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OBJECTIVES: Investigate the effect of aging on the wear behavior of glazed vs polished monolithic zirconia and to establish if glazing provides protection against low temperature degradation. METHODS: 40 1-mm-diameter spheres made from four differently treated monolithic zirconia (VITA YZ® HT); polished, polished-aged, glazed and glazed-aged (n = 10), were tested in a wear testing machine (UFW200) against bovine enamel in artificial saliva as per the following settings (ISO20808:2016): ball-on-disc configuration, 5 N vertical load, 0.1 m/s sliding speed, 400 m sliding distance and 37 °C temperature. Vertical substance loss (mm) wear of zirconia and enamel specimens was measured. Data were statistically analyzed with Kruskal-Wallis one-way ANOVA test (α > 0.05). RESULTS: Glazed-aged zirconia specimens resulted in the greatest amount of enamel wear (0.823 mm ± 0.157) followed by glazed (0.729 mm ± 0.289), polished-aged (0.377 mm ± 0.201) then polished (0.247 mm ± 0.125). In the groups with the same surface finish, aging showed no statistical difference in wear (P > 0.008). Glazing resulted in a higher enamel wear compared with polishing that was statistically significant (P < 0.008) except when the polished specimens were aged and the glazed specimens were not aged. SIGNIFICANCE: Aging increases abrasiveness of monolithic zirconia regardless of the type of surface finish. The effect of aging is "latent" and only revealed under mechanical loading during wear simulation which increases surface roughness and wear by adversely affecting zirconia's mechanical properties, making it less capable to maintain its initial surface smoothness. The glaze layer may protect zirconia from LTD, however, it is susceptible to aging which further increases its abrasiveness.

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BACKGROUND AND AIMS: The human iliotibial tract (IT) is increasingly used in different types of musculoskeletal models. Previous findings indicate age-dependent changes of the human IT tensile properties, these lack confirmation to date. The relationship of the human IT and anthropometrical parameters, such as body height and weight has not been investigated before. MATERIALS AND METHODS: 33 fresh human IT samples (age range 4 months to 93 years) were uniaxially tested using digital imaging correlation and the latest advances in 3D-printing to standardize biomechanical soft tissues testing. RESULTS: The tensile parameters of the human IT are not age-dependent, except for the maximum strain in males. Height significantly correlated to elastic modulus, tensile strength and maximum strain of the human IT in males. Females just showed a significant correlation between maximum strain and weight, which was contrary to the findings in males. DISCUSSION AND CONCLUSION: Age-dependency of human IT tensile parameters could not be confirmed in the larger sample size investigated in this study. Due to the strong correlation with the tensile IT parameters in males, we suggest that height should be integrated when the IT is used in simulations, such as finite element analyses of the hip and knee.

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OBJECTIVE/AIMS: The aim of this study was to measure continuously the intraoral pH and temperature of healthy individuals to investigate their diurnal variations. MATERIALS AND METHODS: Seventeen participants (mean age, 31±9 years) wore a custom-made intraoral appliance fitted with a pH probe and thermocouple for two sets of 24 h, while carrying out normal daily activities including sleep. The continuous changes in intraoral pH and temperature were captured using a sensor placed on the palatal aspect of the upper central incisors. The collected data were categorised into different status (awake and sleep) and periods (morning, afternoon, evening and night). Both quantitative and qualitative analyses were conducted. RESULTS: The intraoral pH change was found to show a distinctive daily rhythm, showing a 12-h interval between maximum (7.73) and minimum (6.6) pH values. The maximum and minimum values were found to repeat after 24 h. The mean pH over 48 h (two sets of 24 h) was found to be 7.27 (±0.74). There was significant difference found in pH when subjects were awake and asleep and different periods during the day (P<0.001). The mean intraoral temperature was 33.99 °C (±4.9), with less distinctive daily rhythm compared with pH. There was a significant difference found in temperature depending on the time of the day, except between morning and afternoon (P=0.78). CONCLUSION: Our results showed that there is a distinctive daily, circadian-like pattern in intraoral pH variation over a 24-h period, which has been considered as one of the risk factors in sleep-related dental diseases.

