Category: Nevin Manimala

JMIR Ment Health. 2022 Jul 29;9(7):e34254. doi: 10.2196/34254.

ABSTRACT

BACKGROUND: Rates of mental health problems among youth are high and rising, whereas treatment seeking in this population remains low. Technology-delivered interventions (TDIs) appear to be promising avenues for broadening the reach of evidence-based interventions for youth well-being. However, to date, meta-analytic reviews on youth samples have primarily been limited to computer and internet interventions, whereas meta-analytic evidence on mobile TDIs (mTDIs), largely comprising mobile apps for smartphones and tablets, have primarily focused on adult samples.

OBJECTIVE: This study aimed to evaluate the effectiveness of mTDIs for a broad range of well-being outcomes in unselected, at-risk, and clinical samples of youth.

METHODS: The systematic review used 5 major search strategies to identify 80 studies evaluating 83 wellness- and mental health-focused mTDIs for 19,748 youth (mean age 2.93-26.25 years). We conducted a 3-level meta-analysis on the full sample and a subsample of the 38 highest-quality studies.

RESULTS: Analyses demonstrated significant benefits of mTDIs for youth both at posttest (g=0.27) and follow-up (range 1.21-43.14 weeks; g=0.26) for a variety of psychosocial outcomes, including general well-being and distress, symptoms of diverse psychological disorders, psychosocial strategies and skills, and health-related symptoms and behaviors. Effects were significantly moderated by the type of comparison group (strongest for no intervention, followed by inert placebo or information-only, and only marginal for clinical comparison) but only among the higher-quality studies. With respect to youth characteristics, neither gender nor pre-existing mental health risk level (not selected for risk, at-risk, or clinical) moderated effect sizes; however, effects increased with the age of youth in the higher-quality studies. In terms of intervention features, mTDIs in these research studies were effective regardless of whether they included various technological features (eg, tailoring, social elements, or gamification) or support features (eg, orientation, reminders, or coaching), although the use of mTDIs in a research context likely differs in important ways from their use when taken up through self-motivation, parent direction, peer suggestion, or clinician referral. Only mTDIs with a clear prescription for frequent use (ie, at least once per week) showed significant effects, although this effect was evident only in the higher-quality subsample. Moderation analyses did not detect statistically significant differences in effect sizes based on the prescribed duration of mTDI use (weeks or sessions), and reporting issues in primary studies limited the analysis of completed duration, thereby calling for improved methodology, assessment, and reporting to clarify true effects.

CONCLUSIONS: Overall, this study’s findings demonstrate that youth can experience broad and durable benefits of mTDIs, delivered in a variety of ways, and suggest directions for future research and development of mTDIs for youth, particularly in more naturalistic and ecologically valid settings.

PMID:35904845 | DOI:10.2196/34254

Int J Oral Maxillofac Implants. 2022 Jul-Aug;37(4):784-792. doi: 10.11607/jomi.8924.

ABSTRACT

PURPOSE: Immediate dental implants revolutionized the field of implant dentistry with significant advantages over conventional implants. The lack of adequate bone in the extraction socket raises the question of the appropriate timing of implant loading. Platelet concentrates have been used widely to accelerate bone regeneration in the maxillofacial region. This study evaluates the effect of platelet concentrates on bone healing and implant stability in the maxillary and mandibular molar regions. Bone regeneration is regulated by several growth factors, particularly vascular endothelial growth factor (VEGF) and transforming growth factor-β1 (TGF-β1); therefore, quantification of these factors in platelet concentrates and its correlation with bone healing has been assessed in this study.

MATERIALS AND METHODS: The primary aim of this randomized clinical trial was to compare the stability of immediate dental implants in the maxillary and mandibular molar regions treated with platelet-rich fibrin (PRF) versus concentrated growth factors (CGF) using resonance frequency analysis (RFA). The secondary objectives were to evaluate the bone regenerate around implants with the use of PRF and CGF and to quantify growth factors VEGF and TGF-β1 in the prepared CGF and PRF and their correlation with bone healing, if any. A total of 36 patients were randomized into three groups (12 each): control, PRF, and CGF. In all patients, immediate implants were placed either with or without platelet concentrate (PRF or CGF). Implant stability was measured using RFA immediately postoperatively and at 4, 8, and 12 or 16 weeks (12 weeks for mandible and 16 weeks for maxilla) postoperatively. Radiodensity and the bone gap (horizontal/vertical) were measured on intraoral periapical radiographs immediately postoperatively and at 8 weeks and 12 or 16 weeks postoperatively.

