Optimal Plate Choice for High-Neck Mandibular Condyle Fracture: A Mechanistic Analysis of 16 Options

(1) Background: Mandibular fractures are common, with the condylar process being a frequent site of injury, accounting for 25-45% of cases. This research aims to assess the mechanical suitability of various plates for high-neck condyle fractures. (2) Methods: Polyurethane models mimicking high-neck condyle fractures were utilized in this study. Sixteen distinct plate designs, constructed from titanium sheets, were tested. The figures underwent force assessments on a durability testing apparatus, and the relationship between used force and fracture movement was documented. (3) Results: For high-neck breaking, the two straight plates emerged as the most effective, aligning with established osteosynthesis standards. The second-best plate exhibited nearly half the strength of the gold standard. (4) Conclusions: In response to the aim of this study, considering the mechanical aspects, the double plain plate stands out as the optimal choice for osteosynthesis in cases of high-neck fractures of the mandibular condylar process. In addition, the authors propose the Mechanical Excellence Factor (MEF) as a superior metric for appraising a plate's mechanical force, surpassing the conventional Plate Design Factor (PDF).

Internal Adaptation of Composite Fillings Made Using Universal Adhesives-A Micro-Computed Tomography Analysis

This study aimed to evaluate internal tooth-filling interfaces of composite fillings made using universal adhesives using micro-computed tomography (µCT). Sixty class V cavities were randomly assigned into six groups: Peak Universal etch and rinse (PER), Peak Universal self-etch (PSE), Adhese Universal etch and rinse (AER), and Adhese Universal self-etch (ASE). Two further adhesives considered gold standards were used as control groups: OptiBond FL (OER) for the etch and rinse technique and Clearfil SE for the self-etch technique (CSE). All teeth were subjected to thermomechanical loading and four-year water storage. Next, they were analyzed using µCT to investigate the internal tooth-filling interfaces. The proportions between the gap volume (GV) at the tooth-filling interface and the volume of applied composite filling (FV), between the gap and cavity volumes (CV), and between the gap volumes at the tooth-filling interface of the external (EGV) and internal (IGV) parts were calculated. Adhese Universal achieved the significantly lowest gap-to-filling- and gap-to-cavity-volume ratios for both types of etching techniques comparing to those of the Peak Universal and control groups. Significant differences between the gaps in external and internal parts of the tooth-filling interface were only noted in the control groups. Internal gap formation and development at the tooth-filling interface depend on the material as well as the type of its application.

Which of the 37 Plates Is the Most Mechanically Appropriate for a Low-Neck Fracture of the Mandibular Condyle? A Strength Testing

(1) Background: The mandible is the most frequently injured component of the facial skeleton, with 25-45% of mandibular fractures involving the condylar process. This study aims to mechanically compare which plates are most suitable for use in low-neck fractures of the condyle. (2) Methods: Polyurethane mandibular models with simulated low-neck fractures were tested using 37 distinct plate designs. These plates were fabricated from 1 mm thick, grade 23 titanium sheets. The models were then subjected to force tests on a strength machine, and the correlation between applied force and fracture displacement was recorded. (3) Results: For low-neck fractures, XCP side-dedicated 3+5 and ACP-T plates demonstrated strength comparable to that of two straight plates, the current gold standard in osteosynthesis. (4) Conclusions: The Mechanical Excellence Factor (MEF) introduced by the authors provides a more accurate metric for theoretically predicting a plate's mechanical strength compared to the Plate Design Factor (PDF). Eight plate characteristics were utilized to calculate the MEF. Employing the MEF allows for rapid, preliminary validation before undertaking strength tests. Furthermore, the findings of this study can guide the selection of the most durable plate designs for subsequent fatigue testing.

Evaluation of Fracture Resistance of Occlusal Veneers Made of Different Types of Materials Depending on Their Thickness

Pathological tooth wear is an escalating social problem. Occlusal veneers can be an alternative to traditional prosthetic restorations such as crowns, inlays, and onlays.

