The Periotest Method: Implant-Supported Framework Precision of Fit Evaluation

: In this study, the Periotest instrument was used to measure the precision of fit between cast high noble-metal frameworks and the supporting implants in a patient-simulation model. Three framework conditions and three implant-location variables were used to evaluate the rigidity of the assembly as measured by the Periotest method. The framework variables were (1) one-piece castings (OPC); (2) sectioned-soldered inaccurate castings (SSIC); and (3) sectioned-soldered accurate castings (SSAC). The implant-location variables were right anterior (RA), center (C), and left anterior (LA). Materials and Methods : The patient simulation model used consisted of three self-tapping BrÅnemark implants in a reasonable arch curvature in bovine bone. Three working casts were fabricated from the patient-simulation model using polyvinyl siloxane and tapered impression copings. From the working casts, three sets of three frameworks were fabricated as OPCs, SSICs, and SSACs using type 3 high noble alloy. The SSICs were fabricated with a quantitative misfit of 101.6 Μm at the facial surface, between the abutment-to-gold cylinder interface at the C implant location. Periotest value (PTV) measurements were made at the midfacial surface of the frameworks directly above each abutment-to-gold cylinder interface. Three measurements were made for each test condition. The data were analyzed to compare framework condition(s) and implant location(s) using ANOVA and Fisher's Protected Least Significant Difference Comparison Test. Results : The ANOVA showed that significant differences exist between the mean PTV data for framework condition and for implant location (p < .01). Significant differences were shown between the mean PTV data for the SSAC assemblies and the OPC and SSIC assemblies. The SSICs displayed a more positive (+) mean PTV than the OPCs. The OPC assemblies had a more positive mean PTV than the SSAC assemblies. The mean PTV data for the SSAC assemblies had a significantly different PTV (p < .01) than the other two framework condition assemblies. The OPC and the SSIC assemblies had PTVs that were not significantly different. The C implant location was significantly different from the RA and the LA implant locations (p < .01). The RA and the LA implant locations were not significantly different from each other. The C implant location always demonstrated the most positive mean PTV regardless of the framework condition being tested. Conclusions : The Periotest instrument quantified differences in the precision of fit between three framework conditions. The SSAC assemblies were significantly more rigid than the OPC and SSIC assemblies. The OPC and SSIC assemblies' mean PTVs were not significantly different. The mean PTVs for the C implant location and the RA and LA implant locations were significantly different (p < .01). The mean PTVs of the RA and LA implant locations were not significantly different. The implant-location PTVs followed the same rank order for all three framework conditions. The procedures used to fabricate a more precise fit between the framework and the supporting implants is influenced by the skill of the clinician and technician.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75096/1/j.1532-849X.1996.tb00298.x.pd

Is the northern high-latitude land-based CO2 sink weakening?

Author Posting. © American Geophysical Union, 2011. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Global Biogeochemical Cycles 25 (2011): GB3018, doi:10.1029/2010GB003813.Studies indicate that, historically, terrestrial ecosystems of the northern high-latitude region may have been responsible for up to 60% of the global net land-based sink for atmospheric CO2. However, these regions have recently experienced remarkable modification of the major driving forces of the carbon cycle, including surface air temperature warming that is significantly greater than the global average and associated increases in the frequency and severity of disturbances. Whether Arctic tundra and boreal forest ecosystems will continue to sequester atmospheric CO2 in the face of these dramatic changes is unknown. Here we show the results of model simulations that estimate a 41 Tg C yr−1 sink in the boreal land regions from 1997 to 2006, which represents a 73% reduction in the strength of the sink estimated for previous decades in the late 20th century. Our results suggest that CO2 uptake by the region in previous decades may not be as strong as previously estimated. The recent decline in sink strength is the combined result of (1) weakening sinks due to warming-induced increases in soil organic matter decomposition and (2) strengthening sources from pyrogenic CO2 emissions as a result of the substantial area of boreal forest burned in wildfires across the region in recent years. Such changes create positive feedbacks to the climate system that accelerate global warming, putting further pressure on emission reductions to achieve atmospheric stabilization targets.This study was supported through grants provided as part of the Arctic System Science Program (NSF OPP‐ 0531047), the North American Carbon Program (NASA NNG05GD25G), and the Bonanza Creek Long‐Term Ecological Program (funded jointly by NSF grant DEB‐0423442 and USDA Forest Service, Pacific Northwest Research Station grant PNW01‐JV11261952‐231)

Clinical management and microscopic characterisation of fatique-induced failure of a dental implant. Case report

