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Biomedical subjects

J E Hutton

Publications and source records attributed to J E Hutton.

At least 19 recordsLinked to original sources
PubMed1997

The effect of diet on the bearing mucosa during adjustment to new complete dentures: a pilot study.

PURPOSE: This pilot study investigated the reliability of the conventional prosthodontic wisdom that a modified diet ameliorates soreness during the adjustment to new complete dentures. Tissue ulceration of the bearing mucosa served as the indicator of patient soreness as a function of diet. MATERIAL AND METHODS: Fourteen men were randomly assigned to two equal treatment groups. One group consumed a consistency-gradated diet and the other (control) ate as they wished. New complete dentures were fabricated for both groups by the same provider, technician, materials, and method; the study was double-blinded. Tissue ulceration was assessed and totaled for the 10 days after denture placement, constituting a soreness score. RESULTS: Data analysis identified a significant difference in soreness scores between dietary groups (p < 0.05). Wearing time had a significant inverse relation to soreness (p < 0.05) in this study. A host of potential explanatory variables of clinical interest failed to relate significantly to the outcome of soreness. CONCLUSIONS: The results of this study indicated that a consistency-gradated diet had a significant effect in diminishing tissue ulceration during the immediate postplacement period for this group of men. Potentially, these findings could contribute to enhanced quality of care and to the more efficient allocation of provider-based resources.

Adaptation, Physiological↗
PubMed1997

In vitro enamel demineralization and the marginal gap of simulated cast restorations with three different cements.

PURPOSE: This study investigated 1) the relationship between marginal gap sizes and enamel demineralization, and 2) the influence of three cements on this enamel demineralization. MATERIALS AND METHODS: Horizontal sections of 60 noncarious, freshly extracted human third molars were randomly assigned to one of four groups. Simulated cast restorations were attached to the specimens with 1) zinc phosphate cement, 2) glass ionomer cement, 3) composite resin cement, or 4) no cement (control). The tooth/restoration gaps were controlled at 51, 102, and 204 microns. The specimens were incubated for 16 weeks in buffered lactic acid gelatin to induce demineralization. Photomicrographs were obtained from sections of each sample using a polarized light microscope. Three evaluators measured wall and primary enamel lesion depths allowing for the determination of a demineralization ratio (DR). Data were analyzed by repeated-measures ANOVA (alpha = 0.05). RESULTS: The between-evaluator effects were not significant. All evaluators agreed that DR was significantly related to cement (p = .0001) but not to marginal gap size. The resin cement had the smallest DR (0.7 +/- 0.3), and the control group had the greatest (4.4 +/- 2.0). CONCLUSIONS: The presence of any one of the three investigated cements resulted in decreased demineralization. The amount of demineralization was unaffected by marginal gap size.

Analysis of Variance↗
PubMed1997

Bond strengths of the adhesive resin-amalgam interface.

PURPOSE: To evaluate the tensile and shear bond strengths of eight adhesives and two amalgams (spherical and lathe cut). MATERIALS AND METHODS: Two high-copper amalgams (Tytin, spherical; and ANA-2000, dispersed phase) and seven adhesives (Panavia EX, C&B Metabond, Chameleon Metal Resin Cement, All-Bond 2, All-Bond C&B, Photo-Bond and Imperva Dual) were evaluated. An epoxy resin (Stycast 1266) was included as a control for comparison because it was an adhesive material of similar viscosity but different chemistry from the dental adhesives. The aluminum surfaces were sandblasted with 50 microns aluminum oxide just prior to coating with adhesive resins. The testing area was defined with a 4 mm circular adhesive Mylar mask. All adhesives were mixed and handled according to manufacturers' instructions. Freshly mixed amalgam was condensed into the test cavity and onto the surface immediately after coating with adhesive. After 24 hours storage, the bond strengths were determined in an Instron testing machine at a crosshead speed of 2 mm/minute. The debonded surfaces were examined in an optical microscope for site of failure. The few samples which showed failure at the aluminum-resin interface were not included in the study. Selected debonded surfaces were examined by SEM. A 2-way ANOVA (General Levin Models-GLM) was used to analyze the data from both the tensile and shear bond strength tests. GLM was used instead of standard ANOVA because of the unbalanced design. The lack of balance occurred because some of the bonding resin/amalgam groups had different sample numbers. RESULTS: A wide variation in bond strengths was obtained with adhesive resin cements and not all appeared suitable for adhesive amalgam restorations. Panavia EX, C&B Metabond, Chameleon Metal Resin Cement and All-Bond C&B showed the best potential for amalgam bonding, with shear and tensile bond strengths greater than 8 MPa. Viscous, filled versions of adhesives appeared to be more effective. Choice of amalgam appeared to be less important than choice of adhesive.