BACKGROUND

The aim of this study is to assess the fracture resistance of occlusal veneers made of various materials depending on their thickness.

METHODS

In total, 120 occlusal veneers were examined. The restorations were made of four ceramics: leucite LC (IPS Empress Esthetic), hybrid HC (Vita Enamic), lithium disilicate LDC (IPS e.max Press), and zirconium oxide ZOC (Ceramill Zolid HT). A total of 30 veneers were made of each material, 10 for each of the three thicknesses: 1 mm, 1.5 mm, 2 mm. The restorations were cemented on identical abutments duplicated from the developed phantom tooth 35 (KaVo) with composite cement (All Bond Universal). The samples prepared in this way were subjected to a compressive strength test in a universal testing machine. Statistical analysis of the results was performed.

RESULTS

The average fracture resistance of occlusal veneers made of zirconium oxide ceramic was 1086-1640 N, of lithium disilicate ceramics 456-1044 N, of hybrid ceramics 449-576 N, and of leucite ceramics 257-499 N.

CONCLUSIONS

Occlusal veneers made of ceramics, zirconium oxide and lithium disilicate, had the highest resistance to fractures. Restorations made of leucite ceramics turned out to be the least resistant to forces. The greater the thickness of the ceramic occlusal veneers, the greater their fracture resistance.

The Influence of Alumina Airborne-Particle Abrasion with Various Sizes of Alumina Particles on the Phase Transformation and Fracture Resistance of Zirconia-Based Dental Ceramics

The surface of zirconia-based dental ceramic restorations require preparation prior to adhesive cementation. The purpose of this study was to assess the influence of airborne-particle abrasion with different sizes of alumina particles (50 μm, 110 μm, or 250 μm) on the mechanical strength of zirconia-based ceramics' frameworks and on the extent of phase transformations. A fracture resistance test was performed. The central surface of the frameworks was subjected to a load [N]. The identification and quantitative determination of the crystalline phase present in the zirconia specimens was assessed using X-ray diffraction. The Kruskal-Wallis one-way analysis of variance was used to establish significance (α = 0.05). The fracture resistance of zirconia-based frameworks significantly increases with an increase in the size of alumina particles used for air abrasion: 715.5 N for 250 μm alumina particles, 661.1 N for 110 μm, 608.7 N for 50 μm and the lowest for the untreated specimens (364.2 N). The X-ray diffraction analysis showed an increase in the monoclinic phase content after air abrasion: 50 μm alumina particles-26%, 110 μm-40%, 250 μm-56%, and no treatment-none. Air abrasion of the zirconia-based dental ceramics' surface with alumina particles increases the fracture resistance of zirconia copings and the monoclinic phase volume. This increase is strongly related to the alumina particle size.

Which of 51 Plate Designs Can Most Stably Fixate the Fragments in a Fracture of the Mandibular Condyle Base?

In the surgical treatment of the most common fracture of the mandible, which is a fracture of the condylar base, a great choice of different plate shapes is observed. The aim of this study was to determine which shape gives the greatest fixation stiffness. To ensure homogeneity in comparison, tests were performed on polyurethane models divided at the level of the condylar base fracture and each were fixed with 51 plates. The plates were cut from a 1 mm thick grade 23 titanium sheet. The models were then loaded and the force required for 1 mm of fracture displacement was recorded. It was noted that in addition to osteosynthesis from two simple plates, there were also two dedicated single plates with similar rigidity. Among the large number of described designs of plates, there is considerable variation in terms of the stability of the fixation performed with them. The proposed Mechanical Excellence Factor allows a pre-evaluation of the expected rigidity of fixation with a given plate shape without the need for a loading experiment. The authors expect this to be helpful for surgeons in the application of relevant plates, as well for inventors of new plates for the osteosynthesis of basal fractures in mandibular condyle.

