bluuebunny/crossref_metadata_2025 huggingface dataset:
Laser Hair Transplanting 1997
Authors: Unger Walter P.
Published: January 2017

The purpose of this article is to review the author's experience with the Ultrapulse CO2 laser and the Sharplan CO2 laser. Histologically, the best settings for five- to six-hair slit graft sites produced with the Ultrapulse scanner are pattern 4, 300–325 mJ, and 40–60 W; the best settings for Sharplan-produced 0.8-mm round holes for two- to three-hair grafts are 0.1–0.15 seconds and 50–80 W. Cosmetic results have been superior in Ultrapulse-laser-slittreated areas in 285 of 357 cases; they were equal in 69 of the cases and inferior in 3. Clinical results with Sharplan laser round grafted areas have not yet been assessed by the author but have shown good hair yield in the hands of other investigators. A new photographic computer-assisted five-center study has begun that will compare hair yield in laser-prepared and conventionally prepared graft sites. In the author's opinion, new lasers will undoubtedly be developed to produce even less adjacent thermal damage and better results. “Laser hair transplanting” is not merely a marketing tool.
The Science of Stretching Skin and its Clinical Application
Authors: Vogel James E.
Published: January 2017

The new technology that is currently available to the hair restoration surgeon goes beyond the sole use of small hair grafts to restore the bald pate. Current use of scalp stretching concepts and devices has enabled the hair restoration surgeon to efficiently increase the available donor supply of the patient to cover a greater zone of alopecia. The science and clinical application of immediate and prolonged scalp stretching techniques is discussed.
New Graft Dispenser to Simplify Hair Transplantation
Authors: Banuchi Isabel M.
Published: January 2017

The Banuchi graft dispenser is an instrument for transplanting a plurality of hair grafts into preformed holes that facilitates and reduces the time of the implant procedure. The graft dispenser is an elongated hollow tube having both proximal and distal ends open to facilitate the hair graft loading process. It has an open channel extending along the length of the tube that holds the grafts, simplifying the counting process during the procedure. This instrument offers many advantages. The most attractive advantage for both patients and surgeons is that it reduces the time of implantation significantly. This reduction in time is due to the fact that with the graft dispenser, the surgeon can use the instrument not only to hold the grafts, but to dilate the preformed incisions and make the insertion more accurately and quickly. The new instrument has been designed in stainless steel and soon will be available in disposable plastic for further convenience. A multiple-channel instrument with a common funnel has been tested and proven to be very useful. A special tray to keep the loaded grafts in saline solution has also been designed.
Attenuation of Glucan-binding Protein C Reduces the Cariogenicity of Streptococcus mutans: Analysis of Strains Isolated from Human Blood
Authors: Nakano K. , Matsumura M. , Kawaguchi M. , Fujiwara T. , Sobue S. , Nakagawa I. , Hamada S. , Ooshima T.
Published: January 2017

A blood isolate of Streptococcus mutans strain TW871 shows relatively low homology with MT8148, a reference oral isolate strain, and lacks the serotype-specific polysaccharide antigen, suggesting that other cell-surface structures correlate with cariogenicity. We compared cariogenicity of TW871 with MT8148 (serotype c) and blood isolate TW964 (serotype f) in rats. Strain TW871 showed significantly lower cariogenicity than MT8148 or TW964 and expressed significantly lower sucrose-independent cellular adhesion to saliva-coated hydroxyapatite and dextran-binding activity than strain MT8148. Strains TW871 and TW964 showed a defect in the gbpA gene by Southern hybridization analysis, while sequencing analysis revealed gbpC variation in TW871. These results suggest that variation in GbpC may alter cellular adherence properties and can be correlated with the cariogenicity of S. mutans in this strain.
Use of Topiramate in Localization-Related Epilepsy in Children
Authors: Holland Katherine D. , Wyllie Elaine
Published: January 2017

Topiramate has been shown to be safe and effective in refractory partial epilepsy in children. Pharmacokinetic studies show that the clearance of topiramate is greater in children than in adults; therefore, higher doses may be needed in children than adults. It is generally well tolerated, except for cognitive dysfunction. Weight loss and the risk of renal stones can be significant in some cases. However, when compared with other anticonvulsant medications, topiramate has few serious idiosyncratic reactions such as rash, hematologic reactions, and hepatotoxicity. (J Child Neurol 2000;15:S3-S6).
Use of Topiramate in Childhood Generalized Seizure Disorders
Authors: Wheless James W.
Published: January 2017