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PURPOSE OF STUDY: The severity of tooth wear is known to have an association with intraoral pH and temperature depending on the site. OBJECTIVE: To compare the intraoral pH and temperature between the maxillary and mandibular arch. METHODS: Fourteen participants (mean age=25.8 years) wore a custom-made intraoral appliance fitted with a pH probe and thermocouple for 24 h while carrying out normal activities including sleep. All participants wore a maxillary appliance; four participants repeated the process and wore the mandibular appliance. Measurements were taken from the palatal aspect of the upper central incisors and lingual aspect of the lower canines. Both qualitative and quantitative statistical analyses were conducted. RESULTS: The mean intraoral pH from the maxilla was 7.32 (±0.52) and 7.07 (±0.26) for the mandible. During daytime, there was no statistical significance difference between the two arches (P=0.12). During sleep, there was a significant difference (P<0.001) between the mean pH of the maxilla, 7.0 (±0.46), and mandible, 6.46 (±0.31). The fluctuation patterns of pH and temperature from both arches were similar, but the maxilla showed more variations. The mean temperature from the mandible was slightly higher (36.18 °C (±0.96)) than the maxilla, 33.12 °C (±5.51) during daytime; however, there was no statistically significance difference in temperature between the arches during daytime (awake) or sleep (P=0.27). CONCLUSION: The results showed that there is significant difference in mean intraoral pH between the maxilla and the mandible during sleep, but not during the day and this difference may be associated variations in tooth wear between the arches.

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Little is known about the persistence of gunshot residue (GSR) in soft tissue and bones during decomposition in marine environments. For a better understanding, qualitative and quantitative data were obtained on GSR retention on soft tissue and bony gunshot wounds (GSWs). A quantity of 36 fleshed and 36 defleshed bovine ribs were shot at contact range with 0.22 calibre hollow point ammunition using a Stirling 0.22 calibre long rifle. Bone specimens in triplicate were placed in three environments: submerged, intertidal and in supralittoral zone. Sets of triplicates were recovered on day 3, 10, 24 and 38, and analysed with scanning electron microscopy with energy dispersive X-ray spectrometry (SEM-EDX), and inductive coupled plasma mass spectrometry (ICP-MS). The SEM-EDX recorded GSR-indicative particles surrounding the bullet entrance on all bone types (fleshed and defleshed) in all environments throughout the study. GSR-unique particles were only detected on the supralittoral bones. The ICP-MS analysis showed faster GSR loss on submerged than intertidal and supralittoral defleshed specimens. Fleshed specimens showed a faster GSR loss on intertidal than submerged and supralittoral specimens. In conclusion, the GSR disappeared faster from submerged and intertidal than non-submerged specimens. The difference of detection of GSR between analysed specimens (defleshed versus fleshed) disappeared upon defleshing. This study highlights the potential of finding evidence of GSR in a submerged body and the potential of microscopic and analytical methods for examining suspected GSW in highly decomposed bodies in marine habitats.

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Reports on penetrating ballistic head injuries in the literature are dominated by case studies of suicides; the penetrating ammunition usually being .22 rimfire or shotgun. The dominating cause of injuries in modern warfare is fragmentation and hence, this is the primary threat that military helmets protect the brain from. When helmets are perforated, this is usually by bullets. In combat, 20% of penetrating injuries occur to the head and its wounding accounts for 50% of combat deaths. A number of head simulants are described in the academic literature, in ballistic test methods for helmets (including measurement of behind helmet blunt trauma, BHBT) and in the 'open' and 'closed' government literature of several nations. The majority of these models are not anatomically correct and are not assessed with high-velocity rifle ammunition. In this article, an anatomically correct 'skull' (manufactured from polyurethane) and 'brain' (manufactured from 10%, by mass, gelatine) model for use in military wound ballistic studies is described. Filling the cranium completely with gelatine resulted in a similar 'skull' fracture pattern as an anatomically correct 'brain' combined with a representation of cerebrospinal fluid. In particular, posterior cranial fossa and occipital fractures and brain ejection were observed. This pattern of injury compared favourably to reported case studies of actual incidents in the literature.

