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Biomedical subjects

M Molin

Publications and source records attributed to M Molin.

33 records · Page 2Linked to original sources

The fit of gold inlays and three ceramic inlay systems. A clinical and in vitro study.

Four inlay systems--gold, Cerec, Mirage, and Empress inlays--were evaluated for their adaptation to stone die and clinically to the tooth by means of a replica technique. Twenty inlays of each system were placed on premolars and molars in the lower jaw. A microscope was used to measure the adaptation at the approximal margin, at the inner axial wall, and at the occlusal cavosurface area. An overall better fit was observed for the gold inlays than for the ceramic inlays. When the different measuring locations were compared, a better fit was found for the occlusal area. The greatest discrepancies were recorded for the Cerec inlays, whereas the Mirage and Empress inlays were comparable.

Adult↗

Validation of respiratory mechanics software in microprocessor-controlled ventilators.

BACKGROUND AND METHODS: Several microprocessor-controlled ventilators, available for clinical use, contain optional computer software programs capable of performing near-instantaneous determinations of airway resistance and lung compliance. This study was undertaken to determine the validity of the measurements for airway resistance and lung compliance obtained by the software packages on three microprocessor-controlled ventilators. Three ventilator models were studied. An artificial ventilator-patient circuit was constructed using a test lung and an endotracheal tube. Airway pressure and gas flow curves were recorded using conventional means. Static lung compliance and airway resistance were calculated using standard equations, while automated measurements were obtained from the ventilators. The following parameters were then varied to simulate a wide variety of clinical situations: tidal volume, peak inspiratory flow rate, respiratory rate, endotracheal tube, and test lung compliance. RESULTS: Automated measurements were highly correlated with values obtained manually (resistance: Puritan-Bennett 7200a r2 = .94, Bear 5 r2 = .98, Veolar r2 = .96; compliance: 7200a r2 = .93, Bear 5 r2 = .97, Veolar r2 = .97). Calculated limits of agreement between the two methods demonstrate that although not in absolute agreement, the software-determined values for airway resistance and lung compliance differed from the manually derived values in a ventilator-specific, predictable fashion. CONCLUSIONS: The correlation and agreement demonstrated between values of airway resistance and lung compliance measured by the respiratory mechanics software packages and those values derived manually suggest that these software packages may be useful for measuring trends, as well as responding to treatment in the clinical setting. These results apply only to the controlled, mechanical ventilation mode. Further studies are indicated to validate this software in patients capable of generating spontaneous breaths.

Airway Resistance↗

A clinical examination of ceramic (Cerec) inlays.

Two hundred and five Cerec ceramic inlays placed by 8 dentists in 72 patients were examined independently by 3 calibrated evaluators 12-24 months after insertion, using the criteria of the California Dental Association (CDA) and also certain periodontal variables. Proximal dental plaque and bleeding on probing were not seen more often on Cerec surfaces than on control homologous surfaces. Ten patients reported postoperative sensitivity after treatment with Cerec inlays. Excellent CDA ratings for Color and Surface were obtained in 57% and 26%, respectively, and for Anatomic Form and Margin Integrity in 55% and 83%, respectively. Obvious differences were seen among the participating dentists with regard to the clinical quality of Cerec inlays. At present, the long-term performance of the Cerec technique cannot be predicted.

Adolescent↗

A clinical evaluation of the Optec inlay system.

To evaluate the clinical quality of ceramic (Optec) inlays, the inlay production of 10 dentists, served by 3 dental laboratories, was examined independently by 2 calibrated examiners. A total of 57 patients with 205 inlays (mean age, 8.1 months) were examined 1 to 32 months after placement by means of using a slightly modified form of the California Dental Association criteria. Periodontal variables such as plaque index, gingival index, and margin index were also recorded. Eight patients reported postoperative but not persistent hypersensitivity in relation to the Optec therapy. No differences between Optec proximal surfaces and homologous control surfaces were seen with regard to plaque or bleeding on probing. The examination using the CDA criteria showed that 59% of the inlays had a slight color mismatch. Slightly roughened surfaces were most common (86%). As to anatomic form and margin integrity, 24% and 67%, respectively, of the inlays were rated excellent. A difference between the dentist with regard to the clinical quality of the inlay treatment procedure was seen. The present results cannot allow a definitive judgement with regard to the long-term clinical quality of the Optec inlay system but will serve as a base for further studies.

