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Delivery and Returns
When you have placed an order with bluesuntree, you will receive a confirmation e-mail immediately to advise we have your order in our system. We will respond to your request usually within 24 hrs to advise the approximate lead time for delivery. In stock items are usually delivered within 3 to 5 working days to a UK address and 7-10 working days to an EU address from time of purchase. For out of stock lines, either Bluesuntree or our carriers will confirm (prior to the delivery date) by phone or e-mail the exact date and approximate time of delivery.
Delivery Prices
|UK Mainland
|Small parcel items e.g a vase – £6.90 per parcel up to 4 parcels
|Parcel and pallet charges are based on our shipper costs and where we ship the order to.
|Larger Parcel Items e.g. a small side table £9.00 per parcel up to 4 parcels - Some very large Parcel items will incur a charge of £18.00
|Express Pallet charges are based on our shipper costs and where we ship the order to.
|UK Standard charges are based on our shipper costs and where we ship the order to.
|UK Gold charges are based on our shipper costs and where we ship the order to.
If you have any special requirements regarding delivery including specific time slots and dates please inform us at the time of placing the order, and we will inform you if this is possible. Please check that all items ordered have been delivered and if possible inspect the items for any damages. For alternate delivery options please contact us on +44 (0)116 267 0267.
Deliveries from stock lines are usually made within 3-5 working days of cleared funds in the UK, and 7 to 10 working days in Europe. Non-stock deliveries are usually made within 10-14 weeks of cleared funds. Non-stock lines are usually delivered within the stated period, however on rare occasions due to circumstances out of our control, we may exceed the 10-14 week delivery period. In these circumstances we can offer a full refund if goods remain un-delivered after 16 weeks from date of payment.
We offer full visibility on orders and will re-advise immediately of any delivery changes from the original stated date. All estimated delivery lead times are available prior to the point of ordering.
Failed deliveries because of not being able to access the property, either due to size of product, or owner not being present on the agreed day may result in a re-delivery charge.
Delivery Charges and International Shipping
Delivery charges will be calculated as the items are being added to the basket; you can see what the charges are by clicking the shipping estimator at any point during the shopping process to show the costs for the items in the basket at that time. Each time a new item is added you can recalculate by clicking the shipping estimator again. All shipping prices will be shown clearly before any payment is made. We can deliver anywhere in Europe, with most destinations covered in our drop down menu during the ordering process. However if your destination is not shown you can contact us for an individual quote.
Cancelling an Order
Should you wish to cancel your order for any reason you can do so up to 7 days after payment has been made.
Cancellations within this time will be eligible for a full refund minus any costs we reasonably incur in fulfilling the order, including but not limited to any credit card charges incurred, delivery and return costs if your order has been dispatched. Please see section 1.7 Terms and Conditions for full details.
To cancel an order please e-mail [email protected], marking the subject field of the e-mail as "cancellation of order"
Cancellations cannot be made after the delivery date has been confirmed, as these have been processed and will be on route to your address.
Should you no longer require the order, you can return it through our returns process up to 14 days after receipt of the goods.
Returning an Order
You may return the product to blue sun tree should you find it damaged, incorrect or the goods do not meet your approval.
Any courier damages or incorrect deliveries should be advised by e-mail, together with a clear digital image of the problem, within 3 days of receipt of the goods to [email protected]
If items are delivered damaged or incorrect we will arrange collection. Collections must be agreed within 30 days of the items being delivered
Mattress returns – for reasons of hygiene we cannot refund or exchange opened mattresses unless they are faulty.
If the goods do not meet your approval, we can either offer a refund or an exchange. You will need to notify blue sun tree by e-mail to [email protected] within 14 days of receipt of the goods, and return the goods within 30 days of receipt of the goods.
All returns should be sent back to the following address, accompanied by a copy of your invoice.
Blue Sun Tree Limited
42 Hayhill Industrial Estate
Barrow Upon Soar
United Kingdom
The cost of any returns carriage shall be borne by you. All returns should be insured against carrier damage i.e. recorded delivery. You are responsible for the safekeeping of the item until we receive it. All returns must be packaged in their original packaging to avoid damage.
All returns will be assessed for damage and customer abuse, should we feel that either have been carried out we may either, offer a partial refund, or no refund. We will not accept returns if the item is used, unless found to be faulty. In the event of a fault you must first contact bluesuntree by phone or e-mail, we may wish to send an agent to access the fault, for possible repair, before agreeing any return.
If you are dissatisfied with our products or services, please see our
This does not affect your statutory rights.


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Get a load of Meek Mill & Rick Ross "Freestyle On Cosmic Kev Come Up Show" Video, a new visual from Meek Mill that saw the light of day on Tuesday, August 2nd, 2011. Meek Mill's movement grows stronger with each new release, and Meek Mill & Rick Ross "Freestyle On Cosmic Kev Come Up Show" Video has further strengthened that fact. It's a solid addition to the commendable body of work Meek Mill has been creating since stepping foot in the rap game, and we're definitely looking forward to what Meek
How do you feel about the production here?
Peep the new visual for Meek Mill's Meek Mill "#DreamChasers Vlog" Video.
Hit up Meek Mill's profile page for the latest info, news, songs, and mixtapes. Check out Meek Mill's Facebook and Twitter.

subset: commoncrawl


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Students with Disabilities
NIEA is committed to ensuring that American Indian, Alaska Native, and Native Hawaiian students with disabilities have the same equal access to a quality education as their peers. As a population who is routinely found to be overrepresented in special education classrooms, it is vital that our students have access to resources that enable them to be successful.
First authorized in 1975, the Individuals with Disabilities Education Act (IDEA) [20 U.S.C. 1400] outlines federal protections for students with disabilities from early childhood through post-secondary education. Under this law, students with disabilities and their parents have a right to "a free and appropriate public education." The 2004 reauthorization of IDEA provides grant funding to support educational opportunities for students with disabilities. Each year, NIEA advocates for funding to ensure that all Native students have access to the resources for college, career, or community success.
Related Resources
IDEA Reauthorization – P.L. 108-446
In 2015, the nation's largest education law, known as the Every Student Succeeds Act (ESSA), included key provisions to advance educational opportunities for students with disabilities. Through these critical provisions, legislators capped the use of alternate tests for students with severe cognitive disabilities to 1% of the state's student population. Such language ensures that states have high learning expectations for students with learning and attention disabilities and places emphasis on academic achievement for students with disabilities. NIEA advocates for culture-based education opportunities that inspire and engage all Native students.
Related Resources
ESSA Reauthorization – P.L. 114-95
ENDREW F. v. DOUGLAS COUNTY SCHOOL DISTRICT
Through a unanimous 2017 ruling in Endrew F. v. Douglas County School District, the Supreme Court raised the bar in defining an "appropriate public education" under IDEA. This decision set forth a new precedent requiring school districts to provide students with disabilities the tools necessary to make "appropriately ambitious" progress in their education.
Related Resources
Opinion – Endrow F. v. Douglas County School District


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20 of November of 2014
Haro, 20 November 2014 – Verema - a website dedicated to rating and recommending wine and other Spanish food and alcohol products is the largest of its kind in the Spanish-speaking world has nominated Gómez Cruzado as the "Best Winery of the Year" for the 2014 edition of their awards. The winner will be announced during the closing ceremonies of the Verema Experience in Valencia on 21 February 2015. The winner is determined by on-line votes cast by users and collected on Verema's website (www.verema.com) until 18 January.
The list of candidates was put together by Verema's editorial staff, along with some regular forum contributors. The following criteria were considered: the wine's presence on the market, the number of comments the wine received on verema.com, and the average rating from wine tastings during the last twelve months.
The nomination of Gómez Cruzado serves as recognition of this winery's history, which dates back over a century in the Barrio de la Estación in Haro. Founded in 1886, Gómez Cruzado is the smallest winery located in this privileged and historic area. In recently renovated facilities, science and technical knowledge work with precision to create well-defined wines suitable for contemporary times without renouncing the traditional Rioja style - the "fine wine" style of Haro.
Fines wines with typicity
Founded in 1886, Gómez Cruzado is the boutique winery of the Barrio de la Estación in Haro. The team at this winery looks after every last detail and the typicity of the area's fine wines, while at the same time exploring the expressions of their 50 hectares of vineyards located across diverse environments: Garnacha in the Alto Najerilla - near the Sierra de la Demanda; and Tempranillo in the heart of Rioja Alta (the triangle formed by Uruñuela, Torremontablo and Cenicero) as well as the mythical foothills of the Sierra de Cantabria, including Rioja Alavesa and Sonsierra.
Some of these vineyards are located in the coldest areas of Rioja, which leads to wines with great acidity and freshness, with more finesse than power. Freshness, respect for the fruit, subtlety, elegance, balance and typicity are words frequently used to describe the Gómez Cruzado collection.


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Community Play Award 2017 news – we're very pleased to announce the winner of our Play Award this year is… Roots and Shoots Highland! 👏🍾🎊🎉
We also had two runners up – Stramash and Kincraig Under 5's!
Thanks to everyone who submitted applications this year, it was a very close competition.


