Comparison Between Single Early-loaded Implants With Sandblasted Acidetched (Sa) Surface Versus Sa Surface Modified With Ph Buffering Agent (Soi): Four-month Data From a Split-mouth, Multicentre Randomized Controlled Trial

PURPOSE. To compare implant survival and success rates and implant stability quotient (ISQ) values of early-loaded single implants with sandblasted acid-etched (SA, control group) surface versus implants with SA surface modified with pH buffering agent (SOI, test group). MATERIALS AND METHODS. This study was designed as multicentre, split-mouth, randomized controlled trial to evaluate implant and prosthesis survival rates, complications, and implant stability quotient (ISQ) in any partially edentulous subject requiring at least two single implant-supported crowns. A one-stage implant placement procedure was used, and implants were randomized after implant site preparation. ISQ values were eva-luated for each implant, at baseline and then every week up to 8 weeks after surgery, and finally at definitive crown delivery (12 weeks after implant placement). RESULTS. Overall, 62 patients from 9 centres were enrolled in this study. One patient dropped out from the study at 8 weeks. In the first 12 weeks of observation, 2 implants failed, both in the SA group, the difference not being statistically significant (P = 0.5). No prosthesis failure occurred up to 4 months after fitting. Five complications were expe-rienced, 3 in the SA group and 2 in the SOI group. The difference between groups was not statistically significant (OR = 0.66, 95% CI: 0.11 to 4.07; P = 0.650). Of these complications, loss of stability without rotation was observed in 2 implants from the SOI group and 2 implants from the SA group, all in the third and fourth weeks of measurements. All the implants were submerged and successfully osseointegrated at the twelfth week. The last complication was an SA implant screw loosening, which was resolved chair-side. The baseline mean ISQ values were 76.57 ± 7.54 (95% CI 74.69 to 78.44) in the SA group and 75.92 ± 7.69 (95% CI 73.89 to 77.73) in the SOI group. The mean ISQ values at 12 weeks were 79.17 ± 7.83 (95% CI 77.03 to 81.29) and 78.82 ± 8.80 (95% CI 76.42 to 81.21) in the SA and SOI groups, respectively. Mixed-effects modelling revealed a statistically significant difference between groups over time, with slightly lower ISQ values for the SOI group (-0.65; 95% CI-1.14 to-0.15). Statistically significant differences were also estimated among centres (P <0.001). CONCLUSIONS. Within the limitations of the present preliminary report, it is possible to conclude that both implants can be successfully loaded early

Digital Workflow for Prosthetically Driven Implants Placement and Digital Cross Mounting: A Retrospective Case Series

Fully digital workflow in implant dentistry is ever increasing. Treatment of partial edentulous cases is well-documented; nevertheless, complete edentulous cases are still a challenge. To present several innovations in the treatment of complete edentulous patients using digital solutions, both for implant placement and restoration delivery, was the objective of this study. It was designed as a retrospective case series study, aimed to tune further research with larger sample size, and a longer follow-up. Patients requiring complete, implant-supported restoration were asked to participate in this study. Enrolled patients were treated with four implants, immediate loading and a definitive complete arch restoration. Patients were treated using computer-assisted, template-based surgery. Multi-piece surgical templates were used to accurately place the implants, to manage the bone if needed and to make immediate loading procedure quicker and easier. After osseointegration period, definitive, extra-oral, digital impressions were taken using newly developed scan analogs, connected in the patient mouth using temporary cylinders and stabilized by means of the low-shrinkage, flowable, resin composite. Outcomes were implant and prosthesis survival rate, complications, accuracy, and patient satisfaction. Radiographic evaluation performed with a preliminary, radiopaque aluminum try-in, was used to test the accuracy of the digital impressions. Overall, 20 implants were placed in five patients. All the implants osseointegrated without complications. One impression was taken a second time due to inaccuracy of the aluminum tray-in. Finally, all of the patients were completely satisfied with both surgical and prosthetic procedures. Within the limitations of this case series, multi-piece surgical templates showed promising results improving the clinician’s confidence in the case of bone reduction, post-extractive implants and immediate loading. The prosthetic template increased the trueness of the digital impression for complete edentulous patients. Finally, even if an impression was performed again, the scan-analog used for extra-oral chair-side digital impressions seemed to be a promising tool. Continuous improvements and further study are needed to confirm these preliminary results

Development of low blood glucose readings in nine non-diabetic patients treated with tumor necrosis factor-alpha inhibitors: a case series

<p>Abstract</p> <p>Introduction</p> <p>Treatment with various biological agents in disease states such as rheumatoid arthritis has been associated with multiple side effects. Whereas many of these are frequently reported in the literature, hypoglycemia, a possible side effect of tumor necrosis factor-alpha inhibitors, may be underpublicized.</p> <p>Case presentation</p> <p>We report nine cases of non-diabetic Caucasian women who were between 29 and 68 years of age and who developed low glucose readings after treatment with tumor necrosis factor-alpha inhibitors. We provide a more detailed discussion of existing evidence of the role of tumor necrosis factor-alpha in the pathogenesis of inflammation and its impact on glycemic equilibrium.</p> <p>Conclusions</p> <p>Physicians using tumor necrosis factor-alpha inhibitors in the treatment of various rheumatic and other autoimmune diseases should be aware of the potential for the development of glycemic disturbance in these patients. A further role of tumor necrosis factor-alpha inhibitors in the glycemic equilibrium warrants larger controlled trials in patients with and those without a history of diabetes.</p