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BACKGROUND: The need for continued refinement of animal models in orthopaedic studies persists despite decades of research. OBJECTIVE: This study investigates the merits of deer bone in comparison to the more commonly used pig and sheep bone as an animal model for the human femur. METHOD: A morphological and biomechanical comparison of deer, pig and sheep rear femurs to those of the human femur is presented. Morphological parameters measured include bone length, cortical and medullary diaphyseal diameters, cortical thickness, cortical cross-sectional area and bone density along the diaphysis. Biomechanical tests included whole-bone four-point flexure tests to determine the bending stiffness (N/mm), Young's modulus of bending (GPa), and ultimate strength in bending (MPa). In addition torsional stiffness (Nm/degree) as well as mid-diaphyseal cortical compressive elastic modulus (GPa) and strength (MPa) is investigated. RESULTS: On average, deer bone was found to be the least dissimilar from human femur. However, no single bone type consistently resembled the human femur. CONCLUSION: Deer femora should be considered a suitable animal model for the human femur.

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BACKGROUND: Computer numeric controlled (CNC) milling was proven to be predictable method to fabricate accurately fitting implant titanium frameworks. However, no data are available regarding the fit of CNC-milled implant zirconia frameworks. PURPOSE: To compare the precision of fit of implant frameworks milled from titanium and zirconia and relate it to peri-implant strain development after framework fixation. MATERIALS AND METHODS: A partially edentulous epoxy resin models received two Branemark implants in the areas of the lower left second premolar and second molar. From this model, 10 identical frameworks were fabricated by mean of CNC milling. Half of them were made from titanium and the other half from zirconia. Strain gauges were mounted close to the implants to qualitatively and quantitatively assess strain development as a result of framework fitting. In addition, the fit of the framework implant interface was measured using an optical microscope, when only one screw was tightened (passive fit) and when all screws were tightened (vertical fit). The data was statistically analyzed using the Mann-Whitney test. RESULTS: All frameworks produced measurable amounts of peri-implant strain. The zirconia frameworks produced significantly less strain than titanium. Combining the qualitative and quantitative information indicates that the implants were under vertical displacement rather than horizontal. The vertical fit was similar for zirconia (3.7 µm) and titanium (3.6 µm) frameworks; however, the zirconia frameworks exhibited a significantly finer passive fit (5.5 µm) than titanium frameworks (13.6 µm). CONCLUSIONS: CNC milling produced zirconia and titanium frameworks with high accuracy. The difference between the two materials in terms of fit is expected to be of minimal clinical significance. The strain developed around the implants was more related to the framework fit rather than framework material.

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PURPOSE: The aim of this study was to review the published literature investigating the accuracy of fit of fixed implant frameworks fabricated using different materials and methods. MATERIALS AND METHODS: A comprehensive electronic search was performed through PubMed (MEDLINE) using Boolean operators to combine key words. The search was limited to articles written in English and published through May 2010. In addition, a manual search through articles and reference lists retrieved from the electronic search and peer-reviewed journals was also conducted. RESULTS: A total of 248 articles were retrieved, and 26 met the specified inclusion criteria for the review. The selected articles assessed the fit of fixed implant frameworks fabricated by different techniques. The investigated fabrication approaches were one-piece casting, sectioning and reconnection, spark erosion with an electric discharge machine, computer-aided design/computer-assisted manufacturing (CAD/CAM), and framework bonding to prefabricated abutment cylinders. CONCLUSIONS: Cast noble metal frameworks have a predictable fit, and additional fit refinement treatment is not indicated in well-controlled conditions. Base metal castings do not provide a satisfactory level of fit unless additional refinement treatment is performed, such as sectioning and laser welding or spark erosion. Spark erosion, framework bonding to prefabricated abutment cylinders, and CAD/CAM have the potential to provide implant frameworks with an excellent fit; CAD/CAM is the most consistent and least technique-sensitive of these methods.

