A prospective, controlled clinical trial evaluating the clinical radiological and aesthetic outcome after 5 years of immediately placed implants in sockets exhibiting periapical pathology

OBJECTIVE: The aim was to compare the clinical, aesthetic and radiological outcome of immediately placed implants in sockets with or without periapical pathology 5 years after placement. MATERIALS AND METHODS: Twenty-seven patients were followed 5 years after immediate implant placement (test-group: 12 patients with periapical pathologies; control-group: 15 patients without periapical pathology). Clinical (FMBS, FMPS, CAL, keratinized mucosa), aesthetical (length of clinical crown, Papilla index), and radiological (vertical distance implant shoulder to first bone to implant contact (IS-BIC)) parameters were assessed. Both 95% confidence intervals, as well as results of statistical tests (one-sample, two-sample, paired t-test) were provided. RESULTS: After 5 years the implant survival rate was 100% for all 27 implants. In the test group the width of the keratinized mucosa increased significantly over the observation period (0.8 ± 1.0 mm). Concerning aesthetic parameters at the 3-month as well as at the 5-year examination no statistically significant difference could be found between the two groups. In the control-group the papilla mesial and distal to the implant increased statistically significant during the observation period by 0.5 ± 0.5 and 0.4 ± 0.6 index score points, respectively. The position of the gingival margin at the implant site and the two neighboring teeth remained stable. At the 5-year visit IS-BIC measured between 1.4 ± 0.5 mm (mesial, control) and 1.7 ± 0.7 mm (distal, test), no significant difference could be found between the two groups. Over the observation period no statistically significant change of IS-BIC could be found in the test- as well as in the control-group. None of the examined radiographs revealed any signs of retrograde peri-implantitis. CONCLUSION: The replacement of teeth exhibiting periapical pathologies by implants placed immediately after tooth extraction can be a successful treatment modality with no disadvantages in clinical, aesthetical and radiological parameters to immediately placed implants into healthy sockets

Somatic mosaicism and common genetic variation contribute to the risk of very-early-onset inflammatory bowel disease

Abstract: Very-early-onset inflammatory bowel disease (VEO-IBD) is a heterogeneous phenotype associated with a spectrum of rare Mendelian disorders. Here, we perform whole-exome-sequencing and genome-wide genotyping in 145 patients (median age-at-diagnosis of 3.5 years), in whom no Mendelian disorders were clinically suspected. In five patients we detect a primary immunodeficiency or enteropathy, with clinical consequences (XIAP, CYBA, SH2D1A, PCSK1). We also present a case study of a VEO-IBD patient with a mosaic de novo, pathogenic allele in CYBB. The mutation is present in ~70% of phagocytes and sufficient to result in defective bacterial handling but not life-threatening infections. Finally, we show that VEO-IBD patients have, on average, higher IBD polygenic risk scores than population controls (99 patients and 18,780 controls; P < 4 × 10−10), and replicate this finding in an independent cohort of VEO-IBD cases and controls (117 patients and 2,603 controls; P < 5 × 10−10). This discovery indicates that a polygenic component operates in VEO-IBD pathogenesis

Bending moments and types of failure of zirconia and titanium abutments with internal implant-abutment connections: a laboratory study

PURPOSE: The aim of this study was to examine the bending moments and fracture patterns of different zirconia abutments with internal implant-abutment connections after static loading and to compare their bending moments to those of internally connected titanium abutments. Materials and METHODS: Three types of customized zirconia abutments (Straumann CARES abutments/Straumann BL implants [T1], Astra ZirDesign abutments/Astra Micro Thread OsseoSpeed implants [T2], Zirabut prototype abutments/Straumann SP implants [T3]) and one type of customized titanium abutment (control group, Straumann CARES abutments/Straumann BL implants [C]) were included. All abutments were one-piece abutments with an internal implant-abutment connection and were customized to the same shape but featured different implant-abutment connection designs. For each group, 20 identical copies of a master abutment were fabricated and fixed on their corresponding implants. Half of the abutments in each group were left unrestored, and the other 10 received glass-ceramic crowns. Static loading was applied at a 30-degree angle to the palatal surface until failure, and bending moments were calculated. The type of failure was characterized visually by dismounting the abutments and by examination of cross-sections of the embedded specimens. The results were analyzed statistically. RESULTS: The mean range of bending moments was higher for the unrestored groups (158.2 to 678.2 Ncm) than for the restored groups (117.9 to 419.4 Ncm). The highest mean bending moments were seen in the control group, both restored and unrestored (419.4/678.2 Ncm). Unrestored, T1 and T2 exhibited significantly higher bending moments than T3. This was also observed in the restored groups. CONCLUSION:Both the abutment material and the implant-abutment connection design affected the bending moments of abutments after static loading. Internally connected zirconia abutments with horizontal mismatch to the implant exhibited significantly higher bending moments compared to those without horizontal mismatch

Chymotrypsin C (CTRC) variants that diminish activity or secretion are associated with chronic pancreatitis.