Topiramate is a sulfamate derivative of the naturally occurring monosaccharide D-fructose. It was initially approved in the United States as adjunctive therapy for partial seizures in 1997. However, there is increasing evidence that it is effective in the treatment of generalized seizures and epilepsy syndromes. Initially, open-label studies using topiramate as add-on therapy in children with refractory generalized seizure types were performed. These showed improvement in patients with the following generalized seizure types: typical and atypical absence, atonic, myoclonic, generalized tonic-clonic, and juvenile myoclonic epilepsy. Double-blind, placebo-controlled multicentered studies in patients with refractory primary generalized tonic-clonic seizures and epilepsy syndromes were performed. The median reduction in seizure frequency for primary generalized tonic-clonic seizures was 56.7% for topiramate and 9% for placebo. Additionally, 13.6% of topiramate-treated patients were primary generalized tonic-clonic seizure free for the study period. In the topiramate-treated juvenile myoclonic epilepsy patients, primary generalized tonic-clonic seizures were reduced >50% in 73% of patients. Open-label extension showed that primary generalized tonic-clonic seizures were reduced >50% in 63% of topiramate-treated patients for ≥ 6 months, and 16% were primary generalized tonic-clonic seizure free ≥ 6 months. Accumulating evidence suggests that topiramate has a broad spectrum of antiepileptic effect. Moreover, life-threatening organ toxicity has not been attributed to topiramate. Topiramate is an effective treatment for refractory generalized seizure types and epilepsy syndromes encountered in children. (J Child Neurol 2000;15:S7-S13).
Rehabilitation Approaches for Children With Cerebral Palsy: Overview
Authors: Stanger Meg , Oresic Susan
Published: January 2017

This article reviews the use of the World Health Organization classification framework for assessing children and adolescents with cerebral palsy and the use of outcome measures as they relate to the International Classification of Functioning, Disability and Health. Various intervention philosophies and approaches are discussed, including the evidence to support their use with children with cerebral palsy. Therapists will be able to use this information to formulate an assessment plan, incorporate the use of outcome measures, and employ evidence-based intervention methods. (J Child Neurol 2003;18:S79—S88).
Pathophysiology of Pediatric Movement Disorders
Authors: Sanger Terence D.
Published: January 2017

Pediatric movement disorders constitute a relatively small cluster of symptoms that can be associated with many different underlying diseases. To provide effective treatment, it is essential to understand the relationship between etiology and clinical expression. This article reviews the recent literature on several common pediatric movement disorders, including spasticity, dystonia, chorea, myoclonus, bradykinesia, and tics, and it discusses current models of physiology that may help link the cellular pathology of specific diseases to the expression of clinical symptoms. (J Child Neurol 2003:18:S9—S24).
Neuroimaging in Spasticity and Movement Disorders
Authors: Hoon Alexander H. , Belsito Karin M. , Nagae-Poetscher Lidia M.
Published: January 2017

Advances in neuroimaging provide unique opportunities to evaluate brain structure, biochemistry, and function. Although a number of imaging techniques have been used in newborns, cranial ultrasonography in premature infants and nuclear magnetic resonance modalities, including magnetic resonance imaging and diffusion-weighted imaging, in high-risk term infants are of foremost benefit. Interpretation is based on knowledge of characteristic imaging findings in specific childhood neurologic disorders and an understanding of differential diagnosis in cerebral palsy syndromes, such as spastic diplegia and various subtypes of extrapyramidal cerebral palsy. This review focuses on imaging studies that can be effectively used in at-risk infants and in children with spasticity and movement disorders to refine diagnosis and guide therapeutic interventions. (J Child Neurol 2003:18:S25—S39).
Injectable Neuromuscular Blockade in the Treatment of Spasticity and Movement Disorders
Authors: Tilton Ann H.
Published: January 2017

Neuromuscular blockade via injection of alcohol, phenol, or botulinum toxin reduces the tone of overactive muscles in order to restore the appropriate balance between agonists and antagonists. Such a restoration allows improved stretch and increased resting length and can reduce the likelihood of contracture. Alcohol or phenol, injected onto the motor nerve, denatures proteins and promotes axonal degeneration. The onset of action is within hours, whereas the duration of action is variable, ranging from 2 weeks to 6 months and beyond. The advantages of alcohol or phenol chemodenervation lie in their low cost and lack of antigenicity. The disadvantages include the technical difficulty of the injections and significant risk for pain as a result of treatment. Botulinum toxins, purified forms of Clostridium botulinum exotoxins, are injected directly into muscle, where they cleave one or more vesicle fusion proteins, thus blocking release of acetylcholine at the neuromuscular junction. Three commercial products—two of serotype A and one of B—are available. Each differs in its unit potency, side effects, and duration of action. On average, botulinum toxin has a clinical onset of action approximately 12 to 72 hours after injection, with a peak effect at 1 to 3 weeks. Effects then plateau for 1 to 2 months, with patients often requiring reinjection approximately every 3 months. Side effects may include local discomfort at the site of the injection and excessive weakness of the injected or nearby muscles, although more distant effects may occur. Antibody formation is a significant clinical concern and eventually obviates treatment benefit in approximately 5% of patients. Switching serotypes may be effective, at least temporarily. Consensus dosing guidelines have been developed and are presented within. Numerous studies have suggested that botulinum toxin has a role in the care of children with spasticity or dystonia related to cerebral palsy, and may improve equinus, gait, upper extremity use, comfort, and care. Evidence of functional improvement remains equivocal in the severely impaired child; however, there is evidence for improvement in less impaired children. The optimal candidate for injectable neuromuscular blockade is one who has a limited number of muscles that need treatment, who does not have fixed contracture, and who retains selective motor control. The ultimate goal of treatment for the hypertonic child is to maximize function, comfort, and independence. Hypertonia is only one aspect of the upper motoneuron syndrome, which includes both positive and negative symptoms. The treatment program, in which chemodenervation is only one tool, requires a multidisciplinary evaluation and individualized plan to address the whole patient. (J Child Neurol 2003:18:S50—S66).
Primary and Secondary Carnitine Deficiency Syndromes
Authors: Pons Roser , De Vivo Darryl C.
Published: January 2017

