Background:The aim of this study was to analyze the predictability of the Kwok and Caton periodontal prognosis system by investigating tooth survival within a 64-month period and to compare this to other well-established prognosis systems. Methods: This retrospective study included the records of patients who had a minimum of two dental exams at least 12 months apart at a single Universityaffiliated Dental Center. Data including patients' age, sex, length of follow-up period, initial tooth prognosis, revised tooth prognosis, tooth type, and number of teeth lost at the latest exam were recorded. Descriptive analysis was used for data interpretation.Results: A total of 4,046 teeth from 174 patients qualified for the study. Teeth with initial poorer prognosis had a higher chance of being extracted compared with those with a better initial prognosis. Tooth survival rate at the latest followup for those with an initial favorable, questionable, unfavorable, and hopeless prognosis was 97.9%, 90.7%, 62.5%, and 17.7%, respectively. Teeth initially assigned to a poorer prognosis category had a higher proportion that changed to a worse prognosis at the latest periodontal exam.
Conclusions:The Kwok and Caton prognosis system can predictably determine tooth survivability within a 5-year period. The defined categories of this prognosis system are more reliable than that of other systems in the short-term. However, long-term (>5 years) prediction accuracy of this prognosis system needs further investigation.
Virtual reality is an immersive experience that has been gaining acceptance in the field of medicine as a tool for reducing patient anxiety. We recently observed the effectiveness of this technology in wide-awake local anaesthesia no tourniquet (WALANT) surgeries. Here we report two cases of patients who used a virtual reality device during hand surgery using the WALANT technique. Both patients reported that the use of VR technology reduced their anxiety and improved their overall experience during surgery. This case report highlights the novel use of virtual reality during hand surgeries where the patients were awake. Based on these two cases, virtual reality may have the potential to reduce anxiety during the perioperative period and enhance a patient’s overall experience in WALANT surgeries.
Developmental regulation of bone formation in the jaw skeleton is essential to species-specific adaptation. The jaws are derived from neural crest mesenchyme (NCM), a progenitor population that directs skeletal patterning by exerting temporal and spatial control over molecular and cellular programs for osteogenesis. One important NCM-mediated gene is Runx2, which is a transcription factor required for osteoblast differentiation. RUNX2 protein binds many target genes involved in the deposition and resorption of bone. To determine the extent to which changes in Runx2 structure, function, and expression underlie the evolution of the jaw skeleton, we compare Runx2 across vertebrates and within birds. Runx2 contains two alternative promoters, tandem repeats of glutamine and alanine with variable lengths in different species, a conserved DNA-binding domain, an exon that is alternatively spliced, as well as two possible C-termini. Such alternative splicing produces eight potential isoforms that show distinct stage- and species-specific patterns in the jaw primordia of chick, quail and duck embryos. We also find that certain isoforms are strongly induced by TGFβ signaling whereas others are not. Overexpressing Runx2 isoforms in NCM reveals that some are transcriptionally activating, while others are repressive. But context appears to be relevant since species-specific polymorphisms in the promoter of target genes like Mmp13, can modulate the effects of different isoforms. Overall, our study indicates that the structure and species-specific deployment of Runx2 isoforms affect the transcriptional activity of target genes in ways that may have played a generative and regulatory role in the evolution of the avian jaw skeleton.
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