Tag: nevin manimala

J Prosthodont. 2025 Jul 6. doi: 10.1111/jopr.14097. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the impact of different complete-arch digital scanning techniques and prosthesis types on the passive fit of computer-aided design and computer-aided manufacturing (CAD-CAM) verification devices.

MATERIALS AND METHODS: Two different maxillary master casts with four multi-unit abutment (MUA) implant analogs (FP-1 and FP-3 prosthesis types) were used as the basis for fabricating verification devices through two impression techniques (OptiSplint and RevEX). Group 1 utilized digital scans of splinted scanbodies reinforced with a light-polymerizing acrylic resin and metal mesh on the FP-1 cast (OptiSplint technique), Group 2 employed the same impression technique as Group 1 on the FP-3 cast, Group 3 applied digital scans of reverse scanbodies connected to a passively fitting interim prosthesis on FP-1 cast (RevEX technique), and Group 4 used the same impression technique as Group 3 on FP-3 cast. A total of 40 milled verification devices were fabricated, with 10 devices allocated to each group. The misfit of verification devices was assessed using visual inspection, tactile sensation, and a one-screw test, with any disagreements between the two primary examiners resolved by a third evaluator. Agreement between the clinicians was assessed using Cohen’s kappa statistics and percent agreement. The percentage of misfits was calculated for each group and compared between groups using Fisher’s exact tests (α = 0.05).

RESULTS: The misfit analysis showed the lowest misfit (10%) in Group 1 (OptiSplint-FP1), followed by Groups 3 (RevEX-FP1) and 4 (RevEX-FP3) at 20%, and the highest (40%) in Group 2 (OptiSplint-FP3), with no significant differences between groups by Fisher’s exact tests (p > 0.05). Odds ratios indicated six times higher misfit odds for FP-3 than FP-1 with OptiSplint, no difference for FP-1 versus FP-3 with RevEX (odds ratio = 1.0), and lower odds with RevEX compared to OptiSplint under FP-3 conditions (odds ratio = 0.375). Inter-examiner agreement was strong, with 90% concordance and a Kappa statistic of 0.66, demonstrating substantial consistency.

CONCLUSION: OptiSplint is preferable for FP1 cases, whereas RevEX suits FP3 cases when intraoral-scanner-based extraoral workflows are used. Despite these recommendations, misfits occurred in every group, suggesting that a verification cast may be prudent when adopting these newer scanning approaches. Clinicians should consider fabricating an additional verification cast with splinted scanbodies or a clinically satisfactory interim implant prosthesis. This cast can confirm implant positions whenever modern scanbodies such as OptiSplint or RevEX are incorporated into the workflow.

PMID:40619568 | DOI:10.1111/jopr.14097

J Prosthodont. 2025 Jul 6. doi: 10.1111/jopr.14098. Online ahead of print.

ABSTRACT

PURPOSE: This study investigated the influence of cement gap size on the marginal and internal fit, and cement gap size and type on retention of additively manufactured zirconia (AM-Z) crowns on titanium bases (Ti-base).

MATERIALS AND METHODS: A total of 135 zirconia crowns were designed with three different cement gap sizes: 20 µm, 30 µm, and 40 µm (n = 45 per group). The crowns were additively manufactured using a lithography-based ceramic 3D printer (Cerafab, Lithoz GmbH, Austria) and a zirconia slurry (LithaCon 3Y 210, Lithoz GmbH, Austria). All crowns, Ti-base (RC Variobase, Straumann, Switzerland), and crown-Ti-base assemblies were scanned, and the marginal and internal gaps were measured using specialized software, following the triple scan protocol. Specimens were further divided into three subgroups based on the resin luting agent used for bonding the crowns to the Ti-bases (n = 15 per subgroup): Group PV21 used Panavia 21 (P21) (Kuraray Noritake Dental Inc., Japan), Group PV5 used Panavia V5 (PV5) (Kuraray Noritake Dental Inc., Japan), and Group MHA used Multilink Hybrid Abutment (Ivoclar Vivadent, Liechtenstein). After cementation, specimens were subjected to thermocycling between 5°C and 55°C. Pull-out forces between the additively manufactured zirconia (AM-Z) crowns and Ti-bases were measured using a universal testing machine. Variance analysis was conducted on root mean square (RMS) values for internal and marginal gaps, as well as pull-out forces (α = 0.05).