The objective of this article is to review primary and secondary causes of carnitine deficiency, emphasizing recent advances in our knowledge of fatty acid oxidation. It is now understood that the cellular metabolism of fatty acids requires the cytosolic carnitine cycle and the mitochondrial β-oxidation cycle. Carnitine is central to the translocation of the long chain acyl-CoAs across the inner mitochondrial membrane. The mitochondrial β-oxidation cycle is composed of a newly described membrane-bound system and the classic matrix compartment system. Very long chain acyl-CoA dehydrogenase and the trifunctional enzyme complex are embedded in the inner mitochondrial membrane, and metabolize the long chain acyl-CoAs. The chain shortened acyl-CoAs are further degraded by the well-known system in the mitochondrial matrix. Numerous metabolic errors have been described in the two cycles of fatty acid oxidation; all are transmitted as autosomal recessive traits. Primary or secondary carnitine deficiency is present in all these clinical conditions except carnitine palmitoyltransferase type I and the classic adult form of carnitine palmitoyltransferase type II deficiency. The sole example of primary carnitine deficiency is the genetic defect involving the active transport across the plasmalemmal membrane. This condition responds dramatically to oral carnitine therapy. The secondary carnitine deficiencies respond less obviously to carnitine replacement. These conditions are managed by high carbohydrate, low fat frequent feedings, and vitamin/cofactor supplementation (eg, carnitine, glycine, and riboflavin). Medium chain triglycerides may be useful in the dietary management of patients with inborn errors of the cytosolic carnitine cycle or the mitochondrial membrane-bound long chain specific β-oxidation system. (J Child Neurol 1995;10(Suppl):2S8-2S24).
Carnitine Deficiency in Epilepsy: Risk Factors and Treatment
Authors: Coulter David L.
Published: January 2017

Numerous studies have shown that plasma carnitine levels are significantly lower in patients taking valproate than in controls. Free carnitine deficiency is not uncommon in these patients and also occurs in newborns with seizures and in patients taking other anticonvulsant drugs. Carnitine deficiency in epilepsy results from a variety of etiologic factors including underlying metabolic diseases, nutritional inadequacy, and specific drug effects. The relationship between carnitine deficiency and valproate-induced hepatotoxicity is unclear. Carnitine treatment does not always prevent the emergence of serious hepatotoxicity, but it does alleviate valproate-induced hyperammonemia. These studies suggest that specific risk factors for carnitine deficiency can be identified. Preliminary data suggest that carnitine treatment may benefit high-risk, symptomatic patients and those with free carnitine deficiency. Carnitine treatment is not likely to benefit low-risk, asymptomatic patients and those with normal carnitine levels. (J Child Neurol 1995;10(Suppl):2S32-2S39).
Neuropathophysiology of Movement Disorders in Cerebral Palsy
Authors: Filloux Francis M.
Published: January 2017

Recent developments in understanding the pathophysiology of disordered motor control in cerebral palsy are reviewed. In spastic cerebral palsy, evidence for abnormal segmental as well as supraspinal control of motor neuron output exists. Impaired Ia inhibition of antagonist muscles has been suggested but recently contested. Evidence also supports the role of decreased presynaptic inhibition of Ia afferents and decreased nonreciprocal Ib inhibition. Furthermore, early cerebral injury results in reorganization of supraspinal (corticospinal) inputs to motor neuron pools. In extrapyramidal cerebral palsy, injury of basal ganglia or thalamus has been demonstrated. A scheme for understanding the neurochemical circuitry of the extrapyramidal system is discussed. Animal models and certain specific human diseases provide examples of how this circuitry may be disturbed, thereby resulting in an imbalance between the direct and indirect striatal output systems and in impaired motor control. Future studies employing postmortem neurochemical analysis, functional magnetic resonance imaging, and positron emission tomographic scanning may foster progress in this area. (J Child Neurol 1996;11(Suppl 1):S5-S 12).
Oral Pharmacotherapy for the Movement Disorders of Cerebral Palsy
Authors: Pranzatelli Michael R.
Published: January 2017

