Anterior crowns & porcelain laminate veneers: a conservative approach

The final results of this case were pleasing to the patient and the dentist (Fig.5). The diastemas had been closed (Fig. 6), and the bioesthetic symmetry and harmony had been restored (Fig. 7). The patient reported an increase in self confidence with his peers and professors, especially during assignments both at work and at the university. (Fig. 8) I want to especially thank Felipe Don Sanders, C.D.T. for his skill in producing the excellent laboratory work for this case.     

Technique for realistic anterior crowns using the IPS Empress porcelain system

Modern notions on the morphology and function of the epithelial barrier of the buccal mucosa are discussed. The basis of this barrier is the epithelial layer, partially covered with horny layer, of a regular thickness and permeability, constantly regenerating, and casting off the injured superficial layers. Nonspecific antibacterial humoral factors (produced by the epithelium and salivary glands) play an important role in the barrier mechanisms, as well as nonspecific cellular mechanisms of defense, due to the presence of intraepithelial granulocytes and monocytes, specific immune humoral and cellular mechanisms including the system of antigen-presenting dendrite cells and lymphocytes, and flow of the saliva containing nonspecific and specific antibacterial factors. The barrier function of the epithelium is provided for by constant interactions between various specific and nonspecific cellular and humoral defense mechanisms.     

The use of resin-bonded porcelain crowns for primary molars in infra-occlusion

Infra-occluded primary molars without permanent successors may require restorative treatment to maintain occlusal stability and periodontal health in addition to creating an aesthetic result. This paper describes the use of two resin-bonded porcelain crowns to provide a simple, minimally invasive technique using a material with good wear resistance and high strength to create an aesthetic and functional occlusion.     

实现等向锻造的水平V型锥面砧锻造法

针对水平Ⅴ型锥面砧拔长矩形截面坯料建立了力学模型,并进行了定性物理模拟实验与生产性实验.研究结果表明,水平V型锥面砧不仅可以实现变形均匀的无横向拉应力锻造,而且提高了轴类锻件的横向力学性能,实现了大型轴类锻件的等向锻造,同部位力学性能值的横纵向之比均约等于1.00.     

Restoration of primary anterior teeth with composite crowns

For children with extensive caries of primary teeth, or with deformed or traumatised teeth, restoration with composite using a crown form gives excellent results. Strength is gained by full crown coverage. The aesthetics are very acceptable. The technique also allows primary teeth to be modified to resemble permanent teeth when these are missing and the primary teeth are being kept until more definitive treatment is provided. Caries is usually well controlled, and space loss due to further tooth breakdown is avoided.     

Repair of Cerec porcelain with seven different systems

Intra-oral repair of fractured porcelain is a challenging clinical necessity, because time, economics, as well as possible trauma to teeth, often contra-indicate replacement of the original restoration. The purpose of this study was to evaluate the bond strength of seven different porcelain repair systems used in combination with Cerec Vitablocs Mark II porcelain. The systems were Scotchbond Multi-Purpose (SMP), All-Bond 2 (AB), Optibond (OB), C&B Metabond (CB), Imperva Bond (IB), Silistor (S) and Mirage Bond (MB). When Mirage Bond was used, the porcelain was either etched with 9.6 percent hydrofluoric acid for 2 min (10 specimens = MB1) or with 4 percent APF gel for 2 min (10 specimens = MB2). The shear bond strengths (SBS) of all the products were determined using an Instron. The effects of the pretreatments on the porcelain with different systems were also examined in a SEM. Data were statistically analysed (Wilcoxon Sum of Rank Test). The mean SBS (MPa) of the products were: SMP = 22.6 +/- 6.5; AB = 17.1 +/- 4.1; OB = 17.1 +/- 2.3; CB = 25.8 +/- 4.2; IB = 18.3 +/- 5.2; S = 16.4 +/- 3.7; MB1 = 13.1 +/- 3.9 and MB2 = 6 +/- 2.1. CB and SMP were significantly stronger (p < 0.05) than all other products, with MB2 statistically weaker (p < 0.01) than the other groups. Most specimens showed cohesive fractures in the porcelain, except when MB was used with 4 percent APF gel, where all samples fractured at the adhesive interface. It can be concluded that all seven systems can be used to repair Cerec Porcelain, except possibly MB when used in conjunction with 4 percent APF etchant.     

