bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histology of Retrieved Immediately and Early Loaded Oxidized Implants: Light Microscopic Observations after 5 to 9 Months of Loading in the Posterior Mandible
Authors: Rocci Antonio , Martignoni Massimiliano , Burgos Patricia Miranda , Gottlow Jan , Sennerby Lars 
Published: October 2006

ABSTRACTBackground:An increased number of publications report that one‐stage surgery and immediate/early loading of dental implants may be a feasible approach for prosthetic reconstruction of the edentate patient. However, little is known about the histologic response to implants subjected to immediate/early loading in patients.Purpose:The aim of the present study was to histologically evaluate oxidized titanium implants subjected to loading immediately following surgery or after 2 months of healing and removed after 5 to 9 months loading.Materials and Methods:Five patients participated in the study; each had consulted for implant treatment in the posterior mandible and subsequently volunteered to have extra implants inserted for the purpose of histologic research. Nine oxidized titanium implants (Brånemark System® TiUnite™, Nobel Biocare AB, Gothenburg, Sweden) were retrieved after 5 to 9 months in function. Two implants had been loaded the same day, whereas seven implants were loaded after 2 months of healing. Resonance frequency analysis was performed at retrieval on seven implants. Ground sections were prepared for histology and analyzed using light microscopic morphometry.Results:Seven and 8.5 mm implants were placed, predominantly in quality 3 and 4 bone. Four implants were straight (Mk III), and five were tapered (Mk IV). All implants were clinically stable at retrieval and showed ISQ values of 65 to 79 with a mean of 71.4 ± 4.4. Eight of the implants were able to be used for histology. A gross histologic examination showed an undisturbed healing of soft and bone tissues with no apparent differences between response to immediately and early loaded implants. Lamellar bone surrounded the implants, and remodeling was evident and more marked near the implant surface. A condensation of bone toward the implant surface was seen; this resulted in a lamina dura‐like structure in trabecular bone. Thin rims of newly formed bone were often seen following the contour of the implant surface. The morphometric measurements showed a mean bone‐to‐implant contact value of 84.2 ± 10.5% and a mean bone area value of 79.1 ± 6.8%. The two immediately loaded implants showed bone‐to‐implant contact and bone area values of 92.9 ± 0.1% and 84.9 ± 0.9%, respectively. The corresponding values for the six early loaded implants were 81.4 ± 10.6% and 77.1 ± 6.8%, respectively.Conclusions:The present study demonstrated that oxidized implants subjected to immediate or early loading do integrate with soft and bone tissues in the posterior mandible.
One‐Year Prospective Three‐Center Study Comparing the Outcome of a “Soft Bone Implant” (Prototype Mk IV) and the Standard Brånemark Implant
Authors: Friberg Bertil , Jisander Sven , Widmark Göran , Lundgren AnnaKarin , Ivanoff Carl‐Johan , Sennerby Lars , Thorén Christina 
Published: October 2006

ABSTRACT Background: Oral implant treatment ad modum Brånemark has been used for decades in the rehabilitation of edentate and partially dentate patients. Posterior jaw regions frequently exhibit bone of poor texture, and it is often difficult to obtain primary stability. Thus, it may prove beneficial to deviate from the original protocol and to use implants with a modified design, for example, with a slightly tapered geometry. Purpose: The purpose of the investigation was to compare the early behavior of a modified (prototype Mk IV, Branemark System, Nobel Biocare AB, Gothenburg, Sweden; test) implant with that of the standard Brånemark implant (control) in regions of mainly type 4 bone. Materials and Methods: Three Swedish centers participated, and a total of 44 patients were treated with oral implants for 39 maxillas and 5 mandibles. The study focused on the most distal right and left implant sites (88 implants), which were randomized to receive either a test or a control implant. Various parameters were recorded, such as registered insertion torque (OsseoCare, Nobel Biocare AB), wobbling during insertion, primary and secondary stability (as measured with resonance frequency), and marginal bone loss. The implants were followed up for 1 year. Results.: The test implant more frequently required a higher insertion torque and showed a significantly higher primary stability than the control implant. This difference in stability leveled out over time, and test and control implants exhibited similar secondary stability at abutment operation and at the 1‐year visit. Wobbling during insertion was rarely recorded for either of the implant designs. The 1‐year cumulative success rate was 93.1% for test implants and 88.4% for control implants. Conclusions: The modified implant design resulted in an increased primary stability, which may be important when placing implants in jaw regions of type 4 bone. However, independent of the achieved primary stability, successful implants tended to approach similar secondary stability in the two designs tested.
Immediate Replacement of Single Upper Posterior Teeth: A Report of Cases
Authors: Vergara Jaime A. , Caffesse Raul G. 
Published: October 2006

