Nevin Manimala

Int J Oral Maxillofac Implants. 2022 Nov-Dec;37(6):1244-1249. doi: 10.11607/jomi.9613.

ABSTRACT

PURPOSE: This study evaluated the effect of two photobiomodulation therapy protocols on bone regeneration in criticalsize bone defects grafted with inorganic bovine bone.

MATERIALS AND METHODS: A critical-size defect was created in 30 adult male rat calvaria, which were divided equally and randomly into three experimental groups (n = 10): (1) DBBM (deproteinized bovine bone mineral); (2) DBBM + PBMT 4 J (4 J; photobiomodulation therapy; GaAlAs, 730 nm, 100 mW, 140 J/cm²); and (3) DBBM + PBMT 6 J (6 J; GaAlAs, 730 nm, 100 mW, 210 J/cm²). Animals were euthanized after 30 days. The neoformed bone area (NBA), linear bone extension (LBE), and area of the remaining particles (ARP) were evaluated. The data were subjected to nonparametric Kolmogorov-Smirnov test and ANOVA, followed by Tukey post hoc test to identify differences between the groups (P < .05).

RESULTS: The 6 J group showed the highest average NBA (48.57% ± 28.22%) and demonstrated a statistically significant difference in NBA and LBE. A higher mean ARP was found in the DBBM group (38.73 ± 6.95) than in the groups irradiated by photobiomodulation therapy, with statistically significant differences (P < .05).

CONCLUSION: The 6 J protocol showed the best results, promoting greater bone formation with greater resorption of residual particles.

PMID:36450031 | DOI:10.11607/jomi.9613

Int J Oral Maxillofac Implants. 2022 Nov-Dec;37(6):1223-1231. doi: 10.11607/jomi.7198.

ABSTRACT

PURPOSE: To compare three different types of custom-made root-analog immediate (RAI) dental implants.

MATERIALS AND METHODS: Patients with fractured and/or nonrestorable teeth with uncompromised periodontal ligaments were included in the study. The exclusion criteria were as follows: any uncontrolled systemic disease, bruxism, poor oral hygiene, active periodontal disease, and/or chronic marginal periodontitis. CBCT scans of the teeth were taken, and the datasets were used to reconstruct 3D models that were transferred to 3D modeling software to design the RAIs. Group 1 (GR1) consisted of zirconia RAIs manufactured using a computer numerical control (CNC) machine, group 2 (GR2) consisted of titanium RAIs formed by using a CNC machine, and group 3 (GR3) consisted of titanium RAIs manufactured by using direct laser metal sintering (DLMS) technology, all of which were placed immediately after tooth extraction. Primary stability was measured by using Periotest M. Metal-ceramic single crowns were cemented 3 months later. All implants were evaluated clinically and radiologically 1 year after implant placement.

RESULTS: A total of 51 patients (18 men, 33 women) aged between 18 and 66 years (average 34.2 years) were included in the study. In 4 patients, RAIs could not be placed due to the lack of primary stability, and they were excluded. In the remaining 47 patients, the custom-made RAIs (GR1: n = 21, GR2: n = 17, GR3: n = 18, total: n = 56) were placed into fresh extraction sockets immediately after tooth extraction for each patient. Primary stability was achieved. Periotest values (PTV) were between -1.4 and -6.2 (mean -3.3). The mean initial PTV (PTV0) was -2.3 ± 1.8 for the failed implants and -4.5 ± 0.8 for the surviving implants. PTV0 was an independent risk factor (HR 3.61, 95% CI: 1.56-8.35, P = .004) for survival rate, which was 33.3%, 70.6%, and 44.4% for GR1, GR2, and GR3, respectively. The overall survival rate was 48.2%. There was no significant difference between the groups regarding the probability of survival (P = .051). The survival rate was significantly lower for anterior RAIs (P < .001). Clinically healthy gingival margins were observed without any signs of periodontitis or implant mobility, and the mean PTV was -4.0 ± 1.9 in surviving implants, whereas the mean marginal bone loss was 1.3 ± 0.6 mm (median, 0.8; 95% CI: 0.1-3.4) at the 1-year follow-up.

CONCLUSION: This study was the first attempt to compare different RAI manufacturing techniques and biomaterials in the literature. Although the probability of survival was not statistically significant between the groups, the survival rate in GR2 was higher than in the other two groups. Nevertheless, the overall survival rate was significantly lower (48.2%) than in the previous reports. Primary stability was an independent risk factor for failure. Further studies with the minimized variables between groups should be designed for precise results.