Evaluation of the Relationship of Screw Pullout and Plate Fracutre in Fixation of Mandible Condyle Fractures: A Mechanistic Study

BACKGROUND

The mandible is the most injured part of the facial skeleton, and 25-40% of mandibular fractures involve the condyle process. The aim of this study is to answer the question of the relationship between screw pullout and/or plate fracture during osteosynthesis.

METHODS

We tested polyurethane models of mandibles whose condylar process was cut (simulating a fracture) and fused using plates and screws.

RESULTS

A total of 672 plates were tested. A total of 25.6% of them were fractured during the test, with most being fractures of the base of the condyle. More screws (81.97%) are pulled out from the ramus than from the condyle-69.15%.

CONCLUSIONS

The gold standard in the osteosynthesis of condylar fractures is two straight plates. Other than these, there is no one-size-fits-all plate for every type of fracture. Plates fixed with fewer screws (smaller plates used in higher-lying fractures) are more likely to result in screw pullout. On the other hand, in plates fixed with more screws, plate fracture is more common.

The Effect of Acrylic Surface Preparation on Bonding Denture Teeth to Cellulose Fiber-Reinforced Denture Base Acrylic

Patients who require dental prosthetic restoration using frame dentures in the front part of the mouth very frequently report that teeth fall out of their dentures. However, the available scientific papers are insufficient to compare the various methods of improving the connection between the denture base and the artificial tooth and choosing the best solution. This paper focuses on providing all parameters, enabling the reproduction of tests, and accounting for all variables. The paper uses an original method of creating grooves, sandpaper, sandblasting, and cutting the acrylate layer with a burr in one and two directions. Developed surfaces were additionally subjected to detailed examination. This study used 180 specimens divided into three groups and subjected to various environments (dry, artificial saliva, and thermocycles). Shearing and tensile strength tests were performed. The best results were obtained with a carbide burr. The increase in connection durability was as follows in the case of the shear test: 116.47% in dry samples, 155.38% in samples soaked in artificial saliva, and 46.59% in samples after thermocycles. The increase in tensile resistance was: 198.96% in a dry environment, 88.10% before being soaked in artificial saliva, and 94.04% after thermocycles.

Open Rigid Internal Fixation of Low-Neck Condylar Fractures of the Mandible: Mechanical Comparison of 16 Plate Designs

BACKGROUND

In the literature, no information on plates for low-neck mandibular condylar osteosynthesis can be found, despite the fact that 30 plate designs have already been published. The aim of this study was to compare any dedicated plates for possible use in low-neck condylar fracture osteosynthesis.

METHODS

The force required for 1-mm displacement of the fixed fracture fragments and incidents of screw loosening were recorded on polyurethane mandibles among 16 designs of titanium plates fixed by 6-mm screws in a 2.0 system.

RESULTS

Double-straight plate fixation was the mechanical gold standard (15.2 ± 3.5 N), followed by A-shape Condylar Plates (14.9 ± 2.1 N), X-shape Condylar Plates (14.2 ± 1.3 N) and Auto Repositioning Plates (11.8 ± 2.4 N). Screw loosening was uncommon, as a minimum of three screws were placed into the condylar part. Fewer screws were lost from the ramus part of the fixation if the plate was attached to the condylar part by three screws. Often, the stability of the ramus screws was lost when there were only two fixing screws in the condyle (p < 0.001).

CONCLUSIONS

It is advisable to consider the mechanical advantages as one decides which plate to choose for open rigid internal fixation in low-neck condylar fractures, or to only be aware of the significant differences in mobility within the fracture line after fixation with different dedicated plates.

Mechanical Evaluation of Titanium Plates for Osteoesynthesis High Neck Condylar Fracture of Mandible

Background: In the literature no information about plates for the high-neck mandibular condylar osteosynthesis could be found despite that 30 plate designs have been published. The main course consider the basal condylar or diacapitular fractures. The aim of the study was to test mechanically all available designs (only 4 of 30 was proper) on polyurethane mandibles using an individually designed clamping system. Methods: Forces required for a 1 mm displacement of fixed fracture fragments and incidents of screw loosening were recorded. Results: It has occured that dedicated plates for fixation are much weaker than set of two straight plates (p < 0.0001). General observation is the bigger plate and more screws, the better rigid stable osteosynthesis of mandibular condyle, however, there are limitations in plates design for high-neck fractures resulted in restricted operation field. Conclusion: Double straight plates occured to be the best mechanical fixation for high-neck fractures of the mandibular condyle. Maybe other existing plates could be used but only after prebending or that fracture required novel dedicated plates design.