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Hong Kong
An exceptional two bedroom penthouse set on the fifth floor of this spectacular new boutique development located on Chancery Lane, WC2.
Designed by the noted creative house March and White, this stunning penthouse promotes elegance with an edge, where the traditional aspects of its historic location converge with contemporary style. This extraordinary home comprises a large open plan living area and kitchen, which leads beautifully on to the large terrace, offering spectacular views over the historic Maughan library and across London providing the perfect entertaining space or simply a welcome retreat from city living. Finished with bespoke Silestone Quartz worktops and fitted top of the range Gaggenau appliances, the kitchen is designed to the highest specification with modern living in mind. The master bedroom suite encompasses a luxury dressing room and en suite bathroom boasting a free-standing bath tub and stunning marble flooring that runs throughout. A further double bedroom, en suite and third bathroom utilise the rest of this magnificent space perfectly. Each bedroom has fitted wardrobes, offering an abundance of storage space in the property. Penthouse residents benefit from direct lift access and a 7 day a week concierge service. Perfectly midtown, Chancery Quarters is an exciting new boutique development located on the historic Chancery Lane, nestled between The Royal Courts of Justice and Kings College Londons Maughan Library. Just a short walk west to the beautiful Lincoln Inns Fields and the theatres, restaurants and bars of Covent Garden and with easy access to St Pauls Cathedral, and the City of London, Chancery Quarters offers the best of London right on its doorstep. Ideally located, Chancery Quarters is serviced by excellent transport links, providing easy access to London and beyond. Chancery Lane Station is within a seven-minute walk (0.4 miles), Temple Station seven-minute walk (0.3 miles) and Farringdon Station is a 14-minute walk.Less


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Natalie: "Mom, do you grow blueberries?"
Me: "Yes. They are a plant."
Natalie: "Then how do you get macaroni?"
Natalie: "Mom, how many days will I be alive?"
Me: "Hopefully more than I can count."
Natalie: "I'm so glad I chose you to be my mom."
Me: (Speechless)
Saturday, June 29, 2013
Musings from Natalie #53
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Ha! I'd spend entire tasks feeling uncertain and guilty because maybe I should be doing other things but I didn't know because I'd never sat down to number my tasks. Most days I dove right in with a simplistic agenda that read something like this: Put. Out. Fires. Everything I tried to do got complicated. I'd mark out time to get something from the store and they wouldn't carry it. Then there were sales I'd been waiting for at two different stores, but no money set aside for those expenditures this month. Brian was going away for a week, and we need to sell our vehicle before we buy another, but I didn't want to field calls while he was away. On the other hand, I seriously doubted he'd have time when he got back. It went on and on like this.
I did cling to some semblance of the minimalist ideas and they helped me along, but here's what made it impossible to follow through well with any of them: I got scared. In passing, I'd probably nickname it stress, maybe even admit I was worried. But inside, I was scared. Here came a storm of activity - things to accomplish, people to interact with, money decisions to make. And it wasn't short-term, but stretched beyond any hormonally super-powered week. (Seriously, I'm a rock-star every once in a while.) Would I hold it together or lose everything I'd caught glimpses of? Now that I'm writing this, I remember one of the few times I've felt God "talk" to me, which means a totally contrary idea came into my head with such strength and warmth that I knew it wasn't mine. I was stressing about getting to pen and paper to write down what I'd learned from my prayer time - afraid I'd forget, when he said, "You can't lose me." I wish I'd remembered that in the face of the flurry, but I'm remembering now, mid-storm and it will make a nice mantra.
So back to my fear. It was the posture I chose, but I didn't realize it. Since then, I've been confronted with the idea that we choose between trust and stress. Why would anyone choose stress? It wreaks havoc in my body, from tension headaches to a popping jaw, but I choose it. I couldn't even picture myself doing the opposite. Trust seemed even scarier. Scarier because it feels like letting go and giving up control. When I tell people, "I'm so stressed," they think I have a lot on my plate - lots of big, grown-up, important things to handle and manage and make better. I'm pretending I'm in charge of all these things going on with me. So I asked myself what I'm so desperate to control? And here's what I said:
Finances. Kids' salvation. Kids' safety. Disney trip. Husband's safety. My emotional status. A car sale and purchase. Larger church organization. The food industry's moral compass. Heck, terrorists.
|what I imagine it feels like to be small and trusting and happy
As I made my list, I was struck by my smallness. I'm not big enough to be in charge of any of these things. And then I thought, maybe that's what's ultimately stressful. I'm insisting on managing things too big for me, things I was never supposed to take responsibility for. I thought being overly responsible was a virtue, but maybe it's just the how-to for unhappiness. This is hard if you've sung yourself the "I can't trust anyone else to do it right" song. Hard to let go.
Maybe the only thing I need to let go is my doubt. Do bad things go on? Yes. Is that how God made the world. No. Did he or did he not give himself to make things good again? He did. Then his love is proven and I have no basis for my doubt. Every other tragedy is distraction because it can all be redeemed. What he set straight is eternity. So I'm refocusing. My storm isn't over, so I have a chance to practice saying no to stress and yes to God. Because he's trustworthy. And he's big, so it's okay that I'm small. Jesus told the grown-ups to be small. I can stop pretending I have control and do my small work.
Which is...
Do what I should and do it with love.
Open my eyes to see the gifts and let my soul swell with gratitude.
I'm gonna try.


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Mobilebet Casino Review
*Mobilebet Review Update* – It was announced in September 2019 that Mobilebet would stop operating in the UK market and would soon stop accepting British players. Head to our online casino reviews UK to select an alternative GBP welcome bonus.
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The Professor is a very busy man. He has a lot to do and his speed isn't what it used to be. This is why the Professor appreciates a good mobile casino when he sees one. Mobilebet has been around since 2014, and while a few years have already passed, they have still managed to build upon their concept in a way that still makes it as modern as ever. If you're looking for a great mobile casino, Mobilebet really is one to watch.
Of course, you shouldn't think that Mobilebet is only for people who are using their mobile devices to play. Instead, they have a great desktop version as well.
Mobilebet Bonus
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We normally don't talk about sportsbook bonuses all that much, but we can tell you that they are basically giving you a €10 free bet on your first deposit. It's not much, but it's still something. The casino bonuses we will talk about below.
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Mobilebet and ComeOn Casino are very closely related as you can tell from the sites' designs. For our German players, they offer a bonus like this:
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Welcome bonus for players from Sweden is as follows:
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Norwegian players get to choose between bonuses as well, just like our Swedish buddies. The Norwegian bonus look like this:
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Bonus codes are not needed at Mobilebet.
Mobilebet Free Spins
Mobilebet offers free spins for German players as well as Finnish players. Finnish players can check out their bonus from here. Good news for players with free spins: they are completely wager free!
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It doesn't really matter which casino you choose to invest your money on, you still have to beat wagering requirements. This means that your money will need to be wagered on games for more than its worth. Here at Mobilebet the wagering requirement is 35x, for bonus + deposit. This is somewhat high, but not too bad. Even so, sometimes we feel that these wagering requirements tend to somewhat spoil the fun. Also, you should note that deposits made via Skrill, Neteller and Paysafecard are excluded from this casino promotion. Also, minimum deposit is €/£20.
For more information on this bonus's terms and conditions, we advise you to read all of it at Mobilebet's website. This will save you from any harm.
If you're based in the UK, there are quite a few payment methods for you to use: Visa, Mastercard, Maestro, Entropay, Neteller, Online bank transfer, Skrill, and Paysafecard. For other locations, you might want to check their site, although you're probably going to find the same list for most countries.
Mobilebet Games
They also have quite a few game providers in their pocket, which makes for a diverse and multifaceted experience. The names here include NetEnt, Microgaming, Williams, Yggdrasil, Betsoft, Play'n GO, Quickspin, Evolution Gaming, Playtech, NoLimit City and Thunderkick.
All in all, there are almost 700 games at Mobilebet. This is an astounding number and includes games like slots, video pokers, bingo, scratch cards, live casino games and even some Keno. You will definitely not feel bored here.
As we've been saying from the start, Mobilebet is designed for mobile casino gaming. Thus, you won't find many casinos that are on Mobilebet's level here.
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Mobilebet has been around for a few years already, and they have established quite a reputation for being honest, safe and secure. They have a license from the Malta Gaming Authority, which means that they are firm believers in fair play and are certainly playing by the rules.
Restricted Countries
Not all countries' residents are allowed to sign up at Mobilebet. Here is a list of the excluded ones: Australia, Czech Republic, USA, France, Turkey, Curacao, Croatia, Spain, Hungary, Romania, Portugal, Poland, Ireland and the Netherlands.
Mobilebet review by Casino Professor
The Casino Professor really likes Mobilebet and what it brings to the table with its special points system and mobile offering.
Mobilebet's welcome offer might not be the greatest of all time, but this is still a casino that's worthy of being recommended by the Professor. You're going to find many other promotions here as well, and the points system is quite addictive it its own right.
Remember to write your own Mobilebet review below!
Casino Professor


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Air transport
Air Greenland is operating Sisimiut. There are daily connections to and from Kangerlussuaq and Nuuk, and several weekly flights to and from Maniitsoq, Aasiaat and Ilulissat.
From Kangerlussuaq there are connections to Denmark with Air Greenland.
Sea transport
Umiaq Arctic Line A/S sailing Sisimiut two times a week during the summer.
Land transport
In summer there is the opportunity to hike from Kangerlussuaq, and in winter can make the trip with either dog sled or snowmobile.
You can visit Arctic Circle Trail website for more informations about the hiking trail.