Microleakage of dentin-bonded crowns placed with different luting materials

This review defines the term "compound allergy" in the context of new findings, and discusses evidence that allergenic reaction products have been identified. Material was gathered by searching Index Medicus and the Science Citation Index, and reviewing several standard texts. Issues regarding the validity of patch test results are addressed and we introduce the term "pseudocompound allergy" to cover cases of false-negative patch tests. We present new theories regarding the mechanisms by which new allergens are formed and a means of classification.     

Masking severely tetracycline-stained teeth with ceramic laminate veneers

When the primary restorative objective is the reinstatement of vital natural tooth color, dark tetracycline-stained teeth still represent the ultimate challenge for ceramic laminate veneers. Masking severe stain with opaquing composite resins is a significant advancement; however, the procedure requires additional chairtime, is technique sensitive (to avoid excessive opacity), and involves removal of additional tooth structure. The learning objective of this article is to describe and compare two different methods for masking tetracycline-stained teeth. The article illustrates the natural tooth color derived from ceramic laminate veneers when bonded to opaque composite resins in the maxillary arch, and compares it to a new ceramic veneer formulation in the mandibular arch, which masks the stain, eliminates the need for subopaquing with composite resins, and resembles the qualities of natural tooth color.     

Mitral valve repair in a patient with severe porcelain aorta

We repaired the mitral valve in a patient with severe porcelain aorta. Significant mitral regurgitation developed in a 66-year-old woman with heavy calcification throughout the whole aorta. At operation, cardiopulmonary bypass was properly established by combined axillary and femoral arterial cannulations for sufficient systemic flow. Likewise, the combination of a superior mitral approach and profound hypothermic fibrillatory arrest in conjunction with low-flow cardiopulmonary bypass allowed us to repair the mitral valve successfully.     

80kA电解槽不停电修复铝母线的实践

介绍两端四点进电纵向排列槽的母线修复方案，经过应用，效果良好。     

Computerized cognitive training for severely emotionally disturbed children with ADHD

An experiment was conducted to investigate the influence of Captain's Log (a computerized cognitive-training system) on the behaviors and performance capabilities of 4 severely emotionally disturbed children with Attention Deficit Hyperactivity Disorder (ADHD), ages 7 to 11. Behavioral scales, spectral electroencephalograms, and intelligence and performance tests were assessed pre- and posttreatment. A behavioral point system and monitoring of progress on computer tasks were used throughout treatment to evaluate ongoing improvements. There were 64 training sessions administered over a 16-week period. Outcome of treatment was determined by computer advancement, changes in behavioral points, and pre- and postmeasures. Results support the expectation that children who were most successful in the training would demonstrate the highest levels of generalization of those skills that were the focus of treatment.     

Simultaneous communication with autistic and other severely dysfunctional nonverbal children

Despite its widespread application, the teaching of speech does not appear to be effective with all autistic and other severely dysfunctional, nonverbal children. A body of recent evidence points to the peculiarities in the information processing of these children and to the importance of gestures as aids or alternatives to speech. The present study reports on the use of simultaneous communication (gestures plus speech) with five such children. The fact that four of the five children showed marked gains in their ability to communicate over a 5-week period raises some theoretical and methodological issues pertinent to the treatment of autistic and autistic-like children and to our general understanding of the processes involved in nonverbal communication.     

