Implant survival and success rates in patients with risk factors: results from a long-term retrospective study with a 10 to 18 years follow-up

OBJECTIVE: Risk factors for implant therapy are represented by all general and local conditions that through various mechanisms can increase either short-term and long-term failure risk. The aim of this study is to assess the implant survival and implant success rates with single and multiple risk factors. PATIENTS AND METHODS: To address the research purpose, a retrospective cohort study was designed and implemented, including a sample of 225 patients with a total of 871 implants placed. The following risk factors were considered: smoking, bruxism, bone augmentation procedures and the presence of load risk (implants with crown/implant relation > 0.8; angulation > 25°; presence of cantilever). Follow-up ranged from 10 years to 18 years (average follow-up 13.6 years). Failures were subdivided into short-term failures, before the prosthetic phase, and long-term failures, after definitive prosthesis. The success criteria published by Albrektsson and Zarb were adopted. A Cox proportional hazard regression model was used to calculate hazard ratio, with a statistically significant p-value <0.05. RESULTS: Out of the 871 implants placed, 138 did not meet the success criteria, (success rate 84.16%), sixty (43.47%) were classified as "early failure" and seventy-eight as "late failure" (56.53%). A total of 70 dental implants were removed, with a survival rate of 91.96%. CONCLUSIONS: The presence of a single risk factor does not imply a marked increase of failure risk. Among the analyzed factors, the one that proved to be the most dangerous was bruxism, even when presented as the only risk factor. Bruxism with load risk proved to be the most dangerous association (success rate 69.23%) and could be included among the absolute contraindications for implant treatment

A randomized clinical trial about presence of pathogenic microflora and risk of peri-implantitis: comparison of two different types of implant-abutment connections

OBJECTIVE: The aim of this in vivo study was to evaluate two different types of implant-abutment connections: screwed connection and cemented connection, analyzing peri-implant bacteria microflora as well as other clinical parameters. PATIENTS AND METHODS: Twenty implants were selected, inserted in 20 patients, 10 with a screwed implant-abutment connection (Group 1) and 10 with a cemented implant-abutment connection (Group 2). The peri-implant microflora was collected, after at least 360 days from the prosthetic rehabilitation, using paper points inserted in peri-implant sulcus for 30 s. Polymerase chain reaction (PCR) Real-time analyzed the presence of 9 bacteria periodontal-pathogens and Candida albicans. RESULTS: Our findings showed that bacteria colonized all Groups analyzed, the average bacterial count was 3.7 E +08 (±1.19) in Group 1, compared to 2.1 E +08 (±0.16) in Group 2; no statistically significant differences were observed (p>0.0.5). In Group 1, however, bacterial colonization of peri-implant sulci was over the pathogenic threshold for 5 bacteria, indicating a high-risk of peri-implantitis. Also in Group 2, results showed a microflora composed by all bacteria analyzed but, in this case, bacterial colonization of peri-implant sulci was over the pathogenic threshold for only 1 bacterium, indicating a lower risk of peri-implantitis. Moreover, clinical parameters (PPD > 3 mm and m SBI > 0) confirmed a greater risk of peri-implantitis in Group 1 compared to Group 2 (p<0.05). CONCLUSIONS: We concluded that, also after only 360 days, implants with screwed connection showed a higher risk of peri-implantitis that implants with cemented connection

Migraine-specific quality of life questionnaire and relapse on medication overuse headache

Background: The management of Medication overuse headache (MOH) represents a difficult challenge for clinicians and headache experts, particularly for the responder rate after a successful withdrawal treatment. The purpose of this study was to investigate the role of demographic and clinical characteristics as well as the score of Migraine-Specific Quality of Life Questionnaire (MSQ), Migraine Disability Questionnaire and Leeds Dependence Questionnaire in predicting a response after a successful withdrawal treatment in patients with MOH. Methods: This ancillary study is part of a randomized trial that demonstrated the safety and the efficacy of a 3-month treatment with sodium valproate (VPA) (800 mg/day vs placebo) in MOH. Demographic and clinical characteristics and questionnaire results were obtained from the entire sample. Results: A significant correlation was found only between MOH relapse and the total MSQ score, the Role Preventive sub-scale and the Emotional Function sub-scale, suggesting a poorer quality of life in non responders. Conclusion: A high MSQ score could be associated with a poor short-term outcome in MOH patients after a successful treatment with detoxification followed by a new treatment

