Early Wound Healing Score: a system to evaluate the early healing of periodontal soft tissue wounds

Purpose: Numerous indices have been proposed to analyse wound healing in oral soft tissues, but each has specific shortcomings. A new method of analysis, the Early Wound Healing Score (EHS), was evaluated in the present study. The aim was to assess more accurately early healing by primary intention of surgical incisions in periodontal soft tissues. Methods: Twenty-one patients were treated with different surgical procedures comprising 1 or 2 vertical releasing incisions as part of a surgical access flap. Twenty-four hours after surgery, early wound healing at the vertical releasing incisions was assessed using the EHS. This score assessed clinical signs of re-epithelialization (CSR), clinical signs of haemostasis (CSH), and clinical signs of inflammation (CSI). Since complete wound epithelialization was the main outcome, the CSR score was weighted to be 60% of the total final score. Accordingly, a score of 0, 3, or 6 points was possible for the assessment of CSR, whereas scores of 0, 1, or 2 points were possible for CSH and CSI. Higher values indicated better healing. Accordingly, the score for ideal early wound healing was 10. Results: Thirty vertical releasing incisions were assessed in 21 patients. At 24 hours after incision, 16 vertical releasing incisions (53.33%) received the maximum score of CSR, while 6 cases (20%) received an EHS of 10. None of the cases received 0 points. Conclusion: The EHS system may be a useful tool for assessing early wound healing in periodontal soft tissue by primary intention after surgery

Hierarchic plate and shell models based on p-extension

Formulations of finite element models for beams, arches, plates and shells based on the principle of virtual work was studied. The focus is on computer implementation of hierarchic sequences of finite element models suitable for numerical solution of a large variety of practical problems which may concurrently contain thin and thick plates and shells, stiffeners, and regions where three dimensional representation is required. The approximate solutions corresponding to the hierarchic sequence of models converge to the exact solution of the fully three dimensional model. The stopping criterion is based on: (1) estimation of the relative error in energy norm; (2) equilibrium tests, and (3) observation of the convergence of quantities of interest

Current management of dentin hypersensitivity

Objectives: The aim of the article was to present an overview of the management strategies of dentin hypersensitivity (DHS) and summarize and discuss the therapeutic options. Materials and methods: A PubMed literature search was conducted to identify articles dealing with dentin hypersensitivity prophylaxis and treatment. We focussed on meta-analyses of available or controlled clinical trials. Results: DHS therapy should start with noninvasive individual prophylactic home-care approaches. In-office therapy follows with nerve desensitizing, precipitating, or plugging agents. If the hypersensitivity persists, depending on the hard and soft tissue components at reevaluation, i.e., presence or absence of cervical lesions and the gingival contour, adhesive restorations including sealing or mucogingival surgery may be an option. They allow for the establishment of a physicomechanical barrier. As the placebo effect may play an important role, adequate patient management strategies and positive reinforcement may improve the management of DHS in the future. Conclusions: Lifelong maintenance under the premise of strict control of the causative factors is crucial in the management of DHS. Clinical relevance: Clinicians are faced with a broad spectrum of therapeutic options. Therapy should not only focus on pain reduction or better elimination but also on the modification of the exposed cervical dentin area based on the defect typ

Biomolecular Coarse-Graining with Latent Variables

Molecular Dynamics (MD) is a computational microscope which enables the quantitative assessment of thermodynamic and dynamical behavior of chemical and biological systems. However, the spatiotemporal scales reachable via conventional MD render atomistic MD largely unable to appropriately probe biologically pertinent events computationally. Coarse-grained (CG) modeling expands these spatiotemporal scales through systematic elimination of atomistic degrees of freedom in favor of a CG molecular representation. Bottom-up CG modeling aims to develop an effective Hamiltonian which accurately recapitulates the statistical behavior of the CG degrees of freedom. In this work, bottom-up CG methods are developed and applied in a systematic manner to capture various aspects of lipid phase behavior. First, a general protocol for the development of CG lipid models which exhibit self-assembling behavior, the defining characteristic of amphiphiles, is developed. Second, we build upon this work to develop the first bottom-up CG models of simple lipid domains, i.e., ternary mixtures of bilayers in which cholesterol-induced phase separation is observed. We demonstrate a greater sampling efficiency for bottom-up CG models in comparison to top-down CG models. Third, we develop a machine-learning based virtual particle theory for CGing and demonstrate its utility in capturing solvent-mediated behavior, namely the membrane bending modulus, in implicit solvent models of lipid bilayers. Fourth, we develop an entropy-based approach for the variational optimization of ultra coarse-grained (UCG) ‘internal states’ as well as a relative entropy approach to UCG modeling. We apply these methods in tandem to develop a UCG model of a liquid-vapor interface as well as in capturing phase-coexistence in a ripple-phase bilayer. Lastly, we expand the bottom-up CG formalism to include bosonic and fermionic systems and establish the quantum analogue to the relative entropy principle of CGing and its semiclassical expansion

Integrating multiple evolutionary processes in models of captive breeding

Models of captive breeding tend to come in two varieties: one type examines the potential for different strategies to preserve genetic diversity, while the other considers the impacts of many evolutionary processes but uses a simple mating system. This study presents an individual-based, stochastic simulation model that seeks to combine aspects of drift, mutation, selection, and gene flow with a breeding protocol similar to that used by captive population managers. It also tests a model of genetic adaptation to captivity, in which alleles are selected for in captivity that are deleterious in the wild. Both captive and wild fitness values are calculated. Results show that adaptation occurs rapidly and can lead to significant decline in wild fitness compared to the founding population. The most serious threats to captive fitness are the sensitivity of the species to inbreeding and the relative contribution of lethal and mildly deleterious alleles

