Interventions for dental implant placement in atrophic edentulous mandibles: vertical bone augmentation and alternative treatments. A meta-analysis of randomized clinical trials

Background: the purpose of the current study is to assess which vertical bone augmentation techniques are most effective for restoring atrophic posterior areas of the mandible with dental implants and compare these procedures with alternative treatments.Methods: electronic literature searches in PubMed (MEDLINE), Ovid, and the Cochrane Library were conducted to identify all relevant articles published up to July 1, 2015. Eligibility was based on inclusion criteria, and quality assessments were conducted. The primary outcome variables were implant and prosthetic failure. After data extraction, meta-analyses were performed.Results: out of 527 potentially eligible papers, 14 randomized clinical trials were included. Out of these 14 studies, four trials assessed short implants (5 to 8 mm) as an alternative to vertical bone augmentation in sites with a residual ridge height of 5 to 8 mm. No statistically significant differences were found in implant (odds ratio [OR]: 1.02; 95% confidence interval [CI]: 0.31 to 3.31; P = 0.98; I-2: 0%) or prosthetic failure (OR: 0.64; 95% CI: 0.21 to 1.96; P = 0.43; I-2: 0%) after 12 months of loading. However, complications at treated sites increased with the augmentation procedures (OR: 8.33; 95% CI: 3.85 to 20.0; P < 0.001; I2: 0%). There was no evidence of any vertical augmentation procedure being of greater benefit than any other for the primary outcomes (implant and prosthetic failure). Conclusions: short implants in the posterior area of the mandible seem to be preferable to vertical augmentation procedures, which present similar implant and prosthetic failure rates but greater morbidity. All the vertical augmentation technique comparisons showed similar intergroup results

Heterosexual oral and anal sex in Kinshasa (D.R.Congo): Data from OKAPI prospective cohort

Background Sexually transmitted infections can be spread through oral and anal heterosexual sex. There are few data on these practices in Sub-Saharan Africa. We analyzed the prevalence of heterosexual oral and anal sex among HIV Voluntary Counseling and Testing (VCT) attendees in Kinshasa and the associated sociodemographics, perceptions and behavioral factors. Methods OKAPI (Observational Kinshasa AIDS Prevention Initiative) prospective cohort study. It evaluates the VCT impact on HIV-related knowledge and behaviors at 6 and 12-month follow-up. Since April 2016 until April 2018, 797 persons aged 15–59 years were HIV tested and replied to a baseline interview, including information about anal and oral sex. Descriptive, bi- and multivariate analyses were performed using baseline data. Results Among 718 sexually active participants reporting heterosexual sex, 59% had had oral sex, 22% anal sex and 18% both practices. Among participants reporting “not” having had sex, 6% reported oral sex, 3% anal sex and 1% both. Oral sex was associated with a daily use of the Internet/mobile phone, perceiving low community HIV risk, reporting HIV-related behaviors (multiple partners, inconsistent condom use, anal, paid and forced sex) and having been pregnant. Being married-monogamous was inversely associated with oral sex. Anal sex was directly associated with having other risk sexual behaviors. Conclusions Oral and anal sex were common among people reporting heterosexual sex in Kinshasa. Perceiving a low community HIV risk and having other sexual risk behaviors are associated with these practices, which are commonly not considered as risky despite their strong association with HIV/STIs. They need to be considered when designing preventive strategies in Kinshasa

Male condom use, multiple sexual partners and HIV: a prospective case-control study in Kinshasa (DRC)

In the Democratic Republic of Congo no previous studies have assessed the factors associated with different patterns of condom use and with multiple sexual partners and the association between condom use simultaneously taking into account multiple sexual partnerships, and HIV infection. We carried out a prospective case-control study. From December 2010 until June 2012, 1,630 participants aged 15-49 getting HIV Voluntary Counseling and Testing in a hospital in Kinshasa were selected. Cases were new HIV diagnosis and controls were HIV-negative participants detected along the study period. We recruited 274 cases and 1,340 controls that were interviewed about HIV-related knowledge, attitudes and behaviours. Among cases there was a high prevalence of multiple lifetime and concurrent sexual partnerships (89.8% and 20.4%, respectively) and most cases never used condoms with only 1.5% using them consistently. Condom use and multiple partnerships were associated with male, single and high-educated participants. An association was found between multiple lifetime partners and `any condom use´ (OR=2.99; 95%CI: 2.14-4.19) but not with consistent use. Both having two or more multiple concurrent sexual partners or not using condoms were variables similarly and highly associated to HIV risk. The association found between having two or more concurrent sexual partners and HIV was slightly higher (OR=3.58, 95%CI:2.31-5-56) than the association found between never condom use and HIV (OR=3.38, 95%CI:1.15-9.93). We found a high prevalence of multiple lifetime sexual partners and an extremely high prevalence of inconsistent condom use, both strongly associated with HIV seropositivity. Local programs would benefit from comprehensive interventions targeting all behavioural and sociocultural determinants

