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[Preparation of bonded porcelain inlays and onlays using a milling-coping system].

The Celay-system offers an interesting alternative to existing systems for esthetic posterior restorations with ceramics. The basic idea of the concept is to prepare, either directly on the patient or indirectly on a plaster model, a pro-inlay using a light-curable precision material. The modelling also covers the occlusal surface. This pro-inlay is then used with the help of a milling center to machine a precise replica out of a ceramic block. The copying process is carried out via three-dimensional mechanical scanning and milling using eight axes of freedom. In this way additional corrections on the ceramic within the mouth can almost completely be avoided. The system is designed to be used as a direct chairside method by the dentist or as an indirect method by the dental technician. It is a promising but unproved restoration, more research and long-term clinical evaluation is recommended.

Adhesives↗

Ultrasound therapy in tendinous injury healing in goats.

The effect of ultrasound therapy on tendon injury healing was studied on 12 locally available non-descript adult goats of either sex divided equally in two groups (I and II) consisting of six animals each. The superficial digital flexor tendon (SDFT) was transected and immediately repaired with nylon (2/0) using a locking loop suture pattern under atropine-triflupromazine-lignocaine epidural analgesia and strict aseptic condition. A full limb plaster of Paris cast was applied to immobilize the operated limb for 3 days. Postoperative care was similar in both the groups. In group I, the operated limb was allowed to heal without ultrasound therapy. In group II, pulsed ultrasound therapy was started 3 days after repair of tendinous injury at an intensity of 1 W/cm(2) for 10 min daily for 10 consecutive days. The animals of both groups were evaluated clinically and haemato-biochemically on days 1, 3, 7, 15, 20 and 30 postoperatively. Air tendonograms and ultrasonography were performed on days 0, 10, 20 and 30 post-tenorrhaphy. Histopathological examination of tendon biopsy samples was performed on day 30 post-tenorrhaphy. Resolution of inflammatory swelling, pain, weight bearing and tendon gliding movement was earlier in the test group than control. Rectal temperature, total leucocyte count and differential leucocyte count did not vary significantly at various stages of observation in both the groups. Serum glucose, cortisone and serum alkaline phosphatase levels increased significantly after tendon injury repair in all the animals and decreased slowly at all subsequent intervals in control group, whereas, it was near normal in the treatment group on day 30 post-tenorrhaphy. Air tendenograms and ultrasonography examinations in the test group revealed that there was a marked regression of peritendinous adhesion between the tendon and skin on day 30 post-tendon injury repaired and the tendon at the reconstructive site attained near normal thickness and density. Adhesions were present in the reconstructed site of SDFT in all animals of the control group. Histopathologically, the granulation tissue was comparatively bettered organized at the healing site in the ultrasound-treated animals.

Animals↗

[Autologous transplantation of rib perichondrium in treatment of deep cartilage defects of the knee joint of sheep. Morphologic comparison of two resorbable fixation methods].

The purpose of this study was to examine the fate of autologous perichondrial grafts after transplantation into cartilage lesions in weight-bearing joints, with reference to different fixation methods and different regimens of postoperative functional treatment. Full-thickness osteochondral lesions were drilled in the articular surface of knee joints in 36 sheep. The defects were filled with autologous rib perichondrial grafts, which were secured by either collagen sponges (group A; n = 12 animals) or fibrin glue (group B; n = 12 animals). Defects not filled with perichondrial grafts served as controls (group C; n = 12 animals). Following 1 week of immobilization of the treated leg, the plaster was removed and the animals were allowed to move freely. Animals were sacrificed after 4, 8, 12 and 16 weeks. The grafts were removed and investigated histologically. In contrast to weight-bearing areas and control defects, hyaline-like cartilage formation could be noted in non-weight-bearing areas after 4 weeks. This newly formed cartilage revealed strong metachromasie following staining with acidic toluidine-blue and reacted positively with PAS, indicating de novo synthesis of proteoglycans and glycoproteins. Enzyme-histochemistry for alkaline and acid phosphatase activity showed positive reactivity only at the base of the transplants. Quantitatively, hyalin-like cartilage was achieved in 40/48 transplants from the non-weight-bearing area (20/24 transplants fixated with collagen sponge (group A); and 20/24 fixated with fibrin glue (group B). In control defects only fibrous scar tissue was detectable. In transplants from the weight-bearing area only 7/48 (24 of group A and B each) a differentiation into hyalin-like cartilage was visible.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Surgical treatment of extension contractures caused by war injuries to the knee.

Immobilization with external fixation bridging the knee joint in extension is frequently used after sustaining a war injury to the region of the knee joint with femoral and tibial bone fractures. Immobilization of the knee with plaster splints is performed in the same position. This usually prolonged treatment results in extension contractures of the knee joint. From June 1991 until March 1994, 54 patients with extension contractures of the knee caused by war wounds were treated at the Department of Orthopedics, Zagreb University Hospital Center, in Zagreb, Croatia. Results of surgical treatment of 44 patients are presented. The operative procedure consisted of extensive intra- and extra-articular adhesiolysis of the knee. The control group included 30 patients with knee contractures caused by injuries sustained in car crashes or secondary to previous operative procedures. The mean duration of immobilization was 5 months and 6 days. The mean preoperative knee motion amplitude ranged from 5 degrees in extension to 38 degrees in flexion. The mean postoperative knee motion was 98 degrees (range, 2 to 110 degrees). Treatment results did not depend on either duration of preoperative immobilization of the knee or previous infection in the region of injury. Previous knee joint bridging with an external fixator had no impact on the results of extension contracture treatment. Adequate intra- and extra-articular adhesiolysis with appropriate long-term postoperative rehabilitation is essential for the success of the operative treatment for knee joint contracture.

Adolescent↗