Chewing simulation of zirconia implant supported restorations

PURPOSE To test three potential prosthetic material options for zirconia implants in regard to their mechanical properties, loading and retention capacity as well as to record abrasion after chewing simulation followed by thermocyclic aging. METHODS Molar crowns (n = 96) of three different computer-aided design/computer-aided manufacturing (CAD/CAM) materials were produced and cemented on zirconia implants (ceramic.implant, Vita) with a diameter of 4.5 mm. Monolithic zirconia (Vita YZ [YZ] with RelyX Unicem 2 Automix [RUN], polymer-infiltrated ceramic (Vita Enamic [VE]) with Vita Adiva F-Cem [VAF] and acrylate polymer (CAD Temp [CT]) with RelyX Ultimate [RUL]. Fracture load and retentive force of the crowns were measured after 24 h water storage at 37 °C and after a chewing simulation followed by thermocyclic aging. Abrasion was recorded by matching stereolithography-data of the crowns obtained before and after chewing simulation. Additionally, the mechanical properties and bonding capabilities of the crown and cement materials were assessed. RESULTS Fracture load values were significantly highest for YZ > VE = CT. Retention force values did not differ significantly between the materials. The aging procedure did not affect the fracture load values nor the retention force significantly. Abrasion depth of the crowns was lowest for YZ followed by VE and CT. On unpolished crowns, abrasion of YZ and VE tended to be higher than on polished specimens. CONCLUSIONS Based on the obtained in-vitro results, all tested materials can be recommended for the use on zirconia implants, although CT is only approved for temporary crowns. The loading and retention capacity of the materials were not significantly affected by aging

Results at the 1-Year Follow-Up of a Prospective Cohort Study with Short, Zirconia Implants

The objective of this study was to clinically and radiologically evaluate the performance of a short (8 mm), 1-piece, zirconia implant after an observation period of 1 year in function. A total of 47 patients with 1 missing tooth in the position of a premolar or molar were recruited. Short (8 mm), 1-piece, zirconia implants were placed and loaded after a healing period of 2 to 4 months with monolithic crowns made of 3 different materials. Implants were followed up for one year and clinically and radiologically assessed. A total of 46 implants were placed. One was excluded since no primary stability was achieved at implant placement. At the 1-year follow-up, mean marginal bone loss 1 year after loading was 0.05 ± 0.47 mm. None of the implants showed marginal bone loss greater than 1 mm or clinical signs of peri-implantitis. A total of 2 implants were lost during the healing phase and another after loading, resulting in a survival rate of 93% after 1 year. All lost implants showed a sudden increased mobility with no previous signs of marginal bone loss or peri-implant infection. The short, 8 mm, zirconia implants showed stable marginal bone levels over the short observation period of 1 year. Although they revealed slightly lower survival rates, they can be suggested for the use in sites with reduced vertical bone. Scientific data are very limited, and long-term data are not yet available, and therefore, they are needed

Clinical outcomes of all‐ceramic single crowns and fixed dental prostheses supported by ceramic implants: A systematic review and meta‐analyses

Objective: To analyze the clinical outcomes of all-ceramic single crowns (SCs) and fixed dental prostheses (FDPs) supported by ceramic implants. Materials and methods: Based on a focused question and customized PICO framework, electronic (Medline/EMBASE/Cochrane) and manual searches for studies reporting the clinical outcomes of all-ceramic SCs and FDPs supported by ceramic implants ≥12 months were performed. The primary outcomes were reconstruction survival and the chipping proportion. The secondary outcomes were implant survival, technical complications, and patient-related outcome measurements. Meta-analyses were performed after 1, 2, and 5 years using random-effect meta-analyses. Results: Eight of the 1,403 initially screened titles and 55 full texts were included. Five reported on monolithic lithium disilicate (LS2) SCs, one on veneered zirconia SCs, and two on veneered zirconia SCs and FDPs, which reported all on cement-retained reconstructions (mean observation: 12.0-61.0 months). Meta-analyses estimated a 5-year survival rate of 94% (95% confidence interval [CI]: 82%-100%) for overall implant survival. Reconstruction survival proportions after 5 years were: monolithic LS2, 100% (95%CI: 95%-100%); veneered zirconia SCs, 89% (95%CI: 62%-100%); and veneered zirconia FDPs 94% (95%CI: 81%-100%). The chipping proportion after 5 years was: monolithic LS2, 2% (95%CI: 0%-11%); veneered zirconia SCs, 38% (95%CI: 24%-54%); and veneered zirconia FDPs, 57% (95%CI: 38%-76%). Further outcomes were summarized descriptively. Conclusions: Due to the limited data available, only tendencies could be identified. All-ceramic reconstructions supported by ceramic implants demonstrated promising survival rates after mid-term observation. However, high chipping proportions of veneered zirconia SCs and, particularly, FDPs diminished the overall outcome. Monolithic LS2 demonstrated fewer clinical complications. Monolithic reconstructions could be a valid treatment option for ceramic implants. Keywords: ceramics; dental implants; implant-supported dental prosthesis; meta-analysis; survival analysis; systematic review; treatment outcome; zirconia

