Diamond burs versus curettes in root planing: a randomized clinical trial

BACKGROUND

This study compares diamond burs and curettes by clinical, microbiological, biochemical and scanning electron microscopic parameters and treatment time data in the non-surgical periodontal treatment of patients with chronic periodontitis.

METHODS

Two quadrants of each of the 12 patients received root planing with diamond burs, whereas the other two quadrants were treated with curettes. Clinical periodontal measurements were recorded at baseline and then 1, 3 and 6 months after completion of non-surgical periodontal treatment. Subgingival plaque and gingival crevicular fluid samples were obtained at baseline and 1-month control. Twenty-one hopeless teeth received root planing with diamond burs or curettes or no treatment and then extracted for microscopic evaluations.

RESULTS

Clinical periodontal parameters improved similarly with both treatment modalities. Microbiological analyses revealed similar findings for the bacterial load (16S gene copy numbers) and ratio of each bacterium to the total bacterial count at baseline and 1-month control. Cytokine levels in the gingival crevicular fluid samples exhibited differences between the two treatments. Scanning electron microscopic analyses indicated that diamond burs were better in terms of calculus removal and loss of tooth substance indices but roughness index values were better for curettes.

CONCLUSIONS

Diamond burs provide findings comparable with curettes in root planing.

Adsorption of As(V) from water using Mg-Fe-based hydrotalcite (FeHT)

This paper describes a study of the sorptive removal of arsenate (As(V)) from aqueous solutions by synthetically prepared Mg-Fe-based hydrotalcites (FeHT) as layered double hydroxide (LDH) adsorbents. The synthesis of Fe(3+)-substituted hydrotalcites (FeHT) with the chemical formula [Mg(II)(6)Fe(III)(2)(OH)(16)](2+)[CO(3)xyH(2)O](2-) was achieved by a co-precipitation method. The reaction products were characterized by powder X-ray diffraction analysis. The influences of solution pH, initial arsenate (As(V)) concentration, and sorbent concentration were investigated in multiple kinetic runs. The adsorption rates and isotherms were investigated in batch experiments. The pseudo-first-order and second-order kinetic models were tested and the latter was found to fit better to the experimental data. Langmuir and Freundlich isotherms were used to describe the adsorption data from equilibrium experiments. The results have shown that FeHT has a high arsenate removal efficiency, with the ability to reduce the concentration of arsenate in the aqueous solution from an initial value of 330 microg/l to <10 microg/l (i.e. below the limit value specified by WHO).

Potential use of pyrite cinders as raw material in cement production: results of industrial scale trial operations

Pyrite cinders, which are the waste products of sulphuric acid manufacturing plants, contain hazardous heavy metals with potential environmental risks for disposal. In this study, the potential use of pyrite cinders (PyCs) as iron source in the production of Portland cement clinker was demonstrated at the industrial scale. The chemical and mineralogical analyses of the PyC sample used in this study have revealed that it is essentially a suitable raw material for use as iron source since it contains >87% Fe(2)O(3) mainly in the form of hematite (Fe(2)O(3)) and magnetite (Fe(3)O(4)). The samples of the clinkers produced from PyC in the industrial scale trial operation of 6 months were tested for the conformity of their chemical composition and the physico-mechanical performance of the resultant cement products. The data were compared with the clinker products of the iron ore, which is used as the raw material for the production Portland cement clinker in the plant. The chemical compositions of all the clinker products of PyC appeared to conform to those of the iron ore clinker, and hence, a Portland cement clinker. The mechanical performance of the mortars prepared from the PyC clinker was found to be consistent with those of the industrial cements e.g. CEM I type cements. It can be inferred from the leachability tests (TCLP and SPLP) that PyC could be a potential source of heavy metal pollution while the mortar samples obtained from the PyC clinkers present no environmental problems. These findings suggest that the waste pyrite cinders can be readily used as iron source for the production of Portland cement. The availability of PyC in large quantities at low cost provides further significant benefits for the management/environmental practices of these wastes and for the reduction of mining and processing costs of cement raw materials.

