不同粘接剂间隙对CAD/CAM嵌体边缘适应性的影响

目的 探讨不同粘接剂间隙对CAD/CAM嵌体氧化锆粘接强度的影响.方法 选取因正畸需要拔除的第一前磨牙30颗作为本研究对象,依照设置粘接剂间隙参数不同分为10μm(A组)、30μm(B组)、50μm(C组)制作嵌体;用轻体型硅橡胶复制边缘间隙,体视显微镜测量边缘间隙的厚度,使用SPSS13.0软件包对数据进行分析.结果 所有瓷嵌体均可顺利就位,测量数据均小于120μm,A组肩台间隙明显低于B组及C组(P<0.05),且B组轴面显著低于C组(P<0.05).结论 在粘接间隙设定为10~50μm时,CEREC制作瓷嵌体均可取得满意效果.     

All-ceramic systems: laboratory and clinical performance

Several all-ceramic systems have been developed in dentistry to meet the increased expectations of patients and dentists for highly aesthetic, biocompatible, and long-lasting restorations. However, early bulk fractures or chippings have led the research community to investigate the mechanical performance of the all-ceramic systems. This overview explores the current knowledge of monolithic and bilayer dental all-ceramic systems, addressing composition and processing mechanisms, laboratory and clinical performance, and possible future trends for all-ceramic materials.     

Congenital hydrocephalus in clinical practice: a genetic diagnostic approach

Congenital hydrocephalus is a common and often disabling disorder. The etiology is very heterogeneous. Little is known about the genetic causes of congenital hydrocephalus.A retrospective survey was performed including patients with primary congenital hydrocephalus referred to the Department of Clinical Genetics between 1985 and 2010 by perinatologists, (child) neurologists or pediatricians. Patients with hydrocephalus secondary to other pathology were excluded from this survey. We classified patients with primary congenital hydrocephalus into two main groups: non-syndromic hydrocephalus (NSH) and syndromic hydrocephalus (SH). Seventy-five individuals met the inclusion criteria, comprising 36% (27/75) NSH and 64% (48/75) SH. In 11% (8/75) hydrocephalus was familial. The cause of hydrocephalus was unknown in 81% (61/75), including all patients with NSH. The male–female ratio in this subgroup was 2.6:1, indicating an X-linked factor other than the L1CAM gene. In the group of SH patients, 29% (14/48) had a known cause of hydrocephalus including chromosomal abnormalities, L1 syndrome, Marden–Walker syndrome, Walker–Warburg syndrome and hemifacial microsomia.We performed this survey in order to evaluate current knowledge on the genetic etiology of primary congenital hydrocephalus and to identify new candidate genes or regulatory pathways for congenital hydrocephalus. Recommendations were made concerning the evaluation and genetic workup of patients with primary congenital hydrocephalus. We conclude that further molecular and functional analysis is needed to identify new genetic forms of congenital hydrocephalus.     

Computer-aided analysis of the influence of digitizing and surfacing on the accuracy in dental CAD/CAM technology

In dentistry, ceramic materials with high fracture resistance are needed for all-ceramic fixed partial dentures (FPDs). The sophisticated processing of advanced ceramics that can be used for such dental restorations demands the application of CAD/CAM technologies. These techniques necessitate digitizing of the prepared teeth or the planned restoration itself and surfacing of the acquired digital data before milling paths can be generated. As precision in fit is crucial for dental restorations, a computer-aided method for the quantitative and qualitative 3D analysis has been developed and applied. Factors influencing the obtainable precision in the application of CAD/CAM techniques were taken into consideration.     

A Community of Healing: Psychosocial Functions of Integrative Medicine Perceived by Oncology Patients/Survivors,Healthcare Professionals,and CAM Providers

ObjectiveA whole systems research approach was used to explore the psychosocial functions attributed to an Integrative Medicine oncology program. Field research was conducted at a cancer clinic to answer the following questions: (1) what meanings do the participants attribute to the Integrative Medicine oncology program; (2) what contributes to sustaining the Integrative Medicine program; and (3) what role does the Integrative Medicine program play in the lives of the participants.MethodsParticipant observation and in-depth interviews were conducted at a community-based cancer clinic that offers various complementary modalities along with conventional cancer treatments.ParticipantsThe data were obtained from a total of 23 participants including cancer patients/survivors, caregivers, volunteers who provided the complementary therapies, and healthcare professionals at the clinic.ResultsResults indicated that the Integrative Medicine program had three major psychosocial functions for those involved. Participants viewed the Integrative Medicine program as a place (1) to exchange health/medical information and learn from others' experiences and expertise, (2) to give and receive emotional support, and (3) for the individual to act on his/her transformed new identity and new life goals through serving others.ConclusionsThe results illustrate the positive psychosocial impacts an Integrative Medicine program may bring to individuals involved in it and suggest the value of using a whole systems research (WSR) approach to Integrative Medicine research.     

Attenuated expression of interferon-β and interferon-λ1 by human alternatively activated macrophages

Macrophages can be polarized into classically (CAM) or alternatively (AAM) activated macrophages with IFN-γ or IL-4, respectively. CAM are associated with type 1 immune responses and are implicated in autoimmunity; AAM are associated with type 2 responses and are implicated in allergic diseases. An impediment in investigating macrophage biology using primary human monocyte derived macrophages is the wide inter-donor heterogeneity and the limited quantity of cells that survive in vitro polarization. To overcome this impediment, we established a protocol to generate CAM and AAM cultures derived from the THP-1 human promonocytic cell line. In this report, we demonstrate that THP-CAM and -AAM express gene and protein markers that define their primary human monocyte derived counterparts, such as IL-1β, CXCL10, and CXCL11 for CAM, and MRC1, IL-4 and CCL22 for AAM. In addition, we demonstrate that STAT6 is selectively activated in THP-AAM which, upon LPS stimulation, have an attenuated or delayed expression of IFN-β, IFN-λ1, and IFN α/β pathway genes compared to their CAM counterparts. Taken together, these findings may help further investigate human diseases associated with the alternatively activated macrophage phenotype using this reproducible in vitro macrophage model.     

Custom CAD/CAM implants for complex craniofacial reconstruction in children: Our experience based on 136 cases✰

Background

CAD-CAM patient-specific implants offer cerebral protection and improved facial balance without the disadvantages of autologous bone grafting such as donor site morbidity and unpredictable resorption. Several alloplastic materials are available, but titanium, polymethylmethacrylate (PMMA), and polyetheretherketone (PEEK) are the current popular choices. We reviewed our experience of applying different alloplastic CAD-CAM materials in the reconstruction of complex pediatric craniofacial deformities.

A technique for intraoperative creation of patient-specific titanium mesh implants

Prefabricated, patient-specific alloplastic implants for cranioplasty reduce surgical complexity, decrease operative times, minimize exposure and risk of contamination, and have resulted in improved aesthetic results. However, in creating a prefabricated custom implant using a patient’s computed tomography data, a stable, unalterable defect must be clearly defined before surgery. In the event that an intraoperative modification of an exiting skull defect is required, or in cases of tumour resection in which the size of the skull defect is unknown preoperatively, these prefabricated implants cannot be used. The ideal method for alloplastic cranioplasty would enable cost-effective creation of a patient-specific implant with the capacity for intraoperative modification.The present article describes a novel technique of cranioplasty that uses a patient’s computed tomography data to create a custom forming tool (ie, mold), enabling intraoperative creation of a patient-specific titanium mesh implant. The utility of these implants in creating a custom reconstructive solution in cases in which the size of the skull defect is unknown preoperatively will be demonstrated using two case presentations.