66 research outputs found
Implant rehabilitation of the esthetic area: A five‐year retrospective study comparing conventional and fully guided surgery
No full textIntroduction: To compare the clinical outcomes of anterior single maxillary implants placed using conventional or guided implant surgery. Methods: In this retrospective clinical study 44 patients rehabilitated with a single anterior implant in the maxillary arch were included. Twenty-four implants were inserted applying a guided surgery approach (GS), and 20 applying a conventional freehand approach (CS). Outcome measures were: implant survival rate and complications; mean bone level (MBL) evaluated at surgery (T0), after 6 weeks (6 W), and after 1 year (1Y), 2 years (2Y), 3 years (3Y), 4 years (4Y), and 5 years (5Y); patients' satisfaction evaluated through a questionnaire filled out before surgery (BS) and at 1 week, 6 W, 2Y and 5Y; Pink esthetic score (PES) and white esthetic score (WES) evaluated at 1Y, 3Y and 5 Y. Significance of differences between groups were tested by Fisher's exact test, Mann-Whitney U test, and Wilcoxon's signed rank test. Results: During the 5-year follow-up there were no drop-outs and no implant failed. No significant differences between groups were found in MBL. A significant difference between groups was found in VAS scores regarding speech at 2 years, aesthetics at 6 weeks, confidence at 1 week and 6 weeks, satisfaction at T0 and at 1 W, pain/comfort at 1 W and at 6 W; all VAS scores resulted significantly improved compared to baseline. No significant differences in WES were found, while significant differences in PES scores between CS and GS groups were found at 3 and 5 years (p value = 0.023 and 0.004 respectively) with better outcomes for GS. A significant difference over time was found in PES between 5-year and one-year values. Conclusions: Guided surgery and conventional surgery implants did not show any difference in MBL during the 5-year observation period. Guided surgical procedure guarantee optimal esthetic outcome and seems able to guarantee better soft tissue result over time, even though more long-term studies are necessary to confirm this data
Quantification of Thalamic Atrophy in MS: From the Multicenter Italian Neuroimaging Network Initiative Data Set to Clinical Application
No full textBACKGROUND AND PURPOSE: Thalamic atrophy occurs from the earliest phases of MS; however, this measure is not included in clinical practice. Our purpose was to obtain a reliable segmentation of the thalamus in MS by comparing existing automatic methods cross-sectionally and longitudinally.MATERIALS AND METHODS: MR images of 141 patients with relapsing-remitting MS (mean age, 38 years; range, 19-58 years; 95 women) and 69 healthy controls (mean age, 36 years; range, 22-69 years; 47 women) were retrieved from the Italian Neuroimaging Network Initiative repository: T1WI, T2WI, and DWI at baseline and after 1 year (136 patients, 31 healthy controls). Three segmentation software programs (FSL-FIRST, FSL-MIST, FreeSurfer) were compared. At baseline, agreement among pipelines, correlations with age, disease duration, clinical score, and T2-hyperintense lesion volume were evaluated. Effect sizes in differentiating patients and controls were assessed cross-sectionally and longitudinally. Variability of longitudinal changes in controls and sample sizes were assessed. False discovery rate-adjusted P <.05 was considered significant.RESULTS: At baseline, FSL-FIRST and FSL-MIST showed the highest agreement in the results of thalamic volume (R = 0.87, P <.001), with the highest effect size for FSL-MIST (Cohen d = 1.11); correlations with demographic and clinical variables were comparable for all software. Longitudinally, FSL-MIST showed the lowest variability in estimating thalamic volume changes for healthy controls (SD= 1.07%), the highest effect size (Cohen d = 0.44), and the smallest sample size at 80% power level (15 subjects per group).CONCLUSIONS: Multimodal segmentation by FSL-MIST increased the robustness of the results with better capability to detect small variations in thalamic volumes
6 mm vs 10 mm-long implants in the rehabilitation of posterior jaws : A 10-year follow-up of a randomised controlled trial
