Should edentulous patients be constrained to removable complete dentures? The use of dental implants to improve the quality of life for edentulous patients

doi:10.1111/j.1741‐2358.2009.00294.x
Should edentulous patients be constrained to removable complete dentures? The use of dental implants to improve the quality of life for edentulous patients Background: Nowadays, there is some speculation among dental educators that the need for complete dentures will significantly decrease in the future and that training in their provision should be removed from the dental curriculum. Objective: To sensitise the reader to the functional shortcomings of complete denture therapy in the edentulous patient and present restorative options including implants to improve edentulous quality of life in these patients. Methods: Information retrieval followed a systematic approach using PubMed. English articles published from 1964 to 2008, in which the masticatory performance of patients with implant‐supported dentures was assessed by objective methods and compared with performance with conventional dentures, were included. Results: National epidemiological survey data suggested that the adult population in need of one or two complete dentures will increase from 35.4 million adults in 2000 to 37.9 million adults in 2020. Clinical studies have showed that the ratings of general satisfaction were significantly better in the patients treated with implant overdentures post‐delivery compared with the complete denture users. In addition, the implant group gave significantly higher ratings on comfort, stability and ability to chew. Furthermore, patients who received mandibular implant overdentures had significantly fewer oral health‐related quality of life problems than did the conventional group. Conclusion: Implant‐supported dentures including either complete overdentures or a hybrid prosthesis significantly improve the quality of life for edentulous patients compared with conventional removable complete dentures. Therefore, the contemporary dental practitioner should consider other options as well as conventional removable complete dentures to restore edentulous patients.     

Does sexual conflict contribute to the evolution of novel warning patterns?

Why warning patterns are so diverse is an enduring evolutionary puzzle. Because predators associate particular patterns with unpleasant experiences, an individual's predation risk should decrease as the local density of its warning pattern increases, promoting pattern monomorphism. Distasteful Heliconius butterflies are known for their diversity of warning patterns. Here, we explore whether interlocus sexual conflict can contribute to their diversification. Male Heliconius use warning patterns as mating cues, but mated females may suffer costs if this leads to disturbance, favouring novel patterns. Using simulations, we show that under our model conditions drift alone is unlikely to cause pattern diversification, but that sexual conflict can assist such a process. We also find that genetic architecture influences the evolution of male preferences, which track changes in warning pattern due to sexual selection. When male attraction imposes costs on females, this affects the speed at which novel pattern alleles increase. In two experiments, females laid fewer eggs with males present. However, although males in one experiment showed less interest in females with manipulated patterns, we found no evidence that female colouration mitigates sex-specific costs. Overall, male attraction to conspecific warning patterns may impose an unrecognized cost on Heliconius females, but further work is required to determine this experimentally.     

How symmetric are metal-on-metal hip resurfacing patients during gait? Insights for the rehabilitation

Metal-on-metal hip resurfacing patients demonstrate hip biomechanics closer to normal in comparison to total hip arthroplasty during gait. However, it is not clear how symmetric is the gait of hip resurfacing patients. Biomechanical data of 12 unilateral metal-on-metal hip resurfacing participants were collected during gait at a mean time of 45 months (SD 24) after surgery. Ankle, knee, hip, pelvis and trunk kinematics and kinetics of both sides were measured with a motion and force-capture system. Principal component analysis and mean hypothesis’ tests were used to compare the operated and healthy sides. The operated side had prolonged ankle eversion angle during late stance and delayed increased ankle inversion angle during early swing (p = 0.008; effect size = 0.70), increased ankle inversion moment during late stance (p = 0.001; effect size = 0.78), increased knee adduction angle during swing (p = 0.044; effect size = 0.57), decreased knee abduction moment during stance (p = 0.05; effect size = 0.40), decreased hip range of motion in the sagittal plane (p = 0.046; effect size = 0.56), decreased range of hip abduction moment during stance (p = 0.02; effect size = 0.63), increased hip range of motion in the transverse plane (p = 0.02; effect size = 0.62), decreased hip internal rotation moment during the transition from loading response to midstance (p = 0.001; effect size = 0.81) and increased trunk ipsilateral lean (p = 0.03; effect size = 0.60). Therefore, hip resurfacing patients have some degree of asymmetry in long term, which may be related to hip weakness and decreased range of motion, to foot misalignments and to strategies implemented to reduce loading on the operated hip. Interventions such as muscle strengthening and stretching, insoles and gait feedback training may help improving symmetry following hip resurfacing.     