RESULTS: The one-way analysis of variance test revealed a statistically significant difference in marginal discrepancy values (p < 0.001). A post-hoc Tukey analysis indicated that the marginal (25.9 µm) and internal discrepancy (24.6 µm) values associated with the 30 µm cement gap size were higher than those obtained with other cement gap sizes (p < 0.01). No significant differences were found between the 20 µm and 40 µm cement gap sizes (p = 0.113). The 30 µm cement gap group demonstrated lower discrepancies. Both cement gap size and cement brand significantly influenced the marginal and internal fit, as well as the pull-out resistance of the crowns. The impact of the cement brand, the cement gap size, and their interaction significantly affected the retention between the Ti-bases and crowns (p < 0.01). The use of P21 with a 30 µm gap resulted in significantly higher pull-out values than P21 with a 20 µm gap (p = 0.008) and P21 with a 40 µm gap (p = 0.004). Retention with a 40 µm cement gap was not significantly different from that with a 20 µm cement gap, regardless of the cement brand (p = 0.089). PV5 presented the lowest pull-out values across all cement gap sizes (p = 0.02).

CONCLUSION: Cement gap size significantly affected the fit, and cement gap size and type significantly impacted the retention between AM-Z crowns and Ti-bases. Cement space of 30 µm and PV21 resin luting agent led to improved adaptation and high bonding strength.

PMID:40619567 | DOI:10.1111/jopr.14098

J Egypt Natl Canc Inst. 2025 Jul 7;37(1):38. doi: 10.1186/s43046-025-00297-9.

ABSTRACT

BACKGROUND: The literature on nutrition support therapy prescribing practices by physicians and the roles of nutrition support pharmacists in palliative and hospice care cancer patients is limited.

METHODS: The study aimed to analyze the prescribing practices of physicians and the roles of clinical pharmacists at a tertiary cancer center. A retrospective analysis of 12527 electronic records of hospice and palliative care cancer patients. All nutrition support therapy prescriptions by physicians and clinical pharmacists’ interventions were recorded. Analysis was conducted utilizing the Jamovi statistical package 2022.

RESULTS: The study population comprised inpatients and homecare patients. The most frequently prescribed nutrition support therapy was vitamins and minerals supplements, followed by enteral nutrition and parenteral nutrition. The total number of nutrition support pharmacist interventions was 660 (5.2%). The acceptance rate of interventions by physicians was 90%. Initiating mineral use was the most frequent intervention, followed by discontinuation of mineral use.

CONCLUSION: Vitamins and mineral supplements are the most prescribed type of nutrition support therapy. The interventions of clinical pharmacists were highly accepted by physicians. Initiating mineral use is the most frequent intervention. Further research is needed to explore the impact of nutrition support therapy on patient outcomes and barriers to its implementation.

PMID:40619553 | DOI:10.1186/s43046-025-00297-9

Sci Rep. 2025 Jul 6;15(1):24115. doi: 10.1038/s41598-025-09362-8.