Analysis of Variance↗
PubMed1995

Expansion of phosphate-bonded investments: Part II--Thermal expansion.

This study investigated the thermal expansion of phosphate-bonded investment materials. Three investments were mixed with either distilled water or their special liquids and allowed a setting time of 1 or 24 hours. Hydration and thermal expansions were measured with a vertical dilatometer and were analyzed for interactive and main effects. The amount of expansion attributed to hydration was minimal, whereas thermal expansions varied and were of greater magnitudes. Material I exhibited the greatest thermal expansion. Materials II and III recorded smaller thermal expansions that increased when the materials were mixed with their special liquids. Setting time did not substantially influence hydration expansions but did influence thermal expansions, and heating the materials to 800 degrees C instead of 700 degrees C did not dramatically elevate expansions.

Absorption↗
PubMed1995

An assessment of the association between functional edentulism, obesity, and NIDDM.

OBJECTIVE: To assess the association between a measure of extensive tooth loss (functional edentulism) and obesity with non-insulin-dependent diabetes mellitus (NIDDM) in a racially heterogeneous sample. RESEARCH DESIGN AND METHODS: A cross-sectional survey (370 subjects) was performed by reviewing the medical and dental records of dependently or independently living individuals who were treated as inpatients and/or outpatients at a Department of Veterans Affairs facility. Frequencies and descriptive measures were derived; univariate and multiple logistic regression analyses were conducted to test for associations, confounding, effect modification, and interaction using functional edentulism and obesity as the independent variables and NIDDM as the dependent measure. RESULTS: Functionally edentulous individuals were at significantly greater risk for NIDDM (estimated odds ratio [OR] = 4.06), than the obese (OR = 3.29). These relationships were not confounded by age or race in this sample. Obesity did confound functional edentulism in the multivariable model, suggesting that they act independently on the outcome variable (NIDDM). CONCLUSIONS: Dentist-assessed functional edentulism and physician-diagnosed obesity were significantly associated with NIDDM in this sample of predominantly older men. This finding ought to be considered by primary care providers in formulating dietary strategies in order to facilitate the realization of their therapeutic goals.

Adult↗
PubMed1993

The expansion of phosphate bonded investments: Part I--Setting expansion.

Less expensive silver and palladium (AgPd) dental casting alloys are popular, but require phosphate bonded investments. The physical properties of such materials have not been thoroughly investigated. This study determined whether three different phosphate bonded investments could provide adequate expansion to compensate for the casting shrinkage of AgPd. The investments were mixed with distilled water or their unique special liquids provided by the manufacturers and allowed setting times of 1 hour or 24 hours. Setting expansions were measured with a vertical dilatometer. When mixed with special liquid, material I had a mean setting (1 hour) expansion of 0.19% +/- 0.01%; material II, 0.14% +/- 0.03%; and material III, 1.17% +/- 0.08%. Twenty-four hours of setting did not significantly increase the setting expansion (p > 0.05). Mixing the three investments with distilled water drastically reduced setting expansions. A three-way analysis of variance was computed to evaluate the data and investigate significant interactive and main effects. The two-way interaction (material x liquid) was significant. The results were consistent with the concept of a higher silica-containing special liquid for material III compared with the other materials.

Analysis of Variance↗
PubMed1993

Axiographic tracings of temporomandibular joint movements.

Three-dimensional condylar movements of 49 symptomatic and asymptomatic volunteers were recorded with a hinge axis tracing system axiograph during maximal opening, protrusion, and mediotrusion. The tracings displayed in sagittal and frontal planes were measured to evaluate biomechanics of the temporomandibular joint. The only differences in condylar tracings between symptomatic and asymptomatic groups were in the right joint, recorded in the sagittal plane during maximal opening, and the Bennett angle. The symptomatic group had a significantly longer condylar path and a smaller Bennett angle compared with the asymptomatic group. The results were interpreted as indications of adaptive morphologic instead of pathologic changes. The alterations in condylar tracings as an indicator of joint pathology should be considered cautiously.

Adult↗
PubMed1992

A multicenter study of overdentures supported by Brånemark implants.

