Comparison of functional and esthetic outcomes in digital versus analog rehabilitation of one-piece screw-retained implant crowns placed at second stage surgery

PURPOSE Analog and digital impressions are established procedures for restoration of single-tooth implants. In this study, single-tooth implants were restored with definitive restorations during second-stage surgery. Analog and digital workflows were compared. MATERIAL AND METHODS Eighty single-tooth implants were examined in total. In 40 implants, an index was taken immediately after implant placement using composite resin to fabricate the final crowns (analog workflow). For the other 40 single-tooth implants, intraoral intraoperative scans were performed (digital workflow) during primary surgery. The custom-fabricated screw-retained crowns were placed during second-stage surgery. Photographs and examinations for the scores were taken at the time of the follow-up visit, 1-4 years after placement of the crowns. The number of treatment appointments required was recorded and the modified pink esthetic score (PES) was determined. Additionally, the functional implant prosthetic score (FIPS) was measured. RESULTS The mean PES was 12.15/14 for the digital workflow and 11.95/14 for the analog workflow. The most common deficit was incomplete papillae for both workflows. Three treatment appointments were required for both workflows: (1) Scan and/or impressions making and patient consent, (2) implant placement, and (3) second-stage surgery with crown insertion. The FIPS was 9.1/10 for the digital workflow group and 9.2/10 for the analog workflow group. Common deficits presented as missing papillae as well as open approximal contacts. The FIPS was not significantly different between workflows (p = 0.679). The PES also did not show a statistically significant difference for both workflows (p = 0.654), however, the analog workflow showed better values for the papillae (p < 0.05). A significant difference was also found in the other PES values, with the digital workflow showing better results here (p < 0.05). A chronological analysis of the results of the digital technique showed that the cases treated last had significantly better values than the cases treated first. CONCLUSIONS According to the results of this study, both workflows allowed placement of the definitive crowns on single-tooth implants during second-stage surgery. Both workflows were found to be equivalent in terms of esthetic results in this study, although the digital workflow demonstrated a learning curve

Application of non-thermal plasma in medicine: a bibliometric and visualization analysis

Non-thermal plasma has been widely studied in medicine due to its beneficial effect with low thermal or other damages. Numerous medical research studies have been conducted using non-thermal plasma devices; yet, to date, there is no report summarizing this field as a whole. In this study, we aim to perform a bibliometric analysis to assess the state of research, current research priorities, and emerging trends in non-thermal plasma medicine over the last two decades. Publications related to non-thermal plasma medicine (2002–2022) were searched in Web of Science core collection. Bibliometric analysis and visualization was then performed using R-Bibliometrix and CiteSpace. A total of 725 publications related to non-thermal plasma were identified. The annual number of publications has increased continuously over the past two decades. n the field of non-thermal plasma medicine, Germany, China and the United States dominated. Of all institutions, Leibniz Institute for Plasma Science and Technology published the most papers. The journal with highest citation was JOURNAL OF PHYSICS D-APPLIED PHYSICS. Bekeschus Sander published the highest H-value of articles. “Inactivation”, “Apoptosis”, “Chronic Wound” is the primary focus area of non-thermal plasma medicine, “Differentiation”, “Water”, “Gene Expression” and “Cell Death” were the main keywords of the new research hotspots. In this study, bibliometric methods were used to analyze current research priorities and trends in non-thermal plasma medicine and to identify the countries, institutions, authors, and journals with the greatest influence in the field to enhance collaboration and learning

Trends over time in congenital malformations in live-born children conceived after assisted reproductive technology

IntroductionChildren born after assisted reproductive technology, particularly singletons, have been shown to have an increased risk of congenital malformations compared with children born after spontaneous conception. We wished to study whether there has been a change in the past 20 years in the risk of major congenital malformations in children conceived after assisted reproductive technology compared with children spontaneously conceived. Material and methodsPopulation-based cohort study including 90 201 assisted reproductive technology children and 482 552 children spontaneously conceived, born in Denmark, Finland, Norway and Sweden. Both singletons and twins born after in vitro fertilization, intracytoplasmatic sperm injection and frozen embryo transfer were included. Data on children were taken from when the national Nordic assisted reproductive technology registries were established until 2007. Multiple logistic regression analyses were used to estimate the risks and adjusted odds ratios for congenital malformations in four time periods: 1988-1992, 1993-1997, 1998-2002 and 2003-2007. Only major malformations were included. ResultsThe absolute risk for singletons of being born with a major malformation was 3.4% among assisted reproductive technology children vs. 2.9% among children spontaneously conceived during the study period. The relative risk of being born with a major congenital malformation between all assisted reproductive technology children and children spontaneously conceived remained similar through all four time periods (p = 0.39). However, we found that over time the number of children diagnosed with a major malformation increased in both groups across all four time periods. ConclusionWhen comparing children conceived after assisted reproductive technology and spontaneously conceived, the relative risk of being born with a major congenital malformation did not change during the study period.Peer reviewe

Improved in vitro test procedure for full assessment of the cytocompatibility of degradable magnesium based on ISO 10993-5/-12

