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Nevin Manimala Statistics

Horizontal Ridge Reconstruction of Atrophic Anterior Maxillary Ridges Using Customized Xenograft Bone Shell with 1:1 Mixture of Autogenous and Xenograft Bone Particulate (A Case Series Study)

Int J Oral Maxillofac Implants. 2023 Nov 1;0(0):1-24. doi: 10.11607/jomi.10613. Online ahead of print.

ABSTRACT

INTRODUCTION: Different surgical procedures have been proposed to achieve successful horizontal ridge reconstruction of the anterior maxilla, most of these procedures require complex surgical stages with morbidity and are time-consuming.

AIM: The purpose of this study is to evaluate the efficacy of using a customized xenograft shell with a 1:1 mixture of particulates xenograft and autogenous bone for the reconstruction of horizontally deficient anterior maxillary alveolar ridges.

METHODS: Cone beam computed tomography (CBCT) images of the atrophic maxilla of eight patients were acquired and generated into 3D models. The data were transferred to a 3D printer and solid models were fabricated. During the surgery, the xenograft blocks were manually sliced and customized on the 3D printed models and fixed then the gap was augmented with a 1:1 xenograft autograft mixture.

RESULTS: Clinical assessment showed no adverse effects. However, one patient exhibited wound dehiscence. The mean difference between the preoperative and the six months postoperative showed a net average bone gain by 4.06 mm at 2 mm from the crest and 4.34 mm at 5 mm from the crest, which was statistically significant. On the other hand, a statistically significant graft resorption by 1.41 mm and 2.19 mm at 2 and 5 mm from the crest was found when the mean difference between the immediate and the six months postoperative was calculated.

CONCLUSIONS: Within the limitations of the study, the use of xenograft shells as a barrier for maxillary alveolar ridge reconstruction is predictable technique however, further investigations regarding the required time for graft consolidation is required.

PMID:37910833 | DOI:10.11607/jomi.10613

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Untreated Mineralized Dentin Graft Versus Xenograft Around Immediately Placed Dental Implants in the Mandibular Anterior Region: A Randomized Controlled Clinical Trial

Int J Oral Maxillofac Implants. 2023 Nov 1;0(0):1-29. doi: 10.11607/jomi.10584. Online ahead of print.

ABSTRACT

PURPOSE: The structural and compositional similarities between dentin and alveolar bone formed the basis for utilizing dentin for bone regeneration. Various authors recommended using treated mineralized, partially demineralized, and demineralized dentin grafts over xenografts because of their comparable clinical and radiographic results and lower costs. Therefore, the current study aimed at comparing the effect of untreated mineralized dentin grafts (UMDG) versus xenografts in vertical and horizontal augmentation around dental implants that were immediately placed in the mandibular anterior region.

MATERIALS AND METHODS: A total of 56 patients who required immediate dental implant placement in the lower anterior region were randomly allocated to group I (study), where ground dentin was washed with normal saline and placed around the dental implants, and to group II (control), where xenograft was used. The primary implant stability was measured at the time of implant placement. Secondary stability, plaque index (PI), bleeding index (BI), probing depth (PD), and keratinized mucosa width (KMW) were assessed at baseline (time of definitive abutment and temporary crown placement) and then at 3, 6, and 12 months. Pain and the number of analgesics consumed were assessed daily during the first postoperative week. Marginal bone loss (MBL) and radiodensity were assessed radiographically.

RESULTS: There were no significant differences between both groups in terms of postoperative pain, the number of analgesic tablets consumed, peri-implant mucositis, or peri-implantitis. Both groups showed comparable results for the PI, BI, and BD. Moreover, there was no statistical difference between both groups with regard to primary implant stability and secondary stability at baseline and 12 months. Group I showed significantly lower secondary stability after loading at 3 and 6 months and significantly greater bone loss and lower bone density before exposure. KMW and MBL after exposure were significantly higher in group I at all time points.

CONCLUSION: Although UMDG showed similar clinical results as xenografts, including primary and secondary implant stability, they had higher resorption rates than xenografts. Therefore, treatment of the dentin graft is required. Thus, the authors do not recommend using untreated mineralized dentin grafts.

PMID:37910831 | DOI:10.11607/jomi.10584

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Comparison of screw loosening and fracture resistance in different hybrid abutment crown restorations after thermomechanical aging

Int J Oral Maxillofac Implants. 2023 Nov 1;0(0):1-25. doi: 10.11607/jomi.10595. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of the study is to investigate the screw loosening and fracture resistance of different hybrid abutment crown restorations after thermomechanical aging.

