The influence of dental loupes on the quality of adhesive removal in orthodontic debonding

Objective: Bracket bonding has been a major advance in orthodontic treatment. However, the method of debonding can lead to diverse problems such as enamel fractures, enamel loss and enamel scratching. In this clinical investigation we aimed to evaluate the influence of wearing dental loupes on enamel damage during the debonding procedure. Material and Methods: 22 consecutive patients were randomly assigned in a split-mouth study to evaluate adhesive removal with and without the use of dental loupes (2.5×, LED headlight). Tooth replicas in epoxy resin were made from silicone impressions. Electron microscopic images (50× magnification) of 394 buccal enamel surfaces were evaluated according to an enamel damage index (EDI), line angle grooves (LAG) and composite residues (CR) on anterior teeth, premolars and molars. Results: The EDI revealed highly significant advantages for debonding with dental loupes, with which the EDI was significantly higher for molars, while still less than without dental loupes. We detected no differences between the tooth groups without dental loupes. We found significantly fewer LAG on anterior teeth debonded with dental loupes. CR were fewer in the dental loupes group, and we noted no significant differences between the tooth groups. Conclusions: Dental loupes affect the quality of the debonding procedure, resulting in less enamel damage and composite residue, as well as fewer LAG compared to the control group. We therefore strongly recommend the use of dental loupes in orthodontic debonding procedure

Dentinogenesis imperfecta

Zusammenfassung: Unter Dentinogenesis imperfecta versteht man eine kongenitale Dysplasie des Dentins, die isoliert oder im Zusammenhang mit einer hereditären Allgemeinerkrankung wie der Osteogenesis imperfecta auftreten kann. Sie wird meist autosomal dominant vererbt und manifestiert sich klinisch in einer opaleszierenden Goldbraun- oder Graublauverfärbung der Zähne beider Dentitionen in variabler Ausprägung. Die verschiedenen Varianten der Dentinogenesis imperfecta werden nach Shields et al. (1973) in 3Gruppen eingeteilt: TypI, assoziiert mit Osteogenesis imperfecta; TypII, hereditär opaleszierendes Dentin; TypIII, Brandywine-Typ. Die Phänotypen der Dentinogenesis imperfecta werden in dem vorliegenden Beitrag hinsichtlich Gendefekt, klinischer Symptomatik, Radiologie und Histopathologie beschrieben, die zahnärztliche Behandlungsstrategie wird dargestell

Influence of damaging and wilting red clover on lipid metabolism during ensiling and in vitro rumen incubation

This paper describes the relationship between protein-bound phenols in red clover, induced by different degrees of damaging before wilting and varying wilting duration, and in silo lipid metabolism. The ultimate effect of these changes on rumen biohydrogenation is the second focus of this paper For this experiment, red clover, damaged to different degrees (not damaged (ND), crushing or frozen/thawing (FT)) before wilting (4 or 24 h) was ensiled. Different degrees of damaging and wilting duration lead to differences in polyphenol oxidase (PPO) activity, measured as increase in protein-bound phenols. Treatment effects on fatty acid (FA) content and composition, lipid fractions (free FAs, membrane lipids (ML) and neutral fraction) and lipolysis were further studied in the silage. In FT, red clover lipolysis was markedly lower in the first days after ensiling, but this largely disappeared after 60 days of ensiling, regardless of wilting duration. This suggests an inhibition of plant lipases in FT silages. After 60 days of ensiling no differences in lipid fractions could be found between any of the treatments and differences in lipolysis were caused by reduced FA proportions in ML of wilted FT red clover Fresh, wilted (24 h) after damaging (ND or FT) and ensiled (4 or 60 days; wilted 24 h; ND or FT) red clover were also incubated in rumen fluid to study the biohydrogenation of C18:3n-3 and C18:2n-6 in vitro. Silages (both 60 days and to a lower degree 4 days) showed a lower biohydrogenation compared with fresh and wilted forages, regardless of damaging. This suggests that lipids in ensiled red clover were more protected, but this protection was not enhanced by a higher amount of protein-bound phenols in wilted FT compared with ND red clover The reduction of rumen microbial biohydrogenation with duration of red clover ensiling seems in contrast to what is expected, namely a higher biohydrogenation when a higher amount of FFA is present. This merits further investigation in relation to strategies to activate PPO toward the embedding of lipids in phenol protein complexes

