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Biomedical subjects

J M Leary

Publications and source records attributed to J M Leary.

At least 19 recordsLinked to original sources

Evaluation of the fracture resistance of a wrought post compared with completely cast post and cores.

The intraradicular fracture of a post and core presents a difficult and often unrestorable situation. Attempts to prevent this problem involved the use of materials with increased physical properties. The use of a preformed wrought post with a core cast to it may provide a more fracture-resistant foundation. This investigation compared a commercially available noble alloy-wrought post that had a gold core cast to it with completely cast specimens from three different alloys. A standard pattern was designed to simulate a post and core that would be used in a tooth of limited length and canal space. Patterns were cast and fixed to custom holding devices. Each specimen was subjected to a shearing force until catastrophic failure in a universal testing machine. Significant differences were noted among the groups.

Analysis of Variance

Pontic design and localized ridge augmentation in fixed partial denture design.

The endpoint of fixed prosthesis design is an esthetic and functional pontic that is compatible with soft-tissue health. In the posterior segment, where esthetics is not as critical, a sanitary pontic form is most compatible with function and hygiene. In the maxillary anterior region, a properly contoured modified ridge-lap pontic design constructed of glazed porcelain most readily fulfills both the esthetic and physiologic requirements. Although the ovate pontic form may satisfy esthetic demands to a greater degree, this is often at the expense of underlying soft-tissue health. In maxillary edentulous regions, ridge deformities may preclude a good pontic fit and esthetic result and dictate the need for surgical augmentation of the collapsed ridge. Selection of the appropriate surgical procedure and graft material depends on the nature and extent of the defect and availability of donor tissue. The subepithelial graft employing the tunnel approach is appropriate when augmentation in only a labial dimension is necessary. When the employing the trapdoor approach or full thickness gingival onlay graft may be employed. In large defects, sequential grafting procedures may be necessary to achieve the desired result. An esthetic and functional result can be attained through proper execution of an appropriate surgical technique and adherence to the principles of proper pontic design.

Alveolar Ridge Augmentation

Methylphenidate and seizure frequency in brain injured patients with seizure disorders.

BACKGROUND: Psychostimulant drugs such as methylphenidate are increasingly being used in patients with traumatic brain injury or other brain injuries for a variety of cognitive and behavioral problems. However, there is some reluctance among clinicians and family members to use methylphenidate in brain injured patients because of warnings of seizure occurrence, which are prominently reported by the product labeling included in the Physicians' Desk Reference. METHOD: We retrospectively studied the use of methylphenidate in 30 consecutive patients with active seizure disorders. We compared the seizure frequency in the 3 months before and after methylphenidate with the seizure frequency during methylphenidate treatment, using the Wilcoxon signed-rank test. RESULTS: Overall, the findings demonstrated a trend toward a lesser incidence of seizures in patients during methylphenidate treatment. Only 4 patients had greater seizure frequency during methylphenidate treatment, and 3 of these 4 were receiving tricyclic antidepressants. CONCLUSION: Methylphenidate can be safely used in brain injured patients, even those at high risk for seizures, as it was associated with a trend toward reduction (rather than increase) in seizure frequency in this population.

Adult

Vertical root fracture and relative deformation during obturation and post cementation.

There are several speculated etiologies of vertical root fractures such as pressure exerted during post placement and excessive forces during lateral condensation. However, there are no reports comparing these two forces by use of the same measurement system. This study determined and compared on single-rooted teeth (1) the amount of strain to the root that occurs during obturation and post cementation and (2) the incidence of incomplete and complete vertical root fractures occurring during the aforementioned procedures. Canals of 32 extracted maxillary central incisors were step-back prepared. Teeth were randomly divided into negative and positive controls and experimental groups. The amount of root distortion was recorded with a strain gauge during each of the following procedures: (1) lateral condensation, and (2) lateral condensation plus cementation of a cast gold post. Relative deformations were compared statistically. Teeth were examined by transillumination and stereomicroscopy for incomplete and complete fractures and compared among groups. Data showed significantly more relative deformation with placement of a post and loading than with obturation alone. The accumulation of strain from both procedures did not significantly increase incidence of vertical root fractures. The results indicate that stresses from cementation of posts is more likely to cause relative deformation of roots.