Excess urate excretion correlates with severely acidic urine in patients with renal hypouricemia

OBJECTIVE: To evaluate how the extreme poverty of the patients and the poor salaries of the staff combined to increase the cost of treatment to patients within the subsidised national tuberculosis programme in Sierra Leone. DESIGN/SETTING: From September to December of 1994, semi-structured interviews were conducted with 72 patients and 17 staff of the National Leprosy and Tuberculosis Control Programme of Sierra Leone, a screening and treatment programme funded by international donors. RESULTS: Although some extra costs were indeed incurred within the subsidized national tuberculosis treatment programme, they were much lower than those incurred during the pre-programme period when the patients sought intermittent help from a wide range of traditional and biomedical sources within the plural healing continuum. The national politico-economic crisis, and the consequent poverty of most patients, impeded compliance with and sustainability of treatment, even within the formal subsidised treatment programme. CONCLUSIONS: More money was spent by patients on treatment in the months/years preceding entry into the national tuberculosis programme. Many factors retarded entry, including poor communications, misinformation, malpractice by health professionals, and displacement resulting from chronic internal warfare. The war intensified all factors that predispose to tuberculosis and retarded access to treatment. Supra-programme cost, or 'corruption,' was minimal due to the poverty of health professionals, with a few salient exceptions.     

Marginal gap of crowns made with a phosphate-bonded investment and accelerated casting method

BACKGROUND: Most patients undergoing in-hospital cardiac resuscitation will not survive to hospital discharge. OBJECTIVE: To derive a decision rule permitting the discontinuation of futile resuscitation attempts by identifying patients with no chance of surviving to hospital discharge. PATIENTS AND METHODS: Patient, arrest, and outcome data for 1077 adult patients undergoing in-hospital cardiac resuscitation was retrieved from 2 randomized clinical trials involving 5 teaching hospitals at 2 university centers. Recursive partitioning was used to identify a decision rule using variables significantly associated with death in hospital. RESULTS: One hundred three patients (9.6%) survived to hospital discharge. Death in hospital was significantly more likely if patients were older than 75 years (P<.001), the arrest was unwitnessed (P = .003), the resuscitation lasted longer than 10 minutes (P<.001), and the initial cardiac rhythm was not ventricular tachycardia or fibrillation (P<.001). All patients died if there was no pulse 10 minutes after the start of cardiopulmonary resuscitation, the initial cardiac rhythm was not ventricular tachycardia or fibrillation, and the arrest was not witnessed. As a resuscitation rule, these parameters identified all patients who survived to hospital discharge (sensitivity, 100%; 95% confidence interval, 97.1%-100%). Resuscitation could have been discontinued for 119 (12.1%) of 974 patients who did not survive, thereby avoiding 47 days of postresuscitative care. CONCLUSIONS: A practical and highly sensitive decision rule has been derived that identifies patients with no chance of surviving in-hospital cardiac arrest. Prospective validation of the rule is necessary before it can be used clinically.     

Restoring palatal tooth loss with composite resin, aided by increased vertical height

The Mini-Mental-State Examination (MMSE) is widely used as a screening tool for dementia in epidemiological studies. Its applicability in population-based studies is nevertheless limited by its low specificity. The effect of age and educational level have been usually ignored when cut-off scores have been selected. The aim of this study was to evaluate the effect of age and educational level on the MMSE scores in a representative sample of subjects older than 70 and provide adjusted normalised data according to these two variables, after excluding subjects with dementia or cognitive decline. Population-based, cross-sectional and longitudinal study of a representative cohort of 1367 subjects older than 70. All subjects with suspected dementia or cognitive decline received a neurological evaluation where clinical and etiological diagnosis were established. Normal MMSE scores, as defined by the 10th percentile, varied significantly across age and educational level groups. Exclusion of demented or cognitively declined patients from the reference population reduced the variability and "range of normality", but this remained excessively high in the older and less educated groups. The use of different cut-off points for each age and educational level groups may improve the specificity and applicability of the MMSE in population-based epidemiological studies. However, the wide amplitude of the range of normality suggests that different approaches, other than this vibariate analysis, may prove more adequate in the selection of cut-off scores for the MMSE.