RESULTS: On comparing the implant stability quotient (ISQ), radiodensity/grayscale (GS), and horizontal and vertical bone gap (HG and VG), there was no significant difference noted between the three groups at any point in time. On ISQ analysis at 8 weeks, the control group showed a significant improvement (P = .04), whereas at 12 or 16 weeks, significant improvement was seen in PRF (P = .03) and CGF groups (P = .02). In GS assessment, only the control group showed significant improvement at 12 or 16 weeks (P = .009). In horizontal and vertical bone gap analysis all three groups showed significant improvement at 8 weeks (control [P < .001], PRF [P = .001], CGF [P = .01]) as well as 12 or 16 weeks (control [P < .001], PRF [P < .001], CGF [P = .006]). The enzyme-linked immunosorbent assay (ELISA) quantification of VEGF and TGF-β1 showed significant concentration of VEGF in PRF as compared to the plasma, while concentration of TGF-β1 was found to be comparable in both groups.

CONCLUSION: The application of platelet concentrates seems to enhance stability of implants, but intergroup results were nonsignificant at all time points. There was no statistically significant difference between the three groups when comparing quality (radiodensity/grayscale) and quantity (horizontal and vertical gap reduction) of bone regenerate. Studies with larger sample sizes are required to make conclusive assertions regarding efficacy of platelet concentrates in dental implants.

PMID:35904836 | DOI:10.11607/jomi.8924

Int J Oral Maxillofac Implants. 2022 Jul-Aug;37(4):748-755. doi: 10.11607/jomi.8953.

ABSTRACT

PURPOSE: To evaluate the mechanical stability of highly translucent zirconia (Zr) cantilevered fixed dental prostheses (cFDPs) and to investigate the influence of the number of implants (one versus two) supporting cFDPs with different restorative materials on their mechanical stability and load-bearing capacity.

MATERIALS AND METHODS: Thirty-two specimens consisting of implant-supported prostheses embedded in resin blocks were fabricated. Sixteen specimens received one implant (bone-level implant, 4.1-mm diameter, 13-mm length; Straumann) to support two-unit cement-retained cFDPs with one extension unit and the other 16 received two implants (bone-level implant, 4.1-mm diameter, 13-mm length; Straumann) positioned corresponding to the missing maxillary central incisors to support three-unit cement-retained cFDPs with one extension unit. Two different prosthetic materials, chromium-cobalt (Cr-Co; Wirobond C+, Bego) and highly translucent Zr (Lava Plus, 3M ESPE) were selected to fabricate the two- and three-unit cFDPs. Standardized twoand three-unit Cr-Co frameworks (CC-I, n = 8; CC-II, n = 8) and highly translucent Zr frameworks (Zr-I, n = 8; Zr-II, n = 8) with a 6-mm cantilever extension were fabricated using CAD/CAM (EOS M 290). Following thermomechanical fatigue loading, the specimens were tested for fracture resistance under static loading. The influence of restoration material and number of supporting implants on fracture resistance were tested using two-way analysis of variance (ANOVA). The level of statistical significance was set below 5% (α < .05).

RESULTS: All specimens survived aging. The mean (± standard deviation) fracture resistance values were 416.25 (± 42.71) N for Zr-I, 548.75 (± 75.41) N for Zr-II, 601.0 (± 41.51) N for CC-I, and 664.5 (± 37.59) N for CC-II. CC and Zr group specimens showed significantly different fracture resistance results (P < .001). The number of implants significantly influenced the fracture resistance of Zr groups (P = .001), whereas the influence was not significant for CC groups (P = .089).

CONCLUSION: Within the limitations of this in vitro study, highly translucent zirconia cFDP frameworks demonstrated the potential to withstand reported physiologic occlusal forces applied in the anterior region. The increase in the number of implants supporting zirconia cFDPs significantly contributed to achieving higher fracture resistance values.

PMID:35904831 | DOI:10.11607/jomi.8953

Int J Oral Maxillofac Implants. 2022 Jul-Aug;37(4):685-689. doi: 10.11607/jomi.9433.

ABSTRACT

PURPOSE: A new tissue-level implant design with angulations of 17, 30, and 45 degrees has been introduced to allow the use of the existing bone while maintaining the restorative platform at an angle to ensure an optimal functional and esthetic result for treatment of edentulous patients. The aim of this study was to measure implant survival, bone loss, and peri-implant health of the novel tissue-level angled-head dental implant system.