No full textPurpose: The aim of this study was to compare survival and success rates of 6 mm-long and 10 mmlong implants in partially edentulous posterior areas. Materials and methods: Twenty-four patients with a partially edentulous area were included in the study. Patients were randomly allocated according to a parallel group design to receive 6 mm or 10 mm-long implants. A total of 54 implants were placed (26 × 6 mm implants). Patients were followed for 10 years after prosthetic loading. Outcome measures were prosthesis and implant survival, marginal bone level changes and complications. Results: After 10 years, 17 patients (eight with 6 mm implants and nine with 10 mm implants) were available: three 6 mm and four 10 mm patients were lost to follow-up. One 6 mm implant failed during the healing period and its related prosthesis could not be placed. No implants were lost after loading. Nine patients in the 6 mm group registered a total of 15 complications: two mucositis, six decementations and seven chippings. Ten patients in the 10 mm group registered a total of 13 complications: five mucositis, two decementations and six chippings. Overall the difference for complications between the two groups was not statistically significant (P = 0.22; difference in proportion = -0.02; 95% CI: -0.31 to 0.27). Decementations in the 6 mm group were statistically significant higher than the 10 mm group (P = 0.04; difference in proportion = 0.39; 95% CI: 0.03 to 0.74). Marginal bone loss at 10 years was 0.84 and 0.37 mm with the 6 mm and 10 mm groups, respectively (difference between the two groups 0.49 mm; 95% CI -0.31; 1.29; not statistically significant: t test P = 0.22). Conclusions: Rehabilitations supported by 6 mm or 10 mm-long implants showed similar clinical outcomes in terms of survival and success rates, although 6 mm implants had more decementations. Conflict of interest statement: The present study was supported by grant 369_2004 from ITI, Basel, Switzerland used to provide free implants and prosthetic components to the patient. The authors declare no conflict of interest
The Conometric Connection for the Implant-Supported Fixed Prosthesis: A Narrative Review
No full textAim: The conometric concept was proposed as a possible connection between the abutment and the prosthetic coping. This research aimed to review the features and possible clinical uses of this connection in an implant-supported fixed prosthesis. Methods: An electronic search was conducted on an online database for the topic in object; articles published in international literature were considered and the research gave 17 results, and 6 parameters were analyzed. Results: This connection eliminated the possibility of cement residues in the subgingival region, reducing the risk of inflammation of peri-implant soft and hard tissues; not having to remove the cement residues, it is possible to place the margins in more apical portions, improving the aesthetics outcomes of the rehabilitations. It is also known that the retention by means of a screw causes a weakening of the restoration. The retentive force is adequate for fixed rehabilitation even after a high number of insertion–disengagement cycles; in vitro studies have also shown a high bacterial sealing. Implant rehabilitation using preformed components, such as conometric hoods, is helpful for CAD/CAM, so a digital workflow is possible. Several types of prosthesis were presented, all of which demonstrated adequate clinical performance in the follow-up observation. Conclusions: This type of connection seems to be suitable to support fixed implant rehabilitations, but long-term clinical studies are needed to validate this system
Excess Mortality among Physicians and Dentists during COVID-19 in Italy: A Cross-Sectional Study Related to a High-Risk Territory
No full textBackground: Many studies previously reported epidemiological data on mortality due to COVID-19 among health workers. All these studies included a partial sample of the population with a substantial selection bias. The present study evaluates the trend of mortality among physicians and dentists operating in an area considered to be at high risk during the COVID-19 pandemic. Methods: Data relating to all physicians and dentists registered in the province of Pavia (Italy), a sample consisting of 5454 doctors in 2020 was analyzed. The mortality rates obtained were compared with those related to the 5-year period preceding the pandemic and with those related to the general population. Results: In the area considered, a mortality rate of 0.83% (+69% compared to 2015–2019) was observed in the entire sample in 2020 and 0.43% (−11% compared to 2015–2019) in 2021; among physicians, there was a mortality rate of 0.76% (+53% compared to 2015-2019) in 2020 and 0.35% (−29% compared to 2015–2019) in 2021; for dentists, there was a mortality rate of 1.27% (+185% compared to 2015–2019) in 2020 and 1.01% (+127% compared to 2015–2019) in 2021. Conclusions: These data report the global impact of the SARS-CoV-2 pandemic on physicians and dentists in a high-risk territory. In 2020, a significant increase in the mortality rate compared to the previous 5 years was observed for both physicians and dentists; in 2021, a significant increase in the mortality rate was observed only for dentists. These data are also significant in evaluating the impact of vaccination on physicians and dentists and indicate that dentists were among the professions most at risk during the pandemic
A Study on the Collective Perceived Representation of a Real Urban Area through the Usage of an Engaging Framework, Based on a 3D Virtual Environment and Openstreetmap Data
