Biomedical subjects
Publications and source records attributed to P Magne.
The current abundance of posterior esthetic restorative materials and techniques may be confusing. This paper describes a simple and logical global concept that assists clinicians in choosing the appropriate therapeutic modality according to well-defined clinical criteria. Practical considerations about cavity preparation, base-lining, filling, luting, and finishing procedures are reviewed.
Provisional restorations represent a key element in the realization of extensive esthetic rehabilitations. In particular, they provide indispensible diagnostic information contribute significantly to adjacent soft tissue conditioning, and ensure the patient's comfort during the intermediate phase of treatment. The-treatment outcome strongly depends on the treatment approach chosen. This article describes a treatment rationale comprising the use of a diagnostic template. This type of work strategy, documented with clinical cases, integrates diagnostic waxups and indirect provisional restorations using simplified and efficient fabrication techniques.
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Dentinal seal and the internal adhesive interface of bonded tooth ceramic overlays were evaluated in vitro, using a dye infiltration test and direct-indirect SEM observations. The new adhesives such as Optibond or Scotchbond MP demonstrated better performances in dentin bonding than former adhesives. With the large cementing space (300 microns), a rigid set-up restraining compensatory phenomena between the restoration and the tooth proved again to negatively influence the dentinal seal of bonded ceramic overlays. In the present test conditions, dentin bonding of the new adhesives remains perfectible, even if the total etch technique is applied. Failure modes of Optibond and Scotchbond MP showed some specific features. For both brands, bonding failures occurred mainly between the hybrid layer and the overlaying resins; these are not of an artefactual nature, as was demonstrated by indirect SEM observations. The cohesiveness of the adhesive interface does not appear optimal at the present time; the need for stress reduction in the cementing space therefore remains of primary concern in dentin bonded restorations.
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The increase in the demands made by patients for esthetic or metal-free restorations, together with the ever-growing interest shown by the dental profession for tooth-colored materials and techniques, led to the current development of posterior adhesive restorations. This paper reviews critical elements such as adhesion to dental hard tissues as well as current properties of bases/liners, filling materials, and luting materials. A rationale for the successful use of currently available restorative systems is presented.
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The wall-to-wall contraction of the cementing layer of bonded restorations is compensated for mainly by elastic and plastic tooth substrate-cement deformation but may result in adhesive fracture. Occlusally flattened teeth and corresponding computer-designed onlays, both positioned in a special device, were used to study marginal and internal seal of the adhesive interface with respect to four variables: rigidity of the restoration-substrate setup, cement thickness, adhesive configuration (enamel-dentin ratio and bonding agent), and luting agent. The results of dye infiltration tests revealed the significant influence of the adhesive configuration and rigidity of the setup. A high enamel-dentin ratio, use of a dentinal adhesive on dentinal margins and relative restoration-substrate "mobility" are required to preserve satisfactory marginal seal. However, in the present experimental conditions, no statistically significant differences were found among the diverse cement thicknesses or the luting agents evaluated.
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A retrospective study of 212 vascular graft failures, using different criteria of infection evidenced a relatively high incidence of infectious complications. Vascular graft infection was assessed on one of the following criteria: clinical infection, positive bacteriological and/or virological examination of the graft, presence of characterized micro-organisms and of microstructures 0.1 to 0.5 micron in size at the blood/prosthesis surface at scanning electron microscopy, and presence of foci of persistent polymorphonuclear cells and lymphocytes at histological microscopy. In the absence of overlapping between these criteria, the present results raise the question of the adequacy of conventional bacteriological sampling on explanted artificial surfaces.
Generally, the principles of tooth preparation are well established in the majority of textbooks dealing with fixed prosthodontics. However, one specific related aspect, retention and resistance form, still features some elements that might be less known to the clinician. The purpose of the present literature review is to contribute to the classification and current understanding of the terms of retention and resistance. Finally, the resulting clinical implications, focusing primarily on cast full veneer and porcelain-fused-to-metal crowns, will be discussed.
We have studied the structure-function relationships in newly discovered hemoglobin (Hb) mutants with substitutions occurring at the tight and highly hydrophobic cluster between the B and G helices in the beta chains, namely, Hb Knossos or beta A27S and Hb Grange-Blanche or beta A27V. The beta A27S mutant has a 50% decrease in oxygen affinity relative to native human Hb A, while the beta A27V mutant has an increased oxygen affinity. We have also engineered the artificial beta A27T mutation through site-directed mutagenesis. This new mutant exhibits functional properties similar to those of Hb A. None of these mutants is unstable. X-ray analyses show that the substitution of Val for Ala may reduce the relative stability of the T structure of the molecule through packing effects in the beta chains; for the beta A27S mutant a new hydrogen bond between serine and the carbonyl O at beta 23 (B5) Val is observed and is likely to increase the relative stability of the T structure in the mutant hemoglobin. However, no significant changes in the crystals were observed for these mutants between the quaternary R and T structures relative to native Hb A. We conclude that small tertiary structural changes in the tight hydrophobic B-G helix interface are sufficient to induce functional abnormalities resulting in either low or high intrinsic oxygen affinities.
