Full Digital Workflow for Prosthetic Full-Arch Immediate Loading Rehabilitation Using OT-Bridge System: A Case Report

Nowadays, digital technologies have brought very important advancements in clinical prosthetic dentistry. However, a full digital workflow is still considered to be challenging in the management of full-arch implant cases with immediate prosthetic loading. The aim of this case report is to show a full-digital workflow for the fabrication of an implant-prosthetic fixed provisional prosthesis for immediate loading on seven implants in the upper maxilla. The static guided implant surgery and the OT Bridge prosthetic system were used to rehabilitate the patient. In this way, the combination of a well-known surgical technique with a peculiar prosthetic system that allows for a certain degree of tolerance resulted in it being useful for full-arch immediate loading. Future research and studies are necessary to prove the reliability of this full-digital protocol

The Interplay of Lipids, Lipoproteins, and Immunity in Atherosclerosis

Purpose of Review: Atherosclerosis is an inflammatory disorder of the arterial wall, in which several players contribute to the onset and progression of the disease. Besides the well-established role of lipids, specifically cholesterol, and immune cell activation, new insights on the molecular mechanisms underlying the atherogenic process have emerged. Recent Findings: Meta-inflammation, a condition of low-grade immune response caused by metabolic dysregulation, immunological memory of innate immune cells (referred to as “trained immunity”), cholesterol homeostasis in dendritic cells, and immunometabolism, i.e., the interplay between immunological and metabolic processes, have all emerged as new actors during atherogenesis. These observations reinforced the interest in directly targeting inflammation to reduce cardiovascular disease. Summary: The novel acquisitions in pathophysiology of atherosclerosis reinforce the tight link between lipids, inflammation, and immune response, and support the benefit of targeting LDL-C as well as inflammation to decrease the CVD burden. How this will translate into the clinic will depend on the balance between costs (monoclonal antibodies either to PCSK9 or to IL-1ß), side effects (increased incidence of death due to infections for anti-IL-1ß antibody), and the benefits for patients at high CVD risk

On the Combined Use of Ground Penetrating Radar and Crack Meter Sensors for Structural Monitoring: Application to the Historical Consoli Palace in Gubbio, Italy

The paper deals with joint use of non-invasive monitoring technologies and civil engineering analysis methods aimed at providing multi-sensing information about the structural health of historical and cultural assets. Specifically, linear variable displacement transducers (LVDT) and ground penetrating radar (GPR) are considered for monitoring a significant crack affecting the Consoli Palace in Gubbio, Italy, precisely one of the walls of the cross-hall leading to the Loggia. In this frame, LVDT is adopted to control horizontal amplitude variations of the crack, while GPR is applied to investigate the wall interior and to detect the occurrence of inner issues related to the visible appearance of the crack on the wall surface. The effectiveness of GPR surveys is improved by means of a microwave tomography-based data processing strategy. The main result is that there is a consistency between the monitoring outputs of LVDT, which allowed us to display the crack widening/contraction due to the seasonal temperature variations, and the fact that no significant changes of the geometry of the inner areas of the walls were observed by the GPR

The New Elderly Patient: A Necessary Upgrade

The elderly individual is becoming the most common patient in clinical practice due to the increasing average life span, especially in developed countries. The current elderly patients are different from those of some decades ago. They usually have an active social life, want to be informed, and are actively involved in the current society with consequent high expectations for medical and dental treatment. However, not all the elderly patients are like this. Some of them show limited financial resources, reduced mental and manual skills, and poor motivation. The purpose of this communication is to make a brief characterization of the new elderly population in view of prosthetic and dental management

Evaluation of Load Distribution in a Mandibular Model with Four Implants Depending on the Number of Prosthetic Screws Used for OT-Bridge System: A Finite Element Analysis (FEA)

In full-arch implant rehabilitations, when the anterior screw abutment channel compromises the aesthetic of the patient, the OT-Bridge system used with its Seeger rings may provide the necessary retention of the prosthesis. However, no studies have evaluated the forces generated at the Seeger level during loading. This Finite Element Analysis aims to investigate the mechanical behavior of Seeger rings in a mandibular model with four implants and an OT-Bridge system, used without one or two anterior prosthetic screws. A 400 N unilateral load was virtually applied on a 7 mm distal cantilever. Two different variables were considered: the constraint conditions using two or three screws instead of four and the three different framework materials (fiberglass reinforced resin, cobalt-chrome, TiAl6V4). The FEA analysis exhibited tensile and compressive forces on the Seeger closest to the loading point. With the resin framework, a tension force on abutment 3.3 generates a displacement from 5 to 10 times greater than that respectively expressed in metal framework materials. In a full-arch rehabilitation with four implants, the case with three prosthetic screws seems to be a safer and more predictable configuration instead of two. Considering the stress value exhibited and the mechanical properties of the Seeger, the presence of only two prosthetic screws could lead to permanent deformation of the Seeger in the screwless abutment closest to the loading point

