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Partial molar volume, surface area, and hydration changes for equilibrium unfolding and formation of aggregation transition state: high-pressure and cosolute studies on recombinant human IFN-gamma.

The equilibrium dissociation of recombinant human IFN-gamma was monitored as a function of pressure and sucrose concentration. The partial molar volume change for dissociation was -209 +/- 13 ml/mol of dimer. The specific molar surface area change for dissociation was 12.7 +/- 1.6 nm2/molecule of dimer. The first-order aggregation rate of recombinant human IFN-gamma in 0.45 M guanidine hydrochloride was studied as a function of sucrose concentration and pressure. Aggregation proceeded through a transition-state species, N*. Sucrose reduced aggregation rate by shifting the equilibrium between native state (N) and N* toward the more compact N. Pressure increased aggregation rate through increased solvation of the protein, which exposes more surface area, thus shifting the equilibrium away from N toward N*. The changes in partial molar volume and specific molar surface area between the N* and N were -41 +/- 9 ml/mol of dimer and 3.5 +/- 0.2 nm2/molecule, respectively. Thus, the structural change required for the formation of the transition state for aggregation is small relative to the difference between N and the dissociated state. Changes in waters of hydration were estimated from both specific molar surface area and partial molar volume data. From partial molar volume data, estimates were 25 and 128 mol H2O/mol dimer for formation of the aggregation transition state and for dissociation, respectively. From surface area data, estimates were 27 and 98 mol H2O/mol dimer. Osmotic stress theory yielded values approximately 4-fold larger for both transitions.

Dimerization↗

Molar substitution and C2/C6 ratio of hydroxyethyl starch: influence on blood coagulation.

BACKGROUND: Development of hydroxyethyl starches (HES) with a low impact on blood coagulation but a long intravascular persistence is of clinical interest. A previous in vitro study showed that low substituted high molecular weight HES does not compromise blood coagulation more than medium molecular weight HES. In the present study we assessed the individual effects on blood coagulation of molar substitution and C2/C6 ratio of a high molecular weight HES. METHODS: Blood was obtained from 30 healthy patients undergoing elective surgery and mixed with six high molecular weight (700 kDa) HES solutions differing in their molar substitution (0.42 and 0.51) and C2/C6 ratio (2.7, 7 and 14) to achieve 20, 40 and 60% dilution. Blood coagulation was assessed by Thrombelastograph analysis (TEG) and plasma coagulation tests. Data were compared using a three-way analysis of variance model with repeated measures on the three factors. RESULTS: Higher molar substitution compromised blood coagulation most (for all TEG parameters, P<0.05). The lowest C2/C6 ratio was associated with the lowest effect on blood coagulation; r (P<0.001), angle alpha (P=0.003) and coagulation index (P<0.001). No effect on k and maximum amplitude was observed (P for both >0.50). The higher molar substitution was associated with a lesser increase in PT (P=0.007) and a greater decrease in factor VIII (P=0.010). PTT, functional and antigenic von Willebrand factors were not significantly influenced by molar substitution (P for all >0.20). No significant differences between solutions with the same molar substitution but different C2/C6 ratios were found in plasma coagulation parameters (P for all >0.05). CONCLUSIONS: TEG analysis indicates that high molecular HES with a molar substitution of 0.42 and a C2/C6 ratio of 2.7 has the lowest effect on in vitro human blood coagulation.

Adult↗

[Molar pregnancy. Retrospective study of 60 cases in Tunisia].

To identify the epidemiologic, clinical end therapeutic particularities of molar pregnancies in Tunisia. A retrospective study of 60 cases of molar pregnancy Diagnosis of MP was base on elevated urine HCG level and/or histologic examination of uterine revision done for all patients. The incidence of MP is 1/793(60/47624) pregnancies. The mean age of patients was 31.7 years and 16 patients had more than 35 years. The metrorragia is the main symptom (91.6%). Excessive uterine enlargement and lutein ovarian cysts were observed respectively in 57 and 6.6% of cases. Human chorionic gonadotropin level was upper than 50,000 UI/l in 91.4% of cases. Ultrasonography contributed to diagnosis in 82.8% of cases. Histological findings were complete molar in 33 cases and partial molar in 27 cases. 6 of 33 patients having complete molar developed persistent gestational trophoblastic tumor. Actinomycin D induced complete remission in all cases. Molar pregnancy is a relatively common disease in Tunisia. Careful and reliable human chorionic gonadotropin monitoring is essential for the early detection of post molar persistent gestational trophoblastic tumor.