Adolescent↗

Mobilized mercury in subjects with varying exposure to elemental mercury vapour.

In a mercury mobilization test, 0.3 g of the complexing agent sodium 2,3-dimercaptopropane-1-sulfonate (DMPS) was given orally to 10 workers with moderate occupational exposure to elemental mercury vapour, to 8 dentists with slight exposure, to 18 matched controls, and to 5 referents without amalgam fillings. In the workers, DMPS caused an increase in 24-h urinary mercury excretion by a factor of 10; in the dentists, 5.9; in the controls, 5.3; and in the amalgam-free referents, 3.8. Of the mercury excreted during 24 h, 59% appeared during the first 6 h. Close, albeit non-linear, associations were found between mobilized mercury and the premobilization mercury levels in plasma and urine, but not with the duration of occupational exposure or the rough estimate of the integrated function of blood levels vs time. The present data indicate that mercury mobilized after a single DMPS dose in close connection with exposure is mainly an index of recent exposure and is not significantly affected by slow body pools or long-term exposure.

Adult↗

Management of splenic injuries.

The structure and function of the spleen are reviewed in the context of providing a rational basis for splenic salvage after trauma. Guidelines for operative and nonoperative management are provided, and the results of treatment from recent large series are summarized.

Adult↗

Mercury, selenium, and glutathione peroxidase before and after amalgam removal in man.

In 10 healthy persons all amalgam fillings were replaced with gold inlays. Blood and urinary levels were measured on 10 occasions during a 4-month period before and a 12-month period after amalgam removal. These variables were also measured three times in 10 healthy controls. A strong statistically significant relation was found between plasma mercury values and both the total number of amalgam surfaces (r = 0.71, p = 0.0006) and the total surface area of the fillings (r = 0.73, p = 0.0004). In the immediate postremoval phase plasma mercury rose three- to four-fold, whereas the urinary and erythrocyte mercury rose about 50%. These peak values declined to the preremoval level at about 1 month. Twelve months after the removal the plasma and urinary mercury levels were significantly reduced to 50% and 25%, respectively, of the initial values for the experimental group. Apart from the significantly lower plasma selenium values 5 and 10 days after removal no significant differences were found with regard to plasma selenium or erythrocyte glutathione peroxidase either within or between the experimental and the control groups. A large number of supplementary biochemical analyses did not show any influence on organ functions or any differences between the groups before or after the amalgam removal. Amalgam fillings considerably contributed to the plasma and urinary mercury levels.

Adult↗

The influence of dental amalgam placement on mercury, selenium, and glutathione peroxidase in man.

Amalgam restorations were inserted in eight healthy persons, previously unprovided with dental restorations, who had several severe carious lesions. The mean number of surfaces restored were 16.1 (range, 11 to 22). The total mean calculated amount of mercury inserted was 2.9 g (range, 1.5 to 4.3 g). Blood and urinary levels were measured on seven occasions during a 4-month period before and a 3-month period after amalgam placement. One and 3 months after placement, the P-mercury mean values were almost equal to the preplacement values (3.3 nmol/l). After placement U-mercury increased continuously; 3 months after placement a statistically significantly higher (p less than 0.05) mean U-mercury value (0.58 nmol/mmol creatinine) was found compared with the mean preplacement value (0.34 nmol/mmol creatinine). No statistically significant correlation was found between the P- and U-mercury concentrations and the total number of amalgam surfaces. Selenium levels in plasma and urine and erythrocyte glutathione peroxidase showed no systematic change of pattern. The results show that the insertion of amalgam fillings contributed to the U-mercury concentration, but apparently even more extensive amalgam therapy and/or longer exposure periods are needed to affect the P-mercury concentration. No negative effects on the P- and U-selenium or the erythrocyte glutathione peroxidase levels could be found during the 3 months immediately after an extensive amalgam placement. The supplementary blood and urine analyses were not influenced by the insertion of amalgam fillings.

Adult↗

An in vivo study of glass ceramic (Dicor) inlays. Preliminary report.

For the purpose of evaluating the clinical quality of glass ceramic (Dicor) inlays 15 patients with 37 inlays were examined 1 to 22 months after placement. In addition to certain periodontal variables, the inlays were rated by two independent examiners using the California Dental Association (CDA) quality evaluation system. The results of the present study showed that dental plaque was seen less often on proximal surfaces with inlays than on homologous proximal surfaces. Three patients reported hypersensitivity of the dental pulp. The examination using the CDA criteria showed that 54% of the inlays had a slight color mismatch, and slightly roughened surfaces were occasionally seen (35.5%). In nearly 30% of the inlays there was visible evidence of ditching along the margins. At present, no judgement can be made about the longevity of ceramic inlays.