Contains fulltext : 69611.pdf (publisher's version ) (Closed access)Chronic pancreatitis is a persistent inflammatory disease of the pancreas, in which the digestive protease trypsin has a fundamental pathogenetic role. Here we have analyzed the gene encoding the trypsin-degrading enzyme chymotrypsin C (CTRC) in German subjects with idiopathic or hereditary chronic pancreatitis. Two alterations in this gene, p.R254W and p.K247_R254del, were significantly overrepresented in the pancreatitis group, being present in 30 of 901 (3.3%) affected individuals but only 21 of 2,804 (0.7%) controls (odds ratio (OR) = 4.6; confidence interval (CI) = 2.6-8.0; P = 1.3 x 10(-7)). A replication study identified these two variants in 10 of 348 (2.9%) individuals with alcoholic chronic pancreatitis but only 3 of 432 (0.7%) subjects with alcoholic liver disease (OR = 4.2; CI = 1.2-15.5; P = 0.02). CTRC variants were also found in 10 of 71 (14.1%) Indian subjects with tropical pancreatitis but only 1 of 84 (1.2%) healthy controls (OR = 13.6; CI = 1.7-109.2; P = 0.0028). Functional analysis of the CTRC variants showed impaired activity and/or reduced secretion. The results indicate that loss-of-function alterations in CTRC predispose to pancreatitis by diminishing its protective trypsin-degrading activity

Differential MSH2 promoter methylation in blood cells of Neurofibromatosis type 1 (NF1) patients

Neurofibromatosis type 1 (NF1) is caused by NF1 gene mutations. The phenotype is highly variable, with ‘modifiers' being discussed as potential determinants. Mismatch repair deficiency was shown to cause NF1 mutations, but constitutional mutation of mismatch repair genes was identified only once in a NF1 patient. We aimed to analyze whether DNA methylation of mismatch repair gene promoters, known to lead to transcriptional silencing, is associated with increased tumor load in NF1 defined by the number of cutaneous neurofibromas. Leukocyte DNA of 79 controls and 79 NF1 patients was investigated for methylation of mismatch repair genes MLH1, MSH2, MSH6, and PMS2 by methylation-specific PCR and pyrosequencing. MLH1, MSH6, and PMS2 promoters were not methylated. By contrast, we found promoter methylation of MSH2 with a higher rate of methylation in NF1 patients compared with controls. Furthermore, when comparing NF1 patients with a low vs those with a high number of cutaneous neurofibromas, MSH2 promoter methylation was significantly different. In patients with a high tumor burden, methylation of two (out of six) CpGs was enhanced. This finding was not confounded by age. In conclusion, enhanced methylation involving transcription start points of mismatch repair genes, such as MSH2 in NF1, has not been described so far. Methylation-induced variability of MSH2 gene expression may lead to variable mismatch repair capacity. Our results may point toward a role of MSH2 as a modifier for NF1, although the amount of DNA methylation and subsequent gene expression in other cell types of NF1 patients needs to be elucidated

Keratin 8 sequence variants in patients with pancreatitis and pancreatic cancer.

Contains fulltext : 50765.pdf (publisher's version ) (Closed access)Keratin 8 (KRT8) is one of the major intermediate filament proteins expressed in single-layered epithelia of the gastrointestinal tract. Transgenic mice over-expressing human KRT8 display pancreatic mononuclear infiltration, interstitial fibrosis and dysplasia of acinar cells resulting in exocrine pancreatic insufficiency. These experimental data are in accordance with a recent report describing an association between KRT8 variations and chronic pancreatitis. This prompted us to investigate KRT8 polymorphisms in patients with pancreatic disorders. The KRT8 Y54H and G62C polymorphisms were assessed in a cohort of patients with acute and chronic pancreatitis of various aetiologies or pancreatic cancer originating from Austria (n=16), the Czech Republic (n=90), Germany (n=1698), Great Britain (n=36), India (n=60), Italy (n=143), the Netherlands (n=128), Romania (n=3), Spain (n=133), and Switzerland (n=129). We also studied 4,234 control subjects from these countries and 1,492 control subjects originating from Benin, Cameroon, Ethiopia, Ecuador, and Turkey. Polymorphisms were analysed by melting curve analysis with fluorescence resonance energy transfer probes. The frequency of G62C did not differ between patients with acute or chronic pancreatitis, pancreatic adenocarcinoma and control individuals. The frequency of G62C varied in European populations from 0.4 to 3.8%, showing a northwest to southeast decline. The Y54H alteration was not detected in any of the 2,436 patients. Only 3/4,580 (0.07%) European, Turkish and Indian control subjects were heterozygous for Y54H in contrast to 34/951 (3.6%) control subjects of African descent. Our data suggest that the KRT8 alterations, Y54H and G62C, do not predispose patients to the development of pancreatitis or pancreatic cancer

British III done: recent work on Shakespeare and British, English, Irish, Scottish and Welsh identities

This contribution to &lt;i&gt;Literature Compass&lt;/i&gt; has a three-fold purpose. First, it aims to do what it says in the title, and flag up recent approaches to British identities in Shakespeare studies. Secondly, it seeks to remind readers of an earlier and now largely forgotten tradition of nationalist criticism and scholarship preoccupied with the place of Britain – nation, state and empire – that flourished in the 1920s and 1930s. Thirdly, it endeavours to excavate some of the more obscure material on the subject that, because of its place of publication, may have been overlooked. The material collected here covers issues of borders, colonialism, culture, genre, identity, invasion, language, mapping, monarchy, plantation, union, and the matter of Britain, especially in the histories, though as will be seen this work encompasses most of Shakespeare's corpus. The short introductions to each section and the accompanying bibliography of over 300 items, ranging from notes and queries to substantial essays, is divided into six sections, beginning with a brief overview of the historical debate, then focusing on criticism dealing broadly with Britain, then embracing material ordered by constituent nation: England, Ireland, Scotland and Wales. That there is an even spread of material under this handful of headings suggests that each and every nation within this multi-nation state, as well as the problematic and often contested whole, has attracted its fair share of critical concern