Movement disorders are a well-recognized feature of some patients with cerebral palsy and often require treatment. However, treatments have been symptomatic and empiric, and there have been few pharmacologic studies. The major movement disorders in cerebral palsy are dystonia and the hyperkinesias choreoathetosis and myoclonus. They may occur in combination, often accompanied by spasticity and sometimes by epilepsy. Some drugs are useful treatments for all of these problems, but others may improve one while worsening another. Pitfalls in management include not diagnosing metabolic/degenerative disorders, which may mimic cerebral palsy, or not recognizing reversible complications of cerebral palsy, which may exacerbate symptoms. This review attempts to summarize empiric drug use and recommendations for therapy, drug studies in extrapyramidal cerebral palsy, and prospects for new drugs or models for the problem. Many new pharmacologic agents are available for study in cerebral palsy. Better methods of detecting basal ganglia injury after perinatal injury in asymptomatic infants may allow early intervention in the biologic process of recovery and adaptation. (J Child Neurol 1996;11(Suppl 1): S 13-S22).
Role of Stereotaxis in the Treatment of Cerebral Palsy
Authors: De Salles Antonio A. F.
Published: January 2017

There is a renewed interest in basal ganglia surgery for improvement of motor symptoms in cerebral palsy Rigidity, choreoathetosis, and tremor can be improved or abolished by a well-placed radiofrequency lesion, either in the ventrolateral nucleus of the thalamus or ventroposterior pallidum. The target is chosen based on the predominance of the symptoms in a given patient. A review of the main reports on surgery of the basal ganglia for cerebral palsy, as well as the author's data, shows that the surgery can have a remarkable impact on patients' quality of life when motor dysfunction is improved. An update of the physiopathology of cerebral palsy motor symptoms related to anatomic findings on experimental work, magnetic resonance imaging, and autopsy is used to rationalize surgery of the basal ganglia. Modem stereotactic technique based on exquisite demonstration of the basal ganglia anatomy by magnetic resonance imaging is described and supported by intraoperative electricophysiologic studies. The author stresses the importance of a multidisciplinary approach to provide the cerebral palsy patient with a comprehensive treatment plan before stereotactic surgery. (J Child Neurol 1996;11(Suppl 1):S43-S50).
Quantifying the Effects of Interventions for Movement Disorders Resulting From Cerebral Palsy
Authors: Campbell Suzann K.
Published: January 2017

The purpose of this article is to review a variety of tests and measures that are useful in documenting and quantifying the outcomes of intervention for persons with cerebral palsy. The topics included are (1) a discussion of the need for meaningful outcome measures, (2) a model of the disabling process for classifying measures used to assess several different dimensions of disablement, and (3) a review of selected tests and measures categorized according to the model described. (J Child Neurol 1996;11 (Suppl 1): S61-S70).
Property Crime and Drug Enforcement in Portugal
Authors: Mendes Silvia M.
Published: January 2017

The author tests the effect of drug law enforcement on the property crime rate in Portugal, investigating the hypothesis that there exists a property crime and drug crime trade-off. The test is an approximate replication of the Sollars, Benson, and Rasmussen (1994) model using data from 274 Portuguese municipalities in 1996, adjusted for societal differences. Increasing concern over the rise of the drug problem in this country and its seemingly unsuccessful effect on crime has led policy makers to doubt further allocation of scarce resources toward a strict drug policy. Evidence is found that supports the trade-off hypothesis; that is, in Portugal there is a trade-off between efforts to control drug crimes and efforts to control property crimes.
Juvenile Delinquency and the Social Development Model: The Retrospective Accounts of Homeless Substance Abusers
Authors: Hartwell Stephanie W.
Published: January 2017

Teens involved with drugs and engaged in delinquent behavior lessen their life chances. This article examines the relationship between early illicit drug exposure, delinquency, and subsequent adult experience through the life history accounts of 31 men who are homeless drug addicts today. The men's retrospective reports link personal history and social circumstance to describe common pathways associated with and emerging from adolescent delinquency and drug involvement. Their accounts, framed within the social development model, indicate that the life chances of teens at risk might improve if policy-based solutions and interventions target and ameliorate contextual and interpersonal risk factors interfering with the accumulation of social capital.
Multicultural Communication Training for Law Enforcement Officers: A Case Study
Authors: Cornett-DeVito Myrna M. , McGlone Edward L.
Published: January 2017

This exploratory case study focused on multicultural communication training within the community policing context. Little research has addressed what constitutes effective content and delivery of multicultural training for law enforcement officers. Brislin and Yoshida's four-component multicultural plan was combined with limited law enforcement-related multicultural training literature to design a training program for a small city's police department. Two 4-hour training sessions were conducted by one of the investigators using a culture-general content approach and selected training methods to determine their usefulness for improving officers' multi-cultural competencies. The case included the training sessions together with pre-and posttraining activities over a period of approximately 3 months. Data were collected with selected test instruments and also from the field notes taken during the case activities. The results suggest that the culture-general model and interactive training methods and trainer qualifications may be key to yielding positive training outcomes.
Primary Word
Authors: Osborne Allan
Published: January 2017

The holistic approach to education used in primary schools will put management into its proper perspective as an enabling process towards excellent education
Training Notes
Authors: Langton Brian
Published: January 2017

A description of a joint BP/LEA programme
School Finance
Authors: Davies Brent
Published: January 2017

EMS formula funding may force schools out of LWA control
Secondary World
Authors: Wingham Gaynor , Gurney Peter
Published: January 2017

A bottom up approach to make attendance matter.
Management Agenda
Authors: Leach-Bing Ruth
Published: January 2017