Does the reduction of c heme trigger the conformational change of crystalline nitrite reductase?

The structures of nitrite reductase from Paracoccus denitrificans GB17 (NiR-Pd) and Pseudomonas aeruginosa (NiR-Pa) have been described for the oxidized and reduced state (Fül?p, V., Moir, J. W. B., Ferguson, S. J., and Hajdu, J. (1995) Cell 81, 369-377; Nurizzo, D., Silvestrini, M. C., Mathieu, M., Cutruzzolà, F., Bourgeois, D., Fül?p, V., Hajdu, J., Brunori, M., Tegoni, M., and Cambillau, C. (1997) Structure 5, 1157-1171; Nurizzo, D., Cutruzzolà, F., Arese, M., Bourgeois, D., Brunori, M., Cambillau, C. , and Tegoni, M. (1998) Biochemistry 37, 13987-13996). Major conformational rearrangements are observed in the extreme states although they are more substantial in NiR-Pd. The four structures differ significantly in the c heme domains. Upon reduction, a His17/Met106 heme-ligand switch is observed in NiR-Pd together with concerted movements of the Tyr in the distal site of the d1 heme (Tyr10 in NiR-Pa, Tyr25 in NiR-Pd) and of a loop of the c heme domain (56-62 in NiR-Pa, 99-116 in NiR-Pd). Whether the reduction of the c heme, which undergoes the major rearrangements, is the trigger of these movements is the question addressed by our study. This conformational reorganization is not observed in the partially reduced species, in which the c heme is partially or largely (15-90%) reduced but the d1 heme is still oxidized. These results suggest that the d1 heme reduction is likely to be responsible of the movements. We speculate about the mechanistic explanation as to why the opening of the d1 heme distal pocket only occurs upon electron transfer to the d1 heme itself, to allow binding of the physiological substrate NO2- exclusively to the reduced metal center.     

Does asymmetric gene flow among matrilines maintain the evolutionary potential of the European eel?

Using evolutionary theory to predict the dynamics of populations is one of the aims of evolutionary conservation. In endangered species, with geographic range extending over continuous areas, the predictive capacity of evolutionary‐based conservation measures greatly depends on the accurate identification of reproductive units. The endangered European eel (Anguilla anguilla) is a highly migratory fish species with declining population due to a steep recruitment collapse in the beginning of the 1980s. Despite punctual observations of genetic structure, the population is viewed as a single panmictic reproductive unit. To understand the possible origin of the detected structure in this species, we used a combination of mitochondrial and nuclear loci to indirectly evaluate the possible existence of cryptic demes. For that, 403 glass eels from three successive cohorts arriving at a single location were screened for phenotypic and genetic diversity, while controlling for possible geographic variation. Over the 3 years of sampling, we consistently identified three major matrilines which we hypothesized to represent demes. Interestingly, not only we found that population genetic models support the existence of those matriline‐driven demes over a completely panmictic mode of reproduction, but also we found evidence for asymmetric gene flow amongst those demes. We uphold the suggestion that the detection of demes related to those matrilines reflect a fragmented spawning ground, a conceptually plausible consequence of the low abundance that the European eel has been experiencing for three decades. Furthermore, we suggest that this cryptic organization may contribute to the maintenance of the adaptive potential of the species.     

Competition patterns among phytoplankton functional groups: How useful are the complex mathematical models?

