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Selected AbstractsTwo-Year Outcome with Nobel Direct® Implants: A Retrospective Radiographic and Microbiologic Study in 10 PatientsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2009Tommie Van de Velde LA ABSTRACT Introduction: The Nobel Direct® implant (Nobel Biocare AB, Göteborg, Sweden) was developed to minimize marginal bone resorption and to result in "soft tissue integration" for an optimized aesthetic outcome. However, conflicting results have been presented in the literature. The aim of this present study was to evaluate the clinical and microbiologic outcomes of Nobel Direct implants. Materials and Methods: Ten partially edentulous subjects without evidence of active periodontitis (mean age 55 years) received 12 Nobel Direct implants. Implants were loaded with single crowns after a healing period of 3 to 6 months. Treatment outcomes were assessed at month 24. Routine clinical assessments, intraoral radiographs, and microbiologic samplings were made. Histologic analysis of one failing implant and chemical spectroscopy around three unused implants was performed. Paired Wilcoxon signed-rank test was used for the evaluation of bone loss; otherwise, descriptive analysis was performed. Results: Implants were functionally loaded after 3 to 6 months. At 2 years, the mean bone loss of remaining implants was 2.0 mm (SD ± 1.1 mm; range: 0.0,3.4 mm). Three out of 12 implants with an early mean bone loss >3 mm were lost. The surviving implants showed increasing bone loss between 6 and 24 months (p = .028). Only 3 out of the 12 implants were considered successful and showed bone loss of <1.7 mm after 2 years. High rates of pathogens, including Aggregatibacter actinomycetemcomitans, Fusobacterium spp., Porphyromonas gingivalis, Pseudomonas aeruginosa, and Tanerella forsythia, were found. Chemical spectroscopy revealed, despite the normal signals from Ti, O, and C, also peaks of P, F, S, N, and Ca. A normal histologic image of osseointegration was observed in the apical part of the retrieved implant. Conclusion: Radiographic evidence and 25% implant failures are indications of a low success rate. High counts and prevalence of significant pathogens were found at surviving implants. Although extensive bone loss had occurred in the coronal part, the apical portion of the implant showed some bone to implant integration. [source] Methodological aspects of 3D and automated 2D analyses of white matter neuronal density in temporal lobe epilepsyNEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 3 2006S. H. Eriksson White matter neuronal density has been correlated with clinical outcome after temporal lobectomy for refractory epilepsy. Both morphometric 2D (two-dimensional) and stereological 3D (three-dimensional) analyses of neuronal density have been performed. 3D analyses are thought to be more accurate than 2D counts, but more time-consuming. We compared 3D and automated 2D measurements in the same specimens. Adjacent 20-µm (for 3D analyses) and 5-µm (for 2D analyses) sections from 10 temporal lobectomies were stained for NeuN immunohistochemistry. Analysis of 100% of a region of interest (ROI) in deep white matter was performed using an image analysis system (Histometrix, Kinetic Imaging, UK). 3D analyses were undertaken using ×,63 magnification (6 h/case). Automated 2D analyses were undertaken using automatic neuronal identification at ×,10 magnification with three to four repeats (1.5 h/case). The range of neuronal densities for 3D measurements was 2120,4910 neurones/mm3, and for automated 2D measurements 17.4,47.1 neurones/mm2. There was a linear correlation between the two methods with an r2 of 0.58. The limits of agreement for the two methods were 1718 to ,2234 neurones/mm3. Count,recount variability was 1.4,9.9% for the 3D and 5.1,36.6% for the automated 2D measurements. We found a wide range of white matter neuronal densities using either analysis. The low agreement between methods, and the high count,recount variability for the automated 2D analyses, indicate that despite being more time-consuming, rigorous 3D stereological analyses have to be performed to obtain reliable results. These findings have implications for studies requiring neuronal counts in normal and disease states. [source] Long-Term Insulin-Independence After Allogeneic Islet Transplantation for Type 1 Diabetes: Over the 10-Year MarkAMERICAN JOURNAL OF TRANSPLANTATION, Issue 2 2009T. Berney Results of islet of Langerhans transplantation have markedly improved in recent years, but most patients still lose insulin independence in the long-term. We report herein the longest (over 11 years) case of insulin independence after allogeneic islet transplantation. The subject had a 27-year history of type 1 diabetes and received a single islet-after-kidney graft of 8800 islet equivalents (IEQ)/kg, pooled from 2 donors. Insulin was discontinued by 3 months posttransplant and the patient has remained off insulin ever since. Yearly follow-up studies have revealed normal metabolic control, including normal oral glucose tolerance test (OGTT). Reasons for success may involve choice of immunosuppression, low metabolic demand and low immune responsiveness as suggested by an excellent HLA matching and a high count of circulating regulatory T cells. This observation is so far an exceptional case, but clearly demonstrates the validity of the concept that long-term insulin independence after allogeneic islet transplantation is an achievable target. [source] Caries risk factors in the permanent dentition of Tanzanian children: a cohort study (1997,2003)COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 6 2007Flemming Scheutz Abstract Objective:, The aims of the cohort study were to study the association between permanent dentition caries and