MATERIALS AND METHODS: A retrospective analysis of cases from three private offices that were using the new implant system was performed. Data regarding patients’ demographics, number and location of implants, restoration type, bone loss, implant failure, bleeding, and pocket depths were collected and analyzed. The data collected were analyzed using mainly descriptive statistics.

RESULTS: A total of 29 participants were selected, and 185 dental implants were placed. The average patient age was 61 ± 7 years, and 52% were female. Some of the patients were medically compromised; 7% were diabetic, 20% were smokers, and 7% had osteoporosis. The average time from dental implant placement to the placement of the screw-retained crowns was 6 ± 5 months. Four implants failed with an average time to failure of 18 ± 8 months. Implant survival rate was 97.8%. The average bone loss was 0.014 ± 0.082 mm at 1 year, 0.133 ± 0.306 mm at 5 years, and 0.426 ± 0.903 mm at 10 years. Overall, 18.9% of implants were associated with bleeding, and only one implant had a pocket depth greater than or equal to 5 mm.

CONCLUSION: The new tissue-level implant design with angulations of 17, 30, and 45 degrees has demonstrated predictable survival and success rates with minimal bone loss. The long-term follow-up seems highly promising; however, further studies are warranted to validate the results.

PMID:35904824 | DOI:10.11607/jomi.9433

Int J Oral Maxillofac Implants. 2022 Jul-Aug;37(4):677-684. doi: 10.11607/jomi.9657.

ABSTRACT

PURPOSE: To compare the fracture resistance of a press-on ceramic custom implant restoration with pressed and cemented restorations.

MATERIALS AND METHODS: Thirty-two (32) lithium disilicate (IPS e.max Press) custom hybrid abutment restorations were fabricated. The restorations were divided into two groups (n = 16) according to the construction technique: the commercial control group (C) and the press-on group (P). For the control group, lithium disilicate restorations were pressed and cemented on titanium bases. For the press-on group, lithium disilicate pressable ceramic (IPS e.max Press) was pressed on the titanium bases with injection molding. Each group was further divided according to the restoration design, either screw- or cement-retained, into two subgroups of eight specimens each. Specimens of C group were divided into screw-retained (cemented hybrid abutment crown, CHAC) or cement-retained (cemented hybrid abutment, CHA). Specimens of the P group were also divided into screw-retained (pressed hybrid abutment crown, PHAC) and cement-retained (pressed hybrid abutment, PHA). The specimens were subjected to static loading until failure with a universal testing machine. Two-way analysis of variance (ANOVA) was used to assess the effect of different techniques and designs on the fracture resistance of the samples (P < .05), followed by one-way ANOVA and Tukey honest significant difference (HSD) test (α = .05).

RESULTS: C group showed higher mean fracture resistance (812.443 ± 129.14 N) than P group (596.71 ± 108.83 N), and the difference was statistically significant (P < .05). Regarding restoration design, HA groups showed higher mean fracture resistance (742.621 ± 153.82 N) than HAC (666.53 ± 163.07 N) groups with no statistically significant difference. CHA showed the highest mean fracture resistance (817.65 ± 161.76 N), while PHAC showed the lowest mean fracture resistance values (525.83 ± 47.29 N).

CONCLUSION: The commercial cemented lithium disilicate restorations showed higher fracture resistance than the press-on restorations, although both showed a maximum load capacity that was greater than physiologic incisal force in the anterior region, and both hybrid abutments and hybrid abutment crowns were equally efficient in withstanding occlusal loading forces.

PMID:35904823 | DOI:10.11607/jomi.9657

Int J Oral Maxillofac Implants. 2022 Jul-Aug;37(4):653-659. doi: 10.11607/jomi.9577.

ABSTRACT

PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the effects of splinting impression copings on the accuracy of conventional impressions for two-unit nonparallel implant restorations.

MATERIALS AND METHODS: MEDLINE via PubMed, Embase, and Web of Science databases were searched with no publication year or language limits, and studies comparing the accuracy of conventional impressions for two-unit nonparallel implant restorations made using splinted impression copings and nonsplinted impression copings were identified. A meta-analysis was performed using Review Manager software. The mean difference (MD) with 95% confidence interval (95% CI) for the framework strain and marginal gap of the implant-framework connection between impressions using splinted and nonsplinted copings were statistically analyzed (α = .05).

