Ectodermal dysplasia (ED) is a rare hereditary disorder affecting the development of ectoderm-derived organs and tissues. The aim of this study was to describe phenotypic features and the therapeutic approach in dentistry among three patients with ED, correlating their data with the literature. Additionally, to investigate the salivary gland disorders and their impacts on oral microbiota, we performed salivary tests, including salivary flow rate, salivary buffering capacity, and concentration levels of mutans streptococci, lactobacilli, and yeasts. All patients presented oligodontia, resulting in a significant masticatory dysfunction and aesthetic impairment. The counts of mutans streptococci (n=3) and yeasts (n=2) were high; on the other hand, the count of lactobacilli (n=3) was low. Therefore, salivary and microbiological tests showed that the patients with ED, particularly the hypohidrotic type, presented a high risk of enamel caries and susceptibility to oral infections, which may be likely triggered by reduction of salivary flow and/or possible immunological disorders.
Objective The aim of this study was to investigate the effect of the hybrid abutment with different angles (0 and 15 degrees) on the stress distribution and deformation on maxillary implant-supported fixed prosthesis, using digital image correlation (DIC) and finite element analysis (FEA). Materials and Methods For DIC, two situations were considered: conventional straight implant placement and implant placement with 15 degrees inclination. Different zirconia mesostructures were milled, one straight and the other with a 15-degree angulation to correct the implant positioning. Then, the zirconia mesostructures were cemented to the titanium base (Ti base), and both groups received a lithium disilicate crown. The DIC technique was performed to measure the deformation generated on the simulated bone surface (150 N loading). For the FEA (in silico), three-dimensional numerical models based on the in vitro setup were modeled using computer-aided design software. All materials were considered elastic, isotropic, and homogeneous. Comparison of both methods showed coherence between the in vitro and in silico results. The von-Mises stress of the implants, Ti base and screw, and the maximum principal stress in the mesostructure and crown were calculated for both conditions. Results The overall surface deformation distributions determined by both techniques were considered similar allowing the model validation. The higher deformation was found in the cervical region with a higher magnitude for the angled hybrid abutment. The same pattern was observed in the stress fields regardless of the analyzed region and structure. Conclusion Based on this study, using an angled hybrid abutment to correct the implant positioning generated higher stress in the implant fixture, surrounding tissue, Ti base, screw, and crown. Therefore, the implant should be positioned axially, whenever possible, to reduce the mechanical complications.
The aim of this study was to evaluate the effect of biologically oriented preparation technique on the stress concentration of endodontically treated upper central incisors restored with zirconia crown (yttria-stabilized zirconia polycrystalline ceramic) through finite element analysis (FEA). Four models of maxillary central incisors containing enamel, dentin, periodontal ligament, cortical and medullary bone were created in CAD. Each model received a polymeric core-build up with nanofilled dental resin composite. The evaluated models were SM—preparation in shoulder 90°; CM—chamfer preparation; BOPT—biologically oriented preparation technique and BOPTB—BOPT preparation 1 mm below the cement-enamel junction. All models received zirconia crowns (5Y-TZP), fiberglass post and 1 mm ferrule. The models were imported into the analysis software with parameters for mechanical structural testing using the maximum principal stress and the tensile strength as the analysis criteria. Then, load of 150 N was applied at the cingulum with 45° slope to the long axis of the tooth, with the fixed base for each model. The type of marginal preparation affected the stresses concentration in endodontically treated teeth and in the zirconia crown margin. Considering the stress magnitude only, BOPT is a viable option for anterior monolithic zirconia crowns; however, with the highest stress magnitude at the restoration margin.