Loss of chondroprotection of medial collagen meniscus implant (CMI) at 20-year follow-up

Objective: The mid-term results of the collagen meniscus implant (CMI) procedure for the replacement of partial meniscus defects have already been described. However, there is a paucity of long-term comparative studies. This study aimed to compare the clinical outcomes, failures, and osteoarthritis progression of patients who underwent partial medial meniscectomy and medial CMI implantation. Methods: Thirty-six nonconsecutive patients with medial meniscus injuries that underwent medial CMI (MCMI) implantation or partial medial meniscectomy (PMM) between 1997 and 2000 were included in a prospective study with an intermediate 10-year follow-up examination and a final follow-up examination at 20-year follow-up. Outcome measures at the 20-year follow-up included the Lysholm score, visual analogue scale (VAS) for pain, International Knee Documentation Committee (IKDC) knee form , and Tegner activity level. Bilateral weight-bearing radiographs were also performed to evaluate hip-knee-angle (HKA) and the medial joint line height (JL). Data regarding complications and failures were also collected. Results: At the 20-year follow-up, 31 patients (83% follow-up rate) with a mean age of 60.7&nbsp;​±&nbsp;​8.9 years were included in the final analysis (21.1&nbsp;​±&nbsp;​1.2 years follow-up). Four reoperations and one failure per group were reported. When comparing the clinical results of the two groups, no difference was found considering the Lysholm score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner, and the IKDC. Moreover, 20 patients underwent radiographic examination (10 MCMI, 10&nbsp;​MM), and no statistically significant difference was reported concerning the JL, HKA, and the presence and incidence of osteoarthritis between the two groups. Conclusion: The CMI implant for partial medial meniscectomy provided good long-term results and a low failure rate. However, differently from the 10 years follow-up, the clinical and the radiological outcomes were not superior compared to the medial meniscectomy group. The present study's result suggests that using a medial scaffold is not chondroprotective. Level of evidence: III, Prospective case-control study

Cerebral gray matter volume in patients with chronic migraine: correlations with clinical features

Abstract Background To date, few MRI studies have been performed in patients affected by chronic migraine (CM), especially in those without medication overuse. Here, we performed magnetic resonance imaging (MRI) voxel-based morphometry (VBM) analyses to investigate the gray matter (GM) volume of the whole brain in patients affected by CM. Our aim was to investigate whether fluctuations in the GM volumes were related to the clinical features of CM. Methods Twenty untreated patients with CM without a past medical history of medication overuse underwent 3-Tesla MRI scans and were compared to a group of 20 healthy controls (HCs). We used SPM12 and the CAT12 toolbox to process the MRI data and to perform VBM analyses of the structural T1-weighted MRI scans. The GM volume of patients was compared to that of HCs with various corrected and uncorrected thresholds. To check for possible correlations, patients’ clinical features and GM maps were regressed. Results Initially, we did not find significant differences in the GM volume between patients with CM and HCs (p &lt; 0.05 corrected for multiple comparisons). However, using more-liberal uncorrected statistical thresholds, we noted that compared to HCs, patients with CM exhibited clusters of regions with lower GM volumes including the cerebellum, left middle temporal gyrus, left temporal pole/amygdala/hippocampus/pallidum/orbitofrontal cortex, and left occipital areas (Brodmann areas 17/18). The GM volume of the cerebellar hemispheres was negatively correlated with the disease duration and positively correlated with the number of tablets taken per month. Conclusion No gross morphometric changes were observed in patients with CM when compared with HCs. However, using more-liberal uncorrected statistical thresholds, we observed that CM is associated with subtle GM volume changes in several brain areas known to be involved in nociception/antinociception, multisensory integration, and analgesic dependence. We speculate that these slight morphometric impairments could lead, at least in a subgroup of patients, to the development and continuation of maladaptive acute medication usage

Le trasformazioni dello spazio urbano: la quarta dimensione nella georeferenziazione dell’iconografia storica di Rome