BACKGROUND: Osseointegrated endosseous implants are widely used for the rehabilitation of completely and partially edentulous patients, being the final prosthodontic treatment more predictable and the failures extremely infrequent. A case of fracture of an endosseous dental implant, replacing the maxillary first molar, occurring in a middle-age woman, 5 years after placement is reported. MATERIALS AND METHODS: The difficult management of this rare complication of implant dentistry together with the following rehabilitation is described. Additionally, the authors performed an accurate analysis of the removed fractured implant both by the stereomicroscope and by the confocal laser scanning microscope. RESULTS AND DISCUSSION: The fractured impant showed the typical signs of a fatigue-induced fracture in the coronal portion of the implant together with numerous micro-fractures in the apical one. Three dimensional imaging performed by confocal laser scanning microscope led easily to a diagnosis of "fatigue fracture" of the implant. The biomechanical mechanism of implant fractures when overstress of the implant components due to bending overload is discussed. CONCLUSION: When a fatigue-induced fracture of an dental implant occurs in presence of bending overload, the whole implant suffers a deformation that is confirmed by the alterations (micro-fractures) of the implant observable also in the osseointegrated portion that is easily appraisable by the use of stereomicroscope and confocal laser scanning microscope without preparation of the sample

Comparative analysis of collagen membranes for the treatment of implant dehiscence defects

Guided bone regeneration (GBR) evolved from the concept of guided tissue regeneration (GTR) and has been used for reconstructing sites with bone deficiencies associated with dental implants. For GBR, the use of absorbable collagen membranes has been increasing, but, at present, scientific information on the use of collagen membranes for GBR is limited. This study was aimed to clinically and histomorphometrically compare two collagen membranes, Bio-Gide ® and BioMend Extend TM , for the treatment of implant dehiscence defects in eight mongrel dogs. Implant dehiscence defects were surgically created in edentulous ridges, followed by the placement of three endosseous implants bilaterally in the mandible. Each implant dehiscence defect was randomly assigned to one of three treatment groups: (1) control (no membrane), (2) porcine dermis collagen barrier (Bio-Gide) or (3) bovine tendon collagen barrier (BioMend Extend). Dogs were sacrificed at 4 and 16 weeks (four dogs each) after treatment. Histomorphometric analysis included percentage linear bone fill (LF), new bone-to-implant contact (BIC) and area of new bone fill (BF). The results of the study revealed no significant differences among groups for any parameter at 4 weeks. However, at 16 weeks, more LF, BIC, and BF were noted in the membrane-treated groups than controls. BioMend Extend-treated defects demonstrated significantly greater BIC than control ( P  < 0.05) at this time point. BIC at 16 weeks was significantly greater than 4-week BIC ( P  < 0.05). Membrane exposure occurred in 9 out of 15 sites examined, resulting in significantly less LF and BIC than the sites without membrane exposure ( P  < 0.05). The results of this study indicate that: (1) GBR treatment with collagen membranes may significantly enhance bone regeneration, manifested at late stage (16 weeks) of healing; and (2) space maintenance and membrane coverage were the two most important factors affecting GBR using bioabsorbable collagen membranes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72252/1/j.1600-0501.2003.140111.x.pd

The role of historical fire disturbance in the carbon dynamics of the pan-boreal region : a process-based analysis

Author Posting. © American Geophysical Union, 2007. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 112 (2007): G02029, doi:10.1029/2006JG000380.Wildfire is a common occurrence in ecosystems of northern high latitudes, and changes in the fire regime of this region have consequences for carbon feedbacks to the climate system. To improve our understanding of how wildfire influences carbon dynamics of this region, we used the process-based Terrestrial Ecosystem Model to simulate fire emissions and changes in carbon storage north of 45°N from the start of spatially explicit historically recorded fire records in the twentieth century through 2002, and evaluated the role of fire in the carbon dynamics of the region within the context of ecosystem responses to changes in atmospheric CO2 concentration and climate. Our analysis indicates that fire plays an important role in interannual and decadal scale variation of source/sink relationships of northern terrestrial ecosystems and also suggests that atmospheric CO2 may be important to consider in addition to changes in climate and fire disturbance. There are substantial uncertainties in the effects of fire on carbon storage in our simulations. These uncertainties are associated with sparse fire data for northern Eurasia, uncertainty in estimating carbon consumption, and difficulty in verifying assumptions about the representation of fires that occurred prior to the start of the historical fire record. To improve the ability to better predict how fire will influence carbon storage of this region in the future, new analyses of the retrospective role of fire in the carbon dynamics of northern high latitudes should address these uncertainties.Funding for this study was provided by grants from the National Science Foundation Biocomplexity Program (ATM-0120468) and Office of Polar Programs (OPP-0531047 and OPP- 0327664); the National Aeronautics and Space Administration Land Cover Land Use Change Program (NAF-11142) and North America Carbon Program (NNG05GD25G); the Bonanza Creek LTER (Long-Term Ecological Research) Program (funded jointly by NSF grant DEB-0423442 and USDA Forest Service, Pacific Northwest Research Station grant PNW01- JV11261952-231); and the U.S. Geological Survey