Simple models have significant contribution to the development of ecological theory. However, these minimalistic modeling approaches usually focus on a small subset of the causes of a phenomenon and neglect important aspects of system dynamics. In this study, we use a complex aquatic biogeochemical model to examine competition patterns and structural shifts in the phytoplankton community under nutrient enrichment conditions. Our model simulates multiple elemental cycles (org. C, N, P, Si, O), multiple functional phytoplankton (diatoms, green algae and cyanobacteria) and zooplankton (copepods and cladocerans) groups. It also takes into account recent advances in stoichiometric nutrient recycling theory, and the zooplankton grazing term is reformulated to include algal food quality effects on zooplankton assimilation efficiency. The model provided a realistic platform to examine the functional properties (e.g., kinetics, growth strategies, intracellular storage capacity) and the abiotic conditions (temperature, nutrient loading) under which the different phytoplankton groups can dominate or can be competitively excluded in oligo, meso and eutrophic environments. Based on the results of our analysis, the intergroup variability in the minimum cell quota and maximum transport rate at the cell surface for phosphorus along with the group-specific metabolic losses can shape the structure of plankton communities. We also use classification tree analysis to elucidate aspects (e.g., relative differences in the functional group properties, critical values of the abiotic conditions, levels of the other plankton community residents) of the complex interplay among physical, chemical and biological factors that drive epilimnetic plankton dynamics. Finally, our study highlights the importance of improving the mathematical representation of phytoplankton adaptive strategies for resources procurement (e.g., regulation of transport kinetics, effects of transport kinetics on the kinetics of assimilation, relationship between assimilation and growth) to effectively link variability at the organismal level with ecosystem-scale patterns.     

Does land use change affect the interactions between two dry grassland species?

Over the last 20 years, a change in traditional land use practices has taken place in central Germany. Formerly species-rich dry grassland communities have been converted into communities with greatly reduced diversity in many places. Whereas grass species have expanded, several forbs have declined in abundance. For the present study, plant-plant interactions were assessed between the expanding grass Festuca rupicola and the forb Dianthus carthusianorum - two typical, companion grassland species - to ascertain any associated effects of land use change. A competition experiment was set up with replacement design, in which pots were placed in the open field and monitored over two consecutive years. In order to assess the performance of both species in monoculture (D9, F9) and mixture (D3F6, D6F3) the parameters biomass, length of flowering stems, number of flowering stems and number of flowers per individual, or length of panicles, were analyzed. Positive and negative interactions were evaluated using the “Relative Neighbour Effect” index (RNE). To simulate land use by grazing or mowing, individuals in half of the pots were clipped in the first year after sowing. At this time, performance of D. carthusianorum - in terms of length of flowering stems, number of flowering stems and number of flowers - was significantly affected: whereas the first parameter increased, both of the other parameters decreased with increasing presence of the grass species. However, RNE indicated facilitation with a low number of F. rupicola individuals, and competition with a high number of F. rupicola individuals. In contrast, F. rupicola did not show any significant differences in performance with increasing presence of D. carthusianorum, and the RNE switched from neutral interaction to facilitation. In the second year after sowing, the performance of D. carthusianorum in the various treatments did not differ, except for the length of the flowering stems. The simulation of land use practices did not affect the performance of D. carthusianorum, but F. rupicola showed significant differences in biomass and in length of the panicles, as was the case also between monocultures and mixtures. The performance of the grass species was clearly improved in the unclipped treatments. The RNE reflected competition against D. carthusianorum which became reduced in unclipped treatments, while F. rupicola became facilitated. There were no interactions between the different treatments (monocultures and mixtures) and the simulated land use change (clipped and unclipped). Our data suggest that although traditional land use practices, i.e. grazing and mowing, do not affect the development of D. carthusianorum, the abandonment of these practices has improved F. rupicola performance, which has led to the increasingly invasive character of this grass species over the last 20 years.     

Does increasing mortality change the response of fish populations to environmental fluctuations?

Fluctuations of fish populations abundances are shaped by the interplay between population dynamics and the stochastic forcing of the environment. Age-structured populations behave as a filter of the environment. This filter is characterised by the species-specific life cycle and life-history traits. An increased mortality of mature individuals alters these characteristics and may therefore induce changes in the variability of populations. The response of a generic age-structured model was analysed to investigate the expected changes in the fluctuations of fish populations in response to decreased adult survival. These expectations were then tested on an extensive dataset. In accordance with theory, the analyses revealed that decreased adult survival and mean age of spawners were linked to an increase in the relative importance of short-term fluctuations. It suggests that intensive exploitation can lead to a change in the variability of fish populations, an issue of central interest from both conservation and management perspectives.     

Does climate change influence the availability and quality of reindeer forage plants?