Se si considera la componente fisica del sistema città come espressione materiale dell’insieme dei fenomeni evolutivi dei luoghi, appare evidente come la sua rappresentazione possa essere considerata come sistema di conoscenza generale in grado di manifestare una convergenza di informazioni di natura altamente eterogenea. Le vaste trasformazioni che hanno interessato le città nella storia hanno determinato una evoluzione non solo nelle modifiche morfologiche degli assetti territoriali e nella stratificazione architettonica delle strutture urbane, ma anche nella percezione e fruizione degli spazi urbani. Se si considera l’organizzazione dello spazio urbano come ambito di relazione tra gli uomini, i contributi che provengono dalle fonti bibliografiche, iconografiche e cartografiche in particolare possono consentire la ricostruzione diacronica dei tessuti urbani. Questa ricostruzione è resa possibile dalla lettura delle diverse rappresentazioni che della città sono state date nel tempo, come rappresentazioni iconografiche o pittoriche, talvolta simboliche se non addirittura metaforiche, che consentono di acquisire conoscenze dei luoghi, anche quando presentano uno scarso grado di attendibilità. L’introduzione dell’informatica nel rilevamento e nella rappresentazione cartografica e la realizzazione dei sistemi informativi territoriali hanno aperto nuove possibilità non solo nella realizzazione di database collegati e georeferenziati, che possono contenere una notevole quantità di informazioni di diversa natura progressivamente incrementabili, ma soprattutto rendendo agevoli sia le molteplici interrogazioni sia le successive elaborazioni. Lo sviluppo della cartografia digitale dalla quale si possono derivare direttamente modelli tridimensionali, si pone quindi come punto di partenza per una corretta rappresentazione della complessità del fenomeno urbano e per un ripensamento dello spazio non più sulla base di esplorazioni planimetriche, ma tramite la creazione di modelli virtuali generati in maniera più o meno automatica a partire dalla cartografia stessa. In questo senso, il modello di derivazione cartografica costituisce l’aspetto metrico-quantitativo della rappresentazione della città, aspetto che risulta tanto più esatto, obiettivo e verificabile in quanto ottenuto con strumenti che rendono le misurazioni sufficientemente attendibili. Si tratta dunque di esplorare la cartografia tridimensionale cogliendone le peculiarità e la ricchezza nella restituzione dello spazio urbano, caratteristiche, queste, che suggeriscono immediatamente di tentare di ricostruire con la stessa vivacità rappresentativa anche tutti i trascorsi storici della città o, quanto meno, di alcuni dei suoi momenti topici, con particolare attenzione alle trasformazioni di natura orografica ed edilizia. In questo quadro emergono due distinti aspetti di natura metodologica, l’uno concernente la generazione del modello urbano e le implicazioni tecniche che questo comporta (implementazione di dati, automatismi, studi tipo-morfologici, scala del modello, …), l’altro relativo all’evoluzione della città attraverso il confronto tra modelli cartografici diversi (bi e tridimensionali). La realizzazione di un modello virtuale basato sulla cartografia digitale 3D, che fotografa lo stato attuale della struttura urbana, può rappresentare la griglia tridimensionale di riferimento per una visualizzazione delle trasformazioni spaziali attuata con una procedura che ripercorre a ritroso il cammino della storia. Si tratta di riferire a questa griglia orientata sulla base di capisaldi topografici certi i dati cartografici e iconografici provenienti dalla ricerca storico-documentaria, sulla base della individuazione di elementi invarianti della struttura urbana, come assetti orografici, vuoti urbani o edifici esistenti, etc., che non hanno mutato la loro localizzazione e le loro caratteristiche morfologiche. Così concepito, il modello tridimensionale di derivazione cartografica si caratterizza per la capacità di recepire e valorizzare documenti molto diversi e non necessariamente “scientifici” ai fini di una visualizzazione interattiva della storia del singolo brano di città o del singolo edificio per valutarne le trasformazioni sul piano morfologico e dimensionale, ma anche percettivo.Peer Reviewe

Tethyan magnetostratigraphy from Pizzo Mondello (Sicily) and correlation to the Late Triassic Newark astrochronological polarity time scale

