A Study of Success Rate of Miniscrew Implants as Temporary Anchorage Devices in Singapore

Objective. To find out the success rate of miniscrew implants in the National Dental Centre of Singapore (NDCS) and the impact of patient-related, location-related, and miniscrew implant-related factors. Materials and Methods. Two hundred and eighty-five orthodontic miniscrew implants were examined from NDCS patient records. Eleven variables were analysed to see if there is any association with success. Outcome was measured twice, immediately after surgery prior to orthodontic loading (T1) and 12 months after surgery (T2). The outcome at T2 was assessed 12 months after the miniscrew’s insertion date or after its use as a temporary anchorage device has ceased. Results. Overall success rate was 94.7% at T1 and 83.3% at T2. Multivariate analysis revealed only the length of miniscrew implant to be significantly associated with success at both T1 (P=0.002) and T2 (P=0.030). Miniscrew implants with lengths of 10–12 mm had the highest success rate (98.0%) compared to other lengths, and this is statistically significant (P=0.035). At T2, lengths of 10–12 mm had significantly (P=0.013) higher success rates (93.5%) compared to 6-7 mm (76.7%) and 8 mm (82.1%) miniscrew implants. Conclusion. Multivariate statistical analyses of 11 variables demonstrate that length of miniscrew implant is significant in determining success

A Study of Success Rate of Miniscrew Implants as Temporary Anchorage Devices in Singapore

Objective. To find out the success rate of miniscrew implants in the National Dental Centre of Singapore (NDCS) and the impact of patient-related, location-related, and miniscrew implant-related factors. Materials and Methods. Two hundred and eighty-five orthodontic miniscrew implants were examined from NDCS patient records. Eleven variables were analysed to see if there is any association with success. Outcome was measured twice, immediately after surgery prior to orthodontic loading (T1) and 12 months after surgery (T2). The outcome at T2 was assessed 12 months after the miniscrew's insertion date or after its use as a temporary anchorage device has ceased. Results. Overall success rate was 94.7% at T1 and 83.3% at T2. Multivariate analysis revealed only the length of miniscrew implant to be significantly associated with success at both T1 ( = 0.002) and T2 ( = 0.030). Miniscrew implants with lengths of 10-12 mm had the highest success rate (98.0%) compared to other lengths, and this is statistically significant ( = 0.035). At T2, lengths of 10-12 mm had significantly ( = 0.013) higher success rates (93.5%) compared to 6-7 mm (76.7%) and 8 mm (82.1%) miniscrew implants. Conclusion. Multivariate statistical analyses of 11 variables demonstrate that length of miniscrew implant is significant in determining success

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The Singapore dream : myth or reality

130 p.The Singapore Dream has been a much talked about topic in recent years. Amidst the debate over this topic, several differing views and opinions have been brought up. Recognizing the impact of Singapore Dream on society, this research aims to explore what the Singapore Dream is.ACCOUNTANC

3D printed twin block: A feasibility study

Aims: Twin blocks are appliances used for Class II skeletal discrepancies, where the lower jaw is positioned more posteriorly compared to the upper. The conventional method of fabrication of this appliance is tedious and labour-intensive; hence this study intends to explore the feasibility of a digital workflow to three-dimensionally (3D) print them. Methods: Three sets of twin blocks, identical except for amount of offset (0.0 mm, 0.1 mm and 0.2 mm), were designed and 3D printed for 5 anonymized scans of patients with Class II skeletal discrepancies. The intaglio surfaces of the 0.0 mm offset twin blocks were scanned and superimposed onto their original computer-aided-design files. The resultant colour maps, root mean square (RMS) deviations, and percentage in-tolerance values at thresholds of 0.1 mm and 0.2 mm were assessed. The fit and retention of all twin blocks were assessed on their 3D printed models via a fit and retention score (FRS). Results: The median RMS deviation was 0.10 mm; percentage in-tolerance values at thresholds of 0.1 mm and 0.2 mm were 79.90%, and 94.51%. Printing deviations occurred most often at labial and incisal edges anteriorly, and buccal and occlusal surfaces posteriorly. There was no significant difference between the total FRS for the three groups (p = 0.076). However, the frequency of satisfactory scores for upper fit (p = 0.049), lower fit (p = 0.018), upper retention (p = 0.038) and lower retention (p = 0.015) differed significantly between the three groups. Conclusion: This study demonstrated the viability of a digital workflow to 3D print twin blocks. Print accuracy was satisfactory, with 0.1 mm offset providing the best fit and retention

Creative Music Therapy in an Acute Care Setting for Older Patients with Delirium and Dementia

Background/Aims: The acute hospital ward can be unfamiliar and stressful for older patients with impaired cognition, rendering them prone to agitation and resistive to care. Extant literature shows that music therapy can enhance engagement and mood, thereby ameliorating agitated behaviours. This pilot study evaluates the impact of a creative music therapy (CMT) programme on mood and engagement in older patients with delirium and/or dementia (PtDD) in an acute care setting. We hypothesize that CMT improves engagement and pleasure in these patients. Methods: Twenty-five PtDD (age 86.5 ± 5.7 years, MMSE 6/30 ± 5.4) were observed for 90 min (30 min before, 30 min during, and 30 min after music therapy) on 3 consecutive days: day 1 (control condition without music) and days 2 and 3 (with CMT). Music interventions included music improvisation such as spontaneous music making and playing familiar songs of patient's choice. The main outcome measures were mood and engagement assessed with the Menorah Park Engagement Scale (MPES) and Observed Emotion Rating Scale (OERS). Results: Wilcoxon signed-rank test showed a statistically significant positive change in constructive and passive engagement (Z = 3.383, p = 0.01) in MPES and pleasure and general alertness (Z = 3.188,p = 0.01) in OERS during CMT. The average pleasure ratings of days 2 and 3 were higher than those of day 1 (Z = 2.466, p = 0.014). Negative engagement (Z = 2.582, p = 0.01) and affect (Z = 2.004, p = 0.045) were both lower during CMT compared to no music. Conclusion: These results suggest that CMT holds much promise to improve mood and engagement of PtDD in an acute hospital setting. CMT can also be scheduled into the patients' daily routines or incorporated into other areas of care to increase patient compliance and cooperation