Qualitative evaluation of the effects of professional oral hygiene instruments on prosthetic ceramic surfaces

During professional hygiene procedures, different instruments used may cause various damage to dental prostheses. Deplaquing and scaling with curettes and ultrasonic instruments may inadvertently increase the surface roughness of the material and the risk of future bacterial adhesion and/or also compromise the marginal seal of the prosthesis. Hence, the aim of this study was to assess the qualitative effects of two types of curettes and one piezoelectric instrument with a stain-less-steel tip on three types of metal-free samples. After treating the samples with different instru-mentations, they were analyzed using the scanning electron microscope and then underwent a qualitative microanalysis by using a spectroscopy machine. All the materials tested in this study have undergone significant changes of their superficial structure after instrumentation both with mechanical and manual instruments. Plastic curettes appeared to be less aggressive than the other in-struments. Disilicate samples show a significantly lower degree of surface glazing erosion com-pared to the zirconia sample with all the instruments used

Social contacts and loneliness in people with psychotic and mood disorders

Background Social relations can be measured through: a) objective indicators, i.e. the number of social contacts in a given time interval or b) subjective indicators, i.e. feelings of loneliness. Comparing subjective and objective indicators in patients with psychotic and mood disorders may help to understand whether diagnosis-specific interventions should be designed for increasing their social relations. In this study we assessed social contacts outside home, work environments and mental health services, which may be increased by these interventions. We also explored feelings of loneliness which could influence readiness of patients to participate in interventions. Methods 100 patients in outpatient mental health care were asked to: a) list their social contacts; b) report their feelings of loneliness on a validated five point Likert scale. Multiple logistic regression models were used to test associations of diagnostic categories with: a) having more than one social contact in the previous week; b) reporting at least moderate feelings of loneliness. Results Patients had on average 1.7 (SD = 1.7) social contacts in the previous week (median = 1.0); 77 patients reported at least moderate feelings of loneliness. Patients with psychotic disorders (n = 30) showed a statistical trend towards having just one or no contacts in the week before the assessment (Odds ratio, OR = 2.246, p =.087). Patients with mood disorders were more likely to report at least moderate feelings of loneliness (OR = 2.798; p <.05). Conclusions Patients with psychotic disorders, compared to those with mood disorders, may be less likely to report feeling lonely although they tend to have less social contacts. Strategies to enhance social relations of people with psychotic disorders may include approaches to increase patients' drive to establish new social contacts and to emotionally support them in this process

Assessment of Preload Loss after Cyclic Loading in the OT Bridge System in an “All-on-Four” Rehabilitation Model in the Absence of One and Two Prosthesis Screws

The aim of this study was to evaluate the stability of prosthetic screws after applying cyclic loadings in an “all-on-four” rehabilitation model with the OT Bridge system. The model was tested both with and without anterior screws. Four implant analogues following the “all-on-four” concept were inserted in an edentulous mandibular resin model. An OT Bridge system with a Cr–Co prosthetic framework was fabricated. Depending on the presence or absence of one or two anterior screws on the implant analogues, three groups were created, i.e., Gr.1: three tightening screws, Gr.2: two tightening screws, Control Group: four tightening screws. Each single group underwent subsequent 400,000 cyclic loads, simulating approximately a year of chewing by using a dynamometer machine. This cycle was repeated five times for each group, and preload loss values were evaluated on each prosthetic screw after each cycle. All the data obtained were analyzed by one-way ANOVA and Student’s t-test. No statistically significant differences after intragroup analysis were found. A statistically significant difference within the Gr.1 between the screws in positions 33 and 36, equal to 15.2% (p-value = 0.0176), was found. The OT Bridge seems a useful system to maintain the retention of a prosthesis during mechanical stress conditions even in the absence of one screw in an “all-on-four” rehabilitation. This could represent a good solution to solve the esthetic problem of the screw buccal access hole for fixed solutions