RoA's need to be integrated into the learning process
Equal Opportunities
Authors: Buzzing Pauline
Published: January 2017

Managing your school to encourage returners to work in it
Management Agenda
Authors: Peeke Graham
Published: January 2017

Mission possible! How to set a schooll mission statement
Pioneers
Authors: Everard Bertie
Published: January 2017

A review of the contribution made by the founder of Action-centred Leadership
INSET
Authors: Goddard Del
Published: January 2017

An analysis of the impact of the new INSET grant system
Surf Management
Authors: Cracknell David
Published: January 2017

How they are riding the ‘new waves’ of change in East Sussex
Consumerism and the Management of Education
Authors: McGee Paul
Published: January 2017

How Bexley is responding to the new school management context
The Gender Factor: Action at Stanground College
Authors: Barker Bernard
Published: January 2017

Action research can help in the quest for better learning and teaching, as demonstrated in this search for solutions to male underachievement.
Feeling Comfortable
Authors: Dobrzykowski Teresa M.
Published: January 2017

Feeling comfortable is a universal living experience. From the worldview of the humanbecoming paradigm, concept inventing is an appropriate method to expand understanding and knowledge of universal experiences. The purpose of this article is to provide a synthetic definition of feeling comfortable using the concept inventing process. Through concept inventing, a synthetic definition of feeling comfortable emerged as penetrating quietude amid potential upheaval arising with opportunities and restrictions with envisioning the familiar anew. Further development of the concept through qualitative research is recommended.
Writing From the Edge
Authors: Yancey Nan Russell
Published: January 2017

On the 30th Anniversary of Nursing Science Quarterly, the 17-year journey of conceiving, launching, and guiding the “Teaching-Learning Column” was explored in this dialogue with Dr. Sandra Schmidt Bunkers, adjunct professor of nursing, South Dakota State University Brookings, South Dakota, founding contributing editor of the column, and Dr. Barbara Backer Condon, Professor of Nursing, Briar Cliff University, Sioux City, Iowa, contributing editor, 2012-2016. Reflecting on the shared stories, the challenge is offered to continue the tradition of the column in reading, writing, and thinking from the edge, to bravely consider what might be, daring to go beyond the confinements of mainstream thinking, and to vision as yet unimagined possibilities in teaching-learning in nursing.
Healthcare Crisis
Authors: Karnick Paula M.
Published: January 2017

Healthcare is becoming a tangled web of dead ends, refusal of treatments by insurance companies who continue to report incredible profits, leaving many of the middle class and underserved without benefits, treatment, and care. The nursing profession must rise to this catastrophic state and strive for both in unison and individually so patients receive the care they need and deserve.
Transitions and Transformations in Nursing Leadership
Authors: Clarke Pamela N. , Dreher Melanie
Published: January 2017

The dialogue with Dr. Melanie Dreher focuses on a time of transition and her reflections on her career as a dean. Dr. Dreher shares from a personal and professional perspective.
Pregnant With Promise for Far Too Long
Authors: Malinski Violet M.
Published: January 2017

The meaning of the terms nursing science and science of nursing are briefly explored from an historical perspective than from a Rogerian nursing science perspective. Seminal ideas from Martha Rogers’ writings, including an editorial from the inaugural issue of the journal Nursing Science, are noted. The author concludes with a Rogerian nursing science perspective of the unitary rhythm of dying-grieving with examples from participants of a qualitative study of the experience of relating to a loved one who has died.
Socioeconomic Status, Social Capital, and Partisan Polarity as Predictors of Political Incivility on Twitter
Authors: Vargo Chris J. , Hopp Toby
Published: January 2017

Using 414,322 tweets drawn from 143,404 individual Twitter users located in all 435 U.S. congressional districts, this study employed big data and automated content analysis techniques to explore the degree to which socioeconomic status (SES), social capital potential (the degree to which a congressional district has the potential for interconnected citizen networks), and in-district partisan polarization were associated with incivility on Twitter during the 2012 presidential election. Broadly speaking, and with some exceptions, the results indicated that election oriented incivility on Twitter was highest in districts that had low SES indicators, low levels of social capital potential, and low levels of partisan polarity. In its sum, this study shows how large social data sets (i.e., the Census) can be combined with big data to explain social phenomena.
Controlled-Release Therapeutic Systems: Technology Applicable To the Treatment of Oral Disease
Authors: Mirth D.B.
Published: January 2017