Adult↗

[The research of orthodontic therapy in second molar overjet]

The malocclusion of overjet of second molars is very frequent,When the 2183 patients were examined,we found that the above-mentioned malocclusion had 420 cases.It accounts for 19.22%.The factors led this malocclusion are many.The cases of buccoversion of second molar in maxilla and normal of this tooth in mandible are 257.That upper second molar is buccoversion and lower second molar is linguoversion.all in one side,are 104 cases.Upper normal and lower linguoversion are 24.Buccoversion of two second molars only in upper dental arch and lingual position of second molar in one side of lower dental arch are 31.Even that bilateral lower second molars are linguoversion and this tooth of upper jaw in one side is buccoversion are 4.Therefore,we must adopt various technique according to malposition condition of second molar.This paper will describe five corrective.

Journal Article↗

Gestational trophoblastic disease. Subsequent pregnancy outcome, including repeat molar pregnancy.

OBJECTIVE: To determine subsequent reproductive outcomes in patients treated for partial molar pregnancy, complete molar pregnancy and persistent gestational trophoblastic tumors at the New England Trophoblastic Disease Center (NETDC) between June 1, 1965, and December 31, 1996. STUDY DESIGN: Questionnaires were mailed to all patients followed at the NETDC to assess subsequent pregnancy experience. All patients and their referring physicians were also requested to inform the NETDC about later pregnancies. RESULTS: Following partial mole, complete mole and persistent gestational trophoblastic tumor, our patients had 195, 1,234 and 504 later pregnancies, respectively. These patients had a later pregnancy experience comparable to that of the general population. However, after having one molar pregnancy, the risk of molar pregnancy in a later conception was about 1%. Twenty-nine of our patients had at least two episodes of molar pregnancy; following two episodes of molar pregnancy, 6 (23.1%) of 26 later conceptions resulted in another molar gestation. CONCLUSION: Patients with partial mole, complete mole and persistent gestational trophoblastic tumor can be reassured that in general they can anticipate a normal future reproductive outcome.

Female↗

Prediction of maxillary third molar impaction in adolescent orthodontic patients.

The purpose of this study was to identify risk factors for maxillary third molar impaction in adolescent orthodontic patients. Radiographs made before treatment (T1) and after treatment (T2) and at a minimum of 10 years postretention (T3) of 132 patients that allowed accurate diagnosis of impaction vs eruption of one or both maxillary third molars were evaluated. Although univariate logistic regression revealed that the decision to extract premolars reduced the risk of impaction by 76% (P < .01), this parameter was not included in the final prediction model at T1. Multiple logistic regression analyses revealed that third molar impaction could be predicted at T1 according to the size of the retromolar space and the amount of mesial molar movement that will occur during active appliance therapy, reducing the risk of impaction by 22% and 34% for every millimeter increase in distance, respectively (P < .01). At T2, multiple logistic regression revealed that the odds of impaction were more than 60 times higher (P < .01) if the third molar was angulated mesially as compared with less than 30 degrees distally relative to the occlusal plane and almost five times (P < .05) higher if the third molar was angulated more than 30 degrees distally as compared with less than 30 degrees distally. Similar analyses at T2 showed 29% reduced risk of impaction for every millimeter increase in retromolar space and 18% reduced risk for every degree increase in angle MP/SN (P < .01).

Adolescent↗

Radiographic follow-up of impacted third molars from age 20 to 32 years.

Nineteen patients (13 male, six female) with 34 impacted third molars, 21 in the mandible and 13 in the maxilla were radiographically followed from age 20 to 32. All were examined clinically and panoramic radiographs were taken at baseline and at the end of the study. Radiographic analysis included resorption of teeth, enlargement of the follicle, development of the root, change in inclination of the third molar, state of impaction, relative depth of the third molar in bone and relation to the ramus of the mandible and to the second molar tooth. In the mandible, the mean change in inclination was 19 degrees and the percentage of teeth with changed angulation was 76%. In the maxilla, only 23% of the teeth changed their inclination. The state of impaction (soft tissue, partially in bone, completely in bone) had changed for 44% of the teeth. According to the questionnaire, no pain or symptoms in the region of the third molars were reported by 74% of the students during the 12-year period. It is concluded that considerable radiographic changes, without notable symptoms, may occur involving inclination of the tooth and state of impaction in impacted third molars after the usual age of eruption.