RESULTS: Initially, 142 articles were identified after the removal of duplicates. Five in vitro studies were included in the systematic review, and four in vitro studies were included in the meta-analysis. All the included studies were focused on internal-connection implants and implant-level impressions. The implant angulation in the included studies ranged from 8 to 30 degrees. Impressions using splinted impression copings exhibited significantly smaller marginal gaps than those using nonsplinted impression copings (P = .02; mean difference [MD] = -13.34; 95% CI = -24.31 to -2.36). Moreover, with respect to the framework strain, no significant differences were found between impressions using splinted impression copings and nonsplinted impression copings (P = .47; MD = -12.64; 95% CI = -47.32 to 22.03).

CONCLUSIONS: Significantly larger marginal gaps were found in the impressions using splinted impression copings, but the clinical significance was low. Based on the limited number of studies included, splinting copings is unnecessary when making conventional impressions for two-unit nonparallel implant restorations.

PMID:35904821 | DOI:10.11607/jomi.9577

JAMA Netw Open. 2022 Jul 1;5(7):e2224359. doi: 10.1001/jamanetworkopen.2022.24359.

ABSTRACT

IMPORTANCE: Some persons infected with SARS-CoV-2 experience symptoms or impairments many months after acute infection.

OBJECTIVES: To determine the rates, clinical setting, and factors associated with documented receipt of COVID-19-related care 3 or more months after acute infection.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used data from the US Department of Veterans Affairs health care system. Participants included persons with a positive SARS-CoV-2 test between February 1, 2020, and April 30, 2021, who were still alive 3 months after infection and did not have evidence of reinfection. Data analysis was performed from February 2020 to December 2021.

EXPOSURES: Positive SARS-CoV-2 test.

MAIN OUTCOMES AND MEASURES: Rates and factors associated with documentation of COVID-19-related International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes (U07.1, Z86.16, U09.9, and J12.82) 3 or more months after acute infection (hereafter, long-COVID care), with follow-up extending to December 31, 2021.

RESULTS: Among 198 601 SARS-CoV-2-positive persons included in the study, the mean (SD) age was 60.4 (17.7) years, 176 942 individuals (89.1%) were male, 133 924 (67.4%) were White, 44 733 (22.5%) were Black, and 19 735 (9.9%) were Hispanic. During a mean (SD) follow-up of 13.5 (3.6) months, long-COVID care was documented in a wide variety of clinics, most commonly primary care and general internal medicine (18 634 of 56 310 encounters [33.1%]), pulmonary (7360 of 56 310 encounters [13.1%]), and geriatrics (5454 of 56 310 encounters [9.7%]). Long-COVID care was documented in 26 745 cohort members (13.5%), with great variability across geographical regions (range, 10.8%-18.1%) and medical centers (range, 3.0%-41.0%). Factors significantly associated with documented long-COVID care included older age, Black or American Indian/Alaska Native race, Hispanic ethnicity, geographical region, high Charlson Comorbidity Index score, having documented symptoms at the time of acute infection (adjusted odds ratio [AOR], 1.71; 95% CI, 1.65-1.78) and requiring hospitalization (AOR, 2.60; 95% CI, 2.51-2.69) or mechanical ventilation (AOR, 2.46; 95% CI, 2.26-2.69). Patients who were fully vaccinated at the time of infection were less likely to receive long-COVID care (AOR, 0.78; 95% CI, 0.68-0.90).

CONCLUSIONS AND RELEVANCE: Long-COVID care was documented in a variety of clinical settings, with great variability across regions and medical centers and was documented more commonly in older persons, those with higher comorbidity burden, those with more severe acute COVID-19 presentation and those who were unvaccinated at the time of infection. These findings provide support and guidance for health care systems to develop systematic approaches to the evaluation and management of patients who may be experiencing long COVID.

PMID:35904783 | DOI:10.1001/jamanetworkopen.2022.24359

Dent Med Probl. 2022 Jul 29. doi: 10.17219/dmp/147183. Online ahead of print.

ABSTRACT

BACKGROUND: The use of the magnification approach for the periodontal flap surgical procedure helps in better visualization and better handling of soft tissues, which results in early wound healing.

OBJECTIVES: The aim of the present study was to compare the conventional macroscopic approach for periodontal flap surgery with the microsurgically modified approach in a randomized controlled clinical trial.

MATERIAL AND METHODS: A total of 60 subjects were randomly divided into 2 groups: group A (test group), in which the subjects underwent the conventional open flap debridement procedure; and group B (control group), in which the subjects underwent open flap debridement with the use of a microsurgical loupe. The plaque index (PI), the gingival index (GI), the probing pocket depth (PPD), the clinical attachment level (CAL), and gingival recession (GR) were recorded at baseline, and at 3, 6 and 9 months postoperatively. Also, the early wound-healing index (EHI) was recorded at 10 days postoperatively.