PMID:36450029 | DOI:10.11607/jomi.7198

Int J Oral Maxillofac Implants. 2022 Nov-Dec;37(6):1217-1222. doi: 10.11607/jomi.8855.

ABSTRACT

PURPOSE: To evaluate the fracture load of monolithic, single-tooth implant-supported crowns cemented on solid or Ti-base (Variobase C) abutments.

MATERIALS AND METHODS: Besides abutment types (solid and Ti-base abutments), two ceramic systems (IPS e.max CAD and Zirconia inCoris ZI) and two occlusal thicknesses (0.5 and 1.5 mm) were also investigated in this study. In total, eight groups (n = 8) with 64 maxillary second premolar crowns were fabricated. All the crowns were cemented with resin cement, and the screw accesses in Ti-base groups were sealed with composite resin. After mechanical cycling, the specimens were submitted to fracture load test with the maximum force recorded in Newtons (N). Three-way analysis of variance (ANOVA) and Tukey post hoc test were used for statistical analyses (α = .05).

RESULTS: Both the abutment type (P = .0001) and the ceramic system (P = .0001) significantly affected the results. Screw-access channels reduced the fracture load of crowns by half compared to those cemented on solid abutments. The 1.5-mm and 0.5-mm zirconia crowns placed on solid abutments had similar highest fracture loads, while the e.max CAD groups positioned on Ti-base abutments showed significantly lower values compared with other groups.

CONCLUSION: The screw access reduces the resistance of crowns supported by Ti-base abutments compared to crowns cemented on solid abutments. The inCoris ZI showed a higher fracture load than the IPS e.max CAD regardless of the abutment type and thickness.

PMID:36450028 | DOI:10.11607/jomi.8855

Int J Oral Maxillofac Implants. 2022 Nov-Dec;37(6):1186-1194. doi: 10.11607/jomi.9907.

ABSTRACT

PURPOSE: To study the influence of insertion depth and implant angulation on the 3D trueness of models obtained with different impression techniques.

MATERIALS AND METHODS: Four different reference models (model 1: parallel, depth of 1.5 mm; model 2: parallel, depth of 4 mm; model 3: 20-degree angle, depth of 1.5 mm; and model 4: 20-degree angle, depth of 4 mm) of partially edentulous maxillae were generated by altering implant angulations and subgingival depths. All scans of reference models were done with a laboratory scanner, and obtained data were exported into standard tessellation language format to be used as virtual reference images. Impressions were obtained from each reference model via three conventional techniques (closed tray [CT], non-hexed open tray [NHOT], and hexed open tray [HOT]) and one digital technique (intraoral scanning [IOS]). A total of 160 impressions were made. The reference and experimental scan data were superimposed by using the best-fit alignment algorithm. Angular (AD), linear (LD), and 3D (RMS) deviations were computed, and obtained data were statistically analyzed.

RESULTS: In premolar implant sites, AD and LD values were significantly affected by model type (P ≤ .001 for AD and LD) and impression technique (P = .001 for AD, P = .002 for LD). However, no significant interaction was detected (P = .703 for AD, P = .768 for LD). Model 1 (0.44 ± 0.25 for AD, 7.79 ± 6.29 for LD) and the NHOT technique (0.49 ± 0.43 for AD, 9.04 ± 8.14 for LD) exhibited the lowest mean AD and LD values. In molar implant sites, AD and LD values were significantly affected by model type (P ≤ .001 for AD and LD) and impression technique (P ≤ .001 for AD and LD), as well as by their interaction terms (P = .037 for AD, P = .005 for LD). Considering interaction terms, while the highest and lowest mean AD values were exhibited by IOS-model 4 (1.56 ± 0.25) and NHOTmodel 2 (0.46 ± 0.28), respectively, the highest and lowest mean LD values were exhibited by CT-model 4 (41.40 ± 14.48) and NHOT-model 2 (8.03 ± 4.86), respectively. RMS estimate values were significantly influenced by model type (P ≤ .001) and impression technique (P ≤ .001), as well as by their interaction terms (P = .019). The highest and lowest mean RMS values were exhibited by IOS-model 4 (70.02 ± 4.74) and NHOT-model 2 (25.96 ± 17.67), respectively.