Misconceptions about HIV infection in Kinshasa (Democratic Republic of Congo): a Case-control Study on knowledge, attitudes and practices

Objectives: To evaluate the prevalence of HIV-related misconceptions in an Outpatient Centre of Kinshasa (D.R.Congo) and analyze the association between these beliefs and HIV infection. Methods: A case-control study was carried out from December 2010 until June 2012. We assessed 1,630 participants aged 15-49 attending a primary outpatient centre in Kinshasa: 762 HIV Voluntary Counseling and Testing attendees and 868 blood donors. A 59-item questionnaire about knowledge, attitudes and practice was administered during a face-to-face interview, followed by an HIV test. Cases and controls were respondents with a newly diagnosed HIV positive or negative test, respectively. Unconditional logistic regression was used to analyse the association between misconceptions and HIV seropositivity. Results:Two hundred and seventy four cases and 1,340 controls were recruited. Cases were more likely than controls to have a low socioeconomic status, no education, to be divorced/separated or widowed. An association was found between the following variables and HIV-seropositivity: having a poor HIV knowledge (adjusted OR=2.79; 95%CI:1.43-5.45), not knowing a virus is the cause of AIDS (adjusted OR=2.03; 95%CI:1.38-2.98) and reporting more than three HIV-transmission-related misconceptions (adjusted OR=3.30; 95%CI:1.64-6.64), such as thinking an HIV+ person cannot look healthy and that HIV is transmitted by sorcery, God´s punishment, a kiss on the mouth, mosquitoes, coughs/sneezes or undercooked food. Conclusion:Despite having access to health care services, there are still many people in Kinshasa that have HIV-related misconceptions which increase their HIV risk. Our findings underscore the need for a culturally-adapted and gender-orientated basic HIV information into Congolese HIV prevention programs

Interventions for dental implant placement in atrophic edentulous mandibles: vertical bone augmentation and alternative treatments. A meta-analysis of randomized clinical trials

Background: the purpose of the current study is to assess which vertical bone augmentation techniques are most effective for restoring atrophic posterior areas of the mandible with dental implants and compare these procedures with alternative treatments.Methods: electronic literature searches in PubMed (MEDLINE), Ovid, and the Cochrane Library were conducted to identify all relevant articles published up to July 1, 2015. Eligibility was based on inclusion criteria, and quality assessments were conducted. The primary outcome variables were implant and prosthetic failure. After data extraction, meta-analyses were performed.Results: out of 527 potentially eligible papers, 14 randomized clinical trials were included. Out of these 14 studies, four trials assessed short implants (5 to 8 mm) as an alternative to vertical bone augmentation in sites with a residual ridge height of 5 to 8 mm. No statistically significant differences were found in implant (odds ratio [OR]: 1.02; 95% confidence interval [CI]: 0.31 to 3.31; P = 0.98; I-2: 0%) or prosthetic failure (OR: 0.64; 95% CI: 0.21 to 1.96; P = 0.43; I-2: 0%) after 12 months of loading. However, complications at treated sites increased with the augmentation procedures (OR: 8.33; 95% CI: 3.85 to 20.0; P < 0.001; I2: 0%). There was no evidence of any vertical augmentation procedure being of greater benefit than any other for the primary outcomes (implant and prosthetic failure). Conclusions: short implants in the posterior area of the mandible seem to be preferable to vertical augmentation procedures, which present similar implant and prosthetic failure rates but greater morbidity. All the vertical augmentation technique comparisons showed similar intergroup results

Interventions for dental implant placement in atrophic edentulous mandibles: vertical bone augmentation and alternative treatments. A meta-analysis of randomized clinical trials

