Evaluation of Die Trim Morphology Made by CAD-CAM Technology

Statement of problem The die contour can affect the emergence profile of prosthetic restorations. However, little information is available regarding the congruency between a stereolithographic (SLA) die and its corresponding natural tooth. Purpose The purpose of this vitro study was to evaluate the shapes of SLA die in comparison with the subgingival contour of a prepared tooth to be restored with a ceramic crown. Material and methods Twenty extracted human teeth, 10 incisors, and 10 molars, were disinfected and mounted in a typodont model. The teeth were prepared for a ceramic restoration. Definitive impressions were made using an intraoral scanner from which 20 SLA casts with removable dies were fabricated. The removable dies and corresponding human teeth were digitized using a 3-dimensional desktop scanner and evaluated with computer-aided design software. The subgingival morphology with regard to angle, length, and volume at the buccolingual and mesiodistal surfaces and at zones A, B, C, and D were compared. Data were first analyzed with repeated measures analysis of variance (ANOVA), using locations (buccolingual and mesiodistal), zones (A, B, C, and D), and model type (SLA and Natural) as within-subject factors and tooth type (molar and incisor) as the between-subject factor. Post hoc analyses were performed to investigate the difference between natural teeth and corresponding SLA models, depending upon the interaction effect from the repeated measures ANOVA (α=.05). Results For angle analysis, the incisor group demonstrated a significant difference between the natural tooth and SLA die on the buccolingual surfaces (PPPPPP Conclusions For the comparison of angles, SLA dies did not replicate the subgingival contour of natural teeth on the buccolingual surfaces of the incisal groups. For the comparison of length and volume, SLA dies were more concave and did not replicate the subgingival contour of natural teeth in the incisal and molar groups

Comparison of The Kois Dento-Facial Analyzer System with an Earbow for Mounting a Maxillary Cast

Statement of problem: The Kois Dento-Facial Analyzer System (KDFA) is used by clinicians to mount maxillary casts and evaluate and treat patients. Limited information is available for understanding whether the KDFA should be considered as an alternative to an earbow. Purpose: The purpose of this study was to evaluate maxillary casts mounted using the KDFA with casts mounted using Panadent\u27s Pana-Mount Facebow (PMF). Both articulation methods were compared against a lateral cephalometric radiograph. Material and methods: Fifteen dried human skulls were used. Lateral cephalometric radiographs and 2 maxillary impressions were made of each skull. One cast from each skull was mounted on an articulator by means of the KDFA and the other by using the PMF. A standardized photograph of each articulation was made, and the distance from the articular center to the incisal edge position and the occlusal plane angle were measured. The distance from condylar center to the incisal edge and the occlusal plane angle were measured from cephalometric radiographs. Finally, the 3-dimensional position of each articulation was determined with a Panadent CPI-III. A randomized complete block design analysis of variance (RCBD) and post hoc tests (Tukey-Kramer HSD) (α=.05) were used to evaluate the occlusal plane angle and axis-central incisor distance. A paired 2-sample t test for means (α=.05) was used to compare the X, Y, and Z distance at the right and left condyle. Results: The KDFA and PMF mounted the maxillary cast in a position that was not statistically different from the skull when comparing the occlusal plane angle (P=.165). Both the KDFA and the PMF located the maxillary central incisor edge position in a significantly different position compared with the skull (P=.001) but were not significantly different from each other. The 3-dimensional location of the maxillary casts varied at the condyles by approximately 9 to 10.3 mm. Conclusion: The KDFA mounted the maxillary cast in a position that was not statistically different from the PMF when comparing the incisal edge position and the occlusal plane angle. Both the KDFA and the PMF located the maxillary incisal edge position in a significantly different position compared with the anatomic position on dried human skulls

Interplay of internal stresses, electric stresses and surface diffusion in polymer films

We investigate two destabilization mechanisms for elastic polymer films and put them into a general framework: first, instabilities due to in-plane stress and second due to an externally applied electric field normal to the film's free surface. As shown recently, polymer films are often stressed due to out-of-equilibrium fabrication processes as e.g. spin coating. Via an Asaro-Tiller-Grinfeld mechanism as known from solids, the system can decrease its energy by undulating its surface by surface diffusion of polymers and thereby relaxing stresses. On the other hand, application of an electric field is widely used experimentally to structure thin films: when the electric Maxwell surface stress overcomes surface tension and elastic restoring forces, the system undulates with a wavelength determined by the film thickness. We develop a theory taking into account both mechanisms simultaneously and discuss their interplay and the effects of the boundary conditions both at the substrate and the free surface.Comment: 14 pages, 7 figures, 1 tabl

Effective zero-thickness model for a conductive membrane driven by an electric field

The behavior of a conductive membrane in a static (DC) electric field is investigated theoretically. An effective zero-thickness model is constructed based on a Robin-type boundary condition for the electric potential at the membrane, originally developed for electrochemical systems. Within such a framework, corrections to the elastic moduli of the membrane are obtained, which arise from charge accumulation in the Debye layers due to capacitive effects and electric currents through the membrane and can lead to an undulation instability of the membrane. The fluid flow surrounding the membrane is also calculated, which clarifies issues regarding these flows sharing many similarities with flows produced by induced charge electro-osmosis (ICEO). Non-equilibrium steady states of the membrane and of the fluid can be effectively described by this method. It is both simpler, due to the zero thickness approximation which is widely used in the literature on fluid membranes, and more general than previous approaches. The predictions of this model are compared to recent experiments on supported membranes in an electric field.Comment: 14 pages, 5 figure