How Do the Etching Mode and Thermomechanical Loading Influence the Marginal Integrity of Universal Adhesives?

OBJECTIVE

This study evaluated the effect of etching mode and thermomechanical loading on universal adhesives.

METHODS AND MATERIALS

Two universal adhesives, Peak Universal and Adhese Universal, were used in two etching modes as the experimental groups: Peak Universal etch-and-rinse (PER), Peak Universal self-etch (PSE), Adhese Universal etch-and-rinse (AER), and Adhese Universal self-etch (ASE). Two adhesives considered gold standards were used as control groups: OptiBond FL (OER) was used as a control group for the etch-and-rinse (ER) mode, and Clearfil SE Bond (CSE) was used as a control group for the self-etch (SE) mode. Standardized class V cavities were created on the buccal and lingual surface in 30 extracted caries-free human third molars. Each adhesive and resin composite was applied according to the manufacturer's instructions. The specimens were subjected to thermomechanical loading (TML) immediately after the fillings were placed. Before and after TML, replicas and photographs of the fillings were performed and evaluated quantitatively and qualitatively. The Mann-Whitney U-test or Kruskal-Wallis test was used for quantitative analyses, and Fisher exact test was used for qualitative analysis.

RESULTS

Adhese Universal achieved a significantly higher percentage of continuous margin in the enamel than Peak Universal for the two types of etching both before and after TML (except for the SE group after TML). In dentin, the greatest percentage of continuous margin was achieved for Adhese Universal in the ER group (100%) before TML and for both universal adhesives in the SE groups (61%) after TML. For both etching modes and both time points, Adhese Universal had a greater percentage of continuous margin than Peak Universal for the whole margin. For the ER approach, significant differences were observed both before and after TML, and for the SE approach, significant differences were observed before TML. TML did not cause a significant decrease in the percentage of continuous margin in the enamel, but the results were the opposite in dentin. A qualitative assessment using World Dental Federation criteria did not show statistically significant differences between the groups.

CONCLUSIONS

Scanning electron microscope assessment of marginal integrity showed that the evaluated factors such as etching mode and TML significantly influenced the marginal integrity of the universal adhesives. The replica method shows that laboratory and clinical assessment methods complement each other and give a broader view of marginal integrity.

Evaluation of gap formation at the composite resin-tooth interface after using universal adhesives: In vitro SEM study using the replica technique

The aim of this study was to evaluate gap formation after using two universal adhesives, Peak Universal Bond (P), which contains chlorhexidine and Adhese Universal (A), which contains 10-MDP monomer, and to compare them with two gold standard adhesives. The adhesives were tested in different etching modes, etch-and-rinse (ER) or self-etch (SE), and under thermomechanical loading (TML). Two identical Class V cavities were prepared in each of 30 human third molar teeth, and resin-composite restorations were made. Before and after TML, replicas of the restorations were prepared. Gap formation and their frequency according to the modified classification of Blunck and Zaslansky and the width of the maximum marginal gap (MG) were separately evaluated in enamel and dentin. Gap frequency did not differ significantly only in the enamel before TML, despite the use of different adhesives or etching modes. At both timepoints, the highest MG values were obtained with the Peak Universal Bond self-etch (PSE) group in enamel (6.2 μm before TML, 12.2 μm after TML) and the Peak Universal Bond etch-and-rinse (PER) group in dentine (21.3 μm before TML, 35.5 μm after TML). After TML, there was a significant increase of gap frequency for Adhese universal self-etch (ASE) group and MG values for PER, PSE, ASE groups at the resin-enamel interface, and gap frequency and MG values for all groups at the resin-dentin interface. Universal adhesive with 10-MDP monomer have beneficial effect on the resin-dentin interface, while chlorhexidine may reduce the resistance of the universal adhesive system to oral cavity conditions.