Adult↗

Accuracy of the Third Molar Eruption Predictor in predicting eruption.

OBJECTIVE: To evaluate the possibility of applying the Third Molar Eruption Predictor to all panoramic radiographs. STUDY DESIGN: Panoramic radiographs were retrospectively analyzed from a 4-year follow-up study of third molars carried out at the University of Copenhagen, Denmark. The radiographs, taken at a mean age of 20.6 years, included 45 unerupted or partially erupted mandibular third molars in 28 subjects. Because the device was calibrated both with simple proportions and by use of the methods of Bayes' Decision Theory, the separation point of the device was therefore adjusted at 12 mm from the distal surface of the second molar. RESULTS: The predictions of future eruption or impaction made with the calibrated device and the actual clinical outcome 4 years later were in conformity for 80% of the mandibular third molars. CONCLUSION: The Third Molar Eruption Predictor may be applied to all panoramic radiographs, but it seems to require calibration before use.

Adult↗

Use of third molar transplantation for closure of the oroantral communication after tooth extraction: a report of 2 cases.

OBJECTIVE: This clinical report introduces a promising and unique method for the immediate closure of the oroantral communication (OAC) after tooth extraction: the use of the transplanted third molar with closed apices. STUDY DESIGN: In 2 adult patients, OAC caused by the extraction of an upper molar was immediately closed by using a transplanted third molar with complete root formation. After tooth extraction at the recipient site, OAC with perforated mucosa of the sinus floor was confirmed and the donor third molar was transferred to the prepared recipient socket. Endodontic therapy of the transplanted third molar began at 3 weeks after surgery, and prosthetic treatment was completed at 5 months after the operation. These 2 patients were carefully observed both clinically and radiographically. RESULTS: Closure of the OAC was successfully performed, and the transplanted teeth became fixed with the passage of time in these 2 patients. Root resorption did not occur, and good functional results were obtained without any complications. CONCLUSIONS: Tooth transplantation of a mature third molar for closure of the OAC is a simple and excellent method because the transplanted tooth not only closes the communication to the maxillary sinus, but it also satisfactorily functions at the recipient site during mastication, even in adult patients.

Adult↗

Autotransplantation of third molars as treatment in advanced periodontal disease.

The aim of this study was to investigate the prognosis of replacing molars with advanced periodontitis by autotransplanted fully developed third molars. The patient sample consisted of 18 subjects, 24-58 years of age. The patients selected had at least 1 molar with advanced periodontal tissue destruction. After extraction of the diseased molar, autotransplantation of a third molar was immediately performed. After a splinting and healing period of 2-3 weeks, endodontic treatment was carried out. The follow-up included recordings of the clinical parameters, probing periodontal pocket depth, probing attachment level, percussion sound, and mobility. Radiographs were taken immediately after the surgical procedure, after 6 months, 1 year, and thereafter annually. The results of this study indicate that autotransplantation may be an alternative treatment procedure for molars with advanced periodontal disease.

Adult↗

Mesial migration effect on root morphology of mandibular third molars.

OBJECTIVE: To test the hypothesis that there is a relationship between forward mandibular third molar migration and root curvature of the mandibular third molars. MATERIALS AND METHODS: The study is comprised of 64 patients who had a history of unilateral mandibular first molar extraction before 16 years of age with no other missing teeth or prosthetic restorations in the mandible. The extraction space was fully or partly closed. The mean remaining space was 1.1 +/- 0.41 mm. The root angles for the mesial and distal roots of the mandibular third molars were measured on the panoramic radiographs by calculating the differences between the angle formed by the long axis drawn perpendicular to the occlusal plane of the crown of mandibular third molar and the central line of the lower one ninth of the root through the root apex. The differences between the extracted and nonextracted sides for mesial and distal roots were analyzed using a paired sample t-test. RESULTS: Both mesial and distal roots were approximately 8 degrees more vertical on the extraction sides than on the nonextraction sides. The differences were statistically significant. CONCLUSION: Mesial tooth migration of mandibular third molars reduces the amount of root curvature developing on this tooth.