ABSTRACT Background: The immediate replacement of upper molar teeth with implants poses a significant challenge to the clinician because of its sinus involvement. Purpose: The purpose of this article is to report a protocol in which single molar teeth are replaced immediately with implants, minimizing the need for other surgical procedures. Materials and Methods: This protocol has been employed in eight cases. Briefly, the teeth are extracted atraumatically, the sockets evaluated, an osteotomy performed following the direction of the socket, and a wide diameter implant placed using the socket walls and sinus floor to anchor it. A grafting material is placed when the space between implant and socket wall is considerably large. Three cases are reviewed here, and all eight are summarized. Results: All cases have excellent soft and hard tissue healing after 6 months. Furthermore, the overall time needed to restore the cases has been considerably reduced and the need for sinus management eliminated. Conclusion: The cases presented support the use of the described protocol in the placement of implants in maxillary molar areas without any other sinus procedures.
Surgical Intervention in Enchondral and Membranous Bone: Intraindividual Comparisons in the Rabbit
Authors: Slotte Christer , Lundgren Dan , Sennerby Lars , Karin Lundgren Anna 
Published: October 2006

ABSTRACT Background: The long bones, which are of enchondral origin, are often used in histologic evaluations of dental implants that clinically will be placed in bones of membranous origin. Purpose: The aim of this investigation was to study the effect of surgical trauma by multiple drill perforations on both enchondral and membranous bone—the tibial and maxillary bone architecture—8 weeks after surgery. Materials and Methods: In eight rabbits the medial metaphyses of both tibiae and the edentulous ridges of both sides in the maxilla were surgically exposed. On the test sides, 25 to 30 holes were drilled through the cortical plate and 5 mm into the medullary space. The contralateral sides underwent no treatment and served as controls. Eight weeks later the animals were killed to obtain transverse ground sections for histomorphometry. A paired analysis of the bone densities of the tibiae and the jaw specimens was made. Results: In general the morphologic appearances of the test and control tibiae were similar. In the control group the anatomy of the medullary space appeared normal, with few bone trabeculae and with abundant marrow tissue. In the test group, areas of resorption were evident on the cortical bone plate that had been perforated 8 weeks previously; also evident were ingrowths of marrow tissue and bone formation. In a few specimens some newly formed bone trabeculae were found in the medullary space, both contiguous to the perforated cortical bone plate and as small islets in the marrow tissue. The mean test and control site values for each parameter were similar, and no statistically significant differences were found. In the maxilla, the bone architecture had altered substantially by way of an increase in the proportion of trabecular bone and a decrease in the proportion of cortical bone. Drilling appeared to have little effect on tibial bone density, which did not significantly differ between test and control sites. Maxillary bone density, however, was significantly greater at the test sites than at the control sites. Comparisons of bone density between tibia and jaw specimens revealed no significant differences either between test sides or between control sides. Thus, the same magnitude of surgical trauma that altered the bone architecture and density of the rabbit maxilla was not found to have altered those of the tibia in the same animal 8 weeks after surgery. The reasons for the differences are discussed in this article. Conclusions: As observed 8 weeks post surgery, multiple drill perforations were not found to cause significant alterations in the metaphysis of the tibia whereas a considerable change in bone architecture and an increase in bone density were found in the maxilla. Whether this depends on different embryologic origins or reflects morphologic and functional differences in the mature bone demands further study.
A Comparative Study of Computed Tomography and Magnetic Resonance Imaging for the Detection of Mandibular Canals and Cross‐Sectional Areas in Diagnosis prior to Dental Implant Treatment
Authors: Imamura Hideyuki , Sato Hironobu , Matsuura Takashi , Ishikawa Masatsugu , Zeze Ryousuke 
Published: October 2006