No full textThe need for urban regeneration does not come only by structural requirements, but also by socio-cultural needs. What we are going to propose is the urban regeneration as a way to perceive, in a different way, the surrounding spaces allowing users to receive and provide a wide range of information on the urban environment. Each space of a city has a variety of intrinsic meanings provided by human groups interacting with each other everyday. The purpose is collecting the hidden information thanks to citizens' contribution. The objective is the involvement of citizens as "builders of sense" through a playful attitude as "builders of virtual cities", and using game based on motivation as impetus for the regeneration. Urban regeneration is innovative thanks to a new participatory and cooperative methodology based on the perception of every citizen, and on the collection of players' experiences
Quantification of Thalamic Atrophy in MS: From the Multicenter Italian Neuroimaging Network Initiative Data Set to Clinical Application
No full textBACKGROUND AND PURPOSE: Thalamic atrophy occurs from the earliest phases of MS; however, this measure is not included in clinical practice. Our purpose was to obtain a reliable segmentation of the thalamus in MS by comparing existing automatic methods cross-sectionally and longitudinally.MATERIALS AND METHODS: MR images of 141 patients with relapsing-remitting MS (mean age, 38 years; range, 19-58 years; 95 women) and 69 healthy controls (mean age, 36 years; range, 22-69 years; 47 women) were retrieved from the Italian Neuroimaging Network Initiative repository: T1WI, T2WI, and DWI at baseline and after 1 year (136 patients, 31 healthy controls). Three segmentation software programs (FSL-FIRST, FSL-MIST, FreeSurfer) were compared. At baseline, agreement among pipelines, correlations with age, disease duration, clinical score, and T2-hyperintense lesion volume were evaluated. Effect sizes in differentiating patients and controls were assessed cross-sectionally and longitudinally. Variability of longitudinal changes in controls and sample sizes were assessed. False discovery rate-adjusted P <.05 was considered significant.RESULTS: At baseline, FSL-FIRST and FSL-MIST showed the highest agreement in the results of thalamic volume (R = 0.87, P <.001), with the highest effect size for FSL-MIST (Cohen d = 1.11); correlations with demographic and clinical variables were comparable for all software. Longitudinally, FSL-MIST showed the lowest variability in estimating thalamic volume changes for healthy controls (SD= 1.07%), the highest effect size (Cohen d = 0.44), and the smallest sample size at 80% power level (15 subjects per group).CONCLUSIONS: Multimodal segmentation by FSL-MIST increased the robustness of the results with better capability to detect small variations in thalamic volumes
Integration and Characterization of Brain MRI Data from the Italian Neuroimaging Network Initiative (INNI) for the Study of Multiple Sclerosis
No full textMastication Wear of Two Low Profile Attachment Systems for Overdenture: An In Vitro Study
No full textImplant supported cantilevered fixed dental rehabilitations in partially edentulous patients : systematic review of the literature. Part I
No full textObjectives: To investigate in which clinical situations a cantilever fixed implant supported restorations can be a treatment alternative and which complications are reported. Materials and Methods: Two operators screened the literature (MEDLINE, EMBASE) and performed a hand search on the main journals dealing with implantology and prosthetics until 31 December 2017. Only articles that considered cantilever implant fixed restorations with at least 10 patients and with a mean follow-up of at least 5 year were selected. The outcome variables were survival of implants and prosthesis, mechanical, technical and biological complications, marginal bone loss. The review was performed according to the PRISMA statements. Risk of bias assessment was evaluated. Failure and complication rates were analysed using random effect Poisson regression models to obtain summary estimate of 5- and 10-year survival and complication rates. Results: A total of nine papers were selected for partially edentulous patients and reported high survival rate of the prosthesis. The estimated survival rate for 5–10 years was calculated to be 98.4% for the implants and 99.2% for the rehabilitations. Mechanical, technical and biological complications were reported with a cumulative 5–10 years complication rate of 28.66% and 26.57% for the patients and for the prosthesis, respectively. Two papers for single implant supporting 2-unit cantilever were not sufficient to draw conclusions. Conclusions: There is evidence that cantilever can be successful treatment in partially edentulous patients. In two adjacent edentulous sites, data are not yet sufficient
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