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Check out our Financial Aid Booklet, How Financial Aid Works, which will provide you with valuable information about financial aid and student employment as a resource for aid. Some of the highlights in this booklet are financial planning, information on maintaining your financial aid eligibility, what happens when your circumstances change, and a glossary of financial aid acronyms and terms.
Every school's SAP standards include three components:
Please be sure to review UM's SAP policy. If you have any questions, contact the Office of Student Financial Assistance and Employment at email@example.com or 305-284-6000.
Copyright: 2019 University of Miami. All Rights Reserved.
Emergency Information
Privacy Statement & Legal Notices


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Posted On July 06, 2017 by Team iCynosure.
Thursday, July 06, 2017
The diversity that we see is our country, can also be seen in the unique blend of home décor that is available in the Indian markets today. The Indian consumer today is extremely versatile and is on the look-out of products that are traditional yet modern, are showpieces yet useful, and are simple yet technically advanced.
As a professional and a homemaker, as a mother and a wife, my passion lies in decorating my home keeping in mind the sensibilities of our culture, the privacy of my family and the safety of my child along with the utility, the quality, and the minor yet important features of a product. The majority of players in the Indian market are primarily restricted to traditional handicraft based home furnishing products or modern import oriented products. Deco Home, an extension of the brand Deco Window has identified the need of an urbanised generation and created a dynamic line of home décor products that resonate with the personal style and taste of the Indian consumer. The brand offers a huge range of home décor solutions that includes classic and modern profiles, where each piece is engineered for durability, functionality and aesthetics. The highlight of the brand is that it offers 'Complete Solutions' with endless possibilities to indulge in any design impulse.
This season the brand has diversified from window solutions to home solutions that will cater to every type of consumer. After browsing through the extensive range of products both existing lines and new launches, I'm bringing you five of my favourite products that are soon going to find space in my home.
Luxury Bedding Set
Deco Home gives your bedroom a makeover with their complete luxury bedroom sets. The 100% cotton product includes one king-size bedsheet, one duvet cover, two standard pillow covers, two cushion covers and one embroidered cushion cover. Just imagine that feeling when your room looks straight out of a movie set.
Designer Cushion Covers
An extension to design sensibilities used for the new range of curtains in paisley, arabesque, geometric and solid, the complementing cushion covers add spark, texture, and personality to space it will adorn. Not only do these tiny elements of luxury add to the décor but also make you want to snuggle in the comfort of the space.
Space Fill Seals
Gaps between the doors and windows are not only pretty annoying, but hazardous too, if you have a young child at home. I've had instances of when my daughter's foot has been caught between these spaces and has taken a long time to heal. The innovative space seal from the brands' Home Improvement range is perfect to fill these gaps and ensure privacy, safety and convenience.
Garden Torch Lights
Deco Windows' staple outdoor accessory, the garden torch transforms your urban-modern space into a tropical paradise. A perfect way to add light to the balcony, garden, patio; the garden torch is light-weight, weather-proof and easy to assemble. With four different ways that the product can be set, it makes for an ideal gift option too.
Automatic Curtain Track
With all aspects of lifestyle getting technologically advanced, Deco Windows' state-of-the-art motorized curtains, makes life systematically simpler. The advanced technological innovation enables to open and close curtains through a remote, across your home without having to move around or manually change it. This is truly refined living.
Have you used any Deco Window or Deco Home products? Tell me in the comments below which of these is your favourite product.
Until next time,
- Heena
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Bone grafting procedure involves placement of a bone graft in periodontal bone defect to achieve re-establishment of the lost bone volume. In orthopaedics bone grafts have been used for years. The first recorded bone implant was performed in 1668. It was Hegdus, who in 1923 attempted the use of bone grafts for the reconstruction of bone defects produced by periodontal disease 1. After this, many researchers used different forms of bone grafts in periodontal bone defects. A detailed description of historical aspect of bone grafts is available in "History of periodontal regenerative therapyâ€.
Before we read in detail about bone grafts, following terms should be clearly understood.
In this case, viable osteoblasts within the grafted material deposit new bone. It occurs in case of autogenous bone grafts.
Osteoconduction occurs when the bone graft material serves as a scaffold for new bone growth that is perpetuated by the native bone.
It is a process in which new bone is induced to form through the action of factors contained within the grafted bone, such as proteins or growth factors.
It occurs when the grafted material does not possess the osteoinductive properties but enhances osteoinduction by promoting bone formation. For example, it has been shown that enamel matrix derivative do not stimulate denovo bone growth alone, but when used with demineralized freeze dried bone allograft (DFDBA), it enhances the osteoinductive effect of DFDBA 2.
Bone fill:
Bone fill is the presence of hard tissue in a periodontal osseous defect.
These are bone grafts harvested from patient's own body. These are considered ideal because they possess osteoconductive and osteoinductive properties and also source of osteoprogenitor cells.
The isograft is material that is taken from one individual and transplanted into another genetically identical individual, such as an identical twin. In isograft cases donor and the recipient must have the same genotype.
Allografts are derived from other individuals of the same species. Examples include freeze-dried bone allografts (FDBA) and demineralized freeze-dried bone allograft (DFDBA). These are most commonly used grafting materials.
Xenografts are derived from nonhuman animal sources such as bovine. The anorganic bovine bone is chemically treated to remove its organic components,leavinga trabecular and porous architecture similar to human bone.
Alloplasts are synthetic bone substitutes. These are made from hydroxylapatite, a naturally occurring mineral that is also the main mineral component of bone. Bioactive glasses are commonly used alloplasts.
Ideal properties of a bone graft:
There are some basic requirements for a bone grafting material to be designated as ideal. Every grafting material has its own advantages and disadvantages. The ideal grafting material should possess the following properties 3,
- Should be biocompatible and non immunogenic
- Should have…………………….
Autografts are considered to be closest to an ideal grafting material because they possess all the above stated properties. Allografts have osteointegrative and osteoconductive properties and may also exhibit osteoinductive potential, but they are not osteogenic because they do not contain viable cells. Alloplasts or synthetic graft materials possess only osteointegrative and osteoconductive properties. In the following diagram the essential elements for new bone formation have been elucidated,
Requirments for new bone formation
Classification of bone grafts:
Based on the source of procurement, grafts have been divided into following categories 4,
- Autogenous bone grafts
- Allograft
- Xenogenic bone grafts
- Synthetic/Alloplastic bone grafts
- Composite grafts
Following flow chart describes classification of various bone grafts on the basis of their sources of procurement,
Classification of bone grafts
Autogenous Bone Graft:
These bone grafts are obtained from the same individual on whom the bone grafting has to be performed. They may be obtained from a local remote location. As they possess most of the properties of an ideal graft material, they are considered the gold standard bone replacement graft. The graft obtained has viable cells, which participate in new bone formation hence has osteogenic properties. Major advantages of using autogenous grafts are: these grafts are osteogenic and no risk of disease transmission. Major disadvantages of autografts include procurement morbidity, limited availability in case of intraoral sites and high cost of procedure in case of extraoral graft harvesting.
Autografts are subdivided in three groups: cancellous, cortical and or corticocancellous autografts. The cancellous bone grafts is derived from cancellous part of bone. Because of the cancellous nature of the graft, most number of viable cells are available in this type of autograft. Although, after transplantation majority of cells present in the graft die as result of ischemia but mesenchymal stem cells present in the bone marrow which are resistant to ischemia, may survive the grafting procedure. On the other hand, cortical autografts act as osteoconductive graft providing support for bone formation. Because of presence of thick cortical bone, the revascularization and integration of cortical bone grafts is slow. The cortico-cancellous graft offers stability and osteogenic capacity. It can be used in weight-loaded areas. As in case of cortical grafts, vascularisation is slow in these grafts.
Intraoral autogenous bone grafts can be harvested from the edentulous alveolar areas, maxillary tuberosity, healing bony wound, extraction sites and mental and retromolar areas 5.
Cortical bone chips:
The use of cortical bone chips can be traced back to the work of Nabers and O'Leary (1965) 6. They used shavings of cortical bone removed by chisel during osteoplasty and ostectomy, in periodontal bone defects. This type of autogenous bone graft did not get much popularity and is rarely used today because of large size (1,559.6 × 183 μm) of the graft particles, which have more vulnerability for sequestration 7.
Osseous coagulum:
The rationale behind use of osseous coagulum and bone blend was that smaller the size of graft particles, more are the chances for its resorption and replacement with host bone 8. The bone particles were harvested by using round burs, and were then mixed with blood. The rationale for mixing blood with graft particles was to provide osteogenic progenitor cells and morphogens to the wound site and to promote a stable clot formation. Studies on monkey model demonstrated that a small particle size (100 μm) led to earlier and higher osteogenic activity than did the larger particles 9. The major disadvantage of this procedure is difficult graft collection procedure and inability to aspirate during graft collection. Another problem is unknown quantity of the bone fragments collected and material fluidity.
Bone blend:
Bone blend procedure involves collection of cortical or cancellous bone with the help of trephine or rongeurs. Then it is put in an amalgam capsule and triturated to achieve the consistency of a slushy osseous mass. The resultant particle size is in the range of 210 x 105 μm 7. Research reports have shown clinically significant bone fill in areas treated with bone blend 8, 10.
Know more:
Newer techniques for bone graft collection:
The graft material collected by osseous coagulum or bone blend techniques is sufficient for small regenerative procedures. A recent technique for collecting the bone graft by using bone collectors was introduced by Blay et al 11. The bone particles are collected with the help of bone filters. Bacterial contamination during graft collection is one major problem during this procedure. So, a stringent aspiration protocol, preoperative oral chlorhexidine rinse and antibiotic prophylaxis should be applied.
More recently, piezoelectric device (Piezosurgery) has been introduced for different bone augmentation procedures. This device used for ultrasonic cutting of bone create microvibrations that are caused by the piezoelectric effect which was first described by French physicists Jean and Marie Curie, in 1880. The frequency used to cut the bone is 25–29 kHz because the micromovements that are created at this frequency (ranging between 60 to 21 μm) cut only mineralised tissue. The neurovascular other soft tissues are cut at frequencies higher than 50 kHz 12-14. Irrespective of the method used, all the mechanical techniques have some amount of detrimental effects on viability of the cells. Keeping all the biological factors into consideration the bone harvesting procedure should be carefully performed.
Extraoral bone graft harvesting is a popular procedure, especially in cases where……………………………..
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In majority of cases large amount of bone graft is not required, making intraoral bone graft harvesting more preferable.
An allograft is a graft obtained from genetically dissimilar members of the same species. Allografts are obtained under sterile conditions from fresh cadavers, usually within 24 hours of the death of the donor. Their major advantages are unlimited availability and osteoinductive potential comparable with autogenous bone. These are available primarily in two forms: freeze dried bone allograft (FDBA) and decalcified freeze dried bone allograft (DFDBA).
So, what is the need for decalcify / demineralize a cortical bone allograft ?
Demineralization of the cortical bone allograft improves the osteoinductive potential by exposing bone morphogenic proteins, and other inductive factors known to increase bone formation. This is why; FDBA provides an osteoconductive scaffold and elicits resorption when implanted in mesenchymal tissues whereas DFDBA also provides an osteoconductive surface along with osteoconductive scaffold. There are set standards for procuring, processing and sterilization of allografts (FDBA/DFDBA). Most of the bone banks adhere to the guidelines of the American Association of Tissue Banks (AATB) as described by Centers for Disease Control and Prevention 19. According to AATB, allografts should not be collected if,
- Donor is from high-risk groups, as determined by medical testing and behavioral risk assessments.
- Donors has been tested positive for HIV antibody by ELISA
- Autopsy of donor reveals occult disease
- Donor bone has been tested positive for bacterial contamination
- Donor and bone has been tested positive for hepatitis B surface antigen (HBsAG) or hepatitis C virus (HCV)
- Donor has been tested positive for syphilis
Processing of allografts:
Although allograft manufacturing companies do not disclose the exact method of bone processing they follow, however following is the description of basic technique of bone processing,
The first and foremost step is obtaining the bone from a suitable donor and reducing it to bone pieces of small size of approximately 5 mm. Second step is elimination of bone marrow and cellular debris. The elimination of bone marrow and cellular debris is achieved with fluids and detergents, which, by their clearing effect, improve the osteoconductive capacity of the bone. Pressurization allows full penetration of inactivating or eliminating agents into the bone. Various chemical solutions used in this procedure include saline, acetone, ethanol or hydrogen peroxide which remove bioburden and reduce antigenicity. Then bone particles are treated with…………………..
For preparing decalcified freeze dried bone graft (DFDBA), the decalcification process follows after final particle size of 250 to 750 μm is achieved. The bone particles are immersed in a hydrochloric acid bath at concentrations ranging from 0.5 to 0.6 N for various lengths of time. Then these acid treated particles are immersed in a buffering solution to remove residual acid. The demineralized allograft is further rinsed with various solutions (e.g., distilled water) to remove residual buffer solution. Then graft is packed in sterile containers followed by irradiation of low-dose of γ radiations at low temperatures to ensure sterility.
Bone graft processing results in exponential reduction in graft contamination and disease transfer, or both. Sterility assurance level (SAL) is a term used to describe the probability that an item will not be sterile after it has been subjected to a validated sterilization process 20. With proper processing, allografts for dental purposes routinely achieve sterility assurance level (SAL) of 10-6. In other words we can say that the odds of an organism's surviving after allograft processing are lessthan one in 1 million 21.