"Thunderstruck": Penetrating thoracic injury from lightning strike

Lightning strike victims are rarely presented at an emergency department. Burns are often the primary focus. This case report describes the improvised explosive device like-injury to the thorax due to lightning strike and its treatment, which has not been described prior in (kerauno)medicine. Penetrating injury due to blast from lightning strike is extremely rare. These shrapnel injuries should however be rule

On the discovery and development of tandem 1,4- and 1,2-addition of phosphites to 1-azadienes

Over the past 15 years we have developed a one-step protocol for the synthesis of 3-phosphonylated aminophosphonates from alpha,beta-unsaturated imines through tandem 1,4-1,2-phosphite addition. This account covers the initial development, mechanistic implications of using different phosphite nucleophiles and the expansion towards oximes, hydrazones and unsaturated imines included in aromatic sextets, e. g. quinolines, phenanthrolines and napthyridines

"The Practical Perforator Flap": the sural artery flap for lower extremity soft tissue reconstruction in wounds of war

Background: Sural artery perforator flaps have been described for use as both local flaps and in free tissue transfer. We present the use of this flap for compound soft tissue defects of the lower limb in civilian casualties of armed conflict in Afghanistan. Methods/results: Detailed description of the management of blast and high-velocity projectile wounds of the lower extremity with the use of local sural perforator flaps and a review of literature. Conclusions: Sural artery perforator flaps may be harvested to cover complex lower limb defects. The use of this technique is not limited

Prevalence and mortality of abdominal compartment syndrome in severely injured patients: A systematic review

BACKGROUND Abdominal compartment syndrome (ACS) in severely injured patients is associated with high morbidity and mortality. Many efforts have been made to improve outcome of patients with ACS. A treatment algorithm for ACS patients was introduced on January 1, 2005 by the World Society of the Abdominal Compartment Syndrome. The aim of this study was to determine the prevalence and mortality rate of ACS among severely injured patients before and after January 1, 2005 using a systematic literature review. METHOD Databases of Embase, Medline (OvidSP), Web of Science, CINAHL, CENTRAL, PubMed publisher, and Google Scholar were searched for terms related to severely injured patients and ACS. Original studies reporting ACS in trauma patients were considered eligible. Data on study design, population, definitions

Treatment of rectal war wounds

Treatment strategies for penetrating rectal injuries (PRI) in civilian settings are still not uniformly agreed, in part since high-energy transfer PRI, such as is frequently seen in military settings, are not taken into account. Here, we describe three cases of PRI, treated in a deployed combat environment, and outline the management strategies successfully employed. We also discuss the literature regarding PRI management. Whe

A systematic review on intra-abdominal pressure in severely burned patients

Objective Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are complications that may occur in severely burned patients. Evidenced based medicine for these patients is in its early development. The aim of this study was to provide an overview of literature regarding IAH and ACS in severely burned patients. Methods A systematic search was performed in Cochrane Central Register of Controlled Trials, PubMed, Embase, Web of Science and CINAHL on October 1, 2012. These databases were searched on 'burn', 'intra-abdominal hypertension', 'abdominal compartment syndrome', synonyms and abbreviations. Studies reporting original data on mortality, abdominal decompression or abdominal pressure related complications were included. Results Fifty publications met the criteria, reporting 1616 patients. The prevalence of ACS and IAH in severely burned patients is 4.1-16.6% and 64.7-74.5%, respectively. The mean mortality rate for ACS in burn patients is 74.8%. The use of plasma and hypertonic lactated resuscitation may prevent IAH or ACS. Despite colloids decrease resuscitation volume needs, no benefit in preventing IAH was proven. Escharotomy, peritoneal catheter drainage, and decompression laparotomy are effective intra-abdominal pressure (IAP) diminishing treatments in burn patients. Markers for IAP-related organ damage might be superior to IAP measurement itself. Conclusion ACS and IAH are frequently seen devastating complications in already severely injured burn patients. Prevention is challenging but can be achieved by improving fluid resuscitation strategies. Surgical decompression measures are effective and often unavoidable. Timing is essential since decompression should prevent progression to ACS rather than limit its effects. Prognosis of ACS remains poor, but options for care improvement are available in literature