Coronally Advanced Flap with Different Designs in the Treatment of Gingival Recession: A Comparative Controlled Randomized Clinical Trial

The aim of this parallel double-blind randomized controlled clinical trial was to describe a modified approach using the coronally advanced flap (CAF) with triangular design and to compare its efficacy, in terms of root coverage and esthetics, with a trapezoidal type of CAF. A sample of 50 isolated Miller Class I and II gingival recessions with at least 1 mm of keratinized tissue apical to the defects were treated with CAF. Of these recessions, 25 were randomly treated with trapezoidal CAF (control group) while the other 25 (test group) were treated with a modified triangular CAF. The clinical and esthetic evaluations, made by the patient and an independent periodontist, were performed 3 months, 6 months, and 1 year after the surgery. No statistically significant difference was demonstrated between the two CAF groups in terms of recession reduction, complete root coverage, or 6-month and 1-year patient esthetic scores. Better 3-month patient esthetic evaluations and better periodontist root coverage, color match, and contiguity assessments were reported after triangular CAF. Trapezoidal CAF was associated with greater incidence of keloid formation. Single-type gingival recessions can be successfully covered with both types of CAF. The triangular CAF should be preferred for esthetically demanding patients.

CAD/CAM generated all-ceramic primary telescopic prostheses

Computer-aided design and manufacturing (CAD/CAM) systems have proven effective not only for the manufacture of crown and bridge frameworks, inlays, onlays and veneers, but also for the generation of all-ceramic primary telescopic prostheses in more than 10 years of use in dental technology. The new InLab 4.0 software generation makes it possible to design and mill primary telescopic prostheses with CAD/CAM technology. The computer-generated raw crowns for these restorations require very little manual adaptation. The secondary crowns are manufactured by electroforming and bonded onto the tertiary structure or framework.

Nucleic acid testing (NAT) of organ donors: is the 'best' test the right test? A consensus conference report

Nucleic acid testing (NAT) for HIV, HBV and HCV shortens the time between infection and detection by available testing. A group of experts was selected to develop recommendations for the use of NAT in the HIV/HBV/HCV screening of potential organ donors. The rapid turnaround times needed for donor testing and the risk of death while awaiting transplantation make organ donor screening different from screening blood-or tissue donors. In donors with no identified risk factors, there is insufficient evidence to recommend routine NAT, as the benefits of NAT may not outweigh the disadvantages of NAT especially when false-positive results can lead to loss of donor organs. For donors with identified behavioral risk factors, NAT should be considered to reduce the risk of transmission and increase organ utilization. Informed consent balancing the risks of donor-derived infection against the risk of remaining on the waiting list should be obtained at the time of candidate listing and again at the time of organ offer. In conclusion, there is insufficient evidence to recommend universal prospective screening of organ donors for HIV, HCV and HBV using current NAT platforms. Further study of viral screening modalities may reduce disease transmission risk without excessive donor loss.

New implant software abutments for inLab 3.65

The "Implants for inLab" implant software is based on a polyvalent bonding base which can be used on different types of implant. The modifiable part is a zirconium dioxide block with a prefabricated connection configuration for accurate coupling to the bonding base. The software offers different design possibilities which are especially suitable for implant restorations with high esthetic requirements.

Molecular mapping of chromosome 2 deletions in murine radiation-induced AML localizes a putative tumor suppressor gene to a 1.0 cM region homologous to human chromosome segment 11p11-12