After processing bone allograft has to undergo certain tests which include:
Visual inspection test:
Visual detection is done for problems such as gross graft contamination, packaging defects and product mislabeling.
Residual moisture test:
Testing of freeze-dried allografts is done to ensure residual moisture is 6 percent or less.
Residual calcium test:
Testing of demineralized freeze-dried bone allograft is done to ensure residual calcium content is 8% or less.
Commercially available allografts:
Puros (Zimmer Dental, Carlsbad, California): (link)
This is commercially available allograft obtained from human source. It is subjected to patented tutoplast process which gently removes the undesirable components of the bone including fats, cells, antigens, and inactivates pathogens, while preserving the valuable minerals and collagen matrix, leading to complete and rapid bone regeneration 22. Various chemicals are used to eliminate these unwanted components including acetone to remove lipids, H2O2 to oxidize remaining proteins, solvent dehydration with acetone to preserve the collagenous fiber structure, osmotic treatment and low dose gamma irradiation. It is claimed by the manufacturers that this procedure yields a bone graft with nicely preserved trabecular pattern of bone and mineral structure, as compared to freeze-drying process which results in a more osteoconductive material.
Grafton DBM (BioHorizons, Birmingham, Alabama): (link) (link)
This allograft is derived from cadaver long bones. The procured bone is subjected to chemical processing under aseptic conditions to remove unwanted bone components such as lipid, blood, and cellular components before it is frozen. The resultant bone is subjected to reduction in particle size and stored in sterile containers. The graft is combined with a glycerol carrier to stabilize the proteins and improve the graft handling 23.
Grafton DBM (BioHorizons, Birmingham, Alabama)
As already stated, xenografts are grafts transferred between genetically dissimilar members of different species. These are derived from three sources: bovine bone, porcine bone and natural coral. These are osteoconductive, biocompatible and similar to human bone in structure 24, 25.
Bovine derived Xenografts:
Bovine derived Xenografts are processed by…………………………
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Commercially available bovine derived xenografts:
Bio-Oss ® (Osteohealth Co., Shirley, NY): (link)
This is a bovine derived bone grafting material. The unwanted organic material within the bone is removed by chemical processing at low temperature resulting in a porous mineral matrix. Processing at low temperature has an advantage of preservation of natural architecture of bone. This graft material is available in cancellous and cortical granules and blocks. The particle size of the graft is approximately 100 × 200 × 500 Å.
Bio-Oss ® (Osteohealth Co., Shirley, NY)
Bio-Oss Collagen ® (Osteohealth Co., Shirley, NY): (link)
This graft has inorganic and organic components consisting of Bio-Oss Spongiosa granules (0.25–1 mm) and 10% highly purified porcine collagen. The addition of collagen in graft material improves handling characteristics of the graft without acting as a barrier. The graft particles are adhered to each other due to presence of collagen which facilitates graft placement without membrane. The collagen component is resorbed within 4-6 weeks.
OsteoGraf / N ® (CeraMed Dental, LLC, Lakewood, CO):
It is a natural anorganic bovine-derived microporous hydroxylapatite. It is the only xenograft that meets all ASTM (American Society for Testing and Materials) standards for "Composition of Anorganic Bone for Surgical Implants (F1581-95). It achieves a hydrophilic – cohesive consistency when hydrated. It remodels to vital bone at the same rate as host bone. It is manufactured as radiopaque, rounded particles and is available in two particle sizes:
- OsteoGraf / N-300 (250–420 μm) packaged in 1-g and 3-g vials
- OsteoGraf / N-700 (420–1,000 μm) packaged in 1-g and 3-g vials
OsteoGraf / N-300
PepGen P-15 ® (Dentsply Friadent, Mannheim, Germany):
It is a tissue-engineered bone replacement graft material which mimics…………………………………….
Porcine derived Xenografts:
Xenografts derived from porcine cortical and cancellous bone have also been developed to be used as bone substitutes.
OsteoBiol ® Gen-Os (Tecnoss Dental, Turin, Italy): (link)
It is commercially available xenograft of porcine origin. It is a heterologous cortico-cancellous collagenated bone mix. It must always be hydrated before use. It is thoroughly mixed with a few drops of sterile physiological solution to activate its collagen matrix and to enhance its adhesivity. It can also be mixed either with OsteoBiol Gel or with patient's blood. A major advantage of this material is that it can act as carrier for various therapeutic agents and drugs. The collagen present in this bio-material facilitates blood clotting and the subsequent invasion of repairing and regenerative cells, thus favouring bone formation. It also provides a cohesive environment for graft particle. This material has been claimed to have high osteoconductive activity. The particle size of the graft is 250-1,000 μm.
Coralline calcium carbonate:
These are derived from natural coral. The structural features of commercially used coral, Porites, are similar to that of cancellous bone, which makes them a suitable bone substitute.
Biocoral ® (Inoteb,Saint Gonnery, France): (link)
It is a commercially available grafting material derived from natural coral which has a calcium carbonate structure composed primarily of aragonite. It has a porous structure with pore size of 100 to 200 μm. This porous structure provides a large surface area helping in a better cellular resorption and replacement by natural bone. Its osteoconductive properties are comparable to other bone substitutes.
Various commercially available bone substitutes
|Type of substitute
|Commercial name and brand
|Human bone
|Puros (Zimmer Dental, Carlsbad, California)
Grafton DBM (BioHorizons, Birmingham, Alabama)
|Bovine derived
|Bio-Oss ® (Osteohealth Co., Shirley, NY)
Bio-Oss Collagen ® (Osteohealth Co., Shirley, NY)
OsteoGraf/N ® (CeraMed Dental, LLC, Lakewood, CO)
PepGen P-15 ® (Dentsply Friadent, Mannheim, Germany)
|Porcine derived
|OsteoBiol ® Gen-Os
|Coralline calcium carbonate
|Biocoral ® (Inoteb,Saint Gonnery, France)
|Polycrystalline ceramic form of pure densely sintered hydroxylapatite
|Calcitek, Inc., Carlbad, CA.
OsteoGraf / D300 and OsteoGraf / D700 (CeraMed Corp., Lakewood, CO)
|Coralline porous non-resorbable hydroxylapatite
|Interpore 200 (Interpore International, Irvine, CA).
Pro-Osteon 500R (Interpore Cross International, Irvine, CA, USA).
|Resorbable nonceramic hydroxylapatite
|OsteoGen ® (Impladent, Holliswood, NY).
OsteoGraf / LD-300 ® (CeraMed Corp., Lakewood, CO).
Cerabone ® (Coripharm GmbH & Co. KG, Dieburg, Germany).
|Nanocrystalline hydroxyapatite (NHA)
|Ostim™(Heraeus Kulzer, Hanau, Germany).
|Fluorohydroxyapatitic (FHA) biomaterials
|FRIOS ® Algipore ® (Friadent GmbH, Mannheim, Germany)
|β-Tricalcium Phosphate (TCP)
|Bioresorb ® ( Sybron Implant Solutions GmbH Bremen, Germany).
Cerasorb ® (Curasan, Kleinostheim Germany).
Vitoss ® (Orthovita, Malvern, PA, USA).
|Biphasic alloplastic materials
|Calcitec ® Inc. (Austin, TX).
Osteogen ® (Impladent Ltd, Holliswood, NY).
Tricos ® (Baxter, Bern, Switzerland).
Osteon TM (Genoss Co. Ltd., Suwon, Korea).
Bone Ceramic ® (Straumann, Basel, Switzerland).
Ceraform ® (Teknimed SA, Vic-en Bigorre, France).
MBCP+™(Biomatlante biologics solutions).
|Calcium Phosphate Cements (CPC)
|Norian ® PDC™ (Shofu Inc., Kyoto, Japan).
Augmentech AT (Wetzlar, Germany).
Calcibon ® (Biomet).
|Bioactive Glasses
|PerioGlas ® (Block Drug Co., NJ, USA).
PerioGlas ® Plus(Block Drug Co., NJ, USA).
Unigraft ® (Unicare Biomedical Inc., Laguna Hills, CA, USA).
Biogran™ (Orthovita Inc., Malvern, PA, USA).
|Biocompatible osteoconductive polymers
|HTR TM Synthetic Bone (Bioplant, Norwalk, CT)
|Composite Grafts
|Ceramics and bioactive molecules
|Healos ® (Orquest, Mountain View, CA).
Collagraft ® (Zimmer Corp, Warsaw, IN).
Tricos ® (Baxter BioSciences BioSurgery).
Alloplasts are synthetic bone substitutes that are readily available and also eliminate the need for a patient donor site. Like other bone grafting materials, the ideal properties of alloplastic materials include: it should be biocompatible with host tissues, non-antigenic, non-carcinogenic, and non-inflammatory. Along with this, the graft material,
- Should be sufficiently porous and should allow tissues to grow into and around the implant (osteoconduction),
- Should be able to stimulate bone induction, should be resorbable and replaceable by bone,
- Should be radio-opaque in order to be visualized radiographically,
- Should be able to withstand sterilization without losing favourable qualities,
- Should be stable in varying temperatures and humidity,
- Should have surface electrical activity (i.e., be charged negatively),
- Should be Hydrophilic,
- Should be easy to manipulate clinically
- Should have high compressive strength
- Should be inexpensive, and easily attainable.
Various synthetic graft materials include hydroxyapatite, tricalcium phosphate, calcium sulfate (plaster of Paris), bio-active glasses, and hard tissue replacement polymers. Following is a detailed description of these materials.
Hydroxyapatite (Ca4 (PO4)6(OH) 2):
Hydroxyapatite (HA) is basic component of inorganic components of bone. Hydroxyapatite ceramics have a stoichiometry similar to that of bone mineral 28, 29. It can be manufactured from natural reef building coral skeleton by a "hydrothermal exchange reactionâ€, where the trabecular, bone imitating structure of the coral remains unchanged and the calcium carbonate (CC) skeleton is converted to calcium phosphate, the main inorganic salt of bone 30. The main difference………………………………………….
Other methods of manufacturing porous HA include, homogenizing calcium phosphate powder with appropriately sized naphthalene particles, resulting in macroporous material after the naphtalen has been removed. The resultant structure is sintered at high temperature (1100-1300°C). Another method utilizes hydrogen peroxide to generate a pore-filled structure. Porous HA is brittle and can be used only in non-loading sites. Its compressive strength is enhanced by bone ingrowth but it is only comparable to that of cancellous bone 31.
Depending upon method of procurement and processing, HA grafts are available in following forms,
Polycrystalline ceramic form of pure densely sintered HA:
It is a polycrystalline form of HA prepared in relatively large particle size (18–40 mesh). Calcitite, a commercially available HA graft ((Calcitek, Inc., Carlbad, CA), has particle size of 420-840 μm. OsteoGraf / D300 and OsteoGraf / D700 ((CeraMed Corp., Lakewood, CO), have particle sizes 250–420 μm and 420–1,000 μm respectively.
Coralline porous non-resorbable hydroxylapatite:
As already stated they are derived from marine coral skeleton from which organic components have been removed. Interpore 200 (Interpore International, Irvine, CA) and Pro-Osteon 500R (Interpore Cross International, Irvine, CA, USA) are examples of commercially available coralline porous non-resorbable hydroxylapatite.
Pro-Osteon 500R
Resorbable nonceramic hydroxylapatite:
It is a resorbable form of HA which is highly microporous and non-sintered (nonceramic). Particle size varies from 300–400 μm. Commercially available examples of this type of HA grafts include OsteoGen ® (Impladent, Holliswood, NY) which is a low-temperature hydroxylapatite (HA) material. It is manufactured by processing at low temperature and is not sintered. These non sintered precipitated particles have size measuring from 300-400 μm. Other examples include OsteoGraf/LD-300 ® (particles are sized between 250 and 420 μm) (CeraMed Corp., Lakewood, CO) and Cerabone ® (Coripharm GmbH & Co. KG, Dieburg, Germany).
Nanocrystalline hydroxyapatite (NHA):
As the name indicates, nanocrystalline hydroxyapatite (NHA) bone graft has nano sized particles. The main advantage of this biomaterial is improved osteoconductive properties and complete resorption of the material within 12 weeks. Commercially available example of this graft is Ostimâ"¢ (Heraeus Kulzer, Hanau, Germany) (NHA), which is a synthetic nanocrystalline hydroxyapatite (NHA) paste containing 65% water and 35% nanostructured apatite particles.
Fluorohydroxyapatitic (FHA) biomaterials:
Historically, it was observed that some forms of calcified algae have internal structure similar to cancellous bone 32. So, its potential use as bone substitute was proposed.
FRIOS ® Algipore ® (Friadent GmbH, Mannheim, Germany)
It is commercially available fluorohydroxyapatitic (FHA) bone graft. It is derived from calcifying marine algae (Corallina officinalis). This material has got microperforations which are interconnected. The average diameter of the pores is around 10 μm and every pore is limited by one layer of small FHA crystallites with a size of 25–35 nm. The material has good osteoconductivity.
β-Tricalcium Phosphate (TCP):
Tricalcium phosphate is present in two forms: α and β. The α-tricalcium phosphate is monoclinic and consists of columns of cations, while the beta tricalcium phosphate has a rhombohedral structure. The physical properties of these two forms are different. α- TCP is less stable than β- TCP and when mixed with……………………………
Commercially available β-Tricalcium Phosphate (TCP):
Various commercially available β-Tricalcium Phosphate (TCP) graft materials include:
Bioresorb ® ( Sybron Implant Solutions GmbH Bremen, Germany):
It is a β-Tricalcium phosphate bone grafting material having a porous structure similar to human bone. The manufacturers claim a micropore sizes range from 0.5 – 10μm, and the macropore sizes are 50 – 700μm which provides a highly porous structure new bone formation and slow graft resorption. The major advantage of using pure β-Tricalcium Phosphate (TCP) is its high osteoconductivity but at the same time it not as stable as hydroxyapatite and is resorbed at a faster rate.
Bioresorb®( Sybron Implant Solutions GmbH Bremen, Germany)
Cerasorb ® (Curasan, Kleinostheim Germany):
This synthetic graft material has particle size of granules between 150-500 µm. It is a pure-phase β-TCP. It is completely resorbed in 4-12 months and its porous scaffold during that time helps the natural bone formation to occur. It does not contain HA, so its resorption occurs completely, uniformly and parallel to the formation of the surrounding bone. The granules are radio-opaque, resorbing gradually from the inside out, so clinicians can easily monitor the status of grafted site.
Vitoss ® (Orthovita, Malvern, PA, USA) :
It is a β-tricalcium phosphate synthetic bone substitute. The material is is 3-dimensionally macroporous, containing spaces into which bone ingrowth takes place. It does not have significant compressive strength by itself.
Know more…………….
Biphasic alloplastic materials:
Various bone grafts have been developed by combining of hydroxyapatite (HA) and tricalcium phosphate. This combination has been proposed to have better osteoconductive properties as compared to individual material. In these materials the quantity of HA is higher than TCP because it has been suggested that higher HA ratio shows accelerated new bone formation 38. Various commercially available biphasic alloplastic materials include,
Calcitec ® Inc. (Austin, TX):
This synthetic bone graft contains hydroxyapatite (HA) and tricalcium phosphate crystals and is claimed to have high osteoconductive properties as claimed by manufacturers.
Osteogen ® (Impladent Ltd, Holliswood, NY):
It is a biphasic alloplast containing synthetic bioactive resorbable crystals and crystal clusters in the range of 300 to 400 μm which are osteoconductive, highly hydrophilic, and resorbable. The graft material has highly porous crystalline clusters which act as a slowly-resorbing matrix, permitting the infiltration of bone-forming cells and the subsequent deposition of host bone.
Tricos ® (Baxter, Bern, Switzerland):
This synthetic bone graft contains 60% HA and 40% β-TCP. The β-TCP is quickly resorbed and has a high osteogenetic potential and constitutes a source of P+ and Ca++ ions whereas hydroxyapatite is slowly resorbed and ensures the long-term stability of the material.
Osteon TM (Genoss Co. Ltd., Suwon, Korea):
It is composed of 70% HA and 30% β-tricalcium phosphate (β -TCP). Material porosity is in the range of 300–500 nm.
Bone Ceramic ® (Straumann, Basel, Switzerland):