Investigating the contribution of the upper and lower lumbar spine, relative to hip motion, in everyday tasks

Background: It is commonplace for clinicians to measure range of motion (ROM) in the assessment of the lumbar spine. Traditional single 'joint' models afford measuring only a limited number of regions along the spine and may, therefore, over-simplify the description of movement. It remains to be determined if additional, useful information can be gleaned by considering the traditional 'lumbar region' as two regions. Objective: The aim of this study was to determine whether modelling the lumbar spine as two separate regions (i.e. upper and lower), yields a different understanding of spinal movement relative to hip motion, than a traditional single-joint model. This study is unique in adopting this approach to evaluate a range of everyday tasks. Method: Lumbar spine motion was measured both by being considered as a whole region (S1 to T12), and where the lumbar spine was modelled as two regions (the upper (L3-T12) and lower (S1-L3)). Results: A significant difference was evident between the relative contribution from the lower and upper spine across all movements, with the lower lumbar spine consistently contributing on average 63% of the total ROM. A significant difference was also evident between the whole lumbar spine-hip ratio, and the lower lumbar spine-hip ratio, for the movement of lifting only. The lower lumbar spine achieved greater velocity for all tasks, when compared to the upper lumbar spine. Conclusion: This study has consistently demonstrated differences in the contribution of the upper and lower spinal regions across a range of everyday tasks; hence, it would appear that greater focus should be given to performing more detailed assessments to fully appreciate spinal movement

Comparison of clinical parameters of peri-implantitis and parameters related to tissue macrophage sensitization on TiO2

Objective Dental implants show impressive survival and like rates, but peri-implantitis is a frequent inflammatory disease which affects the implant-surrounding tissues. While biofilms on the implant surface is considered its etiologic reason, several risk factors determine the pace of progression of peri-implant bone loss. Some risk factors are generally accepted while others are still unconfirmed and a matter of ongoing discussion. Among the latter, tissue macrophage sensitization on TiO$_{2}$ has gained scientific interest in recent years. The aim of the present case-control study was to test for potential associations between clinically manifest peri-implantitis and MS related parameters. Materials and methods In patients with implants affected by peri-implantitis in the test group and healthy implants in the control group clinical parameters (peri-implant pocket depths (PPD) and bleeding on probing (BOP) were measured. Samples of aMMP-8 were taken from the entrance of the peri-implant sulcus and bacterial samples were collected from the sulcus. Blood samples were obtained from the basilic vein to assess MA-related laboratory parameters. Potential correlations between clinical and laboratory parameters were tested by multiple regression (p < 0.05). Results No statistically significant correlations were found between clinical or bacteriological findings and laboratory parameters were found. Conclusions Based on the findings of this study elevated MA-related laboratory parameters do not appear to be linked to peri-implantitis. Clinical relevance Sensitization on TiO$_{2}$ is not associated with clinical symptoms of peri-implantitis

Hyaluronic acid as an adjunct to coronally advanced flap procedures for gingival recessions: a systematic review and meta-analysis of randomized clinical trials

: Previous systematic reviews have reported that coronally advanced flap (CAF) + connective tissue graft (CTG) are the gold standard in root coverage procedures (RCP). Nevertheless, adjunctive treatment with hyaluronic acid (HA) has been proposed to aim at improving clinical outcomes and reducing patient morbidity. The aim of this systematic review and meta-analysis is to compare the use of HA as an adjunctive treatment to CAF procedures in Miller class I and II (recession type 1; RT1) gingival recession (GR) defects treatment with no adjunctive/other treatments. MEDLINE, The Cochrane Central Register of Controlled Trials, Web of Science, Scopus databases and gray literature were searched up to April 2022. The primary outcome variables were mean recession coverage (MRC) and reduction of the recession depth (RecRed). Weighted mean differences and 95% confidence intervals between treatments were estimated using a random-effect mode. From 264 titles identified, 3 RCTs reporting 90 GR defects in 60 patients were included. Overall analysis of MRC and RecRed were 0.27% (p = 0.01) and 0.40 mm (p = 0.45) in favor of CAF + HA compared to CAF alone/CAF + subepithelial connective tissue graft (SCTG), respectively, with a statistically significant difference only for MRC values. Nevertheless, due to the limited number and heterogeneity of the included studies, well-performed RCTs are needed to clarify a potential advantage of HA in RCPs in the future

National profile of foot orthotic provision in the United Kingdom, part 2 : podiatrist, orthotist and physiotherapy practices.

Background A national survey recently provided the first description of foot orthotic provision in the United Kingdom. This article aims to profile and compare the foot orthoses practice of podiatrists, orthotists and physiotherapists within the current provision. Method Quantitative data were collected from podiatrists, orthotists and physiotherapists via an online questionnaire. The topics, questions and answers were developed through a series of pilot phases. The professions were targeted through electronic and printed materials advertising the survey. Data were captured over a 10 month period in 2016. Differences between professions were investigated using Chi squared and Fischer’s exact tests, and regression analysis was used to predict the likelihood of each aspect of practice in each of the three professions. Results Responses from 357 podiatrists, 93 orthotists and 49 physiotherapists were included in the analysis. The results reveal statistically significant differences in employment and clinical arrangements, the clinical populations treated, and the nature and volume of foot orthoses caseload. Conclusion Podiatrists, orthotists and physiotherapists provide foot orthoses to important clinical populations in both a prevention and treatment capacity. Their working context, scope of practice and mix of clinical caseload differs significantly, although there are areas of overlap. Addressing variations in practice could align this collective workforce to national allied health policy