1,721,038 research outputs found
Reliability of cervical vertebral maturation compared to hand-wrist for skeletal maturation assessment in growing subjects: A systematic review
No full textRadiographic methods to assess skeletal maturity (SM) have a key role in adolescent idiopathic scoliosis (AIS) management, allowing to predict risk of spinal curve progression. Cervical vertebral maturation (CVM) has been recently introduced as an alternative tool to assess skeletal maturity; however, its clinical role is still debated
Clinical outcomes of dental implants in patients with and without history of periodontitis: A 20-year prospective study.
Full text linkAIM
To present the 20-year clinical outcomes of tissue-level implants in partially edentulous patients previously treated for periodontitis and in periodontally healthy patients (PHP).
MATERIAL AND METHODS
The original population consisted of 149 partially edentulous patients consecutively enrolled in a private specialist practice and divided into three groups: PHP, moderately periodontally compromised patients (mPCP) and severely PCP (sPCP). After successful completion of periodontal/implant therapy, patients were enrolled in an individualized supportive periodontal care (SPC) programme.
RESULTS
Eighty-four patients rehabilitated with 172 implants reached the 20-year examination. During the observation time, 12 implants were removed (i.e., 11 due to biological complications and 1 due to implant fracture), leading to an overall implant survival rate of 93% (i.e., 94.9% for PHP, 91.8% for mPCP and 93.1% for sPCP [p = .29]). At 20 years, PCP compliant with SPC did not present with significantly higher odds of implant loss compared with PHP compliant with SPC (p > .05). Conversely, PCP not compliant with SPC experienced implant loss with odds ratio of 14.59 (1.30-164.29, p = .03).
CONCLUSIONS
Tissue-level implants, placed after comprehensive periodontal therapy and SPC, yield favourable long-term results. However, patients with a history of periodontitis and non-compliant with SPC are at higher risk of biological complications and implant loss
How often should implant-supported full-arch dental prostheses be removed for supportive peri-implant care to maintain peri-implant health? A systematic review
No full textPurpose: To systematically screen and summarise the available literature on when and how often it is advisable to perform supportive peri-implant care on implant-supported full-arch dental prostheses to maintain peri-implant health. Materials and methods: The authors employed the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement and the Population, Intervention, Comparison and Outcomes tool. A literature search was conducted on PubMed for randomised controlled trials, controlled clinical trials and cohort studies, reporting results on supportive peri-implant care for full-arch dental prostheses with a follow-up period of at least 1 year. The studies were selected in a blind process with an agreement rate of 100%. For all the included studies, quality assessment was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. Results: The application of the search terms on PubMed led to the selection of 915 results. Only 11 studies were included in the review. Eight of these reported the frequency of supportive peri-implant care, and three detailed the procedures adopted. The number of patients included ranged from 15 to 85, with a mean age from 60.4 to 68.4 years. None of the included studies were judged to be at low risk of bias. Conclusions: Removal of implant-supported prostheses is a crucial aspect in the long-term care of patients rehabilitated with full-arch restorations. Although no specific indications can be drawn with respect to the frequency at which supportive peri-implant care should be delivered and the regime used to do so, practitioners should consider performing professional oral hygiene measures every 6 months and removing prostheses at least once per year. All interventions should be tailored to the patient's risk profile and characteristics
Efficacy of Xanthan‐Based Chlorhexidine Gel in Peri‐Implant Mucositis Treatment: A Split‐Mouth Randomized Clinical Trial
Full text linkObjectives: To investigate the potential benefits of Xanthan-based chlorhexidine gel application in addition to professional mechanical plaque removal (PMPR) in the treatment of peri-implant mucositis (PM). Material and methods: Subjects diagnosed with PM were consecutively included in this randomized split-mouth study. All participants received a single session of PMPR using titanium curettes, followed by the application of an air-polishing glycine powder device. Implants allocated to the Test group were additionally treated with local delivery of Xanthan-based chlorhexidine gel. Clinical evaluation was performed at T0 (i.e., baseline), at 30 (T1), 90 (T2) and 180 days (T3) after treatment, while treatment success was evaluated at T2 and T3. Change in bleeding on probing (BoP) was considered as primary outcome measure. A logistic multivariate regression model was developed to explore the predictive role of implant and patient-level variables on primary outcome measure. Results: Fifty-nine patients (mean age: 65.4 ± 8.7 years; 54.2% male; 88.1% non-smokers) and 182 implants completed the study. At T1, only the Test group displayed a significant reduction in BoP (p 0.05). T2 Treatment success as well as the frequency distribution of complete (BoP = 0) and partial (BoP ≤ 1, ≤ 2, ≤ 3) disease resolution did not significantly differ between groups (p > 0.05). Multiple regression model revealed that smoking (p = 0.008), and implant position (i.e., premolar p = 0.009) did significantly affect the primary outcome measure. Conclusion: The adjunctive use of XanCHX gel did not result in any statistically significant clinical benefit compared to PMPR alone in the treatment of PM up to 6 months, despite the reported clinical positive effects within the first month after treatment