It is composed of 60% hydroxyapatite (100% crystalline), and 40% β TCP (particulate form). The graft material porosity is in the range of 100–500 μm.
Ceraform ® (Teknimed SA, Vic-en Bigorre, France):
It is composed of 65% HA and 35% TCP. The material has a mean granular diameter is between 900 and 1,200 μm and is available in block or granular form.
MBCP+â"¢ (Biomatlante biologics solutions):
MBCP is a Micro Macroporous Resorable Biphasic Calcium Phosphate bone substitute. It is a 3D interconnected scaffold of bone graft with 20% HA and 80% β-TCP.
Calcium Phosphate Cements (CPC):
Calcium phosphate cement (CPC) utilizes two phases of components, one in powder form and another in liquid form. Powder is usually a mix of different calcium phosphate salts where almost all products contain one or several of the components including: amorphous calcium, phosphate (ACP), dicalcium phosphate dihydrate (DCPD), dicalcium phosphate anhydrous (DCPA), α-tricalcium phosphate (α-TCP), dicalcium phosphate (DCP), tetra-calcium phosphate (TTCP),…………………………………………………
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Various studies have shown that CPC are highly biocompatible and osteoconductive materials, which can stimulate tissue regeneration 43-45. These cements can also be used as carriers for drugs and other mediators like growth factors which promote bone formation. A large-scale, prospective, blinded, and randomized controlled clinical trial study demonstrated that the use of rh PDGF-BB + β-TCP was safe and effective in the treatment of periodontal osseous defects 46.
The problem associated with these materials is prolonged setting time and the inability to set in the presence of blood. To overcome these problems new improved cements have been developed. Following are the commercially available calcium phosphate cements used in periodontal bone defects,
Norian ® PDCâ"¢ (Shofu Inc., Kyoto, Japan):
It is an injectable, moldable, fast setting, bioabsorbable calcium phosphate cement having high compressive strength (55 MPa). The powder of the cement consists of a-tricalcium phosphate (a Ca3[PO4]2), monocalcium phosphate monohydrate (Ca[H2PO4]2·H2O) and calcium carbonate (CaCO3). The liquid contains a solution of sodium phosphate. The pore diameter of the set mass is around 300 Ã….
Augmentech AT (Wetzlar, Germany):
This is also a moldable, fast setting, bioabsorbable cement having high compressive strength. The powder of the mix contains tricalcium phosphate (TCP), magnesium phosphate, magnesium hydrogen phosphate and strontium carbonate. The liquid is a watery solution of diammonium hydrogen phosphate.
Calcibon ® (Biomet):
It is a synthetic, biodegradable, calcium phosphate based bone substitute. The powder of the mix contains Powder: α-TCP (61%), DCP (26%), CaCO3(10%), and PHA (3%). Solution contains H2O and Na2HPO4. The set material has got high compressive strength (up to 60 MPa). Compressive strength increases during setting of the material. After 6 hours it is comparable to cancellous bone. The final compressive strength is reached after 3 days.
Bioactive Glasses:
These are silicate based alloplasts containing calcium and phosphate. Hench was the first one to develop bioactive glass that could bind to tissue 47. The formation of carbonated hydroxyapatite layer on its surface when placed in body fluids make this material bioactive. The FDA approved composition of bioactive glass is designated as 45S5. The 45S5 bioactive glass is composed of ………………………………………
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When bioactive glasses are placed in vivo, a highly basic environment with pH around 10 is created, because of which a layer rich in silica gel is formed on the surface of glass particles. Because of interaction with surrounding fluid, a layer of calcium phosphate is formed which is made up of hydroxycarbonate apatite (HCA). Hydroxycarbonate apatite is chemically and structurally very similar to composition of bone. The cellular reactions include colonization, proliferation and differentiation of relevant (bone) cells 49, 51.
Flow chart showing various interfacial reactions involved in forming a bond between bone and a bioactive glass 52
With development in materials over years, new bioactive glass compositions have been introduced. These materials contain no sodium or have additional elements incorporated in the silicate network such as fluorine 53, magnesium 54, 55, strontium 56-58, iron 59, silver 60, 61, boron 62-64 , potassium 65 or zinc 66, 67.
Bioactive glass posses superior mechanical strength compared with calcium phosphate products, as a result of a strong graft-bone bonding 68.
Commercially available bioactive glass alloplasts:
PerioGlas ® (Block Drug Co., NJ, USA):
PerioGlas is a synthetic absorbable osteoconductive bone graft substitute composed of a calcium phospho-silicate bioactive glass, Bioglass. This graft material is available for use since 1995. The particle size of the graft particles varies from 90-710 μm. It is supplied sterile, packaged either in a Tyvek-sealed PET-G cup or in a filled syringe within a second sterile barrier package. While using, the graft is mixed with sterile water, saline, the patient's own blood or marrow or with autogenous or allograft bone to form a wet sandy paste that is applied to the defect 69.
PerioGlas®(Block Drug Co., NJ, USA)
PerioGlas ® Plus(Block Drug Co., NJ, USA):
It is composed of a calcium phosphosilicate material and a calcium sulfate binder. The inorganic calcium and phosphorous components are thermally incorporated in a sodium silicate network (PerioGlas®) designed specifically for its absorbability and osteoconductive nature. The calcium sulphate incorporated in the graft material binds……………………………..
Unigraft ® (Unicare Biomedical Inc., Laguna Hills, CA, USA):
Unigraft is made of synthetic bioactive glass material. The graft material is composed of fused oxides of calcium, phosphorus, silicon and sodium. Upon implantation, the material begins to dissolve by gradually releasing a steady stream of Ca and P ions, along with soluble silica into the bony defect. This increased concentration of local bone mineral ions has been demonstrated to enhance bone regeneration and exhibit an anti-bacterial effect. The particle size of the graft material varies from 200 μm to about 420 μm. It is supplied sterile in foil-sealed polyolefin vial. The graft material is mixed with sterile saline or with patient's blood to form a sandy paste that is to be applied to the defect 71.
Biogranâ"¢ (Orthovita Inc., Malvern, PA, USA):
Biogran is a synthetic bone graft material consisting of 300-355 μm diameter bioactive glass granules. It is composed of bioactive salts of Si, Ca, Na, P. The graft material can be mixed with the patient's blood or sterile saline within the disposable dappen dish cup and subsequently delivered to the defect site. With due course of time, it is slowly resorbed and replaced by host bone.
Biocompatible osteoconductive polymers:
These are nonresorbable, particulate of calcium layered with polymethylmethacrylate and hydroxyethylmethacrylate (PMMA-PHEMA) 72. The polymers used as bone substitutes can be classified as natural and synthetic polymers which can further be divided as degradable and nondegradable 73. Present biocompatible polymers contain calcium hydroxide and polymethylmethacrylate (PMMA) and polyhydroxylethylmethacrylate (PHEMA). Commercially available polymer grafts is HTR TM Synthetic Bone (Bioplant, Norwalk, CT). This composite is prepared from a core of PMMA and PHEMA with a coating of calcium hydroxide 74. The graft material is highly porous with 150–350 μm interled pore size. Being polymers, these grafts are hydrophobic with a negative surface charge (−8 to −10 mV), which is believed to impede development of infection 75. The hydrophobic nature of the material enhances clotting and negative particle surface charge aids in adherence to bone 25. Various studies have provided evidence of bone formation around graft particles 76-78.
Composite Grafts:
These are newly emerging grafting materials. Composite grafts combine scaffolding properties with…………………………………………
Commercially available composite grafts:
Healos ® (Orquest, Mountain View, CA):
Healos® is a matrix of bovine fibrillar Type I collagen coated with hydroxyapatite mineral, which constitutes approximately 25% of the implant by weight. It can be mixed with bone marrow aspirate to provide osteogenic and osteoinductive potential. Another addition to this bone graft is MP52, which is a member of the BMP family. Addition of this protein further increases the osteogenic potential of this bone graft.
Collagraft ® (Zimmer Corp, Warsaw, IN):
Collagraft is a composite of suspended fibrillar collagen and a porous calcium phosphate ceramic, in a ratio of 1:1. The fibrillar collagen is highly purified collagen obtained from bovine dermis. Autologous bone marrow aspirate can be added to these materials or it can be mixed with autologous bone as a bone graft extender. It does not offer structural support by itself and its movement may be difficult to control 80, 81.
Tricos ® (Baxter BioSciences BioSurgery):
Tricos® is a combination of hydroxyapatite-coated beta tricalcium phosphate (HA/TCP) granules and a fibrin matrix. This bioactive material provides a three-dimensional osteoconductive environment for the formation of new bone.
Know more………….
Collagen based delivery systems in tissue engineering:
The biocompatible properties of collagen have resulted in the use of collagen as a matrix or scaffold for tissue regeneration. Collagen has been used as a carrier for various therapeutic agents and bioactive molecules. These include antibiotics, steroids, anticoagulants, antineoplastics, immunosuppressants, growth factors, cytokines and gene therapeutics (e.g., plasmid DNA) 82. The main aim of using a carrier is to deliver the drug or bioactive molecule in a sufficient concentration for appropriate time duration at site where its desired effect is required. Collagen matrices are available in the form of films, sheets, wafers, discs, gels, sponges, 3D scaffolds, and nanofibers (alone and in combination with a plethora of natural and synthetic fibers as well as ceramics).
Another major field of research is culturing specific cell types directly on the collagen-based matrix prior to in vivo application. Delivering these specific cells to the site promotes healing. Various aspects of tissue engineering have been discussed in "Tissue engineering in periodonticsâ€.
Factors affecting success of bone grafts:
Local factors:
Defect size and topography:
It is a very important factor which affects the success of bone graft. The predictability of graft success generally increases as the number of remaining bony walls increases. In other words we can say the graft success is most predictable with three wall and least predictable with one wall defect. A deep narrow defect is more predictable for regeneration than a shallow and wide defect 83, 84.
Presence of infection:
Presence of infection at the grafting site is a major factor responsible for graft failure. Under low pH conditions, bone and graft material are rapidly absorbed through solution mediated resorption. Therefore, it is important to eliminate all reasons for inflammation before placement of bone graft.
Graft stability:
The graft material should be stable at its position to facilitate a proper biological response during healing. An improperly placed graft material with vulnerability to movement is bound to fail.
Space maintenance:
The area in which regeneration has to take place requires space maintenance. If the graft material resorbs too quickly, there is no sufficient time for new bone formation and the defect gets filled with connective tissue rather than new bone 85, 86.
Healing period:
The healing period varies from……………………………….
Adequate blood supply:
For proper healing in area where bone graft has been placed, an adequate blood supply is of paramount importance. The blood supply in this area is derived from two sources: the cortical or cancellous bone and soft tissue covering the defect. The cortical bone has few arterioles as compared to cancellous bone 87, 88.
Primary closure:
Primary closure of the soft tissue at the operated site is paramount for graft success. The opening of the incision line is one of the most common complications during post-operative healing. As a result of this, the graft material may be lost, contaminated and vascularisation is delayed causing graft failure.
Regional acceleratory phenomenon (RAP):
It is a local response to injury; in which healing takes place at a faster rate as compared to normal regeneration process 87. It is basically attributed to increase in the concentration of chemical mediators like growth factors, which may enhance the healing process to almost 10 times that normal 89. RAP begins few days after the injury, reaches its peak at one to two months, lasts four months in bone and totally subsides within 6-24 months.
Affect of growth factors:
Presence of growth factors is required for regeneration to take place. These growth factors are derived from various cellular sources like platelets, macrophages and other cells involved in local inflammatory response……………………………………….
fibroblast growth factor, insulin-like growth factor, keratinocyte growth factor, platelet derived growth factor, transforming growth factor, vascular endothelial growth factor etc. A detailed description of these factors is available in "Growth factors in periodontal regenerationâ€.
Particle size of graft material:
The acceptable size of graft particles ranges from 125-1000 μm. A minimum space of 100 μm is required between the graft particle to allow vascularisation and bone formation. A particle size less than 100 μm elicits macrophage resorption of the graft particles causing their early loss 7. Most commercially available grafts have particle size ranging from 250-750 μm.
Systemic factors:
Systemic condition:
Systemic conditions like diabetes mellitus, hyperparathyroidism, thyrotoxicosis, osteoporosis, Paget's disease etc. have adverse affects on healing of the graft.
Smoking and alcohol also adversely affect the healing of the graft.
Bone substitutes and their application in periodontal regenerative therapy is presently a major field of research in periodontology. In the above discussion, we have discussed in detail various bone grafts and their sources in detail. Although autogenous bone graft is closest to ideal bone graft but it requires extra surgical site to harvest the graft. The allografts provide an alternative to autograft but are not as osteoinductive as autografts are. Synthetic bone substitutes such as various forms of hydroxylapatite, β-Tricalcium Phosphate (TCP), biphasic alloplastic materials, calcium phosphate cements (CPC) and bioactive glasses have provided us a good alternative to autogenous bone grafts. As these materials have a composition which is very similar to bone, they get resorbed and replaced by host bone in due course of time.
The future of bone graft materials are composite bone grafts, which have combined properties of scaffold and biologically active molecules such as bone morphogenetic proteins/growth factors. In other words we can say that the graft material acts as a carrier for biologically active molecules. Incorporation of collagen matrix into these biomaterials makes them ideal for carrying these biologically active molecules. Although the research on these materials is in its initial stage, they may be the closest replacement of autografts. The future directions in bone grafts and other aspects of periodontal regeneration have been discussed in "Tissue engineering in periodonticsâ€.
|Periobasics: A Text Book of Periodontics and Implantology
|For India Users:
|Buy Now
|For International Users:
Read more:
Bone grafts and periodontal regeneration
Michael A. Brunsvold and James T. Mellonig
Periodontology 2000. Volume 1, Issue 1, February 1993, Pages: 80–91.
Hisham F. Nasr, Mary Elizabeth Aichelmann-Reidy and Raymond A. Yukna.
Periodontology 2000. Volume 19, Issue 1, February 1999, Pages: 74–86.
Clinical Evaluation of a Composite Bone Graft with a Calcium Sulfate Barrier.
Dr. Randall J. Harris
Journal of Periodontology, May 2004, Vol. 75, No. 5, Pages 685-692.
The use of biologic mediators and tissue engineering in dentistry.
Richard T. Kao, Shinya Murakami and O. Ross Beirne
Periodontology 2000. Volume 50, Issue 1, June 2009, Pages: 127–153.
Synthetic bone grafts in periodontics.
Raymond A. Yukna
Periodontology 2000. Volume 1, Issue 1, February 1993, Pages: 92–99.
Clinical and Histologic Observations of Sites Implanted With Intraoral Autologous Bone Grafts or Allografts. 15 Human Case Reports.
William Becker, Marshall Urist, Burton E. Becker, William Jackson, David Andrew Party, Mark Bartold, Gianpaolo Vincenzzi, Dino De Georges and Markus Niederwanger
Journal of Periodontology Oct 1996, Vol. 67, No. 10, Pages 1025-1033.


