Methods: Fifty‐five newly diagnosed epileptic children with normal thyroid functions (confirmed with the thyrotropin releasing hormone stimulation test) participated in this study. VPA treatment was started in 30 patients and OXC in 25 patients. Serum thyroxine (T4), free thyroxine (fT4), triiodothyronine (T3), free triiodothyronine (fT3), reverse T3 (rT3), thyroid peroxidase antibodies (TPO‐ab), and urine iodine levels were evaluated at baseline and at the third and sixth months of therapy.

Results: In the OXC group, serum T4, fT4, T3, fT3, and rT3 levels were found to be decreased at the third and sixth months, the differences were significant compared to the baseline values except for fT3 levels at the third month and fT4 and rT3 levels at the sixth month (p < 0.05). At the sixth month, serum T4 level dropped below the normal reference value in 8 (32%), fT4 in 5 (20%), T3 in 4 (16%), and fT3 in 3 (12%) patients. In the VPA group, mean T4, fT4, T3, fT3, and rT3 levels at 3 and 6 months remained similar compared to the baseline values (p > 0.05). Mean serum thyroid stimulating hormone levels increased significantly at the sixth month compared to the baseline values in the VPA group (p < 0.05) while it remained unchanged in the OXC group (p > 0.05). There was no effect of either drug on urinary iodine excretion and serum TPO‐ab levels remained in normal ranges throughout the study.

Conclusions: In this prospective study, it is documented that children under short‐term OXC or VPA therapy showed altered thyroid functions similar to the changes observed after long‐term treatment. Although, the clinical significance of these results need to be evaluated with future studies, this observation of altered thyroid functions points out that thyroid functions may need to be monitored closely in children receiving antiepileptic treatment, even in the short‐time interval.
Mesial Temporal Inhibition in a Patient with Deep Brain Stimulation of the Anterior Thalamus for Epilepsy
Authors: Zumsteg Dominik , Lozano Andres M. , Wennberg Richard A.
Published: October 2006

Summary:  We investigated the electrophysiological effects of high‐frequency anterior thalamic deep brain stimulation using intracerebral mesial and lateral temporal depth electrodes in a patient with intractable focal epilepsy. Monopolar and bipolar stimulation delivered to the thalamic anterior nucleus using the programmable ITREL II stimulation device led to a significant decrease of cross power spectral density and a nonsignificant decrease of coherence in ipsilateral hippocampal structures. No such effect was found in lateral temporal or contralateral sites. The hippocampal inhibition was clearly related to the voltage (≥7 V) and frequency (≥70 Hz) of the thalamic stimulus and occurred with a delay of approximately 60 s after stimulus onset.
Psychiatric Comorbidity in Juvenile Myoclonic Epilepsy
Authors: Trinka Eugen , Kienpointner Gudrun , Unterberger Iris , Luef Gerhard , Bauer Gerhard , Doering Lisa Bartha , Doering Stephan
Published: October 2006

Summary:  Objective: To assess the prevalence of psychiatric disturbances among patients with juvenile myoclonic epilepsy (JME).

Methods: Forty‐three patients with JME (22 female, 21 male, mean age 32.4 ± 13, range 15–63) were assessed by means of the Structured Clinical Interviews for DSM‐IV (SCID‐I and SCID‐II). Current and lifetime psychiatric diagnoses were assigned.

Results: Thirty‐five percent of the JME patients suffered from one or more psychiatric disorders (Axis I and Axis II). Personality disorders were present in 23% and Axis I disorders in 19%. Altogether, 47% had a psychiatric disorder at any time of their life.

Conclusions: Psychiatric diagnoses are slightly higher than in representative community samples. The substantially increased number of personality disorders in JME patients might be attributed to frontal lobe deficits.
Ethanol Decreases Rat Hepatic Arylsulfatase A Activity Levels
Authors: Jean Smith , Kasinathan Chinnaswamy , Buyske Steven , Manowitz Paul
Published: October 2006

Background: Arylsulfatase A (ASA) is an enzyme that catalyzes the degradation of sulfatides, a glycosphingolipid found in many tissues, but predominantly in myelin and kidney. Arylsulfatase A is 1 member of a family of sulfatases that is activated by a required co‐ or posttranslational modification with the oxidation of cysteine to formylglycine. This conversion requires a novel oxygenase mechanism that can be inhibited by reactive oxygen species. Ethanol is known to cause an increase in reactive oxygen species in the liver. Because of its effect on the levels of hepatic reactive oxygen species, we hypothesized that ethanol would cause a specific decrease of rat hepatic ASA activity levels.

Methods: Male Sprague–Dawley rats received ethanol‐containing, Lieber–DeCarli liquid diets for 15 days, and control rats were pair‐fed a liquid diet in which dextrose was isocalorically substituted for ethanol.

