Tag: nevin manimala

Plast Aesthet Nurs (Phila). 2022 Jul-Sep 01;42(3):156-162. doi: 10.1097/PSN.0000000000000442.

ABSTRACT

One of the most common complications associated with a diaphyseal humeral fracture is the development of a radial nerve injury. We conducted a study to analyze the degree of recovery and prognostic factors associated with radial nerve palsy in patients with diaphyseal humerus fractures. We retrospectively analyzed 28 patients who presented to the Hospital La Fe, Valencia, Spain, with a diaphyseal humerus fracture associated with radial nerve injury between 2010 and 2020. A total of 14.3% (n = 4) of the patients in our cohort had open fractures and 85.7% (n = 24) had closed fractures. There were no statistically significant differences between the type of treatment and the type of fracture (p = .13). There were also no significant differences between the type of treatment and recovery time (p = .42). There was a statistically significant difference (p = .04) in the mean recovery time for patients with preoperative radial nerve injuries (11.9 months) compared with patients who sustained a radial nerve injury secondary to surgical repair of the fracture (8.6 months). The difference in recovery time between patients with open and closed fractures was not statistically significant (p = .3). Results of the study showed that the type of fracture (i.e., open or closed) did not affect radial nerve palsy recovery time. Patients who sustain radial nerve injuries secondary to a surgical repair have a shorter recovery time than patients who sustain primary radial nerve injuries.

PMID:36450058 | DOI:10.1097/PSN.0000000000000442

Plast Aesthet Nurs (Phila). 2022 Jul-Sep 01;42(3):152-155. doi: 10.1097/PSN.0000000000000440.

ABSTRACT

The ability to achieve a good functional outcome, quality of life, and patient satisfaction related to the donor site of free flaps is an important factor in flap selection. One of the main advantages of an anterolateral thigh (ALT) free flap is its minimal donor-site morbidity. We conducted a study to analyze healing of ALT flap donor sites based on the type of closure. A total of 65 patients were included in the study. We divided the participants into two cohorts (i.e., primary closure [n = 51] and skin grafting [n = 14]). There were no statistically significant differences between the two cohorts relative to age, gender, or risk factors for wound healing (e.g., tobacco use, obesity, diabetes mellitus, and cardiovascular disease). We found there was a statistically significant difference (p < .05) between the mean donor-site wound healing time in the primary closure group (n = 51; 22.41 days [±9.94]) compared with the skin grafting group (n = 14; 54.57 days [±21.59]). To reduce wound healing time, improve cosmetic results, and increase functional outcomes in patients undergoing ALT free flap, we recommend using primary closure for the donor sites and avoiding skin grafting whenever possible.

PMID:36450057 | DOI:10.1097/PSN.0000000000000440

Int J Oral Maxillofac Implants. 2022 Nov-Dec;37(6):1250-1255. doi: 10.11607/jomi.9735.

ABSTRACT

PURPOSE: The objective of this study was to compare marginal bone loss (MBL) and clinical complications between surviving implants (SIs) and recently placed implants (RIs) splinted together to support a fixed partial restoration (FPR).

MATERIALS AND METHODS: This retrospective study employed the medical records of patients treated with implant-supported FPRs in the Maccabi-Dent Dental Clinic. Patients were included if they were over the age of 18 years, were treated with RIs adjacent to existing SIs that had previously supported FPRs for more than 1 year, and the RIs and SIs were splinted to support new FPRs. Patients who did not receive annual follow-up or whose records had nondiagnostic radiographs or lacked sufficient restorative data were excluded. MBL was assessed at the last available radiograph and compared to one taken 1 year after loading the splinted RIs and SIs together. Clinical complication data were gathered from patient records.

RESULTS: The medical records of 1,907 patients treated with a total of 7,306 implants were examined. Data from 187 implants were extracted from 46 patient records that met the inclusion criteria, with 96 RIs and 91 SIs supporting 56 FPRs. Mean followup was 39 ± 17.5 months. During the follow-up, two implants failed. The overall survival rate was 98.94% (98.96% in RIs and 98.91% in SIs), and the mean MBL in all implants was 0.41 ± 0.58 mm (0.4 ± 0.53 mm in RIs and 0.42 ± 0.45 mm in SIs). Peri-implantitis was reported in eight (4.3%) implants (four RIs and four SIs), screw loosening was reported in nine (4.8%) implants (three RIs and six SIs), ceramic chipping was reported in three (5.3%) restorations supported by four RIs and six SIs, and decementation was reported in one (1.8%) restoration supported by one RI and one SI. There was no statistically significant difference in survival rate, MBL, peri-implantitis, or screw loosening between RIs and SIs.

CONCLUSION: There was no statistically significant difference in MBL or clinical complications between RIs and SIs. Splinting RIs and SIs for new prosthetic restoration support is a reasonable treatment choice with a high implant survival rate, low incidence of complications, and acceptable MBL.

PMID:36450032 | DOI:10.11607/jomi.9735

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