Adolescent↗

A scanning electron microscopy study of disturbances in the developing rat molar induced by cyclophosphamide.

Scanning electron microscopy was used to study the effect of cyclophosphamide (Cy) on molar development in 18 Sprague-Dawley rats from 15 to 48 days of age after birth. Doses of 30 mg/kg body weight of Cy dissolved in 1 ml 0.9% NaCl were given to the rats at 10 and 13 days of age. Eighteen control rats had injections of 1 ml 0.9% NaCl at the same ages. The most obvious changes in the experimental teeth were found in the developing roots of the first and second molars and in both the crown and roots of the third molar. The roots of the first and second molars were short and showed apical closure in the experimental rats. In addition to the disturbances in crown and root formation, the third molars were also significantly reduced in total size as compared with the third molars in the control rats.

Alopecia↗

Autotransplantation of endodontically treated third molars.

OBJECTIVE: To determine the success rate in autotransplantation of endodontically treated third molars. DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: This study was carried out at Armed Forces Institute of Dentistry (AFID), Rawalpindi (Pakistan) from January 2002 to December 2002. PATIENTS AND METHODS: A total of 50 patients meeting the inclusion criteria were selected who had their first or second molars in unrestorable condition with intact third molars. The donor teeth were extracted after the preparation of recipient site. After endodontically treated in vitro the donor teeth were carried to the recipient site and immobilized. Postoperative variables were recorded and analyzed on SPSS version 10. RESULTS: The overall success rate after six months of the transplantation of third molars was 88% with complete root formation after endodontic treatment. All the patients(12%) who had complaints were more than 35 years of age. CONCLUSION: Third molars are good substitute for the unrestorable first or second molars and would be as effective as endosseous implants. The procedure is likely to have complications in the advanced age group.

Adult↗

Three-dimensional measurement of the occlusal surfaces of lower first molars of Australian aboriginals.

The occlusal surfaces of lower first molars of Australian Aboriginals were measured in three dimensions with the aid of Moiré contourography. Molar cuspal heights in this population were higher than in Japanese (Mongoloid) but lower than in Dutch (Caucasoid) populations. Intercuspal distances were considerably larger than those in the two other populations. Populational differences in occlusal features may influence both craniofacial structures and jaw movements in the three populations. Low correlations between the cuspal heights and the intercuspal distances in the other two populations were also found in this population, indicating that human molar cuspal height is independent of the transverse size of the crown. Mean values for the height of the three principal cusps in lower first molars were less than those in upper ones. However, the height of the hypoconid, which was the highest in the lower molar cusps, showed almost the same mean value as the height of the upper three principal cusps, indicating that the height of the main functional cusp, in both upper and lower first molars, was almost the same.

Asian People↗

Molar enamel thickness in the chacma baboon, Papio ursinus (Kerr 1792).

Modern humans exhibit increasing relative enamel thickness from M1 to M3. Some biomechanical (basic lever) models predict that the more distal molars in humans encounter higher occlusal forces, and it has been postulated that this provides a functional explanation for the observed gradient in relative enamel thickness. However, constrained three-dimensional models and experimental observations suggest that there is a reduction in bite force potential from M1 to M3, which would be consistent with the tendency for humans to reduce the size of the distal molars. In this regard, it has been postulated that the distal increase in enamel thickness is a consequence of crown size reduction; thus, it is unnecessary to invoke functional scenarios to explain this phenomenon. We assess these competing proposals by examining relative enamel thickness in a catarrhine primate (Papio ursinus) that exhibits crown size increase from M1 to M3. The molar row of P. ursinus is positioned relatively far forward of the temporomandibular joint, which results in the baboon being able to exert relatively greater muscle forces during posterior biting in comparison to modern humans. Thus, a significant distalward gradient of increasing enamel thickness would be expected in P. ursinus according to the hypothesis that posits it to be functionally related to bite force. The present study reveals no significant difference in relative enamel thickness along the molar row in P. ursinus. This finding lends support to the notion that the relatively thicker enamel of human distal molars is related primarily to their reduction in size. This carries potential implications for the interpretation of enamel thickness in phylogenetic reconstructions: the relatively thick molar enamel shared by modern humans and some of our fossil relatives may not be strictly homologous, in that it may result from different underlying developmental mechanisms.