Adult↗

[X-ray diffraction study of biliary calculi. Morphological and composition correlations of calculi].

In this study, we examined the composition of crystallographic structure of biliary stones in 106 patients (27 male, 79 female). The material has been obtained following cholecystectomy. In 70 cases (66%), the monohydrate cholesterol was the main constituent, alone (33%) or in combination with calcium salts (32%). In 52% of the cases, we found presence of vaterite, aragonite and calcite. The anhydrous cholesterol was determined in 28 subjects (26%), alone (9.4%) or associated with calcium salts (16%). Cholesterol was completely absent in 8 cases: of them, 4 presented an aspecific diffrattografic picture and 4 revealed presence of calcium carbonate. Finally, no correlation was found between epidemiological data (sex or age) and macroscopic feature of biliary stones (chemical and morphological structure).

Calcium↗

Mercury, selenium, and glutathione peroxidase in dental personnel.

Eighteen persons, dentists and nurses, with urinary mercury levels higher than the group median value of all dental personnel in the country of Västerbotten were compared with a group consisting of 15 persons with low urinary mercury levels working in the same clinics. A statistically significant difference between the high urinary mercury group and the low urinary mercury group could be seen in the plasma mercury level. In each group a statistically significant relation could be seen between the plasma mercury level and the total number of amalgam surfaces. The two groups did not differ with regard to the levels of plasma selenium and erythrocyte glutathione peroxidase, and no correlation between these two variables and the plasma mercury levels could be found. To evaluate organ functions, a large number of supplementary analyses were performed. These analyses did not indicate any influence on organ functions. Although the persons in the present study were occupationally exposed to mercury, none of the biologic variables analyzed seemed to be affected. Even among dental personnel who handle amalgam professionally the number of amalgam surfaces is a major contributory factor to the P-mercury level.

Adult↗

Plasma-selenium, glutathione peroxidase in erythrocytes and mercury in plasma in patients allegedly subject to oral galvanism.

Twelve patients with subjective symptoms, ascribed by the patients themselves to mercury released from dental restorations, were investigated. In addition to a general dental examination the following parameters were registered: the total number of amalgam surfaces in the mouth; potential and polarization of existing and accessible dental metallic restorations for calculation of intraoral currents. As regards the highest calculated intraoral current for each individual there was a statistically significant difference between the patient group and a control group consisting of 12 persons. An analysis of the amount of selenium, glutathione-peroxidase and mercury in the blood showed no differences between the patient and the control group. However, a statistically significant positive correlation could be seen between the total number of amalgam surfaces and the plasma-mercury level for patients and controls pooled together. The numerous other blood parameters analyzed did not reveal any differences between the groups.

Adult↗

Chronic vulvar dystrophies. Surgical therapy.

The Authors take up a proposal made in 1976 by the International Society for the Study of Vulvar Dystrophies (I.S.S.V.D.) and, with the help of clinical cases, consider the problem of vulvar dystrophic pathology from the point of view of clinico-histologic classification and terminology. The schematic analysis of the etiopathogenetic hypothesis (still uncertain) and the consequent not infrequent failures of clinical therapy suggest to consider indications for surgical treatment. This is particularly true for young patients because in these cases the treatment must also aim at an acceptable aesthetic result and the recovery of satisfactory sexual function. To show the possibility of meeting these requirements, the Authors report the results of plastic surgical treatment on a 28 year patient suffering from chronic vulvar dystrophy after many failures of medical therapy.

Adult↗

Long-term clinical results after treatment with conical crown-retained dentures.

The clinical outcome of treatment using conical crown-retained dentures was evaluated. Of the initial 25 patients provided with 26 conical crown-retained dentures, 18 patients with 18 restorations could be examined after a time ranging between 73 and 92 months. Of the eight restorations lost, four had been changed as a result of factors that might have been related to the prosthodontic care. Most of the patients were very satisfied with the restorations both functionally and esthetically and found their chewing comfort to be better after treatment with conical crown-retained dentures. However, 50% of the patients reported speech problems related to treatment. Technical failures were not insignificant but were treatable. The survival rate after 73 to 92 months was 78.3%.

Aged↗