Objectives Resin polymerisation shrinkage reduces the congruence of the denture base with denture-bearing tissues and thereby decreases the retention of conventionally fabricated dentures. CAD/CAM denture manufacturing is a subtractive process, and polymerisation shrinkage is not an issue anymore. Therefore, CAD/CAM dentures are assumed to show a higher denture base congruence than conventionally fabricated dentures. It has been the aim of this study to test this hypothesis. Materials and methods CAD/CAM dentures provided by four different manufacturers (AvaDent, Merz Dental, Whole You, Wieland/Ivoclar) were generated from ten different master casts. Ten conventional dentures (pack and press, long-term heat polymerisation) made from the same master casts served as control group. The master casts and all denture bases were scanned and matched digitally. The absolute incongruences were measured using a 2-mm mesh. Results Conventionally fabricated dentures showed a mean deviation of 0.105 mm, SD = 0.019 from the master cast. All CAD/ CAM dentures showed lower mean incongruences. From all CAD/CAM dentures, AvaDent Digital Dentures showed the highest congruence with the master cast surface with a mean deviation of 0.058 mm, SD = 0.005. Wieland Digital Dentures showed a mean deviation of 0.068 mm, SD = 0.005, Whole You Nexteeth prostheses showed a mean deviation of 0.074 mm, SD = 0.011 and Baltic Denture System prostheses showed a mean deviation of 0.086 mm, SD = 0.012. Conclusions CAD/CAM produces dentures with better fit than conventional dentures. Clinical Relevance The present study explains the clinically observed enhanced retention and lower traumatic ulcer-frequency in CAD/CAM dentures.
We investigated the role of secretory leukocyte protease inhibitor (SLPI) in ischemia/reperfusion injury in cardiac transplantation. SLPI-/-mouse hearts and wild-type (WT) controls were transplanted immediately or after 10 h of cold ischemia (CI). Recombinant SLPI (rSLPI) was added to the preservation solution or given systemically. After evaluation of myocardial performance, grafts were investigated for histology, SLPI, TNF-a , TGF-b , NF-j B and protease expression at indicated time points. Early myocardial contraction was profoundly impaired in SLPI-/-hearts exposed to CI and associated with high intra-graft protease expression. Systemic administration of rSLPI had no effect, however, when SLPI was added to the preservation solution, myocardial contraction was restored to normal. At 10 days, inflammation, myocyte vacuolization and necrosis were significantly more severe in SLPI-/-hearts. SLPI gene expression was detected in WT mice at 12 and 24 h and was significantly higher after CI. SLPI protein was observed at 24 h and 10 days. High intra-graft concentrations of SLPI after administration of rSLPI were inversely correlated with protease levels early and TGF-b expression late after reperfusion. SLPI plays a crucial role in early myocardial performance and postischemic inflammation after cardiac transplantation. A dual inhibitory effect on protease and TGF-b expression might be the underlying mechanism.
A high Shulman clock-drawing test score indicates the need for oral hygiene assistance, but it is not suitable as a single tool to assess this need. Patients with other disabilities might equally qualify for assistance. Dentures, however, can be cleaned quickly and efficiently independently of patient compliance; therefore, cleaning the patients' dentures should be part of nursing personnel's daily care routine for every patient.
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