Cementation

An evaluation of porcelain strength and the effect of surface treatment.

This investigation evaluated the flexural strengths of five porcelains commonly used in the all-porcelain margin technique and the effect of surface treatment on the flexural strength. Thirty samples were made by using each of five different porcelain margin systems. The five porcelain groups were subdivided into groups of 10 each to allow the evaluation of three surface treatments. A three-point flexural test was used to test the specimens on a universal testing machine. Crystar shoulder porcelain with distilled water as the binder was significantly stronger than the other porcelains tested, and porcelain treated with an overglaze was stronger than porcelain treated with autoglaze or autoglaze and polish.

Dental Casting Technique

Load transfer of posts and cores to roots through cements.

This study evaluated differences in load transfer when cast posts are fixed to roots with different cements. Cast posts and cores were cemented with 40 endodontically prepared teeth by using four different cement mediums. The load exerted on the root surface through the post was evaluated using a strain gauge. The increased flexure after cementation was statistically analyzed. In conclusion, there was load transfer from post to root structure when posts were cemented, but no difference was found between cementation mediums.

Cementation

Immediate fixed partial dentures.

This technique offers immediate fixed partial denture replacement of dentition lost in either an anterior or posterior location. It allows modification of the preextraction tooth or the diagnostic wax-up. Because the provisional restoration is made indirectly, the extraction site is not contaminated. Postoperative comfort and function for the patient is achieved.

Denture Design

Management of dental patients with bleeding disorders: review and update.

Management of the dental patient who has a bleeding disorder requires an understanding of the normal hemostatic system and the patient's specific coagulation defect. This patient group can receive quality comprehensive dental care, provided appropriate preoperative planning and evaluation with the patient's physician or hematologist is accomplished. Emphasis should be placed on providing appropriate replacement therapy before the dental procedure, selection of conservative treatment approaches, and use of local hemostatic measures to facilitate hemostasis.

Blood Coagulation Disorders

An evaluation of post length within the elastic limits of dentin.

Posted teeth were evaluated to determine the reinforcement capabilities of various post lengths. The results suggest that as internal tooth structure is removed from the tooth the tooth becomes weaker, that teeth with posts do show more reinforcement than nonposted teeth with the same manipulation characteristics, and that some load transfer appears to exist with cemented posts.

Cementation

Multiple cast post and cores for severely worn anterior teeth.

A technique has been presented to simplify the fabrication of multiple direct post and core patterns. When combined with techniques for indirect provisional restorations, this technique merely requires the fabrication of an additional plastic template to form the direct core patterns.

Acrylic Resins

Die recovery technique.

A separating disk is used to make proximal cuts and cuts on the underside surface of the cast. The dies can be recovered without damage to the margins.

Denture Design

The effects of verapamil and paired-pulse stimulation on mammalian ventricle.

Postextrasystolic potentiation induced by paired-pulse stimulation was studied in mammalian ventricle muscle in the presence of verapamil (0.2-4.0 muM). Verapamil exerts a negative inotropic effect on the potentiated contraction, but the force of the potentiated contraction in the presence of verapamil is greater than that of the normal, unpotentiated contraction in the absence of verapamil. The positive inotropic effect of paired stimulation appears to result both from an additional calcium influx appearing as a calcium current during the plateau of the premature action potential and from some additional mechanism, tentatively identified as a Na: Ca exchange. Our results suggest that paired-pulse stimulation could be used clinically to counteract the negative inotropic effects of verapamil; moreover, the antiarrhythmic action of verapamil might counteract any arrhythmias caused by paired pacing.

Animals

In vitro investigation of the wear of resin composite materials and cast direct retainers during removable partial denture placement and removal.

The purpose of this study was to determine whether wear of two resin composite materials and contacting I-bar clasp tips would occur within a simulated RPD placement and removal period of 2 years. The data were compared to enamel with contacting I-bars. Cast I-bar clasps were passed over each specimen in the resin composite and tooth experimental groups (n = 10). Computer digitized image analysis of SEM photomicrographs of the specimens provided data for analysis of wear. Results indicated a statistical difference in the amount of mean wear between the two resin composites and between the I-bar groups. The results from this study suggest that the selection of a resin composite for use as a RPD retentive undercut must be carefully undertaken to avoid excessive wear and loss of retention.

Analysis of Variance