Transition of Experienced and New Graduate Nurses to a Pediatric Hospital

This study reports on the 3-, 6-, 12-, and 18-month outcomes of 118 newly hired registered nurses (RNs) who completed a 12-month transition-to-practice program at a pediatric hospital. Experienced RNs (n = 42) and new graduate RNs (n = 76) showed improved organization, prioritization, communication, and leadership skills over time. The experienced RNs reported better communication and leadership skills than the new graduate nurses. Results inform transition program development for both new and experienced nurses. The American Association of Colleges of Nursing (2012) predicts that, without a multifaceted approach, a national nursing shortage will occur by 2020. Many nurses leave their first position and sometimes the profession within the first year of employment (Baxter, 2010; Welding, 2011). Retaining nurses is a vital component of any approach to averting a nursing shortage. In an attempt to retain nurses, healthcare institutions often provide a transition-to-practice (TTP) or nurse residency program for new graduate nurses (NGN) entering the profession. The Institute of Medicine (2011) in its Future of Nursing report also recommends a transition program for nurses moving to a new specialty or to advanced practice roles. Completing a NGN transition program is associated with a decrease in nurse attrition by as much as 80% (Halfer, Graf, & Sullivan, 2008; Rush, Adamack, Gordon, Lilly, & Janke, 2013; Spector et al., 2015). This reported decrease has led to organizational interest in transition programs to improve retention. The goals of residency programs for the NGN have ranged from increasing new nurse confidence and competence, to increasing satisfaction and retention (Fink, Krugman, Casey, & Goode, 2008; Goode, Lynn, McElroy, Bednash, & Murray, 2013; Institute of Medicine, 2011; Spector et al., 2015). Although literature supports the effectiveness of transition programs for the NGN (Fink et al., 2008; Goode et al., 2013; Spector et al., 2015), there is little evidence on the experienced nurse’s transition to a new specialty practice. Furthermore, most transition programs do not report outcomes beyond the first 12 months of employment. Thus, the purpose of this study is to evaluate nurse stressors and supports during and after a 12-month transition-to-employment program for both new and experienced nurses transitioning to a pediatric practice

Dewetting of thin polymer films: Influence of interface evolution

The dewetting dynamics of ultrathin polymer films, e.g. in the model system of polystyrene on a polydimethylsiloxane-covered substrate, exhibits interesting behavior like a fast decay of the dewetting velocity and a maximum in the width of the built-up rim in the course of time. These features have been recently ascribed to the relaxation of residual stresses in the film that stem from the nonequilibrium preparation of the samples. Recent experiments by Coppee et al. on PS with low molecular weight, where such stresses could not be evidenced, showed however similar behavior. By scaling arguments and numerical solution of a thin film viscoelastic model we show that the maximum in the width of the rim can be caused by a temporal evolution of the friction coefficient (or equivalently of the slip length), for which we discuss two possible mechanisms. In addition, the maximum in the width is affected by the sample age. As a consequence, knowing the temporal behavior of friction (or slip length) in principle allows to measure the aging dynamics of a polymer-polymer interface by simple dewetting experiments.Comment: 6 pages, 2 figure

Lessons Learned: Newly Hired Nurses\u27 Perspectives on Transition into Practice

This descriptive qualitative study explored data from debriefs of all newly hired nurses at 3, 6, and 12 months posthire during a newly designed transition-to-practice program at a pediatric hospital. Four major themes emerged: preceptors, education process, adaptation to the organization, and role transition. Supportive factors included staged orientation, limited preceptors, mentors, regular communication with leaders, and a culture of teamwork. Stressors included too many preceptors, mentorship needs, floating, communication challenges, and organizational changes

Stripe-hexagon competition in forced pattern forming systems with broken up-down symmetry

We investigate the response of two-dimensional pattern forming systems with a broken up-down symmetry, such as chemical reactions, to spatially resonant forcing and propose related experiments. The nonlinear behavior immediately above threshold is analyzed in terms of amplitude equations suggested for a $1:2$ and $1:1$ ratio between the wavelength of the spatial periodic forcing and the wavelength of the pattern of the respective system. Both sets of coupled amplitude equations are derived by a perturbative method from the Lengyel-Epstein model describing a chemical reaction showing Turing patterns, which gives us the opportunity to relate the generic response scenarios to a specific pattern forming system. The nonlinear competition between stripe patterns and distorted hexagons is explored and their range of existence, stability and coexistence is determined. Whereas without modulations hexagonal patterns are always preferred near onset of pattern formation, single mode solutions (stripes) are favored close to threshold for modulation amplitudes beyond some critical value. Hence distorted hexagons only occur in a finite range of the control parameter and their interval of existence shrinks to zero with increasing values of the modulation amplitude. Furthermore depending on the modulation amplitude the transition between stripes and distorted hexagons is either sub- or supercritical.Comment: 10 pages, 12 figures, submitted to Physical Review