Evaluation of dynamic computer-assisted implant placement accuracy by means of a novel digital method: a feasibility clinical study
Full text linkPurpose: To present a novel digital method to evaluate dynamic computer-assisted implant surgery (dCAIS) accuracy comparing digital implant planning to real implant position. Materials and methods: Twenty patients in need of implant supported single unit-crowns (SUC), were consequently treated following a standardized digital protocol encompassing (1) a diagnostic digital intra-oral scan (IOS), (2) a cone beam computed tomography (CBCT), (3) 3D digital implant planning, (4) dynamic navigated implant placement (X-Guide, X-Nav Technologies, LLC, Lansdale, PA, USA) and (5) a post-operative IOS with the scan body in situ. Implant position accuracy was evaluated by superimposing the post-operative IOS with the pre-operative digital planning and calculating the resulting angular deviation (o), global head deviation (mm) and global tip deviation (mm). Results: From the original 30 installed implants, 29 could be analyzed. All surgical procedures were successfully completed without any complication. The calculated mean angular deviation was 4.50° ± 2.59°, while the mean deviation at the implant head was 1.18 ± 0.52 mm. Finally, the global tip deviation was 1.43 ± 0.78 mm. Flapless implant placement was significantly associated with a reduction in both head and tip linear deviations (p = 0.026; p = 0.007), as well as with a significant reduction in angular deviation (p < 0.001). Implants placed in the anterior region showed a mean statistically significantly higher deviation at the implant head compared to those in posterior sites (difference: 0.39 mm; p = 0.043). Conclusions: Despite its limitations, the proposed digital method does represent a promising and patient friendly approach to evaluate dCAIS accuracy. Clinical significance: The proposed digital method represents a promising workflow for the evaluation of dCAIS implant placement avoiding the need of post-operative radiations
Clinical outcomes of full-arch fixed implant-supported prostheses in patients lacking supportive peri-implant care: A cross-sectional study
No full textPurpose: To evaluate the clinical outcomes and prosthetic complications in patients rehabilitated with full-arch fixed implant-supported prostheses according to the Columbus Bridge Protocol who did not adhere to a structured supportive peri-implant care programme. Materials and methods: This cross-sectional study included 56 patients (mean age 67.8 ± 9.2 years; 28.6% smokers; 80% response rate) rehabilitated with 229 implants (implant survival rate 100%) according to the Columbus Bridge Protocol. Patients were divided into three groups based on follow-up duration: 1 to 2 years (n = 19), 3 to 6 years (n = 16) and > 6 years (n = 21). Through a comprehensive examination, clinical parameters (probing depth, plaque index, bleeding on probing and keratinised tissue width) and mechanical and technical complications were examined by a single experienced operator. Plaque accumulation on the prosthesis was assessed through clinical images using a plaque disclosing solution and ImageJ software (National Institutes of Health, Bethesda, MD, USA). Finally, patient satisfaction was assessed using the Oral Health Impact Profile-14 scale. Results: Mean probing depth values remained stable across groups (2.03 to 2.49 mm, P = 0.125), with most sites ≤ 3 mm. No significant differences were found for bleeding on probing among groups (14.8% to 23.1%, P = 0.331). Plaque levels were high both at implant (43.8% to 57.1%, P = 0.233) and prosthesis level (42.9% to 47.0%, P = 0.707), with no significant differences between groups (P > 0.05). Keratinised tissue width ranged from 3.05 to 3.49 mm (P = 0.650). Prosthetic complications showed an increasing trend as follow-up duration increased (5.3% at 1 to 2 years, 18.8% at 3 to 6 years and 33.3% at > 6 years) (P = 0.086). Overall Oral Health Impact Profile-14 scores indicated a high level of patient satisfaction. Conclusions: Despite the lack of adhesion to a supportive peri-implant care programme, reflected by the high plaque values at implant and prothesis level, the Columbus Bridge Protocol resulted in positive clinical outcomes; however, prosthetic complications occurred and increased over time
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Surgical treatment of peri-implantitis.
Full text linkAs utilisation of dental implants continues to rise, so does the incidence of biological complications. When peri-implantitis has already caused extensive bone resorption, the dentist faces the dilemma of which therapy is the most appropriate to maintain the implant. Since non-surgical approaches of peri-implantitis have shown limited effectiveness, the present paper describes different surgical treatment modalities, underlining their indications and limitations. The primary goal in the management of peri-implantitis is to decontaminate the surface of the infected implant and to eliminate deep peri-implant pockets. For this purpose, access flap debridement, with or without resective procedures, has shown to be effective in a large number of cases. These surgical treatments, however, may be linked to post-operative recession of the mucosal margin. In addition to disease resolution, reconstructive approaches also seek to regenerate the bone defect and to achieve re-osseointegration
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