Magnesium (Mg)-based biomaterials are promising candidates for bone and tissue regeneration. Alloying and surface modifications provide effective strategies for optimizing and tailoring their degradation kinetics. Nevertheless, biocompatibility analyses of Mg-based materials are challenging due to its special degradation mechanism with continuous hydrogen release. In this context, the hydrogen release and the related (micro-) milieu conditions pretend to strictly follow in vitro standards based on ISO 10993-5/-12. Thus, special adaptions for the testing of Mg materials are necessary, which have been described in a previous study from our group. Based on these adaptions, further developments of a test procedure allowing rapid and effective in vitro cytocompatibility analyses of Mg-based materials based on ISO 10993-5/-12 are necessary. The following study introduces a new two-step test scheme for rapid and effective testing of Mg. Specimens with different surface characteristics were produced by means of plasma electrolytic oxidation (PEO) using silicate-based and phosphate-based electrolytes. The test samples were evaluated for corrosion behavior, cytocompatibility and their mechanical and osteogenic properties. Thereby, two PEO ceramics could be identified for further in vivo evaluations

Dreidimensionaler morphologischer Vergleich der Palatinalflächen des oberen mittleren und oberen seitlichen Schneidezahns

Studienziel: Ziel dieser Promotion war ein dreidimensionaler Vergleich durch eine Oberflächenanalyse der Palatinalflächen von oberen seitlichen und oberen mittleren Schneidezähnen und die Analyse bezüglich morphologischer Regelmäßigkeiten, sowie die Determinierung konstanter Areale zur lingualen Befestigung voll konfektionierter festsitzender kieferorthopädischer Apparaturen. Methode: Bei insgesamt 102 zufällig ausgewählten Patienten der Poliklinik für Kieferorthopädie der Universität Greifswald wurden Abformungen mit einem Polyether (Impregum® Penta) angefertigt. Es wurden ausschließlich Patienten im Wechselgebiss der ersten Phase mit unversehrten mittleren und seitlichen Oberkieferschneidezähnen ohne Form- und Strukturanomalien eingeschlossen. Nach Herstellung von Modellen aus Hartgips der Klasse IV (Esthetic-rock®) erfolgte die separate Digitalisierung der Palatinalflächen der Zähne 11 und 12 unter Verwendung eines 3D-Laserscanners. Nach Datenimport in die Surfacer-Software® (Imageware) erfolgte nach Zuschnitt die Superimposition der Oberflächenscans. Nach Probemessung von 25 Übereinanderlagerungen teilten wir die Oberflächen in 5 Sektoren ein: Inzisalkantenbereich, mesiale Randleiste, distale Randleiste, Tuberkulum und Mittelfläche der Facies lingualis. Die statistische Auswertung erfolgte mit Hilfe von SPSS® 14.0 durch eine explorative Datenanalyse und gepaarte Stichprobentests (t-Tests, Konfidenzintervall 0,95). Ergebnisse: Die mittlere Fehlerstreuung betrug durchschnittlich 233,4µm. Bei den absoluten maximalen Messwerten stellten wir fest, dass in allen Sektoren signifikante Unterschiede (p0,05, a=0,05). Diskussion: Der Tuberkelbereich wird seit langem zur Klassifikation herangezogen. Wir stellten fest, dass dieser am inkonstantesten ist. Es ist nicht davon auszugehen, dass der obere seitliche Schneidezahn eine verkleinerte Form des oberen mittleren Schneidezahns ist, er ist in seiner Ausprägung noch variabler. Beim Vergleich der Oberflächenmorphologie ergaben sich erwartungsgemäß große interindividuelle Unterschiede und eine hohe Standardabweichung. Feststellungen von Regelmäßigkeiten würden eine Vereinfachung der Verfahrenstechnik bei der Herstellung konfektionierter lingualer Systeme bedeuten. Wir stellten fest, dass der mittlere Bereich und die mesiale Randleiste konstantere Regionen sind. Der Tuberkelbereich zeigte bei allen Messungen signifikant die größten Abweichungen. Zusammenfassung: Für die Befestigung voll konfektionierter lingualer Systeme kommen am ehesten der mittlere Bereich und die mesiale Randleiste in Betracht. Zu prüfen ist, ob diese Flächen für einen stabilen Verbund ausreichend sind. Der obere mittlere und der obere seitliche Schneidezahn sind grundsätzlich verschiedene Zähne mit gleichem Aufgabengebiet.Aim: Aim of this study was a three dimensional comparison of the palatinal surfaces by 3D-laser-surface analysis of the upper central and upper lateral incisor and analysis of morphologic regularities for determination of constant areas for the attachment of completely industrial prefabricated lingual brackets. Method: We took polyether impressions (Impregum® Penta) out of 102 randomised selected patients of the Polyclinic of Orthodontics of the University of Greifswald. There were only subjects included in transitional dentition with unharmed upper teeth without any structural or form abnormities. After pouring stone casts of class-IV gypsum (Esthetic-rock®) we digitalized the palatal surfaces of each 11 and 12 by using a 3D-laser-scanning device. Superimposition was performed by using the “Surfacer-Software” (Imageware). After test measurement of 25 teeth we divided the palatal surfaces into 5 regions: incisal edge, mesial ridge, lateral ridge, tuberculum and medial sector. Statistical analysis was performed by an explorative data analysis and paired t-tests (confidence interval 0.95) by using SPSS® 14.0. Results: The average RMS was 233,4 µm. There were significant differences (p0.05, a=0.05). Dicussion: The tuberculum has been used for classification of the upper incisors for many years. We determined this as the most inconstant region. The upper lateral incisor is more variable and it is not a diminutive form of the upper central incisor. Comparing the surface morphologies there were as expected many interindividual differences and high standard deviations. Determination of surface regularities resp. conformities would mean a simplification of process engineering of completely industrial prefabricated lingual brackets. We determined the medial sector and the mesial ridge as more constant regions. The significantly highest values were noticed at the region of the tuberculum. Conclusion: For the attachment of completely prefabricated lingual brackets at the upper incisors mainly the medial sector and the mesial ridge should be considered. It should be tested if these areas are large enough for a sufficient compound. The upper central and the upper lateral incisor are principally different teeth with similar assignments