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The density of normal red blood cells increases during their 3-month life span. This characteristic has been used for many years to separate younger from older cells by centrifugation, allowing biochemical and physiological studies on the ageing process in red cells to be performed. The methods which have been proposed to date using discontinuous density gradients made of high density chemical compounds required high speed centrifugation of long duration. These gradients with pre-established density layers are well designed to separate red cells when their density varies over a small range as in blood from healthy donors. Pathological red cells such as found in sickle cell anaemia, thalassaemia syndromes or haemolytic anaemia of various origins display a wide and unpredictable range of densities which precludes the use of a standard discontinuous gradient. Because the fractionation of such pathological blood specimens is of great clinical and biochemical interest we report the details of a new method which combines two steps: firstly and analytical method performed with phthalate esters which allows estimation of the distribution of particular red cells, secondly a preparative method using Percoll solutions to prepare the discontinuous density gradient according to the histogram given by the first step. Two examples are described illustrating this interesting method which may possibly be applied to other blood disorders.
A low P50 value in a fresh red blood cell suspension was discovered in a polycythemic patient (Hb 19 g X dl-1). Routine acid and alkaline electrophoreses of the hemolysate were identical to normal hemolysate. Isoelectrofocusing (pH gradient 6-8) did not reveal any abnormal band whether performed with the fully liganded or deoxygenated samples. Precise analyses of the oxygen dissociation curves of the propositus' red cells demonstrated a biphasic Hill plot, a normal Bohr effect and low interaction with 2,3-bisphosphoglycerate (2,3-DPG). Studies on the unfractionated hemolysate confirmed these observations and the inhibition of the effect of organic phosphates. Structural studies were carried out on the mixture of beta A + beta X chains and revealed the presence of two beta Tp14 peptides. Sequencing the abnormal beta Tp14 peptide showed the substitution Ala----Thr of the beta 140 (H18) residue. This new variant was named Hb Saint-Jacques. Examination of the three dimensional model of HbAo indicates that the substitution beta 140 (H18) Ala----Thr induces van der Waals interactions with the nearby lysine-82 (EF6) and leucine-81 (EF5) and a displacement of the EF corner of the beta chains. This is likely to change the normal position of the lysine-82 (EF6), a major anionic binding site in the central cavity between the two beta chains. Functional studies confirm the interpretation of a steric hindrance inhibiting the binding of large organic phosphates to Hb Saint-Jacques.
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PURPOSE: The purpose of this study was to investigate the biomimetic principle in porcelain veneer reconstruction, or in other words, to assess the extent to which the restoration can mimic the biomechanics and structural integrity of the original tooth. Using an optimized luting procedure, porcelain veneers are expected to present such features even when bonded to an extensive dentin surface. METHODS AND MATERIALS: Dentin-bonded porcelain veneers were assessed using functional and cyclic thermal loads with respect to two parameters: coronal stiffness (investigated using experimental strain gauges and finite element analysis) and morphology of the tooth-restoration interface (scanning electron microscope evaluation). Two different application modes of the same dentin-bonding agent, Optibond FL, were evaluated: a traditional method (dentin adhesive applied when proceeding to luting the veneer) and an alternative method (dentin adhesive applied to dentin and cured before taking the impression for the veneer). RESULTS: In the finite element model, the crown compliance increased by a factor of 2.16 after facial enamel removal and returned to 96% of its original value after the placement of the veneer. The finite element values showed a good correlation with strain gauge experimental results (one-sample t test, P > 0.35 after facial enamel removal and P > 0.19 after veneer placement). The dentin adhesive application mode was not critical to the recovery of tooth stiffness (analysis of variance, P = 0.10). However, qualitative scanning electron microscope observations demonstrated that the traditional dentin adhesive application was associated with bonding failures between the hybrid layer and the overlying resin, whereas unbroken and continuous interfaces were obtained with the new method using the same dentin adhesive. CONCLUSION: The results of this study definitely favor the biomimetic behavior of porcelain veneers bonded to teeth using an optimized application mode of dentin adhesives, because this treatment modality proved to restore both the mechanical behavior and microstructure of the intact tooth.