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OBJECTIVE: To introduce a new strain gauge approach to assess the fit of fixed implant frameworks. MATERIALS AND METHODS: A partially edentulous epoxy resin mandible model received two Straumann implants in the area of the lower left second premolar and second molar. The model was used to fabricate four zirconia and four identical cobalt-chromium alloy frameworks using a laboratory computer-aided design/computer-aided manufacturing (CAD/CAM) system. A total of four linear strain gauges were then bonded around each implant on the peri-implant structure (mesial, distal, buccal, and lingual). The experimental part was composed of two phases: qualitative and quantitative. For the qualitative assessment, the model was verified by recording the response of each strain gauge while applying a near-constant force of known directions on each implant. For the quantitative phase, the frameworks were attached on the implants and the screws were torqued to 15 N cm. RESULTS: In the qualitative phase, the strain gauge response to every force direction was recorded. After attaching the frameworks, all frameworks produced measurable strains, but with different strain patterns. Upon correlating the two phases, the zirconia frameworks were found to be slightly smaller than the inter-implant distance, whereas the cobalt-chromium alloy frameworks tended to be slightly larger than the inter-implant distance. CONCLUSIONS: The proposed technique is not only valid for detecting implant framework misfit but also for determining the form of inaccuracies. Model verification is an essential informative step to aid the interpretation of the pattern of framework distortion.

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PURPOSE: This review critically compares the available clinical and laboratory methods for assessing the fit of an implant prosthesis. MATERIALS AND METHODS: MEDLINE and PubMed databases were searched for studies related to the fit of implant prostheses or the effect of misfit. Different combinations of key words were used. The screening procedure was performed in two stages. In the first stage, the relevant articles were selected. In the second stage, from those articles, specific inclusion and exclusion criteria were applied. RESULTS: Fifty-four articles were selected. Two different techniques were identified: in vitro and in vivo. The advantages, disadvantages, and limitations of each technique are discussed. There are clear limitations for the in vivo techniques. The in vitro techniques provide a more accurate measure of prosthesis misfit. CONCLUSIONS: Because of the variety of techniques and the different parameters assessed by each, it is useful to combine several techniques to assess the accuracy of fit, quantify the effect of misfit, and subsequently determine an acceptable level of fit.

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The purpose of this study was to quantify the effect of wave drag due to surface penetration on drag and lift forces (C(d) and C(l)) acting on a hand model. The values of C(d) and C(l) had been acquired to gain the hydrodynamic characteristics of the swimmer's hand and predict force on the swimmer's hand. These values have also been used to benchmark computational fluid dynamics analysis. Because the previous studies used a hand/forearm model which penetrated the water's surface, the values of C(d) and C(l) include the effect of the surface wave on the model. Wave formation causes pressure differences between the frontal and rear sides of a surface-penetrating model as a result of depressions and elevations in the water's surface. This may be considered as wave drag due to surface penetration. Fluid forces due to wave drag on the forearm should not be included in the measured C(d) and C(l) of a swimmer's hand that does not sweep near the water's surface. Two hand/forearm models are compared, one with the hand rigidly connected to the forearm. The other model was constructed to isolate the fluid forces acting on the hand from the influence of wave drag on the forearm. The measurements showed that the effect of wave drag on the hand model caused large increases in the values of C(d), up to 46-98% with lesser increases in C(l) of 2-12% depending on the hand orientation. The present study provides an improved method to determine the values of C(d) and C(l) that eliminates the effect of wave drag on a hand/forearm model by isolating the measurement of fluid forces on the forearm of the hand/forearm model in order to separately acquire the forces on the hand.