Retrospektive Untersuchung von Marschfrakturen bei der Bundeswehr in den Jahren 1998 bis 2000 und biodynamische Untersuchung von Füßen im Kampfstiefel der Bundeswehr mit verschiedenen Einlegesohlen

Studienziel: Retrospektive Darstellung der Situation der Marschfrakturen bei der Bundeswehr in den Jahren 1998 bis 2000 und Druckverteilungsuntersuchung unter dem Fuß im Kampfstiefel der Bundeswehr mit 4 verschiedenen Einlegesohlen. Methode: Anonymisierte statistische Auswertung von 191 Fällen mit 204 Frakturen. Messung der Druckverteilung (Novel pedar-m) unterhalb der Füße von 26 Probanden im Kampfstiefel der Bundeswehr mit den Originaleinlegesohlen (Kunststoffmesh) und angefertigten anatomisch vorgeformten Einlegesohlen (Neopren und EVA-Schaum). Ergebnisse: 82% der betroffenen Soldaten waren zwischen 19 und 22 Jahre alt. Über 50% der Frakturen traten innerhalb der ersten 8 Wochen auf. in rund 64% aller Fälle war der Mittelfußknochen III betroffen, in 25% der II. Mittelfußknochen und in nur insgesamt 11% die Mittelfußknochen IV, V und I. Keine Feststellung von Risikofaktoren für Marschfrakturen hinsichtlich körperlicher Anomalien. Sowohl im Gang als auch im Stand ist die Druckbelastung unter den mittleren Mittelfußknochen höher als unter den lateralen. Es wurden im Bereich der Mittelfußknochen Reduktionen der Spitzendrücke im Vergleich zu den Originaleinlegesohlen um bis zu 31,4% und Verringerungen der Kraft-Zeit-Integrale um bis zu 23,5% festgestellt. Trotz biomechanisch belegbarer Nachteile werden die Originaleinlegesohlen hinsichtlich Empfindung, Komfort und Passform von den Probanden bevorzugt. Schlussfolgerungen: Die Marschfraktur bei der Bundeswehr inst eine nicht berechenbare Erkrankung des jungen und physisch leistungsfähigen Menschen; Jugend ist kein protektiver Faktor. Ein Screening ist nicht möglich. Der Werkstoff Neopren ist hinsichtlich Spitzendruckreduktion, Druckverteilung und Impulsreduktion sowohl EVA-Schaum als auch den Originalplastikmesheinlagen überlegen.Aim: Retrospective analysis of the situation of march fractures at the German Armed Forces in the years 1998 until 2000 and plantar pressure distribution measurement in the combat boot of the German Armed Forces with 4 different insoles. Method: Anonymized statistical evaluation of 191 cases with 204 fractures. Measurement of the pressure distribution (Novel pedar-m) below the feet of 26 test persons in the combat boot of the German Armed Forces with the original insoles (platic mesh) and with anatomically preformed insoles (Neoprene and EVA-foam). Results: 82% of the affected soldiers were beetween 19 and 22 years old. More than 50% of the fractures occurred in the first eight weeks of service. In about 64% the Metatarsal III was affected, in 25% the second and in only 11% of all cases the Metatarsals IV, V and I. No specific body risk factors were found to be connected with the occurrence of march fractures. Both during standing and walking the pressure loading is higher below the middle Metatarsals thanbelow the lateral Metatarsals. There were reductions of the peak pressure up to 31,4% and of the force-time-integrals up to 23,5% determined in the area of the Metatarsals comparing the purpose-built to the original insoles. In spite of the biomechanic disadvantages the original insoles were favoured by the test persons concerning perception, comfort and fitting. Conclusion: March fractures at the German Armed Forces are a non-predictable diseaseof the young and physically fit individuals; youth isn't a protective factor. There is no possibility for a screening. Neoprene as insole material compared to EVA-foam and the original plastic mesh insoles is superior concerning pressure distribution and reduction of peak pressure and force-time-integral