Faculty Bibliography

OBJECTIVE: The purpose of this study was to determine the microtensile bond strength of various resin composite/adhesive systems to alumina particle abraded Ti-6Al-4V substrate after aging for 24h, 10 days, and 30 days in distilled water at 37 degrees C. METHODS: Four laboratory resin composite veneering systems (Gradia, GR; Solidex, SOL; Ceramage, CER; and Sinfony, SF) were bonded to 25 mm diameter machined disks of Ti-6Al-4V with their respective adhesive and methodology, according to the manufacturer's instructions. Microtensile bars of approximate dimensions 1 mm x 1 mm x 6 mm were prepared for each resin composite/adhesive system. After cutting, groups (n=12) from each adhesive system were separated and either stored in water at 37 degrees C for 24h (baseline) or aged for 10 or 30 days prior to loading to failure under tension at a cross head speed of 1.0mm/min. Failure modes were determined by means of scanning electron microscopy (SEM). Statistical analysis was performed through one-way ANOVA and Tukey's test at 95% level of significance. RESULTS: Significant variation in microtensile bond strength was observed for the different systems and aging times. SOL and GR showed the highest mean bond strength values followed by SF and CER at baseline. Aging specimens in water had an adverse effect on bond strength for SOL and CER but not for the SF and GR groups. SIGNIFICANCE: In vitro bond strength of laboratory resin composites to Ti-6Al-4V suggests that strong bonds can be achieved and are stable for certain systems, making them useful as an alternative for esthetic fixed prosthetic restorations

Among dental implant design alterations, surface modifications have been by far the most investigated topic. Regarding implant surface research, the lack of hierarchical approaches relating in vitro, in vivo, clinical trials, and ex vivo analyses has hindered biomaterials scientists with clear informed rationale guidelines for implant surface design. This manuscript provides a critical hierarchical overview of the in vitro, laboratory in vivo, clinical, and ex vivo methodologies used to investigate the performance of novel biomaterials aiming to allow dental professionals to better evaluate the past, present, and future dental implant surface research. This manuscript also contains an overview of the commercially available surface texture and chemistry modifications including novel nanotechnology-based fabrication processes. Over the last decade, surface texturing has been the most utilized parameter for increasing the host-to-implant response. Recently, dental implant surfaces utilizing reduced length scale physico/chemical features (atomic and nanometric) have shown the potential to synergistically use both texture and the inclusion of bioactive ceramic components on the surface. Although surface modifications have been shown to enhance osseointegration at early implantation times, information concerning its long-term benefit to peri-implant tissues is lacking due to the reduced number of controlled clinical trials. Given the various implants/surfaces under study, the clinician should ask, founded on the basic hierarchical approach described for the in vitro, laboratory in vivo data, as well as the results of clinical studies to effectiveness before use of any dental implant

Patients who have developmental disabilities and epilepsy can be safely treated in a general dental practice. A thorough medical history should be taken and updated at every visit. A good oral examination to uncover any dental problems and possible side effects from antiepileptic drugs is necessary. Stability of the seizure disorder must be taken into account when planning dental treatment. Specific considerations for epileptic patients include the treatment of oral soft tissue side effects of medications and damage to the hard and soft tissue of the orofacial region secondary to seizure trauma. Most patients who have epilepsy can and should receive functionally and esthetically adequate dental care

The aim of the present study was to evaluate the potential of acellular dermal matrix as a carrier for delivery of stem cells to the site of soft tissue defect in a murine skin injury model and to determine the potential of stem cells delivered via such an approach to successfully engraft, survive and differentiate locally. We showed that adipose-derived stem cells delivered via this matrix survived after in vivo engraftment, spontaneously differentiated along vascular endothelial, fibroblastic and epidermal epithelial lineages and significantly improved wound healing. Furthermore, an organ survey for transplanted cells showed no evidence of a systemic distribution beyond the cutaneous wound site, indicating that the adipose-derived stem cell-dermal matrix construct provides a novel and effective method for anatomically focused cellular therapy. In conclusion, stem cell-seeded dermal matrix is an effective means for targeted in vivo cell delivery for enhanced soft tissue regeneration.

BACKGROUND:Traditionally, organ transplantation has been synonymous with patients with poor prognosis and outcome. Surgeons felt that the risks posed by immunosuppressive drugs outweighed the benefits of non-life-threatening procedures. With the enormous advances in the field of organ transplantation, a growing number of transplant patients present for a variety of surgical procedures. The objective of this report was to study the surgical outcome of organ transplantation patients who required reconstructive surgery using free tissue transfer. METHODS:A multicenter retrospective study was conducted on organ transplant patients who underwent elective microvascular free flap procedures. Patient chart review included cause of organ failure, medications, reconstruction site, flap choice, days hospitalized, complications, and outcome. RESULTS:Five independent medical centers participated in the study. Nineteen organ transplant patients required free flaps. Free flaps were used to reconstruct a variety of surgical defects, including breast, head and neck, and upper and lower extremities. There were no flap losses. Flaps used included musculocutaneous (n = 13), fasciocutaneous (n = 5), and osteocutaneous (n = 1) free flaps. Hospital length of stay ranged from 3 to 17 days. Complications included loss of skin graft, suture line dehiscence, and hematoma formation. Delayed wound healing was observed in two patients. CONCLUSIONS:In the properly selected patient, microvascular free tissue transfer can be performed safely and with acceptable surgical outcome. Contrary to popular belief, delayed wound healing from immunosuppressive agents was uncommon. Free tissue transfer in healthy organ transplant patients can be considered in reconstructive surgery decision making.

Sclerosing sweat duct carcinoma is a rare, locally aggressive adnexal tumor that frequently occurs on the face of middle-aged adults, invades deeply, and has a propensity to recur. We report a rare instance of sclerosing sweat duct carcinoma occurring in a 6-year-old African American child and review the literature of this infrequently observed neoplasm.