A análise facial consiste em uma etapa importante do diagnóstico e avaliação dos resultados obtidos na harmonização orofacial. Para avaliação dos resultados de procedimentos estéticos, fotografias são muito utilizadas, porém novas ferramentas são necessárias para facilitar a visualização dos pacientes quanto aos ganhos estéticos. Os scanners faciais 3D surgem como alternativa para tal finalidade. O objetivo deste estudo foi analisar, através de fotografias e escaneamento 3D da face, o ganho de volume labial após intervenção de preenchimento. A paciente apresentava insatisfação com relação aos seus lábios. Durante a avaliação, constatou-se ausência de volume e contorno labial. Antes de iniciar o procedimento, realizou-se protocolo fotográfico e escaneamento facial (E1). Para o procedimento, foi utilizada uma seringa de 1 mL de ácido hialurônico. O escaneamento foi feito no pós-imediato (E2), após 10 dias (E3) e após 40 dias da intervenção (E4). Nesta mesma consulta após 40 dias, foi realizado injeção da segunda seringa de ácido hialurônico escaneamento do pós-imediato (E5). Após 40 dias, a paciente voltou (E6). Após análise comparativa das malhas, foi possível verificar ganho de 3 mm entre E1 e E2. Na comparação do pré (E1) e após 10 dias (E3), verificou-se volumização total de 1,85 mm, demonstrando que quase 40% do volume no pós-imediato é edema. Em E6, após 40 dias da aplicação da segunda seringa, foi possível quantificar ganho de 2,12 mm no lábio superior quando comparado a E1. Pode-se concluir que o escaneamento 3D contribui expressivamente para avaliação dos resultados alcançados em procedimentos estéticos.
Background:Diagnostic delay of spondyloarthritis (SpA) has been established even in combination with inflammatory bowel disease and may contribute to radiographic progression and disability.Objectives:We aimed to evaluate diagnostic delay in enteropathic SpA (eSpA) and explore associated demographic, clinical, and radiographic characteristics.Methods:We analysed consecutive eSpA patients referred to the combined gastro-rheumatologic clinic of the University of Rome Tor Vergata. Diagnostic delay was defined as the time interval from the date of first symptoms to the date of diagnosis. Conventional radiography (CR) and magnetic resonance images (MRI) of sacroiliac (SI) joints and spine were performed in axial (ax)SpA patient and examined by two independent radiologists. MRI were assessed for the presence of active/chronic inflammatory lesions, disease activity by ASDAS and inflammatory markers. Statistical analyses were performed using Mann-Whitney, chi square/Fisher tests and covariance analysis (SPSS software).Results:190 eSpA patients (124 female, mean age 47.5±12.8 years, disease duration 72±67.4 months, 73 UC/117 CD; 118 peripheral SpA, 72 axSpA including 44 non radiographic (nr)-axSpA) were evaluated. Axial eSpA patients had a higher prevalence of men sex (p<0.0001), HLA-B27 positivity (p=0.004), uveitis (p=0.01) and pancolitis (p<0.006) compared with peripheral eSpA. AxeSpA patients displayed higher ESR, ASDAS, and VAS pain compared with peripheral ESpA (p=0.0006, p=0.001, p=0.019, respectively). A higher prevalence of csDMARDs was detected in peripheral eSpA compared with axSpA (p=0.002) while treatment with cs and bDMARDs was similar in rad-axSpA and nr-axSpA patients.Median diagnostic delay in eSpA was 48 months (IQR 6-77) with no difference between axial and peripheral patients. Rad-ax-SpA patients displayed a higher diagnostic delay compared with nr-axSpA (median/IQR 36/17-129 vs 31/10-57 months, p=0.03). Patients with rad-axSpA were older and with longer disease duration than patients with nr-axSpA (p=0.005 and p=0.019). Low education status and high rate of employment were found in rad-axSpA compared with nr-axSpA (p=0.003 and p=0.03, respectively).Rad-axSpA patients with sclerosis, syndesmophytes and bridge at CR had a higher diagnostic delay than those without lesions (p=0.03, p=0.043, p<0.0001, Fig. 1A-C). Men showed a higher prevalence of spine damage lesions than women as sclerosis (p=0.02), squaring (p=0.0006), syndesmophytes (p=0.0028) and bridges (p=0.007). Longer disease duration was detected in patients with radiographic damage as bridge (p<0.0001) and sacroiliitis grade 3 (p=0.04). On MRI, SI bone oedema was associated with reduced diagnostic delay (p=0.04) while bone erosions was associated with higher diagnostic delay (p=0.002) compared with that in patients without these lesions (Fig. 1D-E). Rad-axSpA women had a higher prevalence of SI damage lesions at MRI than men (p=0.001). Patients with psoriasis displayed a higher diagnostic delay compared to those without skin involvement (p=0.004).Figure 1.Conclusion:Demographic and clinical factors differentiate axSpA from nr-axSpA patients. Diagnostic delay was higher in rad-axSpA compared with nr-axSpA despite the same treatment. Some lesions of spine/SI at CR and MRI, and psoriasis, were mostly associated with diagnostic delay and sex.Disclosure of Interests:None declared
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