Nine clinical centers participated in a prospective study of overdentures supported by Brånemark implants in the maxilla or mandible. The study initially comprised 133 patients provided with 117 implants placed in the maxilla and 393 implants placed in the mandible. The preliminary results indicate a success rate in the mandible comparable with the reports on fixed prostheses. Conversely, overdenture treatment in the maxilla seems to be less favorable than previous reports of fixed restorations. The differences between the fixed and the present overdentures in the maxilla were mainly based on differences in patient selection and bone quality. A total of 32 implants was mobile and removed and another 29 implants were lost to follow-up because of patient dropout up to the first annual checkup after denture placement. A higher implant failure rate occurred in the maxilla. Mucosal reactions were also more unfavorable around implants placed in the maxilla.

Adult↗
PubMed1990

Clinical spectrum of symptomatic external iliac fibromuscular dysplasia.

External iliac fibromuscular dysplasia is a rare and usually asymptomatic disorder. We report eight symptomatic patients seen over a 15-year period and review pathophysiologic mechanisms accounting for the three following distinct lower extremity ischemic sequelae: (1) Emboli--episodic focal digital ischemia (blue toe) was seen in three patients. Resection and primary anastomosis of focal iliac ulcerative fibromuscular dysplasia (one patient) or resection and replacement (two patients) removed the embolic source and relieved the symptoms. (2) Chronic ischemia--gradual onset of full leg claudication in four patients was treated by operative graduated intraluminal dilation in three patients and prosthetic bypass in one. Arteriography subsequently showed a remodeled lumen in the three patients who underwent dilation. (3) Dissection--acute onset leg ischemia resulted from presumed dissection of the external iliac segment. After 4 months of conservative management of antiplatelet agents and exercise, symptoms resolved completely, and arteriogram showed spontaneous restoration of a normal lumen in the dissected segment. The clinical presentation of fibromuscular dysplasia may mimic other arterial processes such as atherosclerosis. Diagnosis is made only by arteriography with specific magnification views of the external iliac arteries and careful surveillance of the renal arteries. Appropriate treatment should be tailored to the clinical presenting symptom. For microembolic disease, resection and replacement are required. For chronic ischemia, intraluminal dilation is generally sufficient and durable and has proved to be a simpler and acceptable alternative to replacement or bypass. In acute dissection, surgical intervention may be deferred if the limb is viable to allow spontaneous healing and remodeling. Persistent symptoms may be the only indication for intervention in this ischemic manifestation of external iliac fibromuscular dysplasia.

Aged↗
PubMed1983

Evaluation of the effects of palatal augmentation on partial glossectomy speech.

Patients who have had surgical removal of part of the tongue are left with varying degrees of speech deficiencies. Augmentation of the palate has been suggested as a means of compensation for this deficiency. This pilot study suggests a technique for evaluating prosthodontic efforts to improve speech for partial glossectomy patients. Although firm conclusions cannot be based on the observations of one patient, it appears that both the shape of the palatal surface and the contour of the cavity size anterior to the tongue are important factors to be considered in prosthodontic efforts to optimize fricative sound production for partial glossectomy patients. Further studies with patients who have a wider variety of tongue resections are indicated. The technique described is an effective one for further studies.

Evaluation Studies as Topic↗
PubMed1983

Dilation of knitted Dacron aortic prostheses and anastomotic false aneurysms: etiologic considerations.

Five patients with knitted Dacron aortic bifurcation prostheses developed prosthetic dilation and anastomotic false aneurysms. The interval between placement of prostheses and secondary presentation ranged from 4 to 10 years. Three patients presented with femoral false aneurysms (one ruptured) and two presented with aortic false aneurysms (one ruptured). In all cases, anastomotic sutures remained intact on the prosthesis and there was no evidence of infection. The mean (+/- SEM) increase in diameter of prostheses was 85.7 +/- 19.1% (range 76% to 137%). Dilated prostheses were removed in four cases and were tested for tensile strength and studied with scanning electron microscopy. These were compared to normal, nondilated knitted Dacron prosthetic fabric from the same manufacturer. There was no loss of breaking strength in dilated prostheses. Furthermore, on examination with scanning electron microscopy, there was no evidence of degeneration or fracturing of individual Dacron filaments. However, dilated prostheses were found to have a greatly expanded knit. The distance between loops was significantly increased and the number of fibers per 1000 microns was significantly less in comparison to normal knitted Dacron fabric. These studies confirm an association between prosthetic dilation and false aneurysm formation. Further, they suggest that the cause of prosthetic dilation is loss of compactness of the knit not associated with intrinsic Dacron fiber deterioration. A fabrication defect is most likely responsible.