Controlled-release therapeutic systems are designed to deliver a pre-determined amount of drug to a specific anatomical site for an extended period of time. A single controlled-release delivery system no larger than an ordinary tablet or capsule and placed at the desired site of drug action can produce long-term therapeutic effects that previously could only be achieved through multiple administration of conventional dosage forms. Transient spikes in drug concentration seen with multiple dose regimens are eliminated, decreasing the chance of adverse reactions. Because they are effective for an extended period of time, controlled-release therapeutic systems minimize the involvement of the patient in drug administration , a factor which can increase both patient compliance with a prescribed regimen and patient satisfaction with the treatment schedule compared with conventional therapy. Controlled-release technology can be utilized to deliver therapeutic agents ranging in size from small ions to macromolecules. Clinically-proven controlled-release drug delivery systems are currently available with durations of action ranging from several days (e.g., for the prevention and treatment of angina pectoris and motion-induced nausea and the treatment of glaucoma) to one year (e.g. for contraception). A therapeutic system for contraception with a five-year effective lifetime is in clinical trial. Intra-oral controlled-release therapeutic systems are being investigated for the delivery of fluoride and antibiotics. A system for fluoride has reduced experimental dental caries in rats by over 50% and has significantly elevated salivary fluoride concentrations during a six-month trial in adolescents. Tetracycline-containing polymeric fibers can provide site-specific delivery of the antibiotic to periodontal pockets for 10 days or more. An intra-oral controlled-release pellet for tetracycline with a duration of action of one to two weeks is being developed, and additional possibilities exist for the intra-oral use of this versatile technology.
Optical Methods for the Detection and Quantification of Caries
Authors: Angmar-Månsson B. , Ten Bosch J.J.
Published: January 2017

The commonly used clinical methods are inadequate for reliable diagnosis of caries lesions until demineralization is established. By the time a reliable diagnosis can be made, the damage is often irreversible, and restorative methods may be necessary to prevent further progress of the lesions. Early detection of the caries lesion would enable the dentist, by using effective prophylactic measures, to provide remineralization and conservation of the tooth substance rather than restoration of the dentition. Attempts to improve traditional methods or to develop new methods of detecting caries lesions have been numerous. Most of the presently used diagnostic methods require visual observation of an optical signal. Reflected light is used tc detect changes in color, texture, and translucency of the tooth substance. The tools required are a bright light source and a mouth mirror. With special methods utilizing drying, magnification, and photography, the sensitivity of the method can be increased. Various optical methods for the detection and quantification of caries will be discussed - for example, fiber optic transillumination, ultraviolet illumination, the use of various dyes, and fluorescent or non-fluorescent substances to enhance the contrast between the carious and the sound enamel. This presentation will focus on the following two methods: (1) a method that uses visible laser light within the blue-green region as the light source to improve signal-to-noise ratio and increase sensitivity for detection of early caries lesions, and (2) a recently developed quantitative method based on the scattering of light by enamel crystals in relation to their surrounding environment. The possibilities and limitations of the different methods will be critically evaluated. In the near future, optical methods for the detection and quantification of early caries lesions will provide efficient tools for reliable evaluation of caries-preventive measures.
Sonic Diagnosis of Skeletal Defects: A Preliminary Study
Authors: Kwon S. , Katz J.L.
Published: January 2017

Non-invasive in vivo assessment of the mechanical properties of hard connective tissues and its clinical applications has been hampered in part because of coupling effects with the surrounding soft tissues. Here, we present a new technique that can, through correlation analysis, potentially separate the effects of the soft tissues and provide information about the underlying hard connective tissues. Preliminary studies on an animal model and on human subjects, as well as on an ultrasonically equivalent tissue phantom, show that this technique minimizes the effects of the soft tissues and is quite sensitive to defects in the hard connective tissues. It is suggested that suitable adaptations of this technique may prove of diagnostic use in clinical dentistry as well.
Dental Holography—Earlier Investigations and Prospective Possibilities
Authors: Dirtoft B.I.
Published: January 2017

Optical measuring techniques- such as holography, contouring, moire, and speckle- offer new nondestructive possibilities for bridging the gap between in vitro and in vivo measurements in dentistry, and thus increase the possibility of achieving more accurate and sometimes more objective diagnosis and therapy. This presentation is an attempt to illuminate the future prospects of holography and speckle in the dental field by giving a survey of the past in combination with a vision of the future. Holographic determination of implant properties and polymer testing are discussed to show that different prosthodontic constructions and different dental materials can be tested to obtain information about their deformational behavior. Conditions such as loading, temperature, and moisture are no obstacle, and functional tests can be carried out on realistic objects with complex shapes and various thicknesses as well as on test samples. This can be a great advantage in that it facilitates the laboratory testing of samples of real size and shape under the same conditions as those in clinical testing. Although the oral environment gives rise to a very complex situation, including many parameters with unknown relations and magnitudes, optical methods sometimes provide a picture of the total course of events. Furthermore, clinical time can be saved this way by a reduction of the time needed for treatment of the patient. The future is exciting, but it requires further developments using different optical methods. This is not an utopia; interdisciplinary collaborations and communications between the technical and dental fields are imperative.
The Use of DNA Probes in Dental Diagnosis and Therapy
Authors: Quivey R.G.
Published: January 2017

Recombinant DNA technology now allows for the development of genetic probes specific for a growing number of etiologic disease agents, including those suspected pathogens in the oral environment. The increasing refinement of DNA probe methodologies and sensitivities will ultimately permit their commonplace use with clinical samples for the rapid identification of their bacterial compositions. The use of probe technology potentially offers a much more facile, accurate, and less time-consuming mechanism for the identification of fastidious micro-organisms from the oral cavity, many of which are laborious and difficult to cultivate.
Studies on the Changes in Developing Enamel Caused By Ingestion of High Levels of Fluoride in the Rat
Authors: Denbesten P.K. , Crenshaw M.A.
Published: January 2017