CONCLUSION: In the case of angulated and deeply placed implants, splinted NHOT and HOT techniques can be recommended for better trueness.

PMID:36450024 | DOI:10.11607/jomi.9907

Int J Oral Maxillofac Implants. 2022 Nov-Dec;37(7):1151-1159. doi: 10.11607/jomi.9626.

ABSTRACT

PURPOSE: To evaluate the effects of ultraviolet (UV) treatment and alendronate immersion on the osseointegration of dental implants and mucosal attachment of dental implant abutments using a mongrel dog model.

MATERIALS AND METHODS: A total of 48 sandblasted, large-grit, acid-etched (SLA) titanium dental implants and 48 machined surface healing abutments in four male mongrel dogs were prepared. Implants and healing abutments were divided into four groups (n = 12 per group). The control (CON) group did not undergo additional surface treatments. The UV group was treated with UV for 15 minutes, and the alendronate-immersed (AN) group was soaked in 10-3 M alendronate for 24 hours. The UV treatment and alendronate soaking (UVAN) group was treated with alendronate, followed by UV irradiation. All implants were placed in the mandible of mongrel dogs, and the animals were sacrificed at 4 and 8 weeks postoperatively. Bone-to-implant contact (BIC), bone density, and connective tissue attachment were measured.

RESULTS: In cortical bone, the UV group exhibited significantly higher BIC compared to the CON and AN groups (P < .05). In contrast, the AN and UVAN groups did not have significantly higher BIC. In the trabecular bone, there was no statistical difference between the groups. No significant increase in bone density and connective tissue attachment was shown in any group.

CONCLUSION: UV treatment of SLA surface implants significantly increased osseointegration in cortical bone. The alendronate immersion did not increase osseointegration, and there was no synergic effect with UV treatment. Further, UV treatment and alendronate immersion of machined healing abutments did not significantly increase connective tissue attachment.

PMID:36450020 | DOI:10.11607/jomi.9626

Int J Oral Maxillofac Implants. 2022 Nov-Dec;37(6):1145-1150. doi: 10.11607/jomi.9629.

ABSTRACT

PURPOSE: To investigate the effects of injectable platelet-rich fibrin (i-PRF) on implant stability.

MATERIALS AND METHODS: A total of 40 implants (BEGO Semados RS/RSX implants, BEGO Implant System) were surgically placed in 15 patients between the ages of 25 and 67 years who had mandibular edentulous areas. After the implant sockets were prepared with the appropriate protocol, i-PRF was applied to the implant surface and socket with the help of a 5-cc sterile syringe in the study group, and implants were placed without i-PRF in the control group. In the research process, the resonance frequency analysis (RFA) method was used to measure implant stability. The implant stability quotient (ISQ) values were determined during the time of the operation and at the first, second, and fourth weeks.

RESULTS: The results obtained after the stability measurement periods showed that the decrease in the mean ISQ values in the control group was statistically significant in the first week. Evaluations made in the following weeks were not statistically significant. The study group showed an increase in ISQ values during the measurement periods, and the increases in the second and fourth weeks were statistically significant.

CONCLUSION: I-PRF had positive effects on early implant stability, and i-PRF can be safely used in dental implant surgery and promotes bone healing around dental implants.

PMID:36450019 | DOI:10.11607/jomi.9629

Int J Oral Maxillofac Implants. 2022 Nov-Dec;37(6):1095-1099. doi: 10.11607/jomi.10210.

ABSTRACT

When a clinician sees a patient with a complication, they often go through a Bayesian style of logic, most likely without even knowing it. They assess whether they have seen the complication before, provide an intervention based on historical knowledge of what leads to improvement, and then later assess how the intervention is performed. This process, which is routine in clinical practice, can be mathematically extended into an alternative way of performing statistical analyses to assess clinical research. However, this process is contrary to the most common statistical methods used in dental research: frequentist statistics. Though powerful, frequentist methods come with advantages and disadvantages. Bayesian statistics are an alternative method, one that mirrors how we as researchers think and process new information. In this primer, a walkthrough of Bayesian statistics is performed by constructing priors, defining the likelihood, and using the posterior result to draw conclusions on parameters of interest. The motivating example for this walkthrough was a Bayesian analog to logistic regression, fit using a simulated dental-related dataset of 50 patients who received a dental implant-classified as either within or outside normal limits-from practitioners who did or did not receive a training course in implant placement. The results of the Bayesian and traditional frequentist logistic regression models were compared, resulting in very similar conclusions regarding which parameters seemed to be strongly associated with the outcome.