The northward and upward movement of the tree line and gradual replacement of lichens with vascular plants associated with increasing temperatures and nutrient availability may change the reindeer pastures in Northern Fennoscandia. The productivity of reindeer forage will most probably increase, but their protein (nitrogen) concentrations may decrease because of higher temperatures and CO₂ concentration. In the long term, the nutritive value of forage will depend on the mineralization rate and nutrient uptake from the soil. Enhanced UV-B is likely to increase the concentration of phenolics, decreasing forage quality and choice, but reindeer may adapt to increased phenolics. Increased winter precipitation, the occurrence of ice layers, deeper snow cover, and the appearance of molds beneath the snow cover may reduce the availability and/or quality of reindeer forage, but prolongation of snowless periods might have the opposite effect. The net balance of negative and positive effects will vary regionally depending on the climate, bedrock, vegetation, reindeer herding systems and socio-political factors. Multidisciplinary research is needed most importantly on the effects of the changing winter climate on reindeer forage, and the effect of modified forage quality on reindeer physiology.

Does the photosynthetic light‐acclimation need change in leaf anatomy?

There is a strong correlation between leaf thickness and the light‐saturated rate of photosynthesis per unit leaf area (P_max). However, when leaves are exposed to higher light intensities after maturation, P_max often increases without increasing leaf thickness. To elucidate the mechanism with which mature leaves increase P_max, the change in anatomical and physiological characteristics of mature leaves of Chenopodium album, which was transferred from low to high light condition, were examined. When compared with leaves subjected to low light continuously (LL leaves), the leaves transferred from low to high light (LH leaves) significantly increased P_max. The transfer also increased the area of chloroplasts facing the intercellular space (S_c) and maintained a strong correlation between P_max and S_c. The mesophyll cells of LL leaves had open spaces along cell walls where chloroplasts were absent, which enabled the leaves to increase P_max when they were exposed to high light (LH). However, the LH leaves were not thick enough to allow further increase in P_max to the level in HH leaves. Thus leaf thickness determines an upper limit of P_max of leaves subjected to a change from low to high light conditions. Shade leaves would only increase P_max when they have open space to accommodate chloroplasts which elongate after light conditions improve.     

Does natural selection favour taller stature among the tallest people on earth?

The Dutch are the tallest people on earth. Over the last 200 years, they have grown 20 cm in height: a rapid rate of increase that points to environmental causes. This secular trend in height is echoed across all Western populations, but came to an end, or at least levelled off, much earlier than in The Netherlands. One possibility, then, is that natural selection acted congruently with these environmentally induced changes to further promote tall stature among the people of the lowlands. Using data from the LifeLines study, which follows a large sample of the population of the north of The Netherlands (n = 94 516), we examined how height was related to measures of reproductive success (as a proxy for fitness). Across three decades (1935–1967), height was consistently related to reproductive output (number of children born and number of surviving children), favouring taller men and average height women. This was despite a later age at first birth for taller individuals. Furthermore, even in this low-mortality population, taller women experienced higher child survival, which contributed positively to their increased reproductive success. Thus, natural selection in addition to good environmental conditions may help explain why the Dutch are so tall.     

Ectopic pregnancy among early abortion patients: does prostaglandin reduce the incidence?

The availability and efficacy of prostaglandin (PG) F2 alpha and E series analogues has prompted their frequent use for pregnancy interruption. In the course of evaluating our experience with PGs for interrupting early first trimester gestations, we became increasingly impressed by the absence of any with extrauterine pregnancy. A review of 63 reports encompassing 2,965 patients whose pregnancies were less than 8 weeks' gestational age dating from the last menstrual period and who were similarly treated yielded only 2 cases of ectopic pregnancy. When compared with the generally accepted ectopic gestation rates of the order of 1 in 200 pregnancies, this frequency of 1 in 1,483 is unexpectedly low. Preselection does not appear to explain this impressive discrepancy. If the observation proves correct, it implies that PGs have some form of therapeutic effect in eradicating extrauterine pregnancy by nonoperative means. The implications are obvious in terms of its potential therapeutic benefits.     

Does the relationship between offspring size and performance change across the life‐history?