ABSTRACT

The cortical thickness index (CTI) is a radiological measure and correlates with diminishing local bone quality in the proximal femur. The objective of this study was to assess the association between a lower CTI and the occurrence of peri- and postoperative surgical complications. A total of 228 consecutive patients treated with endomedullary nailing for trochanteric fracture (TFx) (AO/OTA 31A1.1-31A2.3) (n = 99) and hemi-/total hip arthroplasty for femoral neck fracture (AO/OTA 31B1-B3) (FNFx) (n = 129) with a mean age of 82 ± 9.9 (50-99) years were retrospectively reviewed. An evaluation of these cases was conducted to ascertain the presence of any surgery-related complications. Eighteen patients (7.9%) undergoing revision surgery were identified. Patient demographics and radiographic measurements of these groups were compared to the cases without complications (n = 210) and statistically analysed. A total of 18 patients (7.9%) with complications who underwent revision surgery were identified. Among the total number of patients, 10 (55.6%) exhibited mechanical complications. The remaining patients underwent a subsequent revision due to infection (n = 4), seroma/hematoma (n = 3), or a running wound (n = 1). The FNFx group exhibited a lack of intraoperative fractures; however, two periprosthetic fractures occurred subsequent to another fall (36 and 59 days postoperatively). A total of five incisions or extractions of the helical blade were identified in the TFx group. The following factors contributed to the necessity for revision: tractus irritation (n = 2), one intraoperative fracture, one running wound, and one seroma. Among all of the variables that were analyzed, including age, body mass index, and hemoglobin level, only the CTI of the affected side in the TFx group was found to be significantly higher in the complications group, as well as the mechanical complications group (0.51 ± 0.09, 0.58 ± 0.05, 0.58 ± 0.05; p = 0.029). Poor local bone quality, as indicated by a low CTI, is not associated with increased complication rates following surgically managed proximal femoral fractures. Instead, the predominant contributors to mechanical complications seem to emanate from alternative factors, such as insufficient fracture reduction and suboptimal blade positioning.

PMID:40619545 | DOI:10.1038/s41598-025-09362-8

J Robot Surg. 2025 Jul 7;19(1):357. doi: 10.1007/s11701-025-02533-9.

ABSTRACT

The recent meta-analysis by Liu et al. comparing postoperative functional complications and quality of life (QoL) between robot-assisted radical prostatectomy (RARP) and radiotherapy (RT) in localized prostate cancer raises important clinical questions but is constrained by methodological and interpretative limitations. Our commentary identifies four key issues: (1) inadequate adjustment for baseline confounding factors such as age, comorbidities, and androgen deprivation therapy exposure; (2) unstandardized aggregation of patient-reported outcome measures (PROMs), impairing statistical comparability; (3) absence of modality-specific stratification within the RT group, which combines external beam and brachytherapy despite differing toxicity profiles; and (4) overinterpretation of functional outcome trends without accounting for follow-up duration and evolving surgical techniques. These issues undermine the validity of the authors’ conclusions regarding RT’s superiority in functional recovery. We argue that future comparative effectiveness research should employ harmonized PROM frameworks, robust causal inference methodologies, and biologically stratified cohort analyses. Our critique underscores the need for precise, individualized assessment in treatment decision-making for localized prostate cancer and supports the broader scientific imperative for methodologically sound patient-centered outcomes research in robotic and radiotherapeutic oncology.

PMID:40619543 | DOI:10.1007/s11701-025-02533-9

Support Care Cancer. 2025 Jul 6;33(7):661. doi: 10.1007/s00520-025-09649-6.

ABSTRACT

PURPOSE: To investigate the clinical characteristics and risk factors associated with medication-related osteonecrosis of the jaw (MRONJ) and to introduce two metrics-equivalent dose (ED) and threshold dose (TD)-as predictive risk assessment tools.

METHODS: In this cross-sectional study, 193 patient records were reviewed from Shahab Dental Clinic and the Oral Medicine Department of Mashhad Dental School (2017-2023). Patients were categorized according to MRONJ stage (0-3) or as “at-risk.” Demographic data, comorbidities, clinical manifestations, and detailed medication profiles were collected. ED for each medication was standardized to the cumulative dose of four years of weekly oral alendronate use (4 × 52 × 70 mg = 14,560 mg). TD was defined as one unit of this ED and served as a cumulative risk cut-off. Statistical analyses included T-tests, ANOVA, and Chi-square tests.