Results: Arylsulfatase A activity levels decreased in livers of animals receiving alcohol compared with control animals. No significant changes in ASA activity levels were observed in the cerebral cortex and kidney. Furthermore, ethanol did not have any significant effect on hexosaminidase activity in any of the tissues examined.

Conclusion: Ethanol caused a tissue‐specific decrease in hepatic ASA activity levels, but not hexosaminidase activity levels.
The Boundaries of the Firm: The Choice Between Stand‐Alone and Integrated Firms
Authors: Berkovitch Elazar , Israel Ronen , Tolkowsky Efrat
Published: October 2006

This study presents a theory of corporate structure selection. It outlines when economic units should be structured as stand‐alone firms versus an integrated firm (conglomerate). The theory suggests that an integrated firm better controls agency problems through yardstick competition between managers for project acceptance. However, this structure reduces the ability to receive division‐specific project information from the market. Based on this trade‐off, we show that divisions within a conglomerate have different characteristics and, thus, different valuations than “similar” stand‐alone firms. Our theory also explains differences in the required rate of return between stand‐alone firms and conglomerates and how they relate to relative valuations of conglomerates and “similar” stand‐alone firm. It also predicts when stock price reaction to divestiture and merger announcements will be positive or negative.
Coordination, Differentiation, and the Timing of Radio Commercials
Authors: Sweeting Andrew
Published: October 2006

This paper examines the timing of commercial breaks by contemporary music radio stations. A simple model shows that stations may prefer, all else equal, to choose the same times (coordination) or different times (differentiation) for breaks depending on how listeners behave. It also shows that how much commercials overlap in Nash equilibrium should vary in different ways with observable market characteristics, such as the number of stations, depending on whether stations prefer to coordinate or differentiate. Panel data on the timing of commercials by 1,094 stations provide consistent support for the hypothesis that stations prefer to coordinate on timing.
Customer Directed Advertising and Product Quality
Authors: Esteban Lola , Hernández José M. , Moraga‐González José Luis
Published: October 2006

This paper studies the relationship between three key elements of the marketing mix, namely, price, product, and promotion, in a model where a seller employs informative advertising to launch a new product. We propose a fairly general advertising technology for the study of three promotional strategies—mass, imperfectly targeted, and customer directed advertising (CDA). We find that both the private and the social incentives to use distinct advertising strategies are aligned, and that sales are likely to be promoted through CDA. Compared to mass advertising, with CDA the social planner reduces quantity and downgrades quality whereas the seller sometimes upgrades it. Our model of targeting with endogenous product quality provides some new insights into the way the transition from mass to specialized advertising can affect market outcomes. Quality distortions imply that (i) even if CDA increases the market price, the degree of market power need not increase and (ii) CDA may yield a welfare loss even if it leads to a lower market price.
Differentiated Duopoly with Asymmetric Costs
Authors: Zanchettin Piercarlo
Published: October 2006

In this paper, we compare Bertrand and Cournot equilibria in a differentiated duopoly with linear demand and cost functions. We extend the Singh and Vives (1984) model by allowing for a wider range of cost and demand (product quality) asymmetry between firms. Focusing on the case of substitute goods, we show that both the efficient firm's profits and industry profits are higher under Bertrand competition when asymmetry is strong and/or products are weakly differentiated. Therefore, Singh and Vives's ranking of profits between the two modes of competition is reversed in a sizeable portion of the relevant parameter space. Contrary to the standard result with symmetric firms, we also show that product differentiation can reduce both the efficient firm's and industry profits, implying that a local incentive towards less differentiation may arise.
Analysis and reporting of platelet kinetic studies
Authors: Dumont Larry J.
Published: October 2006

BACKGROUND: For platelet (PLT) kinetic studies in the healthy subject, autologous transfusion models are standardly used for the evaluation of new or modified PLT collection or treatment methods. The investigator is usually seeking to demonstrate that the new product is not inferior to a control condition. Consistent, statistically sound analysis and reporting methods will enable clear interpretation and communication of the results.

STUDY DESIGN AND METHODS: Noninferiority hypotheses are constructed in light of a recent FDA workshop. One‐ and two‐stage analysis methods are described to evaluate the paired differences in control and test arms with calculation of upper confidence intervals. Sample size estimates are presented for various experimental design options. The sensitivity of sample size to the difference in test and control recoveries is performed.

RESULTS: The noninferiority hypothesis test was applied to a recently published study. Seven‐day, plasma‐stored apheresis PLTs were shown to be noninferior to freshly prepared PLTs with 95 percent confidence that the difference in recovery was not more than 11.4 percent and survival not more than 2.6 days, with maximum acceptable differences of 19.8 percent and 4.4 days. As the test recovery and survival approach the minimum acceptable value, the sample size required to demonstrate noninferiority increases nonlinearly. Preliminary sample size calculations presented here suggest that for most studies such as this, a minimum sample size of 7 should be anticipated. Because most of these studies are used to support regulatory submissions, this is usually executed in at least two centers for a total minimum of 14.