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The LVMH Prize for Young Fashion Designers has revealed the young designers that have been selected to partake in the second edition of the worldwide fashion design competition.
Twenty six designers have been selected from the womenswear and menswear categories and include three designers who partook in last year's edition who have been selected for the second time: Marques Almeida, Jacquemus and Craig Green.
- Agi and Sam, by Agi Mdumulla and Sam Cotton, Menswear, London
- Andrea Jiapei Li, by Andrea Jiaipei Li, Womenswear, New York
- Anton Belinskiy, by Anton Belinskiy, Womenswear, Kiev
- Arthur Arbesser, by Arthur Arbesser, Womenswear, Milan
- Astrid Andersen, by Astrid Andersen, Menswear, London
- Baja East, by Scott Studenberg and John Targon, "ambisexual" fashion, New York
- Coperni Femme, by Sebastien Meyer and Arnaud Vaillant, Womenswear, Paris
- Craig Green, by Craig Green, Menswear, London
- Devon Halfnight LeFlufy, by Devon Halfnight LeFlufy, Menswear, New York
- Faustine Steinmetz, by Faustine Steinmetz, Womenswear, London
- Huishan Zhang, by Huishan Zhang, Womenswear, London
- Jacquemus, by Simon Porte Jacquemus, Womenswear, Paris
- Jourden, by Anais Mak and Benny Woo, Womenswear, Paris and London
- Koché, by Christelle Kocher, Womenswear, Paris
- Marques Almeida, by Marta Marques and Paulo Almeida, Womenswear, London
- Nabil Nayal by Nabil El-Nayal, Womenswear, London
- Nasir Mazhar by Nasir Mazhar, Menswear-Womenswear, London
- Off-White c/o Virgil Abloh, by Virgil Abloh, Menswear – Womenswear, Paris
- Orley, by Alex Orley, Matthew Orley and Samantha Orley, Menswear – Womenswear, New York
- Ryan Lo by Ryan Lo, Womenswear, London
- Ryan Roche by Ryan Roche, Womenswear, New York
- Sankuanz by Zhe Shangguan, Menswear, London
- Vetements, by Demna Gvasali, Womenswear, Paris
- WrittenAfterwards by Yoshikazu Yamagata, Unisex fashion, Tokyo
- Xiao Li by Xiao Li, Womenswear, London
- Ximon Lee by Ximon Lee, Menswear, New York.
The next step for selected designers will be a meeting with forty five international experts from the fashion world in Paris on March 4th and 5th. The extensive panel of experts will then select eight finalists who will go forward to the next stage where they will present their collections to the competition's Jury at the end of May.
The Jury will select a particularly remarkable designer for their talent. The winner receives a grant of 300,000 euros, as well as a personalized mentorship from a dedicated LVMH team in developing their company for a period of twelve months. This support includes all crucial areas of expertise that are critical to successfully building a nascent fashion brand (including advisement on intellectual property, sourcing, production and distribution, image and advertising, marketing).
In addition, the LVMH Prize also recognizes three recent fashion school graduates, offering them an opportunity to join the design team at an LVMH brand for one year and awarding them a 10 000 euro grant.
The Jury is composed of nine artistic directors from LVMH Maisons: Jonathan Anderson (Loewe), Nicolas Ghesquière (Louis Vuitton), Marc Jacobs (Marc Jacobs), Karl Lagerfeld (Fendi), Humberto Leon and Carol Lim (Kenzo), Phoebe Philo (Céline), Raf Simons (Dior), Riccardo Tisci (Givenchy); as well as: Delphine Arnault, Jean-Paul Claverie (advisor to Bernard Arnault and director of LVMH sponsorship), Pierre-Yves Roussel (chairman and chief executive officer of the LVMH fashion division).
The Graduate's Prize will continue to accept applications until May 3rd 2015.
"It is the responsibility of the LVMH Group, as the leader of our industry, to identify and support young designers, and I am delighted that we can do so once again with so many talented candidates." Delphine Arnault
Last year's winner Thomas Tait
Last year's finalists…