MATERIALS AND METHODS: Restorations were produced from zirconia, lithium disilicate, and hybrid ceramics with CAD-CAM system (n=10). Restorations and titanium bases (Tibases) were cemented and the abutment screws were torqued to 30 Ncm. They were retorqued after 10 minutes, and removal torque values (RTV) were measured. When 250000 and 500000 cycles of thermomechanical aging were completed, the RTVs were measured again and removal torque loss (RTL) ratios were calculated. The specimens were subjected to fracture resistance test after 750000 cycles of thermomechanical aging. The load at failure was recorded as the fracture resistance (N). The results were statistically analyzed (α=0.05).

RESULTS: Aging was effective on the RTVs and RTL ratios (P<0.001). The highest RTV was observed before aging; however, the RTVs significantly decreased and RTL ratios significantly increased after aging (P<0.05). The fracture resistance values significantly differed among the ceramic materials. All lithium disilicate and hybrid ceramic specimens showed restoration fracture, while most of the zirconia specimens were displayed Tibase related failure.

CONCLUSION: Hybrid abutment crowns made of zirconia, lithium disilicate, and hybrid ceramics can withstand the average occlusal forces in the molar region; however ceramic type may affect the failure type. Retightening of the abutment screws after 10 minutes after first tightening and annually may be beneficial to prevent the adverse effects of screw loosening on the integrity of implant-abutment connection.

PMID:37910830 | DOI:10.11607/jomi.10595

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Comparison of implantation accuracy among different navigated approaches: A systematic review and network meta-analysis

Int J Oral Maxillofac Implants. 2023 Nov 1;0(0):1-33. doi: 10.11607/jomi.10381. Online ahead of print.

ABSTRACT

PURPOSE: Dental implants are a common method for the treatment of tooth loss, and its accuracy directly affects forward efficacy and stability. This study compared the accuracy of different modalities of dental implant placement (dynamic navigation [DN], fully guided [FG] static navigation, partially guided [PG] static navigation, and free handed [FH]) through a network meta-analysis.

MATERIALS AND METHODS: This study followed the Preferred Reporting Items for Meta-Analyses (PRISMA) guidelines and conducted an electronic literature search (Inception-Oct 2, 2022). The comparison of implant accuracy in all the included randomized controlled trials (RCTs) conformed to at least one of the following: deviation at the crown of the implant, deviation at the apical portion of the implant, or angular deviation of the implant.

RESULTS: Twenty-six articles were included for the qualitative analysis (17 RCTs; 3 prospective studies; 6 retrospective studies), and 17 RCTs of which were included for network meta-analysis. The data included in this study had high consistency, and the funnel plot showed that the articles had low publication bias. Compared with FH, FG and DN had higher accuracy in coronal deviation (P<0.05), and FG, DN, and PG had higher accuracy in apical deviation and angular deviation (P<0.05). According to the SUCRA value, FG had the highest accuracy in coronal deviation, while DN had the highest accuracy in apical deviation and angular deviation.

CONCLUSIONS: According to the results of this literature review, the accuracy of DN, FG, and PG were higher than those of FH. DN showed the highest accuracy in terms of apical deviation and angular deviation. FG had the best control over the coronal deviation. There was no statistical difference between DN and FG in terms of accuracy. Given the limitations of the current study, further validation is required in the future.

PMID:37910829 | DOI:10.11607/jomi.10381

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First-Line Pembrolizumab + Chemotherapy Versus Placebo + Chemotherapy for Persistent, Recurrent, or Metastatic Cervical Cancer: Final Overall Survival Results of KEYNOTE-826

J Clin Oncol. 2023 Nov 1:JCO2300914. doi: 10.1200/JCO.23.00914. Online ahead of print.

ABSTRACT

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.The phase III, double-blind KEYNOTE-826 trial of pembrolizumab 200 mg or placebo once every 3 weeks for up to 35 cycles plus platinum-based chemotherapy, with or without bevacizumab, showed statistically significant survival benefits with the addition of pembrolizumab for patients with persistent, recurrent, or metastatic cervical cancer (primary data cutoff: May 3, 2021). This article reports the protocol-specified final overall survival (OS) results tested in the PD-L1 combined positive score (CPS) ≥1, all-comer, and CPS ≥10 populations. At the final data cutoff (October 3, 2022), the median study follow-up duration was 39.1 months (range, 32.1-46.5 months). In the PD-L1 CPS ≥1 (N = 548), all-comer (N = 617), and CPS ≥10 (N = 317) populations, median OS with pembrolizumab-chemotherapy versus placebo-chemotherapy was 28.6 months versus 16.5 months (hazard ratio [HR] for death, 0.60 [95% CI, 0.49 to 0.74]), 26.4 months versus 16.8 months (HR, 0.63 [95% CI, 0.52 to 0.77]), and 29.6 months versus 17.4 months (HR, 0.58 [95% CI, 0.44 to 0.78]), respectively. The incidence of grade ≥3 adverse events was 82.4% with pembrolizumab-chemotherapy and 75.4% with placebo-chemotherapy. These results show that pembrolizumab plus chemotherapy, with or without bevacizumab, continued to provide clinically meaningful improvements in OS for patients with persistent, recurrent, or metastatic cervical cancer.