RESULTS: MRONJ was identified in 40.4% of cases, while 59.6% were classified as at-risk. Advanced stages were significantly associated with higher ED, prolonged medication use, and key risk factors, including oncologic diseases, medication type and route of administration, comorbidities, age, and surgical interventions such as extractions and ill-fitting dentures (P < 0.001). The novel metrics demonstrated strong predictive value. ED values were significantly higher in zoledronic acid users compared to denosumab users (2.40 [1.05, 6.00] vs. 1.23 [0.75, 2.37], P < 0.001), and positively correlated with MRONJ severity (R = 0.46, P < 0.001). The odds ratio for MRONJ associated with ED was 1.17 (95% CI: 1.06-1.30).

CONCLUSION: This study offers critical insights into MRONJ risk stratification, highlighting the cumulative impact of medication dose alongside clinical risk factors. The introduction of ED and TD represents a transformative advancement in MRONJ risk prediction, enabling precise prevention strategies and guiding clinical management toward standardized care protocols.

PMID:40619534 | DOI:10.1007/s00520-025-09649-6

Eur Spine J. 2025 Jul 7. doi: 10.1007/s00586-025-09055-w. Online ahead of print.

ABSTRACT

PURPOSE: Spinopelvic fixation surgery is widely used for adult spinal deformity, but its impact on hip joint pathology remains unclear. This study investigates its association with femoroacetabular impingement syndrome (FAIS) using ultrasonography.

METHODS: This retrospective study included 80 patients (160 hips) who underwent spinal fusion for adult spinal deformity. Patients were categorized based on sacroiliac joint fixation into fixation (group F) and non-fixation (group N). Ultrasonography was performed to assess hip morphology, including labral degeneration, cam lesions, and acetabular osteophytes. The Kellgren-Lawrence (KL) grade, and alpha angle were measured on standing radiographs. The anterior impingement test was conducted to evaluate clinical symptoms, and prevalence was statistically compared.

RESULTS: We analyzed 151 hips (26 males, 125 females) with a mean follow-up of 52.7 ± 39.6 months. After excluding 27 hips with advanced hip osteoarthritis (KL grade ≥ 2), labral degeneration (69.5% vs. 37.9%, p = 0.0076) and cam lesions (30.5% vs. 6.9%, p = 0.01) were significantly more prevalent in group F than group N. The mean alpha angle did not significantly differ between two groups at the time of surgery, but significantly greater in group F compared to group N (48.7 ± 3.9° vs. 46.7 ± 4.7°, p = 0.01) at final follow-up.

CONCLUSION: Spinopelvic fixation may contribute to FAIS-related hip abnormalities by increasing mechanical stress. Ultrasonography may aid in early detection of hip joint changes after adult spinal deformity surgery.

PMID:40619521 | DOI:10.1007/s00586-025-09055-w

Sci Rep. 2025 Jul 7;15(1):24158. doi: 10.1038/s41598-025-09458-1.

ABSTRACT

The aim of this research was to evaluate the effects of exercise training on mobility, balance and gait parameters, with a particular emphasis on the timed up and go test (TUG), the Berg Balance Scale (BBS), the 6-minute walk test (6MWT), and the 10-meter walk test (10MWT). A systematic search was conducted across several databases, namely Web of Science, Embase, PubMed, and the Cochrane Library for randomized controlled trials (RCTs), to evaluate the effects of exercise interventions on mobility, balance and gait in chronic stroke patients. After rigorous screening, 13 RCTs with both experimental and control groups (193/190 participants) were found eligible for inclusion. The meta-analysis demonstrated significant improvement in the mobility ability, as measured by TUG test after exercise intervention (MD = – 4.81, p < 0.01, 95% CI [- 8.23 to – 1.38]). Furthermore, exercise effectively enhanced the balance ability, as measured by the BBS, among chronic stroke patients (MD = 3.81, p < 0.01, 95% CI [1.98-5.64]). However, no statistically significant impact of exercise training was observed on the 6MWT (SMD = 0.00, p > 0.05, 95% CI [- 0.24 to 0.25]) or 10MWT (SMD = 0.03, p > 0.05, 95% CI [- 0.07 to 0.12]). Exercise training interventions significantly increased mobility and balance scores in chronic stroke patients. However, they had no effect on gait scores. The results of further subgroup analysis show that aerobic training (AT) has a significant effect in enhancing the activity ability index of patients, while resistance training (RT) shows an obvious advantage in improving the balance index evaluated by the Berg Balance Scale (BBS).