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text:
DF Markets Review – A Customer Centric Broker
DF Markets started its FX trading service in 2010 by launching their financial products out of a brokerage situated in the heart of London's capital markets. DF Markets is regulated by the Financial Conduct Authority (FCA) of the UK, which seems to be one of the most trusted and highly popular regulatory organizations in the world. DF Markets appears to be more oriented towards advertising itself as a spread betting brokerage that also offers access to Forex and CFD trading. Therefore, UK traders have the option of enjoying tax-free profits due to the unique tax status of spread betting in the UK. All profits and proceeds from spread betting are excluded from any taxes or stamp duties, which in turn help traders to concentrate on their trading success without worrying about the implications of taxes on their bottom line. FCA regulated brokers are audited and monitored according to the most stringent regulatory guidelines.
Best Online Forex Brokers – List
See a Full List of Forex Broker Companies
Contact Info
- Website: www.dfmarkets.co.uk
- Support: +44 (0) 20 3866 9652
- Address:
- 5 Harbour
- Exchange Square
- London E14 9GE
DF Markets, registered under the name of Delta Financial Markets Ltd., should abide by all the laws and regulations implemented by the FCA and the European MiFID. Since FCA regulated brokers are free to do business in the entire European Union under the European Economic Area (EEA) agreement, Forex brokers in the UK are also expected to adhere to the EU guidelines on Forex broker regulation. To make matters easy for investors while dealing with FX brokers against insolvency or liquidation procedures, clients that are part of the FCA regulated are protected by the Financial Services Compensation Scheme (FSCS). FSCS is an insurance scheme that provides traders up to £50,000 in compensation if a broker fails. The FSCS compensation is provided to all traders under a common insurance fund, which not only protects a trader's capital but also helps in ensuring a fair and transparent trading environment.
DF Markets Platforms & Account Options
DF Markets has their trading interface known as the DFTrader for the PC, DF WebTrader for browser access, and the DF Mobile apps for DF Markets mobile trading. The broker does not provide access to the MT4 terminal (although the company had initially offered an interface under the MT4 license) since it aims to incorporate all of its trading products under a single platform. The DF Markets platform can be used to trade a wide range of financial instruments that include Forex, stocks, indices, commodities, ETFs, and futures under a single interface. The proprietary trading platform should provide all the essential tools and features that one would expect from a leading trading platform, and existing MT4 traders will not find it too hard to make the transition to the DF Trader platform. DF Markets is a market maker that does not offer an ECN account. All traders are provided the option of a single trading account that starts with a minimum deposit of $1 and a maximum DF Markets leverage of 1:200. The minimum deposit should primarily help in catering to smaller retail traders; however, the lower leverage may prove to a problem for a significant majority of traders that are looking to increase their exposure in the market. Nevertheless, the $1 minimum deposit should provide a great reason for both new as well as professional traders to try out DF Markets with a small trading capital before moving on to larger investments. Being a market maker broker, the DF Markets spreads start from 2 pips and changes according to market conditions. The broker does promise to offer spreads as low as 0.8 pips, but under live market conditions, the platform consistently displays spreads in the range of 2 to 4 pips on major currency pairs. The higher than average spreads are bound to be an alienating factor in the highly competitive retail trading market, where regular market maker brokers are known to offer spreads starting from 0.5 pips. Several ECN brokers also promise 0 pips on major currency pairs at the expense or a small commission per trade, which is another factor to consider while choosing DF Markets. DF Markets withdrawal and deposit options are also severely limited, as traders can only make payments through a credit card or via bank transfer. Making small payments through either means can incur hefty charges, which can also limit the freedom of making payments through online payment processors. DF Markets has to concentrate its efforts on improving on a lot of different areas, which should be vital in establishing the broker's presence in the market.
Is There Any Reason To Choose DF Markets?
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text:
Default Insurance Policy
The Leadway Default Insurance Policy product is a credit insurance policy designed to indemnify an airline against financial loss following the default of a ticketing, travel or cargo agent up to agreed limits.
The Policy is open to all IATA approved agents carrying on business in Nigeria, but covers 100% of their default anywhere in the world.
Claims are paid within 30 working days of the submission of all supporting documentation to IATA who then distributes to all airlines who have suffered default.
Premium on this policy is charged per ticket issued by the IATA Agent under the program.
Click here to download our Application Forms or call 01 28007000 to speak with one of our Customer Service team.
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Or call 01-2800700 to speak with one of our Customer Service team.