CONCLUSION: The randomized, paired design is the most efficient approach to these studies. Consistent reporting of summary statistics for each test arm and the paired differences, the upper confidence limit for the differences in recovery and survival, and the maximum acceptable difference for each is recommended.
Echocardiographic Assessment of Left Ventricular Mass in Neonatal and Adult Mice: Accuracy of Different Echocardiographic Methods
Authors: Ghanem Alexander , Röll Willi , Hashemi Toktam , Dewald Oliver , Djoufack P. Chryso , Fink Klaus B. , Schrickel Jan , Lewalter Thorsten , Lüderitz Berndt , Tiemann Klaus
Published: October 2006

Echocardiography is an established method to estimate left‐ventricular mass (LVM) in mice. Accuracy is determined by cardiac size and morphology and influenced by mathematical models. We investigated accuracy of three common algorithms in three early developmental stages. High‐resolution echocardiography was performed in 35 C57/BL6‐mice. Therefore, two‐dimensional‐guided M‐mode echocardiography and parasternal short‐ and long‐axis views in B‐mode were obtained. LVM was assessed in vivo applying Penn (P), Area Length (AL), and Truncated Ellipsoid (TE) algorithms and validated with histomorphometry. Regression analysis of all mice showed fair estimation of LVM assessed with M‐mode‐based Penn algorithm (y = 0.6*x − 0.12, r: 0.71). In contrast two‐dimensional assessment of LVM revealed close linear relationship with histomorphometry (yAL= 1.21*x − 12.1, r: 0.88, yTE= 1.38*x − 2.88, r: 0.86). Bias was lowest for LVM‐AL at diastole underestimating 3.2%. In concordance with the summarized data, LVM‐P revealed lower regression coefficients and significant underestimation in all three subgroups. Small hearts (<50 mg, n = 12) correlated best with LVM‐AL at systole. Hearts of adolescent (50–75 mg, n = 13) and adult (75–100 mg, n = 10) mice revealed close linear relationship with LVM‐AL and LVM‐TE at diastole. Echocardiographic assessment of LVM is feasible in hearts weighting less than 50 mg and can be estimated best in systole. Hearts weighting more than 50 mg are estimated most accurately by means of LVM‐AL at diastole.
Analytical Methods Used for the Discrimination of Substances Suspected to be Bar Soap: A Preliminary Study*
Authors: Arredondo Marlo , LaPorte Gerald M. , Wilson Jeffrey D. , McConnell Tyra , Shaffer Douglas K. , Stam Marianne
Published: October 2006

ABSTRACT: The submission to forensic laboratories of unknown specimens suspected of being biological or chemical warfare agents has increased tremendously with the threat of terrorism. Oftentimes, a threatening correspondence that contains hoax materials is intended to make the recipient(s) believe they have been exposed to a toxin. In some cases, the perpetrator can use standard household products, such as detergents and soaps. Once these materials are received, they become forensic evidence and may be analyzed for identification and/or comparison with known seized material from a suspect(s). Two separate studies were conducted using different analytical protocols for bar soaps. In the first set, the forensic laboratory at the United States Secret Service conducted tests on 68 bars of soap using solid‐phase microextraction and gas chromatography coupled with mass spectrometry. The 68 different soaps displayed unique total ion chromatogram profiles. Energy‐dispersive X‐ray analysis in conjunction with scanning electron microscopy was also used to characterize 46 of the 68 soaps as a preliminary study. In a second set of studies, as part of a homicide investigation, the laboratory at the California Department of Justice, Riverside, conducted examinations on 13 bars of soap by utilizing Fourier transform‐infrared spectroscopy. The case study demonstrated that it is possible to distinguish some bar soaps using infrared analysis. Furthermore, the bar soaps could be distinguished from typical laundry detergents using this technique.
A Mechanistic Model for the Superglue Fuming of Latent Fingerprints*
Authors: Czekanski Patrick , Fasola Michael , Allison John
Published: October 2006

ABSTRACT: The use of superglue vapors to detect latent fingerprints, known as superglue fuming, is a chemical process that has not been fully described. The role of the fingerprint material in the process, leading to formation of methyl cyanoacrylate polymer at the site of the fingerprint, remains to be established. Films of liquid alkanes respond similarly to actual fingerprints in the fuming experiment. Their responses depended on the hydrocarbon used, viscosity, and film thickness. Aspects such as film thickness appear to be relevant for actual fingerprints as well. A model was proposed in light of these observations. The model compares the process with gas chromatography, in which molecules partition between the gas phase and a stationary phase. Aspects such as accumulation of superglue monomers by partitioning into a thin film (or wax) are consistent with the preferential response of fingerprints on surfaces relative to the background.
α‐Amylase Kinetic Test in Bodily Single and Mixed Stains
Authors: Barni Filippo , Berti Andrea , Rapone Cesare , Lago Giampietro
Published: October 2006