ABSTRACTBackground:Computed tomography (CT) is effective in the diagnosis of dental implants. However, it has the disadvantage of exposing patients to high doses of x‐rays, and the mandibular canals cannot be detected by CT in some clinical cases.Purpose:The purpose of this study was to examine the detectability of the anatomic morphology of the molar region in the lower jaw (where implantation is common) by CT and magnetic resonance imaging (MRI), to compare the data, and to determine the usefulness of MRI in diagnosis prior to dental implant treatments.Materials and Methods:Eleven female subjects (average age, 59 years) who had partially edentulous mandibles (total of 19 sites) were included in the study. CT and MRI were performed with the same subjects, and the degrees of identification of the mandibular canal in the first and second molar regions were compared. Dimensional accuracy in the second molar region was also compared.Results:With CT, the canals of the first molar regions were not identified in 11 of 19 sites; however, MRI identified the canals in all 19 sites. Using the kappa index, we found that the inter‐ and intraobserver identification reliabilities (0.84 and 0.87, respectively) were excellent, especially for MRI. Dimensional positioning of the canal in the second molar region was almost the same with MRI as with CT.Conclusions:MRI is an alternative method in diagnosis prior to dental implant treatment in the mandibular molar region.
Clinical Performance of a Method for the Fabrication of Implant‐Supported Precisely Fitting Titanium Frameworks: A Retrospective 5‐ to 8‐Year Clinical Follow‐Up Study
Authors: Hedkvist Lars , Mattsson Torsten , Helldén Leif B. 
Published: October 2006

ABSTRACT Background: The CrescoTi Precision® (CTiP) method (CrescoTi Systems, Lausanne, Switzerland) has been introduced as an alternative method for the fabrication of precisely fitting titanium frameworks. The method is supposed to be used with all major implant systems, without the need for abutments. Purpose: The objectives of this clinical and radiographic retrospective follow‐up study were to report the clinical performances of “CTiP‐fabricated” frameworks that are screw retained directly to Brånemark implants as opposed to Brånemark implant/abutment assemblies (Nobel Biocare AB, Gothenburg, Sweden) and to compare the clinical outcomes of these two modalities. Materials and Methods: Thirty‐six patients were provided with 46 fixed prostheses supported by 207 Brånemark regular‐platform implants. Twenty‐seven prostheses were placed on implant/abutment assemblies, and 19 were placed directly at “implant level.” The prostheses had been in function for 5 to 8 years at the time of the final examinations. Results: Three patients did not attend the final examination. All 43 prostheses in the 33 examined patients were still in function. No major mechanical framework complications were observed during the observation period. One implant was lost after loading. There was no difference in bone loss around the abutment‐free implants when compared with the implants provided with abutments. Conclusions: This long‐term clinical test demonstrated that the CTiP technology constitutes a reliable prosthetic treatment concept in combination with Brånemark implants. The results also revealed that the frameworks could be connected directly to the implants without any negative consequences.
Scanning Electron Microscopy Study of Dental Enamel Surface Exposed to 35% Hydrogen Peroxide: Alone, With Saliva, and With 10% Carbamide Peroxide
Authors: SPALDING MARIANNE , TAVEIRA LUÍS ANTÔNIO DE ASSIS , DE ASSIS GERSON FRANCISCO 
Published: October 2006