Higher traces, noncommutative motives, and the categorified Chern character

We propose a categorification of the Chern character that refines earlier work of Toën and Vezzosi and of Ganter and Kapranov. If X is an algebraic stack, our categorified Chern character is a symmetric monoidal functor from a category of mixed noncommutative motives over X , which we introduce, to S1-equivariant perfect complexes on the derived free loop stack LX. As an application of the theory, we show that Toën and Vezzosi's secondary Chern character factors through secondary K -theory. Our techniques depend on a careful investigation of the functoriality of traces in symmetric monoidal (?,n)-categories, which is of independent interest. MSC 14F05; 18D05; 19D5

Selective redox regulation of cytokine receptor signaling by extracellular thioredoxin-1

The thiol-disulfide oxidoreductase thioredoxin-1 (Trx1) is known to be secreted by leukocytes and to exhibit cytokine-like properties. Extracellular effects of Trx1 require a functional active site, suggesting a redox-based mechanism of action. However, specific cell surface proteins and pathways coupling extracellular Trx1 redox activity to cellular responses have not been identified so far. Using a mechanism-based kinetic trapping technique to identify disulfide exchange interactions on the intact surface of living lymphocytes, we found that Trx1 catalytically interacts with a single principal target protein. This target protein was identified as the tumor necrosis factor receptor superfamily member 8 (TNFRSF8/CD30). We demonstrate that the redox interaction is highly specific for both Trx1 and CD30 and that the redox state of CD30 determines its ability to engage the cognate ligand and transduce signals. Furthermore, we confirm that Trx1 affects CD30-dependent changes in lymphocyte effector function. Thus, we conclude that receptor–ligand signaling interactions can be selectively regulated by an extracellular redox catalyst

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

All-ceramic single crowns supported by zirconia implants: 5-year results of a prospective multicenter study

OBJECTIVES To assess survival/success rates and patient-reported outcome of zirconia-based posterior single crowns (SCs) supported by zirconia implants in a prospective two-center study after five years of observation. MATERIAL AND METHODS Forty-five patients were restored with 45 zirconia implant-supported posterior SCs composed of zirconia frameworks hand-layered with a leucite-reinforced feldspathic ceramic. Survival rates of SCs were assessed and technical success was evaluated according to modified United States Public Health Care (USPHS) criteria. Furthermore, patient-reported outcome measures (PROMs) were assessed by applying visual analog scales (VAS). Wilcoxon matched-pairs signed-rank test, mixed-effects ordered logistic regression, and linear mixed models were used to evaluate time effects on response variables. RESULTS Forty patients were available after a mean observation period of 61.0 ± 1.4 months. One SC had to be replaced, resulting in a Kaplan-Meier (KM) survival estimate for the SCs of 97.5 ± 2.47%. Since nine reconstructions showed at least in one category a major deviation from the ideal (five major chippings, four with increased occlusal roughness, one significant crevice, and one pronounced over-contouring), the KM success estimate was 79.3 ± 5.8%. Incidence of chipping (n = 19) and occlusal roughness (n = 35) was frequent (p < 0.001). All PROMs at prosthetic delivery except for speech (p = 0.139) showed significantly improved VAS scores (81%-94%; p < 0.001) compared to pre-treatment evaluations. Thereafter, no decrease in satisfaction could be observed until the 5-year follow-up (93%-97%). CONCLUSION Veneered zirconia-based SCs supported by zirconia implants showed high survival rates and highly satisfied patients' needs. However, significant incidence of technical complications is compromising the clinical long-term outcome for this indication