ABSTRACT: Recently, in Italy, a murder and a putative sexual violence was accomplished on a child. A bodily fluids mixture on the child's underwear between the victim (female) and the suspect (male) was ascertained by short tandem repeat (STR) DNA typing and, due to the absence of seminal fluid, saliva from the suspect and urine from the child was hypothesized. In order to investigate the possibility of specifically and rapidly detecting saliva stains both alone and mixed with other bodily fluids, we used a quantitative spectrophotometric technique, named Amylase test, for the detection of α‐amylases. We determined α‐amylase activity and reaction kinetic curves in several samples collected from the child's underwear. In order to confirm our intuition, we first tested saliva, perspiration, and urine, singularly and in mixtures; second, several forensic stains including saliva, perspiration, urine stains, saliva/perspiration, and saliva/urine mixture stains were tested. Evaluating α‐amylase activity values and time‐course curves' behavior of α‐amylase reactions we were able to recognize successfully, in all cases, the presence of saliva and to distinguish it specifically from other bodily fluids containing α‐amylase. A further confirmation of our result was provided by STR DNA typing on several areas of the underwear: a clear correlation between α‐amylases activity and male DNA was detected on all the samples evaluated.
Ontogeny of Femur Subtrochanteric Shape in Native Americans and American Blacks and Whites*
Authors: Wescott Daniel J.
Published: October 2006

ABSTRACT: Femur subtrochanteric size and shape can be used to differentiate between adult Native Americans and American Blacks and Whites, but little is known about when shape differences are established during growth and development. Ontological changes in subtrochanteric shape were examined using 74 Native American and 61 American Black/White subadult femora. At birth, the proximal femur diaphysis is relatively circular in both groups. Between birth and 5 years, the diaphysis becomes more mediolaterally broad, especially in Native Americans, due to differential growth between the mediolateral and anteroposterior planes. This change may be due to biomechanical stresses associated with developing a mature gait pattern. After the age of 5, growth occurs more equally in the two planes and shape does not change significantly. The adult shape of the proximal femur is established by c. 5 years of age and can be used to discriminate between Native American and American Black/White femora in older subadults.
Microbial Metagenome Profiling Using Amplicon Length Heterogeneity‐Polymerase Chain Reaction Proves More Effective Than Elemental Analysis in Discriminating Soil Specimens*
Authors: Moreno Lilliana I. , Mills DeEtta K. , Entry James , Sautter Robert T. , Mathee Kalai
Published: October 2006

ABSTRACT: The combination of soil's ubiquity and its intrinsic abiotic and biotic information can contribute greatly to the forensic field. Although there are physical and chemical characterization methods of soil comparison for forensic purposes, these require a level of expertise not always encountered in crime laboratories. We hypothesized that soil microbial community profiling could be used to discriminate between soil types by providing biological fingerprints that confer uniqueness. Three of the six Miami‐Dade soil types were randomly selected and sampled. We compared the microbial metagenome profiles generated using amplicon length heterogeneity‐polymerase chain reaction analysis of the 16S rRNA genes with inductively coupled plasma optical emission spectroscopy analysis of 13 elements (Al, B, Ca, Cu, Fe, K, Mg, Mn, Na, P, S, Si, and Zn) that are commonly encountered in soils. Bray–Curtis similarity index and analysis of similarity were performed on all data to establish differences within sites, among sites, and across two seasons. These data matrices were used to group samples that shared similar community patterns using nonmetric multidimensional scaling analysis. We concluded that while chemical characterization could provide some differentiation between soils, microbial metagenome profiling was better able to discriminate between the soil types and had a high degree of reproducibility, therefore proving to be a potential tool for forensic soil comparisons.
Influence of N‐glycan processing disruption on tyrosinase and melanin synthesis in HM3KO melanoma cells
Authors: Choi Hyunjung , Ahn Soomi , Chang Huikyoung , Cho Nam Suk , Joo Kyungmi , Lee Byeong Gon , Chang Ihseop , Hwang Jae Sung
Published: October 2006