In vitro and in vivo studies on biocompatibility of carbon fibres

In the present study we focused on the in vitro and in vivo evaluation of two types of carbon fibres (CFs): hydroxyapatite modified carbon fibres and porous carbon fibres. Porous CFs used as scaffold for tissues regeneration could simultaneously serve as a support for drug delivery or biologically active agents which would stimulate the tissue growth; while addition of nanohydroxyapatite to CFs precursor can modify their biological properties (such as bioactivity) without subsequent surface modifications, making the process cost and time effective. Presented results indicated that fibre modification with HAp promoted formation of apatite on the fibre surface during incubation in simulated body fluid. The materials biocompatibility was determined by culturing human osteoblast-like cells of the line MG 63 in contact with both types of CFs. Both tested materials gave good support to adhesion and growth of bone-derived cells. Materials were implanted into the skeletal rat muscle and a comparative analysis of tissue reaction to the presence of the two types of CFs was done. Activities of marker metabolic enzymes: cytochrome c oxidase (CCO) and acid phosphatase were examined to estimate the effect of implants on the metabolic state of surrounding tissues. Presented results evidence the biocompatibility of porous CFs and activity that stimulates the growth of connective tissues. In case of CFs modified with hydroxyapatite the time of inflammatory reaction was shorter than in case of traditional CFs

Informational entropy : a failure tolerance and reliability surrogate for water distribution networks

Evolutionary algorithms are used widely in optimization studies on water distribution networks. The optimization algorithms use simulation models that analyse the networks under various operating conditions. The solution process typically involves cost minimization along with reliability constraints that ensure reasonably satisfactory performance under abnormal operating conditions also. Flow entropy has been employed previously as a surrogate reliability measure. While a body of work exists for a single operating condition under steady state conditions, the effectiveness of flow entropy for systems with multiple operating conditions has received very little attention. This paper describes a multi-objective genetic algorithm that maximizes the flow entropy under multiple operating conditions for any given network. The new methodology proposed is consistent with the maximum entropy formalism that requires active consideration of all the relevant information. Furthermore, an alternative but equivalent flow entropy model that emphasizes the relative uniformity of the nodal demands is described. The flow entropy of water distribution networks under multiple operating conditions is discussed with reference to the joint entropy of multiple probability spaces, which provides the theoretical foundation for the optimization methodology proposed. Besides the rationale, results are included that show that the most robust or failure-tolerant solutions are achieved by maximizing the sum of the entropies

Diversity of a cytokinin dehydrogenase gene in wild and cultivated barley

The cytokinin dehydrogenase gene HvCKX2.1 is the regulatory target for the most abundant heterochromatic small RNAs in drought-stressed barley caryopses. We investigated the diversity of HvCKX2.1 in 228 barley landraces and 216 wild accessions and identified 14 haplotypes, five of these with ten or more members, coding for four different protein variants. The third largest haplotype was abundant in wild accessions (51 members), but absent from the landrace collection. Protein structure predictions indicated that the amino acid substitution specific to haplotype 3 could result in a change in the functional properties of the HvCKX2.1 protein. Haplotypes 1–3 have overlapping geographical distributions in the wild population, but the average rainfall amounts at the collection sites for haplotype 3 plants are significantly higher during November to February compared to the equivalent data for plants of haplotypes 1 and 2. We argue that the likelihood that haplotype 3 plants were excluded from landraces by sampling bias that occurred when the first wild barley plants were taken into cultivation is low, and that it is reasonable to suggest that plants with haplotype 3 are absent from the crop because these plants were less suited to the artificial conditions associated with cultivation. Although the cytokinin signalling pathway influences many aspects of plant development, the identified role of HvCKX2.1 in the drought response raises the possibility that the particular aspect of cultivation that mitigated against haplotype 3 relates in some way to water utilization. Our results therefore highlight the possibility that water utilization properties should be looked on as a possible component of the suite of physiological adaptations accompanying the domestication and subsequent evolution of cultivated barley

Incidence and Tracking of Escherichia coli O157:H7 in a Major Produce Production Region in California

Fresh vegetables have become associated with outbreaks caused by Escherichia coli O157:H7 (EcO157). Between 1995–2006, 22 produce outbreaks were documented in the United States, with nearly half traced to lettuce or spinach grown in California. Outbreaks between 2002 and 2006 induced investigations of possible sources of pre-harvest contamination on implicated farms in the Salinas and San Juan valleys of California, and a survey of the Salinas watershed. EcO157 was isolated at least once from 15 of 22 different watershed sites over a 19 month period. The incidence of EcO157 increased significantly when heavy rain caused an increased flow rate in the rivers. Approximately 1000 EcO157 isolates obtained from cultures of>100 individual samples were typed using Multi-Locus Variable-number-tandem-repeat Analysis (MLVA) to assist in identifying potential fate and transport of EcO157 in this region. A subset of these environmental isolates were typed by Pulse Field Gel Electrophoresis (PFGE) in order to make comparisons with human clinical isolates associated with outbreak and sporadic illness. Recurrence of identical and closely related EcO157 strains from specific locations in the Salinas and San Juan valleys suggests that transport of the pathogen is usually restricted. In a preliminary study, EcO157 was detected in water at multiple locations in a low-flow creek only within 135 meters of a point source. However, possible transport up to 32 km was detected during periods of higher water flow associated with flooding. During the 2006 baby spinach outbreak investigation, transport was also detected where water was unlikely to be involved. These results indicate that contamination of the environment is a dynamic process involving multiple sources and methods of transport. Intensive studies of the sources, incidence, fate and transport of EcO157 near produce production are required to determine the mechanisms of pre-harvest contamination and potential risks for human illness