PMID:36450014 | DOI:10.11607/jomi.10210

Rev Bras Enferm. 2022 Nov 28;76Suppl 1(Suppl 1):e20220171. doi: 10.1590/0034-7167-2022-0171. eCollection 2022.

ABSTRACT

OBJECTIVES: to assess the level of anxiety of nurses in an emergency room in view of the new Coronavirus and describe the relationship between the degrees of anxiety and their sociodemographic variables.

METHODS: quantitative descriptive-correlational study with a sample of 60 nurses. A questionnaire was used as a data collection instrument based on the Hamilton Anxiety Assessment Scale.

RESULTS: the nurses’ average anxiety is mild. A statistically significant relationship was found between anxiety and the variables “sex” and “children”, with women having higher levels of anxiety than men, and nurses who do not have children showing mild, moderate, or severe anxiety.

CONCLUSIONS: COVID-19 triggers anxiety in nurses, sometimes at pathological levels. Being female and not having children increase the anxiety experienced. Sex can be considered the determining factor for the level of anxiety experienced.

PMID:36449963 | DOI:10.1590/0034-7167-2022-0171

Dental Press J Orthod. 2022 Nov 28;27(5):e222190. doi: 10.1590/2177-6709.27.5.e222190.oar. eCollection 2022.

ABSTRACT

OBJECTIVE: To investigate the influence of dynamic visualization of cone beam computed tomography (CBCT) scans on orthodontist’s assessment of positioning status and prognosis of interradicular mini-implants (MI).

METHODS: Three MI positions were virtually simulated in thirty CBCT volumes: (1) MI 1 mm from the lamina dura (LD), (2) MI touching the LD and (3) MI overlapping the LD. Each position was exposed to orthodontists (n = 35) as panoramic reconstruction, sagittal reconstruction and a sequence of axial slices. Each orthodontist evaluated the MI position (relationship with the LD) and scored the prognosis using a four-point scale (the higher the score, the better the prognosis). Kappa, Friedman and Nemenyi statistics were used.

RESULTS: Statistically significant associations were detected between the prognosis scores and the type of image visualized (p<0.05). The dynamic visualization of the CBCT volume (axial slices) was associated with higher scores for prognosis and more reliable evaluation of MI positioning. Inconsistent outcomes were more frequently associated with panoramic and sagittal reconstructions.

CONCLUSION: The dynamic visualization of axial slices allowed orthodontists to perform better assessment of MI position and considerably affected prognosis judgment.

PMID:36449961 | DOI:10.1590/2177-6709.27.5.e222190.oar

Arq Bras Cardiol. 2022 Oct;119(5 suppl 1):35-42. doi: 10.36660/abc.20220423.

ABSTRACT

BACKGROUND: The consolidation of new educational paradigms requires the implementation of innovative strategies to transform students into competent professionals.

OBJECTIVES: To assess knowledge and satisfaction of medical students before and after the use of a new humanized digital model of active learning, called virtual case-based learning (VCBL).

METHODS: This was a descriptive, documentary analysis of the teaching-learning process of medical students. Data obtained from theoretical knowledge assessment and satisfaction evaluation questionnaires applied in 2018 and 2019 were analyzed, and the new VCBL was compared with the traditional active methodology PBL (problem-based learning). Descriptive and association analyses were made using the Statistical Package for the Social Sciences.

RESULTS: A total of 167 evaluation forms administered to medical students were analyzed. In the evaluation of theoretical knowledge, the 2018 and the 2019 student groups had a mean of 41.7% and 73.3%, respectively (p<0.001). Among the students who responded to the satisfaction evaluation form, 76.0% gave the highest rating to question one, and 83.0% to question two. Nearly 70.0% of students positively evaluated knowledge acquisition with the Paciente 360 platform; 78.0% reported to feel prepared for working in outpatient care; and 94.0% positively evaluated the new method.

CONCLUSION: In this initial study, the results indicate that the new active method for humanized digital medical education, the VCBL, can help in the betterment of the teaching-learning process, promoting knowledge and satisfaction by the students.

PMID:36449957 | DOI:10.36660/abc.20220423