Abstract:  Tyrosinase, a type I membrane glycoprotein, is synthesized and glycosylated in the endoplasmic reticulum (ER) and Golgi. The enzyme is subsequently transported to melanosomes where it participates in melanogenesis. Previous studies showed that the disruption of early ER N‐glycan processing by deoxynojirimycin (DNJ), an inhibitor of α‐glucosidase, suppresses tyrosinase enzymatic activity and melanogenesis. However, the disruption of late glycan processing, mainly performed by ER and Golgi α‐1,2‐mannosidases, on tyrosinase enzymatic activity and melanogenesis remains to be investigated. Following treatment of HM3KO human melanoma cells with deoxymannojirimycin (DMJ), an inhibitor of α‐1,2‐mannosidase, transport of tyrosinase to the melanosome, enzymatic activity, and melanogenesis were reduced in a dose‐dependent manner. However, DMJ did not directly inhibit tyrosinase enzymatic activity and expression. Interestingly, an extract of Streptomyces subrutilus culture medium (ESSCM) containing DMJ and DNJ as the main components inhibited glycosylation and transport of tyrosinase to the melanosome as well as melanin synthesis, but with no negative effects on cell viability. These inhibitory effects of ESSCM were stronger than those of DMJ or DNJ alone. Tyrosinase glycosylation and melanogenesis in HM3KO melanoma cells were more effectively inhibited by DMJ and DNJ combined than DMJ or DNJ alone. Accordingly, we propose that ESSCM is a potential candidate for treating undesirable hyperpigmentation conditions, such as melasma, postinflammatory melanoderma, and solar lentigo.
Bone Reactions to Oxidized Titanium Implants with Electrochemical Anion Sulphuric Acid and Phosphoric Acid Incorporation
Authors: Sul Young‐Taeg , Johansson Carina B. , Kang Yunmo , Jeon Dong‐Gyun , Albrektsson Tomas
Published: October 2006

Background: The importance of the surface properties of implants for a successful osseointegration has been emphasized. It is generally known that bone response to implant surfaces is considerably related to the various surface properties.

Purpose: The purpose of this study was to investigate bone tissue reactions to multifactorial biocompatibility of the surface oxide of electrochemically oxidized titanium implants. The ultimate objective was to improve surface quality, resulting in enhancement of clinical outcomes of osseointegrated implants.

Materials and Methods: Three different surface types of commercially pure titanium (c.p. Ti) implants were prepared. Turned implants were used for controls and test implants were prepared by the micro arc oxidation (MAO) method, either in sulphuric acid (S implants) or in phosphoric acid (P implants). Implants were inserted in the femur and tibia of 10 mature New Zealand White rabbits. The bone response was evaluated by biomechanical tests, histology, and histomorphometry. The follow‐up time was 6 weeks.

Results: The mean peak values of the removal torque showed significant differences between control and test S implants (p =.022) but showed no significant differences between control and test P implants (p =.195) or between test S and test P implants (p =.457). In addition, the histomorphometric comparisons of the bone‐to‐metal contact around entire implants demonstrated 186% increase in S implants (p =.028) and 232% increase in P implants (p =.028) compared with the paired control groups. Quantification of the bone area in the threads did not show any significant differences.

Conclusions: The present results suggest that the primary mode of action in strong bone response to S implants is mechanical interlocking, and to P implants, it is biochemical interaction. It is possible that the phosphate groups in the titanium oxide of P implants provide potential chemical bonding sites for calcium ions and hydroxyapatite of the bone matrix during biologic mineralization.
Precision Surgical Template for Implant Placement: A New Systematic Approach
Authors: Wat Peter Y. P. , Chow Tak W. , Luk Henry W. K. , Comfort Margaret B.
Published: October 2006

The importance of a precise surgical template for implant placement cannot be overstated. The radiographic template carries both clinical and radiographic information for the planning of fixture angulation and location. This article describes a systematic approach to the fabrication of a dual‐purpose radiographic surgical template. The simple steps result in the accurate transfer of radiographic information to the surgical template with no need for complex equipment or maneuvers.
Effect of Barrier Membranes and Autologous Bone Grafts on Ridge Width Preservation Around Implants
Authors: Becker William , Hujoel Philippe , Becker Burton E.
Published: October 2006

Background: The purpose of this study was to explore the effect of barrier membranes and autologous bone grafts on the preservation of ridge width around implants.

Materials and Methods: Sixty‐one patients were chosen from a database of case series; treatment assignment was based on clinical judgment. The patients received a total of 76 implants:34 implants with guided tissue regeneration procedures, 27 with autologous bone grafts, and 15 without ridge preservation procedures (control group).

Results: The ridge width around the 76 implants decreased an average of 1.4 mm (95% CI, ‐1.9 to‐1.1 mm). Implants placed with autologous bone grafts or membranes tended to have worse outcomes. When compared to the no augmentation group, implants placed with guided tissue regeneration and autologous bone grafts resulted in 0.1 mm of additional bone loss (95% CI, ‐1.7 to ‐1.5 mm; p <.93) and 0.8 mm of additional bone loss (95% CI, ‐2.3 to 0.7 mm; p <.28), respectively.

Conclusions: Autologous graft procedures or barrier membranes do not appear to improve crestal ridge preservation around implants.
Imaging Technique Selection for the Preoperative Planning of Oral Implants: A Review of the Literature
Authors: BouSerhal Charbel , Jacobs Reinhilde , Quirynen Marc , van Steenberghe Daniel
Published: October 2006

Background: As the use of oral implants for the treatment of partially as well as fully edentulous patients has increased the past two decades, more specialized radiographie techniques have become available for the preoperative planning of oral implant placement.

