Machined Versus Cast Abutments for Single Dental Implants: A 3-year within-Patient Multicentre Randomized Controlled Trial

PURPOSE: To compare clinical outcomes of machined titanium abutments (machined group) versus cast cobalt-chrome abutments (cast group). MATERIALS AND METHODS: Thirty-one partially edentulous subjects received two single non-adjacent implant-supported crowns each at three centres. Three and a half months after implant placement, implants were randomized at impression taking to receive one machined and one cast abutment according to a within-patient study design. Four patients dropped out and one patient lost one implant before randomization, so only 26 patients had their implants randomized. Outcome measures were: prosthesis and implant failures, any complications, and radiographic peri-implant marginal bone level changes. Patients were followed up for 3 years after loading. RESULTS: After randomization, three patients dropped out. One implant failed and two crowns on cast abutments were lost, but differences in implant and prosthesis failures were not statistically different (McNemar test P = 1.000; difference in proportions = 0.04 and P = 0.500; difference in proportions = 0.08, respectively). Two minor complications occurred in the cast group versus one in the machined group, the difference not being statistically different (McNemar test P = 1.000; difference in proportions = 0.04; 95% CI 0.18 to 22.06). Both groups presented statistically significant peri-implant marginal bone loss from implant placement to 3 years after loading, respectively -0.72 ± 0.90 mm (P = 0.001) for machined and -0.60 ± 0.61 mm (P <0.001) for cast abutments, with no statistically significant differences between the two groups (mean difference -0.12 mm; 95% CI -0.57 to 0.34; P = 0.624). Both groups gradually lost marginal peri-implant bone from loading (baseline) to 3 years after loading, but this was not statistically significant; machined lost -0.05 ± 0.12 mm while cast lost -0.14 ± 0.11 mm, a difference that was not statistically significant (mean difference 0.06 mm; 95% CI -0.24 to 0.35; P = 0.708). CONCLUSIONS: The present clinical data suggest that implant prognosis up to 3 years after loading is not affected by the choice of machined or cast abutments

Full Understanding of Hot Electrons and Hot/Cold Holes in the Degradation of p-channel Power LDMOS Transistors

Degradation induced by hot-carrier stress is a crucial issue for the reliability of power LDMOS transistors. This is even more true for the p-channel LDMOS in which, unlike the n-channel counterpart, both the majority and minority carriers play a fundamental role on the device reliability. An in-depth study of the microscopic mechanisms induced by hot-carrier stress in new generation BCD integrated p-channel LDMOS is presented in this paper. The effect of the competing electron and hole trapping mechanisms on the on-resistance drift has been thoroughly analyzed. To this purpose, TCAD simulations including the deterministic solution of Boltzmann transport equation and the microscopic degradation mechanisms have been used, to the best of our knowledge, for the first time. The insight gained into the degradation sources and dynamics will provide a relevant basis for future device optimization

The Role of Frequency and Duty Cycle on the Gate Reliability of p-GaN HEMTs

In this letter, we present an extensive analysis on the role of both switching frequency (ranging from 100 kHz to 1 MHz) and duty cycle (from 10% to 90%) on the time-dependent gate breakdown of high electron mobility transistors (HEMTs) with Schottky metal to p-GaN gate. More specifically, results show how the gate lifetime of GaN HEMTs increases by reducing the frequency and the duty cycle of the stressing gate signal (VG). Such behavior is ascribed to the OFF-time, which is responsible to alter the electrostatic potential in the p-GaN layer during the rising phases of VG (from OFF- to ON-state). Findings of this analysis are useful both for further technology improvement and for GaN-based power circuit designers

Machined Versus Cast Abutments for Dental Implants: a 1-year Within-patient Multicentre Randomized Controlled Trial Assessing Marginal Seal Capacity and Outcomes

PURPOSE To compare clinical outcomes of machined titanium abutments (machined group) versus cast cobalt-chrome abutments (cast group) and to evaluate in vitro their implant fit. MATERIALS AND METHODS This study comprised two parts. In the in vitro part, the im-plant–abutment fit of 5 cast abutments and 5 machined abutments screwed on with a torque of 30 Ncm was qualitatively and quantitatively evaluated using micro-computed tomography (µ-CT) and AgNO3 to reveal connection gaps. In the clinical part, 31 partially edentulous subjects received two single non-adjacent implant-supported crowns at three centres. At impression taking, three and a half months after implant placement, implants were randomized to receive a machined or cast abutment according to a wi-thin-patient study design. Unfortunately, four patients dropped out and one patient lost one implant before randomization, so only 26 patients had their implants randomized. Outcome measures were: prosthesis and implant failures, any complications, and radiographic peri-implant marginal bone level changes. Patients were followed up to 1 year after loading. RESULTS The fit of the implant–abutment connection was assessed in vitro using µ-CT scans. No gaps were revealed at any of the machined or cast abutments tested. In the clinical part, after randomization, three patients dropped out, no implant failed, but one crown on a cast abutment was replaced. The between-group difference in prosthesis failure was not statistically different (McNemar chi-square test P = 1.0; difference in proportions = 0.039). One complication occurred in each group, the difference not being statistically different (McNemar test P = 1.000; difference in proportions = 0; 95% CI 0.06 to 15.99). Both groups presented statistically significant peri-implant marginal bone loss from implant placement to 1 year after loading, respectively-0.76 ± 1.01 mm for machined and-0.69 ± 0.82 mm for cast abutments, with no statistically significant differences between the two groups (mean difference 0.07 mm; 95% CI-0.54 to 0.67; P = 0.828). Both groups gradually lost marginal peri-implant bone from loading to 1 year after loading but this was not significantly different, respectively-0.06 ± 0.56 mm for machined and-0.10 ± 0.29 mm for cast abutments, with no statistically significant differences between the two groups (P = 0.739; mean difference 0.07 mm; 95% CI-0.12 to 0.16; P = 0.739). CONCLUSIONS Our clinical data suggests that implant prognosis up to 1 year after loading is not affected by using machined or cast abutments. In support of these findings, in vitro analysis proved that both types of abutments allow a tight fit with no gaps. The-refore, for the time being dentists should feel free to choose whichever type they prefer. However, these preliminary results need to be confirmed by larger trials with at least 10 years of follow-up