PMID:37910822 | DOI:10.1200/JCO.23.00914

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Patient Experiences With Therapeutic Contact Lenses and Dry Eye Disease

Eye Contact Lens. 2023 Nov 1. doi: 10.1097/ICL.0000000000001051. Online ahead of print.

ABSTRACT

OBJECTIVES: To report patient-reported experiences with dry eye disease and therapeutic contact lenses.

METHODS: A survey was distributed to patients with dry eye disease. Demographics, Ocular Surface Disease Index (OSDI), systemic disease, contact lens history, and burden of care information were collected. Descriptive statistics are presented and categorized by nonlens, soft lens, and scleral lens (SL) wearers.

RESULTS: Of 639 respondents, 15% (94/639) were currently using therapeutic soft or SLs (47 soft and 69 SL). Mid-day fogging or clouding of vision was reported by SL (75%, 50/67) and soft lens (62%, 29/47) wearers. Seventy-two percent of SL wearers spent more than 20 min daily on dry eye treatment while 43% of soft lens wearers spent more than 20 min. Median annual expenditure was higher for SL ($1,500, n=63) than nonlens ($500, n=371) or soft lens wearers ($700, n=43). Mean OSDI scores in all groups were in the severe category (51±22 years, n=401 nonlens wearers; mean age; 45±22 years, n=47 soft lens wearers; 60±24 years, n=69 SL wearers).

CONCLUSIONS: Mid-day fogging and blurring of vision was reported by most of the individuals using therapeutic lenses for dry eye disease. SL wearers allocate the most resources for dry eye care.

PMID:37910817 | DOI:10.1097/ICL.0000000000001051

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Evaluation of the Impact of Meibomian Gland Dysfunction Using a Novel Patient-Reported Outcome Instrument

J Ocul Pharmacol Ther. 2023 Nov 1. doi: 10.1089/jop.2023.0080. Online ahead of print.

ABSTRACT

Purpose: This study was intended to characterize the impact of meibomian gland dysfunction (MGD) on patients’ quality of life. Methods: In this prospective, multicenter, noninterventional clinical study (NCT01979887), eligible individuals (age ≥40 years; absence of uncontrolled ocular/systemic disease) were categorized, based on composite grading of ocular symptoms, Schirmer score, and meibum quality, into (1) non-MGD, (2) mild/moderate MGD, or (3) severe MGD cohorts. The MGD Impact Questionnaire (MGD IQ), a 10-item patient-reported outcome measure, was self-administered at clinic visit on day 1, and readministered on day 22 to assess intervisit agreement regarding MGD IQ responses. Results: In total, 75 subjects were assigned to the study cohorts (25 per cohort). Across cohorts, MGD IQ item scores rose incrementally with increasing MGD severity. The severe MGD cohort experienced greater difficulty with reading and performance of leisure activities, greater time on eye care, and greater bother with eye care and eye appearance than the mild/moderate MGD cohort (all P < 0.05). Compared with the non-MGD cohort, the mild/moderate MGD cohort had greater difficulty working on computer, whereas the severe MGD cohort had greater difficulty reading, driving, and performing leisure activities, more frequent difficulty with outdoor activities, more time on eye care, and greater bother with eye care (all P < 0.05). Intervisit agreement between MGD IQ responses was fair to moderate (weighted kappa statistic 0.33‒0.58). Conclusions: Vision-related activities are negatively impacted by increasing severity of MGD. The MGD IQ instrument can help characterize disease severity and amplify the patient’s voice in patient-centric clinical research. ClinicalTrials.gov NCT01979887.

PMID:37910805 | DOI:10.1089/jop.2023.0080

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Application of Laser Treatment in Adhesive Bonding of Liners to Polymethyl Methacrylate Denture Resins: A Systematic Review and Meta-Analysis

Photobiomodul Photomed Laser Surg. 2023 Oct 31. doi: 10.1089/photob.2023.0066. Online ahead of print.