Purpose: The goal of this article was to enable clinicians to select the appropriate imaging techniques when planning for oral implants.

Materials and Methods: This article reviews the available literature about various imaging techniques and their indication for the preoperative planning of oral implants. The advantages and drawbacks of each technique are described. A dosimet‐ric overview is given relative to different radiologie techniques used in various clinical situations.

Results: For preoperative planning of implant placement, advantages and drawbacks of the available imaging techniques have been considered, which allows guidelines for image technique selection to be formulated based on the clinical situation provided, considering the diagnostic yield of each technique and the radiation doses involved.

Conclusions: From the available literature, it can be stated that many clinical situations demand the use of cross‐sectional imaging techniques for optimal preoperative planning of implant placement. Nevertheless, such techniques are not required in cases in which the clinical examination reveals sufficient bone width and where standard radiographie examinations, such as intraoral and panoramic radiography, reveal adequate bone height and space for implant placement.
Prospective Follow‐Up Study of 95 Patients with Edentulous Mandibles Treated According to the Branemark Novum Concept
Authors: Engstrand Per , Grondahl Kerstin , Öhrnell Lars‐Olof , Nilsson Peter , Nannmark Ulf , Branemark Per‐Ingvar
Published: October 2006

Background: The long‐term predictability reported with the traditional two‐staged Brånemark method has led to developments aimed at simplifying the technique and reducing healing time. Results from a pilot study using the Brånemark Novum concept are promising, and it has been shown possible to fabricate and deliver an implant‐supported fixed prosthesis to the patient on the day of surgery.

Purpose: The objective of this study is to report clinical and radiographic outcomes in a group of patients treated according to the Brånemark Novum concept.

Materials and Methods: Ninety‐five patients with edentulous mandibles were consecutively included in the study. Three specially designed fixtures were placed in each patient (285 fixtures in total) using drilling templates. The fixtures were immediately splinted with a prefabricated substructure, and fixed prostheses were delivered the same day in 67% of the patients. For the rest, prosthesis delivery ranged from 1 to 40 days (mean 5.6 d). Clinical and radiographic examinations were performed after 3 months, 6 months, 1 year, and then annually. The follow‐up time was 1 to 5 years (mean 2.5 yr).

Results: The cumulative prosthesis survival rate was 99%. Eighteen fixtures (6.3%) failed in 13 patients. Kaplan‐Meier survival estimates demonstrated a probability implant survival at 1 year of 95.0% (94 patients), at 3 years of 93.3% (47 patients), and at 5 years of 93.3% (9 patients). The mean bone loss was 0.73 mm between the examinations at 3 months and 1 year, 0.16 mm during the second year, and 0.13 mm annually during years 3 to 5.

Conclusions: Comparable results, related to continuous prosthesis stability, were shown for the Novum approach compared with the traditional two‐staged procedure. Survival of individual fixtures is lower when immediate loading is applied.
Efficiency of Immediately Loaded Mandibular Full‐Arch Implant Restorations
Authors: Chee Winston , Jivraj Sajid
Published: October 2006

Background: The concept of immediately loading dental implants in fully edentulous patients offers patients many benefits, including the ability to eat post placement and improved comfort during healing. This approach may also minimize the number of patient visits when compared with the traditional approach of implant placement and healing over a 3‐ to 4‐month healing period.

Purpose: The aim of this study was to compare the number of treatment visits for patients undergoing traditional implant placement and healing with that of patients receiving immediate implant loading prior to construction of the definitive prostheses.

Materials and Methods: This case series evaluated two patient groups. Group 1 consisted of seven patients who were edentulous in the mandible. After implant placement, the implants were covered by oral mucosa during 3 to 4 months of healing. During this time patients wore relined mandibular dentures. Group 2 consisted of seven patients who had their implants immediately loaded with fixed prostheses on the day of implant placement.

Results: The implants in both groups were integrated successfully; however, the number of patient visits between implant placement and construction of the definitive prostheses was 38 in the conventionally loaded group and 1 in the immediately loaded group.

Conclusions: The group with immediate loading required significantly fewer postoperative visits compared with the conventionally loaded group.
Influence of Demineralized Bone Matrix's Embryonic Origin on Bone Formation: An Experimental Study in Rats
Authors: Stavropoulos Andreas , Kostopoulos Lambros , Mardas Nicolaos , Karring Thorkild
Published: October 2006

Background: There are results suggesting that differences regarding bone‐inducing potential, in terms of amount and/or rate of bone formation, exist between demineralized bone matrices (DBMs) of different embryonic origins.

Purpose: The aim of the present study was to examine whether the embryonic origin of DBM affects bone formation when used as an adjunct to guided tissue regeneration (GTR).