Radiation-induced acute myeloid leukemias (AMLs) in the mouse are characterized by chromosome 2 deletions. Previous studies showed that a minimal deleted region (mdr) of approximately 6.5 cM is lost from one homologue in chromosome 2-deleted AMLs. An AML tumor suppressor gene is proposed to map within this mdr. In this study, we refine the mdr to a I cM interval between markers D2Mit126 and D2Mit185 by microsatellite analysis of 21 primary radiation-induced F I AMLs. The construction of a partial yeast artificial chromosome (YAC) contig spanning the mdr and the location of six known genes indicated that the 1 cM mdr is homologous to human 11p11-12, a region implicated in some human AMLs. Screening of five cell lines derived from primary radiation-induced AMLs for homozygous loss of microsatellites and genes mapping within the mdr revealed loss of both copies of the hemopoietic tissue-specific transcription factor Sfpi1(PU.1/Spi1) in one cell line. Studies of primary and F1 AMLs failed to implicate Sfpi1 as the AML tumor suppressor gene. YAC contig construction, together with data suggesting that the critical gene flanks Sfpi1, represents significant progress toward identifying an AML tumor suppressor gene.

Comparison of four strategies for tumour vaccination in the B16-F10 melanoma model

We have compared four cell-based tumour vaccine strategies in prevention experiments using the B16-F10 melanoma model. Two of these are thought to favour the direct antigen presentation pathway (B16-F10 expressing B7.1 and hybrids made between B16-F10 cells and macrophages) and the other two strategies are thought to act by an indirect pathway of presentation (allogeneic tumour cells and autologous tumour cells combined with a powerful adjuvant (Provax-IDEC Pharmaceuticals)). Only the two latter vaccines promoted antitumour activity, whereas the vaccines consisting of B7.1-expressing tumour cells or the hybrid vaccine failed to provide any antitumour activity. Recently human trials have commenced using transfection of the B7.1 molecule, as well as employing the hybrid technology to make tumour-B cell hybrids or tumour and dendritic cell hybrids. Our results suggest that these approaches could be disappointing in the clinics if not optimised.

Epidural infusions of bupivacaine and fentanyl do not improve rehabilitation following one-stage bilateral total knee arthroplasty

Epidural analgesia with local anaesthetic minimizes the catabolic response to surgery. To determine whether this could enhance the rate of recovery following orthopaedic surgery, 51 patients undergoing bilateral one-stage total knee arthroplasty were allocated to receive infusions of either continuous epidural bupivacaine/fentanyl or continuous intravenous fentanyl to compare the efficacy of these modes of pain relief on postoperative clinical outcomes and rates of rehabilitation. Infusions were maintained for 36 to 48 hours in a post-anaesthesia care unit (PACU). Postoperatively, pain relief (visual analogue scale), attainment of physical therapy goals and cardiopulmonary complications were measured daily for 7 days. Epidural analgesia with a combination of bupivacaine and fentanyl did not result in any measurable improvement in rehabilitation milestones or reduction in postoperative complications following bilateral total knee arthroplasty than with fentanyl infusions alone.

A tool for measuring functional outcomes after total hip arthroplasty

PURPOSE

To describe a functional milestone scale (FMS) for measuring functional progression following total hip arthroplasty and to demonstrate that this scale meets accepted standards of scale construction.

METHODS

Inter-observer reliability of the scale was determined for 30 patients using a kappa coefficient of concordance (k) for ordinal data, representing 221 pairs of observations. There were 79, 54, 44, and 44 pairs of observations for transfer, walker, crutch, and stair ambulation, respectively.

RESULTS

The k coefficient ranged from 0.82 to 0.91. Agreement between therapists was almost perfect according to the criteria of Feinstein.

CONCLUSIONS

The FMS exhibits substantial inter-observer reliability and moderate to substantial validity. We have demonstrated its clinical applications as well as showing it to be a useful management and research tool.

[Ultrasound microscopy findings of artificial lenses]

Acoustic microscopy permits a native, nondestructive and artefact-free analysis of the surface of intraocular lenses with regard to manufacturing defects, biologic cellular and membranaceous layers, and signs of degradation. Furthermore, it enables structures below the surface to be evaluated, so that inclusions, pores, microcracks and zones of deformation can be detected. In addition to performance of a one-dimensional, relative intensity profile of the surface and the corresponding pseudo-3D image, the properties of the materials inside the intraocular lens can be characterized by computerized analysis of the reflected ultrasound energy.