We present the magnetostratigraphy and stable isotope stratigraphy from an expanded (∼430-m-thick) Upper Triassic marine limestone section at Pizzo Mondello, Sicily, and review published biostratigraphic information that can be used to define the location of the conodont Carnian-Norian and Norian-Rhaetian boundaries in this section. Pizzo Mondello offers good potential for magneto-stratigraphic correlation of marine biostratigraphic and chemostratigraphic data with the continental Newark astrochronological polarity time scale (APTS) for development of an integrated Late Triassic time scale. The relatively stable average values of δ18O centered on 0‰ are a strong indication that the Cherty Limestone at Pizzo Mondello suffered very little diagenetic overprinting. The conodont Carnian-Norian boundary is located 12.5 m above a positive shift of δ13C. A statistical approach was applied to evaluate various Pizzo Mondello to Newark magnetostratigraphic correlations. Two correlation options have the highest correlation coefficients. In option #1, the base of Pizzo Mondello correlates with the middle part of the Newark APTS, whereas in option #2, the base of Pizzo Mondello starts toward the early part of the Newark APTS. We prefer option #2 in which the Carnian-Norian boundary based on conodonts, as well as its closely associated positive δ13C shift, correspond to Newark magnetozone E7 at ca. 228–227 Ma (adopting Newark astrochronology), implying a long Norian with a duration of ∼20 m.y., and a Rhaetian of ∼6 m.y. duration. These ages are in fact not inconsistent with the few high-quality radiometric dates that are available for Late Triassic time scale calibration. Based on its good exposure, accessibility, stratigraphic thickness and continuity, and multiple chronostratigraphic correlation possibilities, we propose Pizzo Mondello as global stratigraphic section and point for the base of the Norian

Tethyan magnetostratigraphy from Pizzo Mondello (Sicily) and correlation to the Late Triassic Newark astrochronological polarity time scale

We present the magnetostratigraphy and stable isotope stratigraphy from an expanded (∼430-m-thick) Upper Triassic marine limestone section at Pizzo Mondello, Sicily, and review published biostratigraphic information that can be used to define the location of the conodont Carnian-Norian and Norian-Rhaetian boundaries in this section. Pizzo Mondello offers good potential for magneto-stratigraphic correlation of marine biostratigraphic and chemostratigraphic data with the continental Newark astrochronological polarity time scale (APTS) for development of an integrated Late Triassic time scale. The relatively stable average values of δ18O centered on 0‰ are a strong indication that the Cherty Limestone at Pizzo Mondello suffered very little diagenetic overprinting. The conodont Carnian-Norian boundary is located 12.5 m above a positive shift of δ13C. A statistical approach was applied to evaluate various Pizzo Mondello to Newark magnetostratigraphic correlations. Two correlation options have the highest correlation coefficients. In option #1, the base of Pizzo Mondello correlates with the middle part of the Newark APTS, whereas in option #2, the base of Pizzo Mondello starts toward the early part of the Newark APTS. We prefer option #2 in which the Carnian-Norian boundary based on conodonts, as well as its closely associated positive δ13C shift, correspond to Newark magnetozone E7 at ca. 228–227 Ma (adopting Newark astrochronology), implying a long Norian with a duration of ∼20 m.y., and a Rhaetian of ∼6 m.y. duration. These ages are in fact not inconsistent with the few high-quality radiometric dates that are available for Late Triassic time scale calibration. Based on its good exposure, accessibility, stratigraphic thickness and continuity, and multiple chronostratigraphic correlation possibilities, we propose Pizzo Mondello as global stratigraphic section and point for the base of the Norian

Extended narrow-line region in Seyfert galaxies

We present our recent results about the extended narrow-line region (ENLR) of two nearby Seyfert 2 galaxies (IC 5063 and NGC 7212) obtained by modelling the observed line profiles and spectra with composite models (photoionization+shocks) in the different regions surrounding the AGN. Then, we compare the Seyfert 2 ENLRs with the very extended one recently discovered in the narrow-line Seyfert 1 (NLS1) galaxy Mrk 783. We have found several evidences of interaction between the ISM of the galaxies and their radio jets, such as a) the contribution of shocks in ionizing the high velocity gas, b) the complex kinematics showed by the profile of the emission lines, c) the high fragmentation of matter, etc. The results suggest that the ENLR of IC 5063 have a hollow bi-conical shape, with one edge aligned to the galaxy disk, which may cause some kind of dependence on velocity of the ionization parameter. Regarding the Mrk 783 properties, it is found that the extension of the optical emission is almost twice the size of the radio one and it seems due to the AGN activity, although there is contamination by star formation around 12 arcsec from the nucleus. Diagnostic diagrams excluded the contribution of star formation in IC 5063 and NGC 7212, while the shock contribution was used to explain the spectra emitted by their high velocity gas.Comment: 9 pages, 2 figures, proceeding of the conference "Quasars at all cosmic epochs", accepted for publication in Front. Astron. Space Sci. - Milky Way and Galaxie