Anatomy, Cross-Sectional↗

Eruption times of third molars in young rural Nigerians.

The eruption pattern of third molar amongst 1071 rural Nigerians (523 males and 548 females) aged 11-21 years was assessed. The earliest age at which the third molar erupted for males and females was 14 and 13 years respectively with females significantly ahead of males (P < 0.01). A full compliment of erupted third molars was recorded at age 14 years in 1.1 per cent of the population. However, the mean age for the eruption of 1, 2, or 3 and all third molars were 16.58 and 17.50 years respectively. Whilst third molar-eruption was significantly earlier in the mandible, no right-left side differences were found. Problems often associated with the erupting third molars are likely to be seen earlier in young rural Nigerians than in the western countries.

Adolescent↗

Arrest of rat molar tooth development by lactational exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin.

The interference with tooth development by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) was studied in dioxin-resistant Han/Wistar rats. Lactating dams were given a single dose of 50 or 1000 microg TCDD/kg body wt 1 day after delivery and the pup heads were analyzed radiographically or histologically at postnatal days 9 and/or 22. Of 19 animals studied histologically, 10 lacked one or more third molars, which were at the bud stage at the start of the experiment. A higher proportion of pups exposed to the higher dose (9/13) lacked third molars than those exposed to the lower dose (1/6) (27/52 and 2/24 teeth missing, respectively). Missing upper third molars (19/38) were more frequent than were lower (10/38). The development of the third molars present was retarded. The root tips of the more advanced first and second molars were prematurely closed and root formation was arrested, but eruption was not affected. Dentinogenesis of the continuously erupting lower incisor teeth was preeruptively arrested because of pulpal cell death. All the teeth of the control rat pups developed normally. In contrast to the control pups, none of the 11 experimental pups examined radiographically (6 exposed to the higher dose and 5 to the lower) showed mineralization of their third molar cusps. The results show that the effects of TCDD on rat tooth development depend on not only the dose but also the tooth type and developmental stage. Inasmuch as early tooth development is under the control of inductive interactions between the epithelium and the mesenchyme, the interference by TCDD with tooth morphogenesis with the consequent arrest of development is likely to involve epithelial-mesenchymal signaling.

Animals↗

In utero/lactational 2,3,7,8-tetrachlorodibenzo-p-dioxin exposure impairs molar tooth development in rats.

Developmental defects caused by dioxins are causing increasing concern since they occur at low dose levels and are usually permanent. In this study we examined the effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) at low in utero/lactational exposure levels on rat tooth development in three rat lines, denoted A, B, and C, that differ in their TCDD sensitivity and aryl hydrocarbon receptor structure. These rat lines are derived from TCDD-resistant Han/Wistar (Kuopio) and TCDD-sensitive Long-Evans (Turku/AB) rats by selective breeding. The main target teeth were the third molars, since their development spans from the perinatal period to about 6 weeks after birth. Pregnant dams were exposed to 0.03-1 microg/kg TCDD on gestation day 15. Pups exposed in utero and lactationally were euthanized at the age of 5 or 10 weeks and the jaws were examined. The eruption of the third molar was observed by stereomicroscopy and the jaws were further radiographed. TCDD at 1 microg/kg completely prevented the development of the third lower molars in 60% of males and 50% of females in the most sensitive rat line, C, while only 6% or less of the pups in the more resistant lines A and B were lacking this target tooth. TCDD exposure also dose-dependently diminished the proportion of third molars erupted at the age of 5 weeks. The size of molars was dose-dependently reduced in all rat lines. The third lower molars were most severely affected, and the reduction was significant already at 0.03 microg/kg in line A and at 0.1 microg/kg in lines B and C. The results indicate that impaired tooth development is one of the most sensitive endpoints of TCDD-induced toxicity.

Abnormalities, Drug-Induced↗