What selection pressures drive the evolution of offspring size? Answering this fundamental question for any species requires an understanding of the relationship between offspring size and offspring fitness. A major goal of evolutionary ecologists has been to estimate this critical relationship, but for organisms with complex lifecycles, logistical constraints restrict most studies to early life‐history stages only. Here, we examine the relationship between offspring size and offspring performance in the field across multiple life‐history stages and across generations in a marine invertebrate .We then use these data to parameterise a simple optimality model to generate predictions of optimal offspring size and determined whether these predictions depended on which estimate of offspring performance was used. We found that offspring size had consistently positive effects on performance (estimated as post‐metamorphic growth, fecundity and reproductive output). We also found that manipulating the experience of offspring during the larval phase changed the way in which offspring size affects performance: offspring size affected post‐metamorphic growth when larvae were allowed to settle immediately but offspring size affected survival when larvae were forced to swim prior to settlement. Despite finding consistently positive effects of offspring size, early measures of the effect of offspring size resulted in the systematic underestimation of optimal offspring size. Surprisingly, the amount of variation in offspring performance that offspring size explained decreased with increasing time in the field but the steepness of the relationship between offspring size and performance actually increased. Our results suggest caution should be exercised when empirically examining offspring size effects – it may not be appropriate to assume that early measures are a good reflection of the actual relationship between offspring size and fitness.     

Can zebra mussels change stratification patterns in a small reservoir?

Colonization and proliferation of zebra mussel (Dreissena polymorpha) population in Hargus lake, a small thermally stratified reservoir in Ohio, U.S.A., caused a significant increase in water clarity and a remarkable decrease in phytoplankton biomass during the period from 1993 to 1995. Increased light penetration and reduced organic matter loading to the meta-and hypolimnion were reflected in the lake stratification patterns, particularly in the temperature and oxygen profiles in the metalimnion. The meta- and hypolimnetic water temperature increased significantly over three years, irrespective of variation in surface water temperature. The epilimnion depth (mixing depth) increased by about the same magnitude as did the average Secchi depth. However, the total heat content of the lake did not show a consistent trend to increasing zebra mussel abundance, as it was largely influenced by the temperature of the large water volumes near the surface, which were in turn affected by weather conditions. Concurrent with the thermal structure change, the dissolved oxygen structure also changed over three years, though to a lesser extent. The changes in oxygen stratification pattern were reflected by increased oxygen concentrations in the metalimnion and a lowered depth of 3 mg l^–1 DO isopleth. These observed changes were likely attributed to increased water mixing depth, metalimnion photosynthesis and reduced oxygen consumption by organic matter. With increased epilimnion thickness and improved oxygen conditions in the metalimnion, the habitable space for aquatic macro-organisms (including fish) expanded substantially. Our results suggest that the indirect impacts of zebra mussels on small lake stratification patterns may have much broader implications than do the direct trophic interactions to the whole ecosystem.     

Does the Biosocial Model Explain the Emergence of Status Differences in Conversations among Unacquainted Men?

Fifteen triads of unacquainted men conversed for ten minutes while stress was measured in real time by pulse rate and thumb blood volume (TBV). Salivary measures of testosterone (T), cortisol (C), and the stress-related enzyme alpha-amylase (AA) were measured at the beginning and end of the session. Fully or partially transitive status hierarchies formed in 14 triads. (Highest ranked man was scored 1, lowest 3, with ties allowed.) Ten of the triads participated in Study 1, where nothing was at stake in the casual conversation. Five additional triads were run in Study 2, intended to introduce competition by offering a $20 reward to the man afterward chosen as having led the conversation. Most results from the two studies are similar, suggesting that the $20 reward had little effect. Combining studies, pulse and TBV show that conversation is more stressful than watching a video beforehand. Within the conversation, speaking turns are more stressful than listening turns, especially among the lowest ranked men, less so among those higher in rank. This supports a stress-based mechanism for status allocation among humans. Apparently, human speech is a form of status signaling, homologous with nonlinguistic status signals used by other primates, as posited by the “biosocial model.” The biosocial model also posits that a physiological substrate (T, C, and AA) is related to dominance or status. Predicted effects are not replicated here, except for an inverse relationship between the stress enzyme AA and status. The mostly null results, obtained from conversations where there was little or nothing at stake, suggest that T and C (and their interaction) are not relevant to emergent status in the absence of serious competition.