Materials and Methods: Endomembranous (EM) and endochondral (ECH) DBMs were produced from calvarial and long bones of rats, respectively. Prior to the study the osteoinductive properties of the DBMs were confirmed in six rats following intramuscular implantation. Following surgical exposure of the mandibular ramus, a rigid hemispheric Teflon capsule loosely packed with a standardized quantity of DBM was placed with its open part facing the lateral surface of the ramus in both sides of the jaw in 30 rats. In one side of the jaw, chosen at random, the capsule was filled with EM‐DBM, whereas in the other side ECH‐DBM was used. Groups of 10 animals were sacrificed after healing periods of 1, 2, and 4 months, and undecalcified sections of the capsules were produced and subjected to histologic analysis and computer‐assisted planimetric measurements.

Results: During the experiment increasing amounts of newly formed bone were observed inside the capsules in both sides of the animals' jaws. Limited bone formation was observed in the 1‐ and 2‐month specimens, but after 4 months of healing, the newly formed bone in the ECH‐DBM grafted sides occupied 59.1% (range 45.6–74.7%) of the area created by the capsule versus 46.9% (range 23.0–64.0%) in the EM‐DBM grafted sides (p =.01).

Conclusion: It is concluded that the embryonic origin of DBM influences bone formation by GTR and that ECH‐DBM is superior to EM‐DBM.
Immediately Loaded Bar‐Connected Implants with an Anodized Surface Inserted in the Anterior Mandible in a Patient Treated with Diphosphonates for Osteoporosis: A Case Report with a 12‐Month Follow‐Up
Authors: Degidi Marco , Piattelli Adriano
Published: October 2006

Background: It has been suggested that tooth loss is greater in the osteoporotic patient population. Only a few cases have been reported in the literature about the use of dental implants in patients with osteoporosis. Diphosphonates are stable analogs of pyrophosphate, a physiologic regulator of calcification and bone resorption. Multiple implant failures have been reported in a patient undergoing treatment with diphosphonates. Recently, several clinical and experimental reports have shown that immediate loading of dental implants is possible in selected situations.

Purpose: The aim of this case report was to present the clinical outcome of immediate loading of implants in a patient undergoing diphosphonate treatment for osteoporosis.

Materials and Methods: In a 65‐year‐old patient undergoing diphosphonate treatment for osteoporosis, four implants were inserted in the anterior mandible. The implants were connected with a bar supporting an overdenture and were then loaded the same day.

Results: No problems occurred in the postoperative period. At 1‐year follow‐up, all four of the implants appeared to be clinically osseointegrated, and no mobility was present. Minimal bone resorption was present around all implants.

Conclusions: Our case report points to the fact that, contrary to what has been reported in the literature, it is possible to successfully insert and load immediately after surgery dental implants in a patient undergoing diphosphonate treatment for osteoporosis
A 5‐Year Prospective Study of Single‐Tooth Replacements Supported by the Astra Tech® Implant: A Pilot Study
Authors: Gotfredsen Klaus
Published: October 2006

Background:

Implant‐supported single‐tooth replacements are an increasingly used method to replace teeth, especially in young patients. Therefore, long‐term validation of different treatment modalities with different implant systems is of great importance.

Purpose:

The aim of the present study was to make a biologic, technical, and aesthetic evaluation of single‐tooth replacement supported by the Astra Tech® implant (Astra Tech AB, Mölndal, Sweden) during a 5‐year period.

Materials and Methods:

Twenty patients were divided into two consecutively treated groups. In group A the implants were placed “early” in the extraction sockets, and standard single‐tooth abutments were used. In group B the implants were placed “delayed,” and preparable abutments were used. Clinical examinations including registration of plaque, bleeding, crown lengths, soft tissue marginal level, papilla height, complications, and radiography were performed yearly. At the 3‐year control examination the patient and a dentist evaluated aesthetic appearance with a visual analog scale.

Results:

An implant survival rate of 100% and a crown survival rate of 95% over a period of 5 years were found. The mean loss of marginal bone adjacent to implants and neighboring teeth was less than 0.5 mm during the 5‐year period, and there was no significant difference after crown placement between the treatment modality for group A and that for B. There were fewer clinical complications and repairs in group B than in group A. Soft tissue dimensions were more natural around implant crowns in group B as compared to group A, but this was not reflected in the patients' satisfaction with aesthetic appearance. On the other hand the dentist judged the restorations in group B higher concerning aesthetics than in group A.

Conclusion:

Implant‐supported single‐tooth replacement with the Astra Tech system is a reliable treatment resulting in a good 5‐year prognosis and only few complications.
Five‐Year Survival Distributions of Short‐Length (10 mm or less) Machined‐Surfaced and Osseotite® Implants
Authors: Feldman Sylvan , Boitel Nicolas , Weng Dietmar , Kohles Sean S. , Stach Renée M.
Published: October 2006

Background:

In cases of reduced alveolar bone height, implants of short length (10 mm or less) may be employed although there is a perceived risk that because of their small stature they will be unable to tolerate occlusal loads and will fail to osseointegrate.