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Despite a long history of gross and microscopic descriptions of blunt and sharp force injury to the dermal tissues, few have addressed the mechanisms underlying such trauma. The need to develop an understanding of how non-ballistic injury occurs calls for an ability to biomechanically model the process. We recently introduced a basic skin and subcutaneous model, which we used to investigate wounding from a spherical object. Here we employ the same model to examine wounding caused by a sharp wedge shaped object and a blunt rectangular object. Macroscopic examination and SEM views of the surface and cross sections of blunt and sharp force tears show that while in the former there is a clean cut through the skin into the underlying sponge, in the latter there is a tissue plug confined to the skin that is smaller than the impacting rectangle. Fracture initiation in the subdermal tissue occurs at the angles of the impacting object. In sharp force trauma, there is localized breaching of the skin layer coupled with the wedging action of the impacting object. Because the subdermal tissue, in this case the underlying hydrated foam, is attached to the base of the skin, it will contribute to further tearing of the foam beneath the line of contact.

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Knowledge of the biomechanical dynamics of blunt force trauma is indispensable for forensic reconstruction of a wounding event. In this study, we describe and interpret wound features on a synthetic skin model under defined laboratory conditions. To simulate skin and the sub-dermal tissues we used open-celled polyurethane sponge (foam), covered by a silicone layer. A drop tube device with three tube lengths (300, 400, and 500 mm), each secured to a weighted steel scaffold and into which a round, 5-kg Federal dumbbell of length 180 mm and diameter 8 cm was placed delivered blows of known impact. To calculate energy and velocity at impact the experimental set-up was replicated using rigid-body dynamics and motion simulation software. We soaked each foam square in 500 mL water, until fully saturated, immediately before placing it beneath the drop tube. We then recorded and classified both external and internal lacerations. The association between external wounding rates and the explanatory variables sponge type, sponge thickness, and height were investigated using Poisson regression. Tears (lacerations) of the silicone skin layer resembled linear lacerations seen in the clinical literature and resulted from only 48.6% of impacts. Poisson regression showed there was no significant difference between the rate of external wounding for different sponge types (P = 0.294) or different drop heights (P = 0.276). Most impacts produced "internal wounds" or subsurface cavitation (96%). There were four internal "wound" types; Y-shape (53%), linear (25%), stellate (16%), and double crescent (6%). The two-way interaction height by sponge type was statistically significant in the analysis of variance model (P = 0.035). The other two-way interactions; height by thickness and sponge type by thickness, were also bordering on statistical significance (P = 0.061 and P = 0.071, respectively). The observation that external wounds were present for less than half of impacts only, but that nearly all impacts resulted in internal wounds, might explain the observed haematoma formation and contusions so often associated with blunt-force injuries. Our study also confirms the key role of hydrodynamic pressure changes in the actual tearing of subcutaneous tissue. At the moment and site of impact, transferred kinetic energy creates a region of high pressure on the fluid inside the tissue. As a result of the incompressibility of the fluid, this will be displaced away from the impact at a rate that depends on the velocity (or kinetic energy) of impact and the permeability and stiffness of the polymeric foam and skin layer.

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It has been suggested that students approach their learning in at least two qualitatively different ways. In the surface approach, students see tasks as being imposed, for which they develop coping strategies focused on reproduction of essentials and memorising information for assessment rather than for understanding. In the deep approach, students seek to understand ideas to allow them to relate and integrate knowledge from other parts of their study and thereby develop conceptual frameworks from which they can derive solutions to novel problems. To these two approaches, a third, achieving approach, is often added, in which students aim to obtain the highest grades, whether or not they grasp the learning material. In this study we used a subject-specified version of Biggs' Study Process Questionnaire to obtain data about the way dental and dental technology students perceived and approached their learning in oral biology. Questionnaires were distributed to 62 second-year dental students and 23 second-year dental technology students. Within each group the dependent variables examined were deep, surface or achieving approaches to learning. Analysis of these data showed that significant differences between dental and dental technology students centred on their approaches to learning. However, there were no significant differences attributable to gender, country of origin or ethnicity. While dental students, who had a relatively well developed understanding of the nature of their studies in oral biology at the start of their course, adopted deep learning strategies, dental technology students, who had had no prior experience of university education per se, were significantly more surface-orientated.

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