ABSTRACT

Objective: This systematic review and meta-analysis aimed to assess the influence of laser treatment on adhesive bonding of liners to polymethyl methacrylate (PMMA) denture base resins. Methods: The focused question was: “Does the application of laser treatment (Intervention) influence the adhesive bonding strength (Outcome) of liners to PMMA denture base resins (Population) as compared with untreated or unconditioned surfaces (Control)?” In vitro and clinical reports as well as reports on influence of laser treatments on bonding strength of liners to PMMA denture resins in comparison with untreated surfaces were included. Reports without any control group[s], without any application of laser[s] for PMMA denture bases that did not utilize PMMA denture bases, and not evaluate bond strength of PMMA denture base resins were excluded. An electronic search was conducted on PubMed, Scopus, and Web of Science. Meta-analyses were performed for calculating the standard mean difference (SMD) with a 95% confidence interval (95% CI). Results: Nine of the 12 included studies found that laser irradiation treatment produced significant surface texture alterations of the PMMA denture base and improved the adhesion between the PMMA denture base and soft lining. According to the meta-analysis, tensile bond strength showed an SMD of -2.49% (95% CI: -3.89 to -1.08; p = 0.0005), suggesting a statistically significant difference between the control and test groups (i.e., favoring laser-treated samples than untreated samples). Regarding shear bond strength scores, the outcomes showed an SMD of -2.24% (95% CI: -3.79 to -0.69; p = 0.005), suggesting a statistically significant difference between the control and test groups (i.e., favoring laser-treated samples than untreated samples). Conclusions: Despite the high heterogeneity among the included studies, it can be concluded that laser treatment might improve the bonding strengths of liners to PMMA denture base resins as compared with untreated surfaces. To validate the aforementioned conclusions, further verification is required through the implementation of well-designed randomized controlled trials with large sample sizes.

PMID:37910776 | DOI:10.1089/photob.2023.0066

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Atmospheric turbulence characterization with simultaneous measurement of phase, angle of arrival, and intensity in a retroreflected optical link

Opt Lett. 2023 Nov 1;48(21):5519-5522. doi: 10.1364/OL.501346.

ABSTRACT

Free-space optical transmission through the Earth’s atmosphere is applicable to high-speed data transmission and optical clock comparisons, among other uses. Fluctuations in the refractive index of the atmosphere limit the performance of atmospheric optical transmission by inducing phase noise, angle-of-arrival variation, and scintillation. The statistics of these deleterious effects are predicted by models for the spatial spectrum of the atmospheric refractive index structure. We present measurements of phase fluctuations, angle-of-arrival variations, and scintillation, taken concurrently and compared with models for the atmospheric refractive index structure. The measurements are also cross-compared by deriving independent estimates of the turbulence structure constant $C_n^2$. We find agreement within an order of magnitude for derived $C_n^2$ values for all three metrics.

PMID:37910692 | DOI:10.1364/OL.501346

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Identifying Sex-Specific Serum Patterns of Alzheimer’s Mice through Deep TMT Profiling and a Concentration-Dependent Concatenation Strategy

J Proteome Res. 2023 Nov 1. doi: 10.1021/acs.jproteome.3c00496. Online ahead of print.

ABSTRACT

Alzheimer’s disease (AD) is the most prevalent form of dementia, disproportionately affecting women in disease prevalence and progression. Comprehensive analysis of the serum proteome in a common AD mouse model offers potential in identifying possible AD pathology- and gender-associated biomarkers. Here, we introduce a multiplexed, nondepleted mouse serum proteome profiling via tandem mass-tag (TMTpro) labeling. The labeled sample was separated into 475 fractions using basic reversed-phase liquid chromatography (RPLC), which were categorized into low-, medium-, and high-concentration fractions for concatenation. This concentration-dependent concatenation strategy resulted in 128 fractions for acidic RPLC-tandem mass spectrometry (MS/MS) analysis, collecting ∼5 million MS/MS scans and identifying 3972 unique proteins (3413 genes) that cover a dynamic range spanning at least 6 orders of magnitude. The differential expression analysis between wild type and the commonly used AD model (5xFAD) mice exhibited minimal significant protein alterations. However, we detected 60 statistically significant (FDR < 0.05), sex-specific proteins, including complement components, serpins, carboxylesterases, major urinary proteins, cysteine-rich secretory protein 1, pregnancy-associated murine protein 1, prolactin, amyloid P component, epidermal growth factor receptor, fibrinogen-like protein 1, and hepcidin. The results suggest that our platform possesses the sensitivity and reproducibility required to detect sex-specific differentially expressed proteins in mouse serum samples.

PMID:37910662 | DOI:10.1021/acs.jproteome.3c00496