Background: the purpose of the current study is to assess which vertical bone augmentation techniques are most effective for restoring atrophic posterior areas of the mandible with dental implants and compare these procedures with alternative treatments.Methods: electronic literature searches in PubMed (MEDLINE), Ovid, and the Cochrane Library were conducted to identify all relevant articles published up to July 1, 2015. Eligibility was based on inclusion criteria, and quality assessments were conducted. The primary outcome variables were implant and prosthetic failure. After data extraction, meta-analyses were performed.Results: out of 527 potentially eligible papers, 14 randomized clinical trials were included. Out of these 14 studies, four trials assessed short implants (5 to 8 mm) as an alternative to vertical bone augmentation in sites with a residual ridge height of 5 to 8 mm. No statistically significant differences were found in implant (odds ratio [OR]: 1.02; 95% confidence interval [CI]: 0.31 to 3.31; P = 0.98; I-2: 0%) or prosthetic failure (OR: 0.64; 95% CI: 0.21 to 1.96; P = 0.43; I-2: 0%) after 12 months of loading. However, complications at treated sites increased with the augmentation procedures (OR: 8.33; 95% CI: 3.85 to 20.0; P < 0.001; I2: 0%). There was no evidence of any vertical augmentation procedure being of greater benefit than any other for the primary outcomes (implant and prosthetic failure). Conclusions: short implants in the posterior area of the mandible seem to be preferable to vertical augmentation procedures, which present similar implant and prosthetic failure rates but greater morbidity. All the vertical augmentation technique comparisons showed similar intergroup results

Factors that lead to changes in sexual behaviours after a negative HIV test: protocol for a prospective cohort study in Kinshasa

Background: Considering the high percentage of couples in which one or both members are HIV negative, the frequency of transmission among non-regular partners and the probabilities of non-disclosure, attention should be paid to people getting a negative HIV test at the Voluntary Counseling and Testing (VCT). Research has shown that a negative HIV test may be followed by a change in sexual behaviours. In Sub-Saharan Africa, where most HIV infections occur, there are few studies that have analysed the factors associated with changes in sexual risk behaviours after a negative HIV test at the VCT clinic. The aim of this project is to evaluate the specific factors associated with changes in sexual behaviours, three months after a negative result in an HIV test, and to analyse the effect of counseling and testing on HIV-related knowledge of participants in an outpatient centre of Kinshasa (Democratic Republic of Congo). Methods and design: Prospective cohort study from December 2014 until March 2016. People 15-60 year old that received VCT at Monkole Hospital (Kinshasa) were followed three months after they got a negative HIV test. In a face-to-face interview, participants replied to a baseline and a follow-up research questionnaire on HIV-related knowledge, attitudes and behaviours. At follow-up respondents were also offered a new HIV test and additional HIV counseling. Four hundred and fifteen participants completed the baseline questionnaire and 363 (87 %) came back for their 3-month follow up. Discussion: This is the first longitudinal study in the DRC that evaluates the factors associated with changes in sexual behaviours after a negative HIV test at the VCT. Participants attending the VCT services within a clinical setting are a good study population as they can be good transmitters of preventive information for other people with no access to health facilities

Heterosexual oral and anal sex in Kinshasa (D.R.Congo): Data from OKAPI prospective cohort

Background Sexually transmitted infections can be spread through oral and anal heterosexual sex. There are few data on these practices in Sub-Saharan Africa. We analyzed the prevalence of heterosexual oral and anal sex among HIV Voluntary Counseling and Testing (VCT) attendees in Kinshasa and the associated sociodemographics, perceptions and behavioral factors. Methods OKAPI (Observational Kinshasa AIDS Prevention Initiative) prospective cohort study. It evaluates the VCT impact on HIV-related knowledge and behaviors at 6 and 12-month follow-up. Since April 2016 until April 2018, 797 persons aged 15–59 years were HIV tested and replied to a baseline interview, including information about anal and oral sex. Descriptive, bi- and multivariate analyses were performed using baseline data. Results Among 718 sexually active participants reporting heterosexual sex, 59% had had oral sex, 22% anal sex and 18% both practices. Among participants reporting “not” having had sex, 6% reported oral sex, 3% anal sex and 1% both. Oral sex was associated with a daily use of the Internet/mobile phone, perceiving low community HIV risk, reporting HIV-related behaviors (multiple partners, inconsistent condom use, anal, paid and forced sex) and having been pregnant. Being married-monogamous was inversely associated with oral sex. Anal sex was directly associated with having other risk sexual behaviors. Conclusions Oral and anal sex were common among people reporting heterosexual sex in Kinshasa. Perceiving a low community HIV risk and having other sexual risk behaviors are associated with these practices, which are commonly not considered as risky despite their strong association with HIV/STIs. They need to be considered when designing preventive strategies in Kinshasa