text:
The Association Climatologique de la Moyenne-Garonne et du Sud-Ouest (ACMG) works on knowledge of climate conditions and adaptation to climate change. It has an agro-climatological network in Moyenne-Garonne with 92 positions that provide information on weather forecasts, assistance in the case of frosts, water management and technical support for the irrigation association.
The ACMG I has experience in two European projects funded by INTERREG SUDOE: Precirieg (www.precirieg.net) and Telerieg (www.telerieg.net).
In the ADAPTACLIMA II project, the ACMG will coordinate the pilot project designated "optimisation of thermal comfort using renewable resources".


text:
There's a lot to remember when it comes to owning your own home. Taking care of maintenance before a problem arises is critical, but can be difficult to do on your own. Not to worry, the experts at THA Heating, Air, Read More
Whether you live in an apartment, a condo, or a home, utility bills can be a major source of headaches – especially when you don't know where all those costs are coming from. Despite our best efforts to conserve energy, it can Read More
Winter is coming, and with the unmistakable chill of January comes higher heating costs. At THA Heating, Air, & Plumbing we want to help you take control of costs, while also making sure you, your family, and your home are safe. We've Read More
One of the best things you can do as a homeowner is ensure your home is well-maintained throughout the year. Maintenance is key to keeping your appliances running good-as-new and avoiding any unexpected malfunctions. At THA, we believe it's important to give Read More
Gardeners of San Diego! Are you looking for ways to keep your garden lush while cutting down on water consumption? THA Heating, Air & Plumbing has put together an easy-to-follow guide on gardening the environmentally safe way. There are many simple steps Read More
Although the heat of this summer may have seemed never-ending, winter is on its way. With dropping temperatures come higher thermostat settings, followed by increased energy costs. Fortunately, there are several things you can do around your home to prepare for winter. Read More
Shopping for a large appliance like a water heater can be daunting, especially for the newer homeowner. That's why we decided to put together a buying guide to help you determine which water heater is the best fit for your home and Read More
Are you concerned about the impact that you and your family are making on the environment? Do you want to keep energy bills as low as possible? THA is here to help. Here are 11 energy efficiency tips guaranteed to shave off Read More
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|Oracle FAQ
|Your Portal to the Oracle Knowledge Grid
Home -> Community -> Mailing Lists -> Oracle-L -> RE: Oracle Compress Option
Disk is not cheap if you pay for high availability configuration. I compress historical data on daily basis and was able to save 70 percent of the disk space. Imagine the amount of savings for five TB.
Two major issues:
It's mainly good for data warehouses applications.
-----Original Message-----
Sent: Thursday, September 25, 2003 9:05 AM To: Multiple recipients of list ORACLE-L
I think 9202 doesn't like to export compressed tables in direct mode ... so watch out for that ... I implemented, tested and next day reverted back to regular tables due to this export issue. Disk is cheap.
A BAARF party member wannabe !!
-----Original Message-----
<mailto:mln_at_miracleas.dk> ]
Sent: Wednesday, September 24, 2003 10:05 PM To: Multiple recipients of list ORACLE-L
"Compress to impress?" by Julian Dyke is a good presentation on this topic (see for instance http://www.ukoug.org/calendar/jan03/jan30ab.htm <http://www.ukoug.org/calendar/jan03/jan30ab.htm> ).
I do have the article - 202 K with no compression, 147 K with compression :).
Let me know if you're interested, and I'll email it directly to you.
Avnish.Rastogi_at_providence.org wrote:
>Does anybody has any experience with Oracle 9I compression option. I did
some test on 9202 with a table of more 14 million rows. Table has total 7 indexes. Surprising both table and indexes are using more space after compression. Before compression space used is 13064MB and after compression 13184MB. In both the cases I did export from source table and stored in two different tablespaces. Any insight on that and any disadvantages of using that.
-- Please see the official ORACLE-L FAQ: http://www.orafaq.net -- Author: Khedr, Waleed INET: Waleed.Khedr_at_FMR.COM Fat City Network Services -- 858-538-5051 http://www.fatcity.com San Diego, California -- Mailing list and web hosting services --------------------------------------------------------------------- To REMOVE yourself from this mailing list, send an E-Mail message to: ListGuru_at_fatcity.com (note EXACT spelling of 'ListGuru') and in the message BODY, include a line containing: UNSUB ORACLE-L (or the name of mailing list you want to be removed from). You may also send the HELP command for other information (like subscribing).Received on Thu Sep 25 2003 - 08:34:43 CDT
Original text of this message


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My eyes aren't glistening with the ghosts of my past! –Harry Potter
Saturday afternoon I met up with a few of my friends from college for a mini reunion. Moose and I have kept in touch all these years, but the other two guys I hadn't seen in at least 8 years. It was so surreal to all be hanging out together again. The day started out with me third wheeling it with Moose and his lady. We went wine tasting in Sonoma and Napa and it was actually a lot of fun even though I wished Match could have been there. The weather was perfect and it was an absolutely gorgeous day for wine tasting.
We drank a lot of tasty sparkling wine and I got to know Moose's fiancee.
He's actually been engaged three times, and so far she's my favorite. I tease him a lot about being proposal happy and I told him he better be sure that this one stuck. It was great to spend some quality time with Moose before hanging out with everyone else. He's always felt like an older brother and I'm so happy we've stayed friends all these years.
After we drank and had fun in true Napa County style, we headed back to their place in Napa. Napa holds a lot of bad memories for me, but a few good ones. It was in Napa that I first lived with a boy and it ended badly. I think a part of me always worries that I'll run into that ex, Flame Boy. I'm not really sure what I'm so afraid of because I have never been happier with my life. I guess it's just a scary thought to run into ghosts from our past.
Speaking of ghosts, when the other two guys showed up for the BBQ at Moose's, I was forced to remember a lot of other ghosts from my past as "Oregon", the wild party girl. Moose loves to bring up awkward party stories and he loves to see me turn red. You can bet my face was scarlet for most of the evening. Luckily it was all in good fun, but the story telling portion of the night made me grateful Match was at work. I'm most definitely not the girl I once was!
After eating an amazing BBQ dinner and birthday cake (celebrating our September birthdays early) I had sobered up enough to drive downtown with the guys. We piled into my little car and headed down to the local pub. We hung out and the boys drank and we all visited and did some people watching.
It's nice when you can hang out with friends you haven't seen in almost a decade and still feel comfortable. I think I actually felt more comfortable now because I'm grown up and I know who I am. I'm no longer that awkward 18 year old trying to figure out life. My buddies are all a lot more mature now too and all seemed to be happy with their places in life. It was great to reconnect and I hope we do it again soon! Hopefully next time I'll be able to bring my better half to the party.


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If you are scheduling/adjusting an appointment for FEBRUARY 1ST AND BEYOND, please CLICK HERE to access our new booking software & schedule. On January 31st, we will no longer be utilizing this platform.
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