Global Pyrogeography: the Current and Future Distribution of Wildfire

Climate change is expected to alter the geographic distribution of wildfire, a complex abiotic process that responds to a variety of spatial and environmental gradients. How future climate change may alter global wildfire activity, however, is still largely unknown. As a first step to quantifying potential change in global wildfire, we present a multivariate quantification of environmental drivers for the observed, current distribution of vegetation fires using statistical models of the relationship between fire activity and resources to burn, climate conditions, human influence, and lightning flash rates at a coarse spatiotemporal resolution (100 km, over one decade). We then demonstrate how these statistical models can be used to project future changes in global fire patterns, highlighting regional hotspots of change in fire probabilities under future climate conditions as simulated by a global climate model. Based on current conditions, our results illustrate how the availability of resources to burn and climate conditions conducive to combustion jointly determine why some parts of the world are fire-prone and others are fire-free. In contrast to any expectation that global warming should necessarily result in more fire, we find that regional increases in fire probabilities may be counter-balanced by decreases at other locations, due to the interplay of temperature and precipitation variables. Despite this net balance, our models predict substantial invasion and retreat of fire across large portions of the globe. These changes could have important effects on terrestrial ecosystems since alteration in fire activity may occur quite rapidly, generating ever more complex environmental challenges for species dispersing and adjusting to new climate conditions. Our findings highlight the potential for widespread impacts of climate change on wildfire, suggesting severely altered fire regimes and the need for more explicit inclusion of fire in research on global vegetation-climate change dynamics and conservation planning

Long-term kidney function recovery and mortality after COVID-19-associated acute kidney injury: An international multi-centre observational cohort study

Background: While acute kidney injury (AKI) is a common complication in COVID-19, data on post-AKI kidney function recovery and the clinical factors associated with poor kidney function recovery is lacking. Methods: A retrospective multi-centre observational cohort study comprising 12,891 hospitalized patients aged 18 years or older with a diagnosis of SARS-CoV-2 infection confirmed by polymerase chain reaction from 1 January 2020 to 10 September 2020, and with at least one serum creatinine value 1–365 days prior to admission. Mortality and serum creatinine values were obtained up to 10 September 2021. Findings: Advanced age (HR 2.77, 95%CI 2.53–3.04, p < 0.0001), severe COVID-19 (HR 2.91, 95%CI 2.03–4.17, p < 0.0001), severe AKI (KDIGO stage 3: HR 4.22, 95%CI 3.55–5.00, p < 0.0001), and ischemic heart disease (HR 1.26, 95%CI 1.14–1.39, p < 0.0001) were associated with worse mortality outcomes. AKI severity (KDIGO stage 3: HR 0.41, 95%CI 0.37–0.46, p < 0.0001) was associated with worse kidney function recovery, whereas remdesivir use (HR 1.34, 95%CI 1.17–1.54, p < 0.0001) was associated with better kidney function recovery. In a subset of patients without chronic kidney disease, advanced age (HR 1.38, 95%CI 1.20–1.58, p < 0.0001), male sex (HR 1.67, 95%CI 1.45–1.93, p < 0.0001), severe AKI (KDIGO stage 3: HR 11.68, 95%CI 9.80–13.91, p < 0.0001), and hypertension (HR 1.22, 95%CI 1.10–1.36, p = 0.0002) were associated with post-AKI kidney function impairment. Furthermore, patients with COVID-19-associated AKI had significant and persistent elevations of baseline serum creatinine 125% or more at 180 days (RR 1.49, 95%CI 1.32–1.67) and 365 days (RR 1.54, 95%CI 1.21–1.96) compared to COVID-19 patients with no AKI. Interpretation: COVID-19-associated AKI was associated with higher mortality, and severe COVID-19-associated AKI was associated with worse long-term post-AKI kidney function recovery. Funding: Authors are supported by various funders, with full details stated in the acknowledgement section

International comparisons of laboratory values from the 4CE collaborative to predict COVID-19 mortality

Given the growing number of prediction algorithms developed to predict COVID-19 mortality, we evaluated the transportability of a mortality prediction algorithm using a multi-national network of healthcare systems. We predicted COVID-19 mortality using baseline commonly measured laboratory values and standard demographic and clinical covariates across healthcare systems, countries, and continents. Specifically, we trained a Cox regression model with nine measured laboratory test values, standard demographics at admission, and comorbidity burden pre-admission. These models were compared at site, country, and continent level. Of the 39,969 hospitalized patients with COVID-19 (68.6% male), 5717 (14.3%) died. In the Cox model, age, albumin, AST, creatine, CRP, and white blood cell count are most predictive of mortality. The baseline covariates are more predictive of mortality during the early days of COVID-19 hospitalization. Models trained at healthcare systems with larger cohort size largely retain good transportability performance when porting to different sites. The combination of routine laboratory test values at admission along with basic demographic features can predict mortality in patients hospitalized with COVID-19. Importantly, this potentially deployable model differs from prior work by demonstrating not only consistent performance but also reliable transportability across healthcare systems in the US and Europe, highlighting the generalizability of this model and the overall approach