Repaglinide in the management of new-onset diabetes mellitus after renal transplantation

The purpose of this study was to investigate the use of the short-acting insulin secretion drug repaglinide in new-onset diabetes mellitus (NODM) after renal transplantation. Twenty-three Caucasian patients with NODM after renal transplantation were selected to receive repaglinide therapy and were followed for at least 6 months. A control group treated with rosiglitazone was chosen for comparison. Successful repaglinide treatment was defined as a significant improvement of blood glucose concentrations and HbA1c <7% in the absence of glucosuria and without the need for the addition of further anti-diabetic agents. After 6 months of treatment with repaglinide, 14 of the 23 patients were successfully treated. Mean HbA1c decreased from 7.6 +/- 0.6% to 5.8 +/- 0.6% in 14 patients treated successfully. In nine patients, hyperglycemia persisted, and they were switched to insulin treatment (HbA1c 8.5 +/- 2.9% at the beginning to 7.4 +/- 2.2%). Mean serum creatinine levels, cyclosporine A and tacrolimus blood levels did not change significantly following institution of repaglinide therapy. The rate of successful treatment and the degree of HbA1c decrease were similar compared to rosiglitazone-treated control patients. The data from our observational study indicate that repaglinide can be an effective treatment option in Caucasian patients with NODM after renal transplantation.

The prevalence of familial Mediterranean fever in the Turkish province of Denizli: a field study with a zero patient design

OBJECTIVE

This study had two aims: (1) to investigate the prevalence of familial Mediterranean fever (FMF) and Behçet's disease (BD) in school students in Denizli, a province in western Turkey; and (2) to determine whether the previously suggested "zero patient design" was reliable for use in a prevalence survey.

METHODS

The field survey was performed in two stages. In the first stage 7,389 students (3,847 females and 3,542 males) were asked to fill out a questionnaire in the classroom. In the questionnaire, filtering questions for FMF (the presence of recurrent attacks of fever accompanying abdominal pain, joint pain/swelling, and/or chest pain) and BD (presence of aphthous stomatatis) were asked. The second stage consisted of two parts. In the first, 3225 questionnaires were completed by 1778 female and 1447 male students calculated according to the zero patient design, who were selected randomly from among 7389 students for evaluation. Students with any suspicion of FMF and Behçet's disease were called to the hospital for detailed investigation. In the second step the remaining students were evaluated.

RESULTS

Out of 3225 children questioned in the first step, 156 claimed recurrent abdominal pain and/or chest pain, and/or joint pain/swelling with accompanying fever, which might suggest the presence of FMF However, this diagnosis was excluded after further clinical evaluation. In the second step 152 students were called for detailed investigation: 2 patients, one 10 years and the other 12 years old, were diagnosed as having FMF. None were diagnosed to have Behçet's disease.

CONCLUSION

The prevalence of FMF in Turkey in general is about 0.093%. The prevalence rate found in this survey was lower (0.027%) which may be due to the historic background of the region. This is the first study that has shown that the "zero patient design" can be used in an epidemiological survey.

Comparison of modified Teuscher and van Beek functional appliance therapies in high-angle cases