ABSTRACTSeveral vital bleaching systems have been introduced in response to the demand in esthetic dentistry. The active agents are commonly hydrogen peroxide or carbamide peroxide used in at‐home or in‐office techniques. Although generally positive results have been reported concerning the whitening ability of these agents, concerns still remain as to their effects on dental tissues. The purpose of this investigation was to evaluate the effect of these bleaching agents on the enamel surface morphology. Twelve extracted teeth were used according to three experimental protocols. In experimental protocol 1, specimens were treated with 35% hydrogen peroxide. In experimental protocol 2, after treatment with 35% hydrogen peroxide the specimens were immersed in natural saliva for 1 week. In experimental protocol 3, 35% hydrogen peroxide was applied once and 10% carbamide peroxide was applied for 1 week (12 h of 10% carbamide peroxide alternating with 12 h saliva). Scanning electron microscopy evaluation revealed that regional variation in tooth morphology surface sometimes exceeded the effects of the peroxide used according to experimental protocols. Thirty‐five percent hydrogen peroxide had a tendency to promote an increase in density of pits. Precipitates were observed on specimen surfaces immersed in natural saliva according to protocol 2. A smooth and shiny surface was observed in specimens treated according to protocol 3. The potential relationship between surface alterations and differences in enamel permeability is currently under investigation.CLINICAL SIGNIFICANCEThe differences in various articles written on the subject cannot be reconciled because of the lack of standardization of baseline data regarding factors such as location on the tooth, type of tooth, eruption or noneruption, and age in the oral cavity. This article demonstrates that, despite changes observed in the enamel surface after bleaching, normal variation in tooth morphology may exceed the effects of 35% hydrogen peroxide and 10% carbamide peroxide on the teeth. Hence, considering the morphologic features of the tooth surface, bleaching, as described in this study, can be considered safe for enamel.
Perioesthetic Approach to the Diagnosis and Treatment of Carious and Noncarious Cervical Lesions: Part I
Authors: TERRY DOUGLAS A. , McGUIRE MICHAEL K. , McLAREN EDWARD , FULTON RUDOLPH , SWIFT EDWARD J. 
Published: October 2006

ABSTRACTSeveral factors can contribute to the development of noncarious cervical lesions. Therefore, these lesions can be described and classified according to their primary etiology. Traditionally, most dentists have treated noncarious cervical lesions only with restorative methods, for example, composite resin restorations. However, in many cases, a periodontal or a combined restorative/periodontal approach provides a better esthetic and functional result. In part I of this two‐part report, we provide a review of noncarious cervical lesions and a series of clinical case reports showing surgical techniques used and the importance of the periodontal aspect of lesion management.CLINICAL SIGNIFICANCEFor best esthetic results, the periodontal aspect of noncarious cervical lesions must be considered in treatment planning.
Esthetic Soft Tissue Ridge Augmentation Using an Acellular Dermal Connective Tissue Allograft
Authors: MAHN DOUGLAS H. 
Published: October 2006

ABSTRACTResidual ridge defects present significant limitations to the esthetic restoration of edentulous tooth sites. Augmentation techniques can aid in the re‐establishment of natural ridge contours. This article describes a technique in which an acellular dermal connective tissue allograft is used to augment a buccolingual residual ridge defect. A single vertical incision enables the allograft to be placed laterally into a buccal pouch. Augmentation of this edentulous site permitted a three‐unit bridge to be placed with a highly esthetic pontic.CLINICAL SIGNIFICANCEThis article presents a simplified method of esthetic ridge augmentation that reduces patient discomfort.
Does the Wear Resistance of Packable Composite Equal that of Dental Amalgam?
Authors: SUZUKI SHIRO 
Published: October 2006

