Adequately Prepared? A Study Using an Innovative Computer Application to Measure Clinical Crown Convergence Angles Achieved by Students at a UK Dental School

This study examined the total occlusal convergence angles created for full coverage crown preparations by students at a UK dental school. Working casts of 82 clinical crown preparations were scanned using a 3D scanner. Stereolithographic files were uploaded to Preppr, a crown preparation analysis application. Mean bucco-lingual convergence angle were 19.6° (+/-11.7) and mesial-distally 17.8° (+/-11.1). Smallest bucco-lingual convergence angles were achieved for canine teeth with the largest on molar teeth. The smallest mesio-distal values were on canine teeth with the largest on molar teeth. Ideal total convergence angles (4-14°) were achieved in 23% of bucco-lingual preparations and 33% of mesio-distal preparation. Results for clinically acceptable angles (10-20°) were 30% and 40% respectively. There were no statistically significant differences between tooth types for mean bucco-lingual values. (p=0.623), mesio-distal mean values were statistically different by tooth type (p=0.003). Mean values for mandibular molars were significantly higher than for maxillary incisors (p=0.001) and mandibular molars had significantly higher values than maxillary canines (p=0.045). Results in this study were comparable to those of other students and qualified clinicians, with a minority of preparation achieving ideal values.

Selective methylation changes on the Bacillus subtilis chemotaxis receptor McpB promote adaptation

The Bacillus subtilis McpB is a class III chemotaxis receptor, from which methanol is released in response to all stimuli. McpB has four putative methylation sites based upon the Escherichia coli consensus sequence. To explore the nature of methanol release from a class III receptor, all combinations of putative methylation sites Gln(371), Gln(595), Glu(630), and Glu(637) were substituted with aspartate, a conservative substitution that effectively eliminates methylation. McpB((Q371D,E630D,E637D)) in a Delta(mcpA mcpB tlpA tlpB)101::cat mcpC4::erm background failed to release methanol in response to either the addition or removal of the McpB-mediated attractant asparagine. In the same background, McpB((E630D,E637D)) produced methanol only upon asparagine addition, whereas McpB((Q371D,E630D)) produced methanol only upon asparagine removal. Thus methanol release from McpB was selective. Mutants unable to methylate site 637 but able to methylate site 630 had high prestimulus biases and were incapable of adapting to asparagine addition. Mutants unable to methylate site 630 but able to methylate site 637 had low prestimulus biases and were impaired in adaptation to asparagine removal. We propose that selective methylation of these two sites represents a method of adaptation novel from E. coli and present a model in which a charged residue rests between them. The placement of this charge would allow for opposing electrostatic effects (and hence opposing receptor conformational changes). We propose that CheC, a protein not found in enteric systems, has a role in regulating this selective methylation.

Biliary ascariasis. A case report

The presenting features, diagnosis and management of biliary ascariasis in an adult woman are described and the literature is reviewed.

Localized congenital aganglionosis of the colon. A case report

A man with congenital localized absence of ganglion cells in the bowel is described, the clinical and pathological features discussed and treatment reported.