The aim of this study was to investigate the effects of modified Teuscher and van Beek functional appliances on the skeletal and dento-alveolar pattern in high-angle Class II, Division 1 patients. The collective consisted of 32 patients with a high-angle Class II, Division 1 malocclusion. The modified Teuscher activator was applied to a group of twelve patients, and the van Beek activator to a group of ten patients. A control group of ten subjects was used for comparison purposes. The mean chronological ages of the groups were 12, 11.8 and 11.5 years, respectively. 64 cephalograms taken before and after the treatment were evaluated. Intra-group measurement relations were determined by the Wilcoxon test, and inter-group relations by analysis of variance and Duncan tests, using SPSS statistical software. The following results were observed for both treated groups without any change in growth direction: inhibition of maxillary growth, stimulation of mandibular growth, retrusion of upper incisors, distal tipping of upper molars, and reduction of overjet and overbite compared with the control group. The decrease in overbite in the van Beek group was due mainly to intrusion of the incisors, and in the modified Teuscher group to molar extrusion. Both activators were considered preferable in terms of vertical control of the facial height in high-angle cases with deep overbite. However, stimulation of mandibular growth in the modified Teuscher activator group was found to be more significant than in the van Beek activator group.

Effect of papaverine applications on blood flow of the internal mammary artery

The aim of this prospective study was to compare the effect of different papaverine applications on the free blood flow in the internal mammary artery (IMA) prepared for coronary artery bypass grafting (CABG). The patients were divided into three groups: group I (n=50; intraluminal papaverine application), group II (n=50; topical papaverine application), and group III (n=50; periarterial papaverine application). The free flow from the distal cut end of the IMA was measured under controlled hemodynamic conditions (Flow 1). Just before the establishment of cardiopulmonary bypass, the flows of the IMA were measured again (Flow 2). The mean blood flow in the IMA was 60.7+/-6.0 ml/min before papaverine application. After papaverine application, the mean blood flow in group I was 129.3+/-10.0 ml/min, in group II, it was 87.7+/-3.8 ml/min, and in group III, it was 130.6+/-9.2 ml/min (p<0.0001). Proportional increases in blood flow observed in group I (106.3%) and group III (116.2%) were higher than in group II (44.2%) (p<0.0001). Consequently, to relieve perioperative spasm of the IMA, application of papaverine injected into the periarterial tissues of its pedicle was considered to be a safe and effective alternative to topical or intraluminal application.

Premarital screening of beta-thalassemia trait in the province of Denizli, Turkey

A premarital screening program aiming at reducing the incidence of thalassemia major was started under the auspices of the Regional Health Administration in 1995 in the city of Denizli in the Aegean region of Turkey. In this report we assessed the 4-year results of the screening program. All couples who applied for marriage procedures were screened for beta-thalassemia trait by automatic red cell indices and Hb A(2) determination. The couples at risk were counseled and offered prenatal diagnosis and termination of pregnancy in case of an affected fetus. From October 1995 to August 1999, a total of 19,804 subjects (9,902 couples) were recruited for this study. The prevalence of beta-thalassemia trait with increased Hb A(2) was found to be 2.6% (514/19,804). In addition to the thalassemia trait, 22 patients (0.11%) had sickle trait. In 15 of the 9,902 couples, both partners were found to be carriers of the beta-thalassemia trait. After genetic counseling, 2 of the 15 planned carrier marriages were canceled. Seven couples declared that they do not want to have a child at present. Prenatal diagnosis was sought by 6 couples. One fetus was found to be normal, 4 had thalassemia minor and 1 had thalassemia major; this pregnancy was terminated by elective abortion. This study indicated that premarital screening is a very useful tool for detecting carrier couples and an effective way of controlling thalassemia major.

Blink reflex in hyperthyroidism

Although there are studies regarding the effects of thyroid hormones on some neurologic reflexes, literature lacks knowledge of the effects of thyroid hormones on blink reflex circuits. To understand the behaviour of excess thyroid hormone on this circuit that involves synapses in brainstem, we studied electrically elicited blink reflexes of 7 patients with hyperthyroidism, 8 patients with hyperthyroidism who were under therapy and 14 volunteers as control by electroneuromyograph. Mean values of the latencies and amplitudes of the R1 and R2 responses were not statistically different between groups, while the duration of R2 response and controlateral R2 response were found shorter in patients with hyperthyroidism comparing to the patients under therapy and controls. We have thought that these findings might reflect the inhibitor effect of the excess thyroid hormone on polysynaptic reflex arc of the blink response.