RESULTS: Both the conventional and the microsurgical technique provided a statistically significant reduction in PI, GI and PPD as well as gain in CAL. However, the microsurgical technique demonstrated a statistically significant decrease in postoperative GR as well as reduced pain perception and EHI scores.

CONCLUSIONS: The use of the microsurgical approach provides better clinical results with less discomfort, and thus makes the periodontal treatment more acceptable for the patient.

PMID:35904770 | DOI:10.17219/dmp/147183

Dent Med Probl. 2022 Jul 29. doi: 10.17219/dmp/150831. Online ahead of print.

ABSTRACT

BACKGROUND: In the oral cavity, which plays an important role in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is possible to reduce the viral load of SARS-CoV-2 with antiseptics, thereby minimizing the transmission of the virus during dental procedures.

OBJECTIVES: The aim of this study was to clinically evaluate the effect of the hypochlorous acid (HClO) and povidone-iodine (PVP-I) solutions on the oral viral load of SARS-CoV-2.

MATERIAL AND METHODS: This randomized controlled trial was conducted on 75 patients hospitalized in the COVID-19 ward of a local hospital. All the patients included in the study were within the first 24 h of hospitalization and the first 5 days of coronavirus disease 2019 (COVID-19) symptoms. The viral load of mouthwash samples was measured with the cycle threshold (Ct) value of SARS-CoV-2 through a realtime reverse transcription polymerase chain reaction (RT-PCR). The patients were divided into 3 groups. The effect on the patient’s SARS-CoV-2 viral load was investigated after gargling the mouths and throats for 30 s with HClO, PVP-I and isotonic saline. First, a sample was taken after gargling with isotonic saline, then another sample was taken after gargling for 30 s with a particular antiseptic to determine the viral load of SARS-CoV-2.

RESULTS: Comparing the before and after mouthwash samples from all 3 groups, there were no statistically significant differences in the Ct values before and after gargling (p > 0.05). However, there were statistically significant differences in the number of negative samples after the use of HClO and PVP-I, which were positive before gargling (p < 0.05).

CONCLUSIONS: In the light of the data obtained in this study, there is insufficient evidence that gargling with HClO or PVP-I reduces viral load. Taken together, these findings imply no role for antiseptics in the transmission of SARS-CoV-2 by the aerosol generated during dental procedures, or more generally, SARS-CoV-2 infection control.

PMID:35904769 | DOI:10.17219/dmp/150831

Syst Biol. 2022 Jul 29:syac052. doi: 10.1093/sysbio/syac052. Online ahead of print.

ABSTRACT

Organismal traits can evolve in a coordinated way, with correlated patterns of gains and losses reflecting important evolutionary associations. Discovering these associations can reveal important information about the functional and ecological linkages among traits. Phylogenetic profiles treat individual genes as traits distributed across sets of genomes and can provide a fine-grained view of the genetic underpinnings of evolutionary processes in a set of genomes. Phylogenetic profiling has been used to identify genes that are functionally linked, and to identify common patterns of lateral gene transfer in microorganisms. However, comparative analysis of phylogenetic profiles and other trait distributions should take into account the phylogenetic relationships among the organisms under consideration. Here we propose the Community Coevolution Model (CCM), a new coevolutionary model to analyze the evolutionary associations among traits, with a focus on phylogenetic profiles. In the CCM, traits are considered to evolve as a community with interactions, and the transition rate for each trait depends on the current states of other traits. Surpassing other comparative methods for pairwise trait analysis, CCM has the additional advantage of being able to examine multiple traits as a community to reveal more dependency relationships. We also develop a simulation procedure to generate phylogenetic profiles with correlated evolutionary patterns that can be used as benchmark data for evaluation purposes. A simulation study demonstrates that CCM is more accurate than other methods including the Jaccard Index and three tree-aware methods. The parameterization of CCM makes the interpretation of the relations between genes more direct, which leads to Darwin’s scenario being identified easily based on the estimated parameters. We show that CCM is more efficient and fits real data better than other methods resulting in higher likelihood scores with fewer parameters. An examination of 3786 phylogenetic profiles across a set of 659 bacterial genomes highlights linkages between genes with common functions, including many patterns that would not have been identified under a non-phylogenetic model of common distribution. We also applied the CCM to 44 proteins in the well-studied Mitochondrial Respiratory Complex I and recovered associations that mapped well onto the structural associations that exist in the complex.

PMID:35904761 | DOI:10.1093/sysbio/syac052