ABSTRACTBackground:There is little evidence that packable composites are sufficiently wear resistant to be used as an alternative to amalgam.Purpose::The purpose of this study was to evaluate wear rates of packable composites compared with hybrid resin composites and amalgams by an in vitro wear test.Materials and Methods:The following composites were used: three packable composites (SureFil, Dentsply/Caulk, Milford, DE, USA; Alert, Pentron Clinical Technologies, Wallingford, CT, USA; and Solitaire, Heraeus Kulzer, Wehrheim, Germany), two hybrid resin composites (TPH Spectrum, Dentsply/Caulk; and Pyramid enamel, Bisco Inc., Schaumburg, IL, USA), and two amalgams (Tytin, Kerr Manufacturing Co., Romulus, MI, USA; and Dispersalloy, Dentsply/ Caulk). Cylindrical Class I cavities prepared on occlusally flattened, extracted human molars were restored with respective materials according to the manufacturers’instructions. Generalized, localized, and antagonistic enamel wear tests were carried out by a University of Alabama at Birmingham (UAB) wear simulator according to previously reported methods. Seven specimens were tested for each group, and the wear depths were measured on profilometric tracings. The data for each wear mode were independently analyzed by one‐way analysis of variance and Fisher's exact test (p .05).Results:The generalized wear values for SureFil (7.0 ± 3.5 μm), Alert (8.6 ± 1.8 μm), and Pyramid (3.9 ± 0.5 μm) were not statistically different from those of amalgam materials (Tytin 5.8 ± 0.7 μm, Dispersalloy 6.0 ± 0.9 μm) but were different from those of Solitaire (23.9 ± 2.6 μm) and TPH (30.6 ±5.5μm). The localized wear values for SureFil (19.8 ± 14.2 μm) and Alert (28.0 ± 1.6 μm) were significantly smaller than for all other materials. For antagonistic enamel wear, Solitaire exhibited a minimal value (3.4 ± 0.9 μm), whereas values of SureFil (12.6 ±5.6μm) and Alert (12.0 ±6.6μm) were not statistically different from those of TPH (11.0 ± 4.0 μm) and amalgams (Tytin 14.5 ± 4.3 μm, Dispersalloy 7.8 ± 3.3 μm).Conclusions: It can be concluded that SureFil and Alert packable composites possess similar wear resistance and abrasiveness to amalgam on the basis of the limitations of this study, which simulated 3 years of clinical wear.
Encephalopathy after cyclophosphamide with response to methylene blue
Authors: GEDYE Craig A , STEWART Josephine , CHER Lawrence M 
Published: October 2006

AbstractWe present two cases of encephalopathy occurring after chemotherapy containing cyclophosphamide. Patient 1 was receiving vincristine, cisplatin and cyclophosphamide for recurrent medulloblastoma, whilst patient 2 received cyclophosphamide‐containing chemotherapy as adjuvant treatment for early breast cancer. After cumulative doses of 2.8 and 6 g/m2of cyclophosphamide both patients developed a gradual onset of fluctuating attention, slowed mentation and decreased consciousness. Extensive investigations excluded other causes of this altered conscious state. Given the similarity of presentation to ifosfamide encephalopathy, methylene blue (50 mg i.v.) was administered. Patient 1 experienced an immediate improvement that was not sustained, with a subsequent deterioration over several weeks and became unresponsive before death. Patient 2 experienced a dramatic improvement within 3 h and received a second dose of methylene blue with further improvement. To our knowledge, cyclophosphamide has not previously been implicated as a cause of encephalopathy. A review of the literature is presented. We hypothesize that cyclophosphamide may rarely cause encephalopathy and may also contribute to the cognitive dysfunction reported in association with chemotherapy for breast cancer and non‐Hodgkin’s lymphoma.
Physician Participation in Executions: Care Giver or Executioner?
Authors: Clark Peter A. 
Published: October 2006

To circumvent objections that the death penalty was “cruel and unusual punishment” and therefore a violation of the Eighth Amendment to the Constitution, advocates proposed lethal injection and the involvement of physicians to overcome the negative perceptions associated with the death penalty, and to increase public acceptability of the practice. Initiated in 1982, lethal injection is now the primary method of execution in 37 of the 38 states with the death penalty. “To be exact, this method has been used to kill 788 of the 956 men and women who have been executed in the United States since 1976, when the death penalty was reinstated by the Supreme Court.” More recently, of the 191 executions performed in the United States since 2001, 189 have been by lethal injection.This “medicalization” of the death penalty has ignited a debate, by those within the medical profession and by others outside it, about the appropriateness of physicians participating in executions.