Exposure to chronic high levels of fluoride results in the formation of fluorosed enamel. Although enamel may be more susceptible to fluorotic effects at certain stages of development, fluoride at sufficiently high levels may affect enamel at all stages of formation. Careful study of the changes in enamel caused by chronic fluoride ingestion is needed to understand more fully the mechanisms involved in the formation of fluorotic enamel. This paper discusses the various studies we have completed to define the changes, in developing enamel of the rat incisor, caused by long-term ingestion of fluoride in drinking water. Fluoride has been found to inhibit secretion of enamel proteins. Changes in the maturation stage of enamel formation include the retention of amelogenin proteins during early maturation. The various mechanisms which have been investigated in the formation of fluorosed enamel include a direct effect of fluoride on the enamel organ, and specific interactions of fluoride with the extracellular enamel matrix. Although the same amount of protease appears to be secreted in fluorosed and control enamel, a delay in the digestion of amelogenin protein occurs. This suggests that fluoride may directly or indirectly inhibit the protease present in fluorosed enamel to slow the proteolysis of amelogenins.
Effects of Calcium and Phosphate On Secretion of Enamel Matrix and Its Subsequent Mineralization in Vitro
Authors: Woltgens J.H.M. , Lyaruu D.M. , Bervoets TH.J.M. , Bronckers A.L.J.J.
Published: January 2017

We examined the effects of various calcium (Ca) and phosphate (P) levels on enamel matrix synthesis, secretion, and its subsequent mineralization in vitro. Second maxillary molar tooth germs of three-day-old hamsters were cultured for nine days in vitro in media containing low (0.9 mmol/L), moderate (2.6 mmol/L), or high (4.5 mmol/L) medium levels of Ca, with either moderate (1.65 mmol/L) or high (3.65 mmol/ L) medium levels of P. Explants were then examined histologically. For examination of matrix synthesis and mineralization, explants were labeled during the last 24 hr of culture with a triple label of 3H-proline, 45Ca, and 32PO4.

At low Ca levels, tooth germs failed to deposit enamel matrix and dentin, and no mineralization took place, regardless of the levels of P. Low levels of Ca, however, did not prevent deposition of pre-dentin. At moderate and high levels of Ca, considerable amounts of enamel and dentin were deposited in vitro, and both matrices mineralized. At high Ca levels, however, the forming enamel hypermineralized, was more irregular, and tended to be thinner. Increasing P concentrations at moderate and high Ca levels resulted in formation of a more regular enamel and dentin and a better-controlled mineralization. Biochemically, high levels of Ca tended to decrease enamel matrix secretion but significantly enhanced the uptake of 45Ca. This Ca-stimulated increase of 45Ca uptake could be reduced to below control levels by increases in P medium levels.

We conclude that: (1) a minimum medium Ca concentration is required to induce enamel matrix deposition and mineralization of both enamel and dentin; (2) high levels of medium Ca induce hypermineralization of enamel and give rise to deposition of a more irregular enamel than at moderate Ca levels; and (3) high levels of P are not able to induce mineralization when Ca levels are low but seem to moderate effects of moderate and high levels of Ca.
Localization of Cellular Calcium in Differentiating Ameloblasts and Its Relationship To the Early Mineralization Process in Mantle Dentin and Enamel in Hamster Tooth Germs in Vitro
Authors: Lyaruu D.M. , Bronckers A.L.J.J. , Woltgens J.H.M. , Hoeben-Schornagel K.
Published: January 2017

The relationship between the distribution of calcium in the cells of the enamel organ and the mineralization process in mantle dentin and enamel was investigated at the ultrastructural level in cultured hamster second maxillary molar tooth germs explanted before the onset of mineralization (bell stage). During the early stages of pre-odontoblast and pre-ameloblast differentiation, pyroantimcnate (PA) reaction product for calcium was observed only in the nuclei. However, an abrupt increase in PA reaction product appeared in the apical cytoplasm of both the pre-odontoblasts and pre-ameloblasts prior to the onset of mantle dentin mineralization. In the pre-dentin, the PA reaction product was localized mainly on the striated collagen fibers. The PA reaction product in the apical poles of these cells increased concomitantly with increasing mantle dentin mineralization. The amounts of PA reaction product along the plasma membranes and in the cytoplasm decreased in the direction of the basal (stratum intermedium) pole. The highest PA activity in the cytoplasmic side of the plasma membranes of the ameloblasts was found during the secretory phase of amelogenesis. However, in the area around the tips of the Tomes' processes, membrane-associated and cytoplasmic PA activity was low or absent but gradually increased toward the ameloblast cell body, an indication of the presence of a calcium gradient in the processes.