PMID:40619517 | DOI:10.1038/s41598-025-09458-1

Sci Rep. 2025 Jul 6;15(1):24149. doi: 10.1038/s41598-025-08741-5.

ABSTRACT

Brucellosis, a prevalent zoonotic disease, induces substantial economic losses in livestock due to reproductive impairments and high mortality rates; it also presents considerable public health concerns worldwide. The current work highlights the potential application of the developed lateral flow immunochromatographic assay (LFIA) in the rapid and accurate detection of Brucella spp., underscoring its significance in disease management and control. The study investigated the purity of the extracted B. abortus smooth lipopolysaccharides-O (S-LPS-O) using high-performance liquid chromatography (HPLC). Moreover, it delved into the development and assessment of a novel diagnostic kit for Brucella using a recombinant protein A-lateral flow assay in comparison to the RBPT, SAT, MRT, I-ELISA as screening tests, also to C-ELISA, CFT as confirmatory tests. HPLC analysis indicated a distinctive absence of impurities in the extracted S-LPS-O, contrasting with the three peaks observed in the commercial LPS chromatogram. Sensitivity, specificity, and accuracy evaluations were performed, with the LFIA demonstrating promising results, showcasing its potential as a reliable diagnostic tool. Statistical analysis of the LFIA, RBPT, SAT, MRT, ELISA, CFT, and PCR results revealed notable sensitivity, specificity, and accuracy rates, affirming the diagnostic efficacy of the LFIA. The novel layout of the LFIA and the purity of extracted S-LPS-O showcased significant progress in the diagnostic capabilities of the developed LFIA. Moreover, the currently developed LFIA introduces a rapid and reliable diagnostic tool, particularly in resource-limited settings, owing to its ease of use and minimal equipment requirements with its competitively obtained results.

PMID:40619514 | DOI:10.1038/s41598-025-08741-5

Sci Rep. 2025 Jul 6;15(1):24103. doi: 10.1038/s41598-025-09807-0.

ABSTRACT

To compare efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in subjects with type 2 diabetes (T2DM). Electronic databases were searched from inception to 2nd October 2024 for randomised controlled trials comparing GLP-1RAs treating T2DM. Bayesian network meta-analyses were conducted to analyze metabolic and safety outcomes. 64 trials comprising of 25,572 participants were identified. Compared to placebo, tirzepatide showed the greatest reduction in HbA1-c (MD: -2.3%) and FPG (MD: -3.1mmol/L); semaglutide was second (HbA1-c: MD: -1.5%; FPG: MD: -2mmol/L); liraglutide was third (HbA1-c: MD: -1.2% FPG: MD: -1.6mmol/L) (P<0.05). All treatments showed no statistically significant differences in BMI, SBP, DBP, TC, HDL-C and LDL-C compared to placebo. Tirzepatide (MD: -9.1 kg), semaglutide (MD: -2.8 kg) and liraglutide (MD: -1.2 kg) (P<0.05) had significant reduction in body weight compared to placebo. GLP-1 RAs had higher risk of gastrointestinal symptoms. Semaglutide increased the risk of hypoglycemia compared to placebo while liraglutide reduced the risk of hypoglycemia compared to traditional antidiabetic drugs. GLP-1RAs improve glycaemic control, with tirzepatide, semaglutide and liraglutide exhibiting the most significant improvements. Tirzepatide is more suitable for treating T2DM with obesity. For individuals with normal weight, both semaglutide and liraglutide are generally more effective for treating T2DM. However, considering the potential for semaglutide to cause hypoglycemia, liraglutide may be the optimal choice for T2DM treatment to minimize the risk of hypoglycemia.

PMID:40619508 | DOI:10.1038/s41598-025-09807-0