[Value of multiplanar reformations (MPR)in multi-slice spiral CT of the lung]

PURPOSE

To evaluate the quality of multiplanar reformations (MPR) of multidetector spiral-CT (MD-CT) data sets of the chest based on anatomic criteria.

METHODS

90 patients with suspected or known diseases of the lung parenchyma underwent thoracic MD-CT with 1-mm collimation. Axial scans were reconstructed with 1-mm slice width and 0.6-mm reconstruction increment. Coronal and sagittal MPRs were reconstructed with 3, 5 and 8 mm thickness from the axial scans. Three blinded readers rated image quality based on several anatomic criteria and the presence of different artifacts using a 5-point scale. The scores for MPRs were compared with those of 5-mm thick axial scans.

RESULTS

All anatomical structure were equally well depicted on MPRs as on axial scans with very good interobserver correlation (kappa 0.69-0.76). Only the lung parenchyma directly adjacent to the heart and the great vessels were visualized with limited quality due to cardiac pulsation artifacts. Advantages of sagittal MPRs include the sharper delineation of interlobar fissures and thus improved anatomic localization of a lesion. Coronal reformations also offer improved anatomic orientation in comparison with 5-mm axial scans. A slice thickness of 5 mm for MPRs yielded best results.

CONCLUSIONS

MPRs allow an unrestricted assessment of the lung. Sagittal and coronal reformations improve the topographical visualization of chest anatomy.

The retraction of upper incisors with the PG retraction system

The aim of this study was to evaluate the effect on the dentoalveolar structures of the application of PG springs for retraction of upper incisors and to compare the outcome with the effect of a closed coil spring retraction system. Thirty-six subjects with Angle Class I or Class II malocclusions were selected for the study. Each subject had the two upper first premolars extracted and presented a symmetrical extraction space of at least 3 mm distal to the lateral incisors after canine retraction. The subjects were divided into two groups, the PG group with 17 subjects and the coil group with 19 patients. One group had the incisors retracted by PG universal retraction springs, whereas in the other a closed coil spring system was used. The average chronological ages were 18 years 4 months for the PG group, and 18 years 7 months for the coil group. In both groups the springs were activated to produce an initial force of 150 g per side. To examine the type of movement of the anterior and posterior teeth, and the time and rate of space closure, 20 parameters were measured and evaluated statistically with Wilcoxon and Mann-Whitney U-tests. In both groups the incisor retraction was accompanied by mesial movement of the buccal segments. Distal movement of the root apex of the incisors was observed in both groups, although more pronounced in the PG group (P < 0.01). A significant incisor intrusion resulting in a decrease in overbite was found in the PG group, whereas the deep bite increased significantly in the coil spring group. The PG spring produced a three-dimensional control in the movement of the upper incisors, so that application of additional intrusive mechanics after completion of the incisor retraction became unnecessary.

Congenital aortic insufficiency due to aortic cusp stretching: 'kite anomaly'

Aortic insufficiency may be either acquired or congenital. A 46-year-old male had a congenital pathology which resulted in aortic insufficiency due to the presence of a fibrous band that stretched from the non-coronary cusp to the aortic wall. The patient underwent successful aortic valve replacement. At surgery, the fibrous band was stretching the non-coronary cusp so that it prevented coaptation of the aortic valve. The situation was termed by us as the 'kite anomaly'.

The effects of cervical headgear on dentofacial structures

A study was made on the effects of cervical headgear on dentofacial structures, especially non-erupted teeth, in the early and late mixed dentition periods. Pretreatment and post-treatment cephalometric evaluation was done on 8 patients in the early mixed dentition period and 10 patients in the late mixed dentition period. The results showed that any reference line passing through Ptm point should not be used to evaluate the efficiency of cervical headgear, and that such headgear is more effective on non-erupted teeth in early mixed dentition.