Zirconia implants restored with single crowns or fixed dental prostheses: 5-year results of a prospective cohort investigation

AIM: To evaluate the clinical and radiological outcomes of one-piece zirconia implants restored with single crowns (SCs) or fixed dental prostheses (FDPs) over an observation period of 5 years in function. MATERIALS AND METHODS: In a prospective cohort investigation with two investigational centers, one-piece zirconia implants were placed in anterior and posterior sites. After a healing period of at least 2 months in the mandible and 4 months in the maxilla with immediate provisional reconstructions, the final all-ceramic SCs or three-unit FDPs were cemented. Patients were followed for 5 years. Clinical parameters and radiological measurements of the implants and the neighboring teeth were assessed. For the statistical analysis, linear mixed models were applied. RESULTS: A total of 71 implants were placed in 60 patients. Sixty-three implants in 53 patients could be evaluated at the 5-year follow-up. Six patients with a total of seven implants were counted as dropouts. One implant did not achieve adequate osseointegration and had to be removed 5 weeks after implantation. The 5-year survival rate was calculated as 98.4% (95% CI 91.6, 99.9). The mean overall marginal bone loss from implant placement to the 5-year follow-up was 0.7 ± 0.6 mm. After an initial mean marginal loss before loading the implants (0.7 mm), no further statistically significant change in marginal bone level (p = .458) could be observed. CONCLUSION: The investigated one-piece zirconia implant showed a high survival rate, very stable marginal bone, and mucosal margin levels after 5 years in function. Therefore, it can be considered safe and reliable for the reconstruction of implant-supported SCs or FDPs over a mid-term period

Preparation of oval-shaped root canals in mandibular molars using nickel-titanium rotary instruments: a micro-computed tomography study.

INTRODUCTION: This study evaluated the prepared surface areas of oval-shaped canals in distal roots of mandibular molars using four different instrumentation techniques. METHODS: Teeth were prescanned and reconstructed using micro-computed tomography (MCT) scans at low resolution (68 microm). Forty-eight molars with ribbon-shaped/oval distal root canals were selected and randomly assigned to four groups. Distal canals (n = 12 each) were prepared by circumferential filing using Hedström files to apical size #40 (group H/CF); with ProTaper nickel-titanium rotaries to finishing file 4 (F4) considering the distal canal as 1 canal (group PT/1); ProTaper to F4 considering buccal and oral aspects of the distal canal as 2 individual canals (group PT/2); ProTaper to F4 in a circumferential filing motion (PT/CF). Before and after shaping, teeth were evaluated using MCT at 34-microm resolution. The percentage of prepared surface was assessed for the full canal length and the apical 4 mm. Statistical analysis was performed using analysis of variance and Bonferroni/Dunn multiple comparisons. RESULTS: Preoperatively, canal anatomy was statistically similar among the groups (p = 0.56). Mean (+/- standard deviation) untreated areas ranged from 59.6% (+/-14.9, group PT/2) to 79.9% (+/-10.3, PT/1) for the total canal length and 65.2% to 74.7% for the apical canal portion, respectively. Canals in group PT/1 had greater untreated surface areas (p \u3c 0.01) than groups PT/2 and PT/CF. Among all groups, amounts of treated surface areas were statistically similar in the apical 4 mm. CONCLUSIONS: Preparations of oval-shaped root canals in mandibular molars left a variable portion of surface area unprepared regardless of the instrumentation technique used. However, considering oval canals as two separate entities during preparation appeared to be beneficial in increasing overall prepared surface

Impact of solvent interactions on ¹H and ¹³C chemical shifts investigated using DFT and a reference dataset recorded in CDCl₃ and CCl₄

1H and 13C chemical shifts of 35 small, rigid molecules were measured under standardized conditions in chloroform-d and in tetrachloromethane. The solvent change mainly affects carbon shifts of polar functional groups. This difference cannot be adequately reproduced by DFT calculations in implicit solvent and we suspect specific solvent interactions in CDCl3 to be the reason for this. The new dataset provides an accurate basis for the validation and calibration of shift calculations, especially with respect to improved solvent models.ISSN:1463-9084ISSN:1463-907