To Splint or Not to Splint Short Dental Implants Under the Same Partial Fixed Prosthesis? One-year Post-loading Data From a Multicentre Randomised Controlled Trial

PURPOSE. To compare the clinical outcomes of two adjacent 6-mm-long dental implants splinted under the same prosthesis (control group) versus two identical implants sup-porting single crowns (test group). MATERIALS AND METHODS. Forty-seven patients with edentulous posterior (premolars and/or molars) jaws received two adjacent 6-mm-long dental implants, which were sub-merged. Four months later, at impression taking, patients were randomised to receive splinted or unsplinted definitive cemented metal-composite prostheses. Unfortunately, four patients died before randomisation and three patients lost five implants, so only 40 patients were randomised, according to a parallel-group design, to have both implants splinted under the same partial fixed prosthesis (19 patients) or with two single crowns (21 patients). Outcome measures were: prosthesis and implant failures, any complica-tions, peri-implant marginal bone level changes and patient satisfaction. Patients were followed-up to 1 year after loading. RESULTS. One patient from the splinted group dropped out. No implant failures occurred after randomisation. One complication occurred in the unsplinted group versus no complications at splinted implants, the difference not being statistically different (Fisher’s exact test P = 1.000; difference in proportions =-0.04; 95% CI-0.16 to 0.09). Both groups presented significant peri-implant marginal bone loss at 1 year after loading (P<0.05), respectively-0.36 (0.45) mm at splinted implants and-0.17 (0.31) mm at unsplinted implan-ts, but there were no statistically significant differences between the two groups (mean difference 0.19 mm; 95% CI-0.10 to 0.48; P = 0.194). All patients were fully or reasonably satisfied with the treatment, with the exception of two patients, both from the splinted group: one patient was not sure about the aesthetics, and another would not undergo the same treatment again. CONCLUSIONS. The present data seems to suggest that up to 1 year after loading the prognosis of short implants, mostly placed in mandibles characterised by dense bone quality, may not be influenced by splinting or not under the same fixed prostheses. Howe-ver, these preliminary results need to be confirmed by larger trials with follow-ups of at least 5 years

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

Increased efficacy of combining prebiotic and postbiotics approaches in mouse models relevant to autism and depression

The Microbiota-Gut-Brain axis (MGBA) is a bidirectional communication pathway between gut bacteria and the central nervous system (CNS) (including the intestine) that exerts a profound influence on neural development, neuroinflammation, activation of stress response and neurotransmission, in addition to modulating complex behaviours, such as sociability and anxiety. Several MGBA modulating approaches are possible, such as probiotic administration. A reasonable pharmacological approach would also be the contemporarily administration of both prebiotics and postbiotics. To test this hypothesis, we probed the effects of α-lactalbumin (ALAC; a prebiotic in the dose range of 125–500 mg/kg) and sodium butyrate (NaB; a postbiotic in the dose range of 30–300 mg/kg) alone and in combination. We used two animal behavioural models of idiopathic autism, (BTBR mice) and anxiety/depression (chronic unexpected mild stress - CUMS mice) respectively, using several standard behavioural paradigms such as Three-chamber social interaction test, Marble burying assay, depression-, anxiety- and memory-tests. In BTBR autistic mice, we found that both ALAC and NaB improve animal sociability, and memory in the passive avoidance (PA); drug combination was more effective in almost all tests also reducing immobility time in the forced swimming test (FST), which was not affected by single drug administration. Similarly, in the CUMS mice, single drug administration was effective in improving: 1) depressive-like behaviour in the FST and sucrose preference test; 2) memory and learning in the PA, novel object recognition and Morris water maze tests. Drug combination was again more effective than single drug administration in most cases; however, in the CUMS model, neither single drug or combination was effective in the elevated plus maze test for anxiety. Our results suggest that in both models, ALAC and NaB combination is more effective in improving some pathological aspects of animal behaviour than single administration and that the prebiotic/postbiotic approach should be considered a reasonable approach for the manipulation of the MGBA to improve efficacy

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