These results indicate that in vitro: (1) both odontoblasts and (pre)-ameloblasts are involved in the calcium acquisition necessary for the initial stages of mantle dentin mineralization; (2) in ameloblasts, there is a calcium gradient in the direction of the mineralization front from the earliest stages of mantle dentin mineralization onward; (3) enamel matrix does not seem to be involved in calcium translocation to the enamel mineralization front; (4) the Tomes' processes seem to regulate transmembrane calcium transport to the mineralization front; and (5) the distribution of calcium in the enamel organ is comparable with that found in vivo.
Calcium Transport by a Calmodulin-Regulated Ca-ATPase in the Enamel Organ
Authors: Sasaki T. , Colflesh D.E. , Garant P.R.
Published: January 2017

Using aldehyde-fixed rat incisor enamel organ, we localized Ca-ATPase activity ultracytochemically in the plasma membranes, the mitochondrial inner membranes, and the Golgi membranes of secretory ameloblasts and the cells of stratum intermedium at the secretory stage and papillary layer cells at the maturation stage, but not in maturation ameloblasts. This Ca-ATPase activity was totally dependent on substrate ATP, the enzyme activator CaCl2, and also sensitive to the specific calmodulin blocker trifluoperazine (TFP) in the incubation media. Specific antigenic sites of endogenous calmodulin were demonstrated in polyribosomes, the nucleus, mitochondria, and the cytoplasmic matrix along the plasma membranes of secretory ameloblasts, by the protein A-immunogold technique using sheep antiserum against bovine testis calmodulin. All other enamel organ cells-such as stratum intermedium, papillary layer cells, and maturation ameloblasts-were also weakly immunoreactive. In control sections incubated with antiserum pre-absorbed with an excess of calmodulin and protein A-gold complex, only a few gold particles were observed to be randomly associated with the tissues. Daily intraperitoneal injection of TFP (1 and 5 mg per 100 g body weight) for one week resulted in prominent migration of mitochondria from the infranuclear to supranuclear regions of secretory ameloblasts but caused no other morphological alterations in the enamel organ cells. EDX analysis of ultrathin sections revealed significantly lower peaks of Ca and P in the forming enamel of TFP-injected rats than those in controls. However, little reduction in the Ca and P levels in the maturing enamel was observed in TFP-injected rats. When growing enamel surfaces were exposed with NaOCl and examined with SEM, a remarkable defect in the enamel matrix was observed in the forming enamel but not in the maturing enamel. These results suggest that early enamel mineralization is dependent upon an intact calmodulin-regulated Ca-transporting ATPase in secretory ameloblasts and that enamel maturation is controlled by different mechanism(s).
Distribution of Calcium and Phosphate in Cells of the Enamel Organ in the Rat Lower Incisor
Authors: Kawamoto T. , Shimizu M.
Published: January 2017

The distribution of calcium and phosphate in the cells of the enamel organ of the rat lower incisors was investigated by autoradiography and energy-dispersive x-ray spectrometry (EDS).

Radioactive calcium or phosphate was injected i.p. into seven-day-old rats of the Wistar strain. The animals were frozen 0.5, 1, and 10 min after injection, and embedded in 5% carboxymethyl cellulose. Sagittal sections of 10 μm thickness were made in which the lower incisor was included as a part of the whole-body section. For autoradiography, the sections were freeze-dried and placed in contact with dry thin films prepared from autoradiographic emulsion. For EDS, sections were mounted on carbon stubs, freeze-dried, coated with carbon, and examined by EDS in a SEM. 45Ca and 32P autoradiograms showed that the radioactivity was located over the papillary layer cells adjacent to the secretory stage ameloblasts and was much higher here than in the ameloblastic layer. On the other hand, there was no significant difference between the amount of radioactivity of these two cell layers in the maturation stage, although higher radioactivity was detectable in the maturation stage enamel than in the secretory stage enamel. Pronounced Ka x-ray peaks were obtained for P, S, Cl, and K originating from the cells of the papillary and ameloblastic layers in the secretory stage, but only very low peaks were obtained for Ca. On the other hand, in addition to these elements, remarkably high Ca and Fe peaks could be detected in the ameloblastic layer of the maturation stage.
45Ca-Labeled Proteins Found in Porcine Developing Dental Enamel At an Early Stage of Development
Authors: Fukae M. , Tanabe T.
Published: January 2017

The existence of proteins having an affinity for calcium ions in immature enamel was searched for by autoradiography with 45Ca used on the proteins transblotted from the gel to the membrane after electrophoresis. Mainly, two 45Ca-labeled proteins (Mr = 27,000 and 29,000) were found in immature enamel at an early stage of development. Since these labeled proteins corresponded to the bands which were stained blue with Stains-all dye at the same molecular-weight positions, these proteins were always monitored by staining with Stains-all dye during the progressive purification process. The 27-kDa and 29-kDa proteins were partially purified by Sephadex G-100 gel filtration and DE cellulofine AH ion exchange chromatography. The amino acid compositions of both proteins were similar to each other, being relatively rich in Asp, Thr, Glu, and Ala, and different from those of amelogenins and enamelins. These two proteins do not appear to be contaminants from the cells during preparation, based on the result of comparison of the proteins extracted from the cellular layers of enamel organ with those of immature enamel.