malnutrition and other risk factors or indicators in a group of children with little or no access to restorative and preventive dental care. Methods:, The study was conducted at two primary schools in Dar es Salaam, Tanzania in the period 1997,2003. One school recruits its children from affluent families and the other school is attended by the children of poor families. The children attended grade 1 at the first examination and had a mean age of 7.6 years (SD = 0.4); when the study was completed, the mean age was 13.3 years. Two-hundred and eighteen children examined in 1997 were re-examined in 1999; 147 of the children were examined in 1997 as well as in 2003, and 122 children were examined in all three years. An age- and sex-based body mass index (BMI) was computed to determine the nutritional status of each child. Each year, the same standard methods were used to determine the count of lactobacilli and mutans streptococci, stimulated flow rate and buffering capacity of saliva, and caries. Risk ratios were computed with generalized linear models using the tooth as the unit of analysis. Results:, Mean annual caries increment was 0.27 in the period 1997,1999 and 0.80 in the period 1999,2003 with most children developing no caries at all. Malnutrition at baseline in 1997 was insignificantly predictive for the development of caries, whereas a low stimulated flow rate of saliva (,0.7 ml/min) and a high count of lactobacilli (,100 000/ml) at baseline in 1997 were significantly associated. However, the generalized linear models for the two time periods 1997,1999 and 1999,2003 presented a confusing picture with different risk ratios and without consistency of the associations between the exposure variables and the development of caries. In accordance with this finding, the consistency of the exposure variables over time for the individuals was very low. Conclusions:, The results were inconclusive and left us with more questions than answers. The findings do, however, support the view that our methods for predicting caries are inappropriate or nonexistent. [source] Oral status of 35 subjects with eating disorders , A 1-year studyEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2000Rolf Öhrn The aim was to record changes over time in the oral status of subjects with diagnosed eating disorders. The outpatient psychiatrist had referred to the hospital dental clinic 35 women (19,47 yr, median 27 yr) with eating disorders, diagnosed according to DSM III-R criteria. At the baseline examination, dental, medical and dietary histories were taken, and intra-oral clinical and radiographic examinations were supplemented by intra-oral photographs, study casts and salivary analysis. The subjects were re-examined 1 yr later. Together, the investigators assessed progression of tooth wear blindly by comparing coded study casts from the baseline and 12-month examinations. Progression of erosive tooth wear was recorded in almost half of the subjects. Several subjects had low unstimulated salivary flow rates (<0.1 ml/min) and very high counts of mutans streptococci and lactobacilli, both at baseline and 1 yr later. The flow rates for paraffin-stimulated saliva at baseline were significantly lower for subjects with progression of erosive tooth wear than for those without. Because of the increased susceptibility to both caries and erosion, patients with eating disorders should be encouraged to have regular dental check-ups. Test of salivary flow may serve as an indicator of patients' risk of progression of erosive tooth wear. [source] Bronchopneumonia and oral health in hospitalized older patients.GERODONTOLOGY, Issue 2 2002A pilot study Abstract Aims: To correlate microbial findings obtained by bronchoalveolar lavage in pneumonia patients with the clinical situation of the oral cavity. Method: Quantitative aerobic and anaerobic cultures were carried out in 150 ml samples of bronchoalveolar lavage (BAL) obtained by means of an endoscope (Video Endoscope Pentax®) inserted per as in the infected bronchus. Material: Twenty consecutive patients with a tentative clinical diagnosis of bronchopneumonia in whom BAL was carried out for diagnostic purposes. A clinical evaluation of the oral health status (oral hygiene, caries, periodontal diseases) was subsequently carried out. Results: In seven edentulous subjects wearing complete dentures the culture of anaerobic microorganisms was negative or yielding less than 100 cfu/ml BAL. Two patients yielded high counts of S. aureus and one high counts of P. aeruginosa. In the 13 subjects with natural teeth left one showed high counts of Veillonella spp. (anaerobic)+P. aeruginosa, one high counts of Veillonella spp. +S. aureus, one high counts of P. aeruginosa + S. aureus and one high counts of E. coli. These four subjects showed poor oral hygiene, periodontal pockets and a BAL microflora consistent with periodontal pathology. Conclusion: The results of this pilot study suggest that microorganisms of denture plaque or associated with periodontal diseases may give rise to aspiration pneumonia in susceptible individuals. [source] TWO-PASS CUSUM TO IDENTIFY AGE-CLUSTER OUTBREAKSAUSTRALIAN & NEW ZEALAND JOURNAL OF STATISTICS, Issue 3 2010Ross Sparks Summary The paper introduces a two-pass adaptive cumulative sum (CUSUM) statistic to identify age clusters (age grouping) that significantly contribute to epidemics or unusually high counts. If epidemiologists know that an epidemic is confined to a narrow age group, then this information not only makes it clear where to target the epidemiological effort but also helps them decide whether to respond. It is much easier to control an epidemic that starts in a narrow age range of the population, such as pre-school children, than an epidemic that is not confined demographically or geographically. [source] |