Forces Causing One-Millimeter Displacement of Bone Fragments of Condylar Base Fractures of the Mandible after Fixation by All Available Plate Designs

Background: There has been no direct comparison of all existing plates dedicated for fracture osteosynthesis of mandibular condyle base until now. The aim of the study was to test mechanically all available designs of titanium plates on the market on polyurethane mandibles using an individually designed clamping system. Methods: Forces required for a 1 mm displacement of fixed fracture and incidents of screw loosening were recorded. Results indicated the best mechanical plates among all existing designs available. Results: It has occured that some of osseofixation plates should not be used any more, whereas some shape of the single plates are similar shape to two single plates shape are regarded as the best osseofixation method for condyle base fracture. Conclusion: General observation is the bigger plate and more screws, the better rigid stable osteosynthesis of mandibular condyle base. 4 plates of current designs of total 30 tested series can be recommended for open rigid internal fixation of fractures of the base of the mandibular condyle. The rest of 26 existing plates should not be used in condylar base fractures.

A miniature microcontroller curve tracing circuit for space flight testing transistors

This paper describes a novel miniature microcontroller based curve tracing circuit, which was designed to monitor the environmental effects on Silicon Carbide Junction Field Effect Transistor (SiC JFET) device performance, while exposed to the low earth orbit environment onboard the International Space Station (ISS) as a resident experiment on the 7th Materials on the International Space Station Experiment (MISSE7). Specifically, the microcontroller circuit was designed to operate autonomously and was flown on the external structure of the ISS for over a year. This curve tracing circuit is capable of measuring current vs. voltage (I-V) characteristics of transistors and diodes. The circuit is current limited for low current devices and is specifically designed to test high temperature, high drain-to-source resistance SiC JFETs. The results of each I-V data set are transmitted serially to an external telemetered communication interface. This paper discusses the circuit architecture, its design, and presents example results.

Behavioral and cognitive effects of methylxanthines. A meta-analysis of theophylline and caffeine

BACKGROUND

Theophylline has been extensively studied as a treatment of asthma. However, some studies have suggested that theophylline may precipitate adverse behavioral and cognitive effects on children. Other reports have evaluated the effects of caffeine, another commonly used methylxanthine, as a treatment of attention-deficit hyperactivity disorder.

OBJECTIVE

To present a meta-analysis of research on the behavioral and cognitive effects of methylxanthines in children.

METHODS

The meta-analyses were conducted on 12 studies of theophylline and nine studies of caffeine that met inclusion criteria.

RESULTS

In contrast to popular beliefs and earlier scientific reports, meta-analyses of controlled studies did not indicate that either theophylline or caffeine resulted in significant deleterious effects on cognition or behavior. In fact, there was a small, positive effect on parental report of externalizing behavior for both methylxanthines.

CONCLUSIONS

There is little evidence to suggest that methylxanthines have adverse cognitive or behavioral effects on children. Questions remain with regard to the identification and determinants of either responsive or sensitive subgroups, dose-response relationships, and the effects of parent-teacher expectancies on behavioral ratings.

Psychometric properties of the children's atypical development scale

The Children's Atypical Development Scale (CADS) is a 53-item rating scale designed to measure unusual behaviors in children. Principal-factor analysis on a clinic-referred and pediatric sample of 474 children resulted in a four-factor solution: Communication Deficits, Lability, Social Relatedness Deficits, and Preoccupation. The CADS is internally consistent and has adequate temporal stability. CADS factor scores were differentially associated with parent and teacher rating scales, IQ, and Continuous Performance Test errors. The scale shows promise as a clinical and research tool for assessing atypical behaviors associated with pervasive developmental disorder and other neurobehavioral disorders.