Purpose:

This report describes an analysis of prospective multicenter clinical studies evaluating the risk for failure of short‐length implants, comparing dual acid‐etched (DAE) Osseotite® implants (Implant Innovations, Inc., Palm Beach Gardens, FL, USA) to machined‐surfaced implants.

Materials and Methods:

Admission criteria were the same for both data sets. Baseline variables of demographics including age, gender and smoking status, bone quality, location, implant dimensions, and types of prostheses were compared to ensure balance among groups. Cumulative survival rates (CSRs) were calculated with the Kaplan‐Meier estimator.

Results:

The implant data included 2,294 implants for the DAE series and 2,597 implants for the machined‐surfaced series. Patient demographics showed similar percentages of occurrence for all variables. The distributions of implants between short‐ and standard‐length data sets for baseline variables including width, location, and restorative type were similar, qualifying these data sets for comparison of the independent variable of length. Overall, there was a 2.2% difference in 5‐year CSRs between the machined‐surfaced short‐ and the standard‐length implants. For these implants a 7.1% difference was observed in the posterior maxilla and an 8.5% difference in the anterior maxilla. For DAE implants the overall difference between “standards” and “shorts” was 0.7%, which is not statistically significant.

Conclusion:

In this analysis the difference in CSRs between short‐ and standard‐length implants was greater for machined‐surfaced implants than for DAE implants.
Some Biomechanical and Histologic Characteristics of Early‐Loaded Locking Pin and Expandable Implants: A Pilot Histologic Canine Study
Authors: Huré Guy , Aguado Eric , Grizon Florence , Baslé Michel‐Félix , Chappard Daniel
Published: October 2006

Background:

A two‐stage approach with a 3‐ to 6‐month healing period is recommended for the “conventional” osseointegration technique with oral implants. This may induce inconvenience and discomfort for patients, and immediate early loading protocols are preferable.

Purpose:

To compare a new type of implant with two locking pins, designed to allow immediate loading, with an expandable implant design with regard to bone tissue response and implant stability.

Materials and Methods:

The molars and premolars of two beagle dogs were extracted in the mandible, and two types of implants (an apically expandable implant and a locking pin implant) were immediately placed in the sockets. The dogs received at least four implants (two of each type) in each side of the mandible. Implants were loaded with gold‐palladium bridges 15 days later. The loaded implants were left for 3 months, and the dogs were sacrificed. Resonance frequency analysis (RFA) was performed at placement and sacrifice. Ground sections for histomorphometry were produced for each implant.

Results:

Implant stability as measured by RFA was similar for the two types of implants before healing. At termination of the study, stability was higher for the locking pin implants. Bone histomorphometry showed that both types of implant were anchored by the same amount of bone and that bone‐titanium interfaces did not differ.

Conclusion:

The locking pin implant showed better secondary stability than did the expandable implant, probably because of a better transmission of strains to bone.
Using Opaquers under Direct Composite Resin Veneers: An Illustrated Review of the Technique
Authors: FELIPPE LUÍS ANTÔNIO , MONTEIRO SYLVIO , BARATIERI LUIZ NARCISO , ANDRADA MAURO AMARAL CALDEIRA de , RITTER ANDRÉ VICENTE
Published: October 2006

In restorative dentistry direct composite resin materials can be used to conservatively resolve many esthetic problems. Opaque resins are often necessary to mask discolorations and/or dark backgrounds when restoring anterior teeth. This article presents a direct composite resin veneer technique using opaquers. Potential problems with the tone of restorations after the use of opaquers are discussed. Advantages, limitations, and the clinical technique are presented. Training, as well as attention to the technique, contributes to an acceptable result.

CLINICAL SIGNIFICANCE

Resinous opaquers can be used as a valid adjunct to the direct composite resin veneer technique when conservatively restoring dark teeth.
Ceramic Inlays and Onlays: Clinical Procedures for Predictable Results
Authors: FILHO ALFREDO MEYER , VIEIRA LUIZ CLOVIS CARDOSO , ARAUJO ÉLITO , BARATIERI LUIZ NARCISO
Published: October 2006

The use of ceramics as restorative materials has increased substantially in the past two decades. This trend can be attributed to the greater interest of patients and dentists in this esthetic and long‐lasting material, and to the ability to effectively bond metal‐free ceramic restorations to tooth structure using acid‐etch techniques and adhesive cements. The purpose of this article is to review the pertinent literature on ceramic systems, direct internal buildup materials, and adhesive cements. Current clinical procedures for the planning, preparation, impression, and bonding of ceramic inlays and onlays are also briefly reviewed. A representative clinical case is presented, illustrating the technique.

CLINICAL SIGNIFICANCE

When posterior teeth are weakened owing to the need for wide cavity preparations, the success of direct resin‐based composites is compromised. In these clinical situations, ceramic inlays/onlays can be used to achieve esthetic, durable, and biologically compatible posterior restorations.