Aged↗
PubMed1983

Percutaneous transluminal balloon angioplasty of the iliac artery for contralateral ischemia.

The cases of three patients with lower extremity ischemia from ipsilateral iliac artery occlusion and contralateral iliac artery stenosis are presented. Planned treatment was percutaneous transluminal angioplasty (PTA) of the contralateral iliac artery, rendering it an adequate donor vessel for subsequent femorofemoral bypass. Because of adequate collateral vessels across the pelvis, cross-femoral bypass was unnecessary following PTA. Current technology allows simultaneous intraoperative PTA and femorofemoral bypass. We do not recommend this on the basis of our experience.

Aged↗
PubMed1983

Etiologic factors for recurrent carotid artery stenosis.

Since 1966, 29 patients with recurrent carotid artery stenosis have been encountered. The mean (+/- SEM) internal between initial carotid endarterectomy and secondary presentation was 67.5 +/- 9.2 months (range 6 to 180 months). There was a disproportionate number of women with recurrent stenosis. The mean age at initial endarterectomy in patients with recurrent stenosis, 54.6 +/- 1.4 years, was significantly less (P less than 0.001) than that of all patients who had endarterectomy. To define the etiologic factors for recurrence, 21 of these patients were matched with case-control patients of the same age and sex who had undergone endarterectomy the same year but did not develop recognized recurrent stenosis. There was no significant difference in the incidence of hypertension, diabetes mellitus, coronary artery disease, bilateral carotid disease, other vascular operations, or family history for atherosclerosis in patients with recurrent stenosis compared to control patients. The indications for primary endarterectomy, angiographic distribution of disease, and operative details were similar in both groups. There was no difference in the incidence of regular, therapeutic aspirin ingestion following initial endarterectomy (52.5% in both groups). There was a striking difference in smoking habits. Ninety-five percent of patients with recurrent stenosis continued to smoke following initial endarterectomy, compared to 23.8% of control patients (P less than 0.001). Lipid fractionation studies were performed in both groups, and there were no significant differences in levels of cholesterol, triglycerides, high-density lipoprotein (HDL)-cholesterol, and total cholesterol/HDL-cholesterol ratio. Dose-response platelet aggregometry detected no differences between groups in the sensitivity of platelets to adenosine diphosphate (ADP), collagen, and epinephrine. Reoperation in patients with recurrent stenosis was associated with minimal morbidity, no deaths, and generally excellent results.

Anesthesia↗
PubMed1981

A comparison of three techniques for fabricating metal molds.

Investigation on the dimensional accuracy and techniques variability of metal molds and refractory casts for the construction of maxillofacial external prostheses have resulted in the following conclusions. 1. A relative comparison of the box-pour, open-cast, and wax-sprue techniques for constructing metal molds for external prostheses showed the open-cast technique to be the most accurate and easiest techniques. 2. The wax-sprue technique was the most complex and consumed maximum time and materials. This technique also offered the greatest possibility for introducing errors and obtaining inconsistent results because of multiple steps. 3. For all techniques the positive metal molds always demonstrated a poorer fit in comparison to the negative metal molds. The positive metal molds were larger castings. 4. Most metal molds were significantly larger than the standard brass die in length and width dimensions. 5. A direct comparison of a theoretic calculation and experimental measurements for dimensional accuracy shows the construction of metal molds to be very dependent on the manipulation of materials and reproducibility of methods.

Dental Casting Investment↗
PubMed1981

Injuries sustained from high velocity impact with water: an experience from the Golden Gate Bridge.

Over 720 persons are reported to have died jumping from the Golden Gate Bridge. A review of 100 consecutive autopsies showed that, in the majority of cases, massive pulmonary contusion, pneumothorax, laceration or perforation of the heart, great vessels, or lungs by displaced ribs were the causes of immediate death. Irreparable fractures of the liver or spleen were the most common abdominal injuries. The persons fatally injured appeared to have entered the water in a horizontal position, experiencing maximal deceleration. In contrast, six survivors entered the water feet first with more gradual deceleration. These survivors remained conscious but sustained similar injuries of lesser degree; only one sustained rib fractures. Fifty per cent had fractures of the liver or spleen requiring operative therapy. Fifty per cent sustained lung contusions and subsequent pneumothoraces. Suspicion of underlying injuries to the liver, spleen, and lungs is essential during resuscitation of those who survive impact with water.

Abdominal Injuries↗