Reducing errors in guided implant surgery to optimize treatment outcomes.

Clinical considerations and treatment criteria in implant placement are constantly evolving. Prosthetically driven implant surgery has become the standard of care to improve short and long-term functional and esthetic outcomes. Therefore, implant position and angulation are planned according to the available bone, anatomical structures, and the requirements of the future prosthetic superstructure. In parallel with these developments, significant progress has been made in data imaging and different software technologies to allow the integration of data within a digital file format. Digitalization in implant surgery enables optimal planning of implant position, as well as the ability to transfer this planning to the surgical field-a process defined as "computer-supported implant planning and guided surgery." The aims of the present review are as follows: (a) to critically appraise the indications and potential "added value" of guided implant surgery, elaborating the main differences between dynamic and static guidance; and (b) to discuss the most important clinical considerations relevant for the different steps of the workflow that might influence the surgical outcome and to offer recommendations on how to avoid or reduce process errors in order to optimize treatment outcomes

Tissue Reactions to Various Suture Materials Used in Oral Surgical Interventions

A variety of suture materials are available for primary wound closure following oral surgical procedures. The aim was to review the tissue reactions to the various suture materials used in oral surgical interventions. Databases were searched using the following keywords: cotton, nylon, polyglecaprone 25, polytetrafluoroethylene (ePTFE), Polyglactin 910, polyglycolic acid (PGA), polylactic acid, silk, surgery, suture, and tissue reaction. Articles published only in English language were included. Seventeen studies were included. Two studies reported that polyglecaprone 25 had positive effects on wound-healing as compared to silk. Six studies reported that silk elicits more intense tissue inflammatory response and delayed wound healing as compared to other suture materials (including ePTFE, polyglecaprone-25, PGA, and nylon). Polyglactin 910 sutures were associated with the development of stitch abscess in one clinical study. Eight studies reported that tissue reactions are minimal with nylon sutures. Tissue reactions to suture materials used for oral surgical interventions may vary depending on the surface properties and bacterial adherence properties of the material

Comparison of Two Differently Processed Acellular Dermal Matrix Products for Root Coverage Procedures: A Prospective, Randomized Multicenter Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141116/1/jper1693-sup-0001.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141116/2/jper1693.pd

A diamino-functionalized silsesquioxane pillared graphene oxide for CO2 capture

In the race for viable solutions that could slow down carbon emissions and help in meeting the climate change targets a lot of effort is being made towards the development of suitable CO2 adsorbents with high surface area, tunable pore size and surface functionalities that could enhance selective adsorption. Here, we explored the use of silsesquioxane pillared graphene oxide for CO2 capture; we modified silsesquioxane loading and processing parameters in order to obtain pillared structures with nanopores of the tailored size and surface properties to maximize the CO2 sorption capacity. Powder X-ray diffraction, XPS and FTIR spectroscopies, thermal analysis (DTA/TGA), surface area measurements and CO2 adsorption measurements were employed to characterize the materials and evaluate their performance. Through this optimisation process, materials with good CO2 storage capacities of up to 1.7/1.5 mmol g(-1) at 273 K/298 K in atmospheric pressure, were achieved

A comparison of Child-Pugh, APACHE II and APACHE III scoring systems in predicting hospital mortality of patients with liver cirrhosis

BACKGROUND: The aim of this study was to assess the prognostic accuracy of Child-Pugh and APACHE II and III scoring systems in predicting short-term, hospital mortality of patients with liver cirrhosis. METHODS: 200 admissions of 147 cirrhotic patients (44% viral-associated liver cirrhosis, 33% alcoholic, 18.5% cryptogenic, 4.5% both viral and alcoholic) were studied prospectively. Clinical and laboratory data conforming to the Child-Pugh, APACHE II and III scores were recorded on day 1 for all patients. Discrimination was evaluated using receiver operating characteristic (ROC) curves and area under a ROC curve (AUC). Calibration was estimated using the Hosmer-Lemeshow goodness-of-fit test. RESULTS: Overall mortality was 11.5%. The mean Child-Pugh, APACHE II and III scores for survivors were found to be significantly lower than those of nonsurvivors. Discrimination was excellent for Child-Pugh (ROC AUC: 0.859) and APACHE III (ROC AUC: 0.816) scores, and acceptable for APACHE II score (ROC AUC: 0.759). Although the Hosmer-Lemeshow statistic revealed adequate goodness-of-fit for Child-Pugh score (P = 0.192), this was not the case for APACHE II and III scores (P = 0.004 and 0.003 respectively) CONCLUSION: Our results indicate that, of the three models, Child-Pugh score had the least statistically significant discrepancy between predicted and observed mortality across the strata of increasing predicting mortality. This supports the hypothesis that APACHE scores do not work accurately outside ICU settings

Penetration Depth of Initiated and Non-Initiated Diode Lasers in Bovine Gingiva

Background: This study aimed to evaluate the penetration depth of 445 and 970 nm diode lasers using both initiated and non-initiated fibers on bovine gingiva in an ex vivo model. Methods: In this in vitro experiment, 445 nm and 970 nm diode lasers were compared in pulsed (35 Hz, duty cycle: 50%) and continuous mode with both initiated and non-initiated tips. All experimental groups had laser output settings of 2 Watts with a 320 μm thick glass fiber utilized for delivery. Two posterior teeth were randomly selected from four bovine mandibles for each group. The teeth were irradiated for 30 s buccal and 30 s lingual before the gingiva was harvested for histological evaluation. Samples were fixed in 10% formalin and stained via elastin Van Gieson. Sections were examined microscopically to evaluate collagen denaturation due to thermal effects, which were measured and compared using a mixed-effect model with Tukey adjustment. Results: The 445 nm wavelength groups displayed significantly higher penetration depths when compared to the 970 nm wavelength groups. The initiated tip groups tended to display a lower penetration depth than non-initiated groups; however, these values were similar (p > 0.05) for the 445 nm pulsed lasers (initiated vs. non-initiated). Conclusions: We can conclude that the 445 nm laser wavelength displayed greater thermal denaturation in bovine gingiva ex vivo when compared to the 970 nm wavelength. Additionally, the pulsed settings displayed less thermal penetration depth when compared to the continuous emission modes of the same power output. However, additional studies are necessary to better compare initiated and non-initiated tips using the novel blue laser light

Spectrometric Analysis of the Wear from Metallic and Ceramic Dental Implants following Insertion: An In Vitro Study

Titanium wear is a growing area of interest within dental implantology. This study aimed to investigate titanium and zirconium wear from dental implants at the time of insertion using X-ray-fluorescence spectrometry (XRF) and an in vitro protocol utilizing artificial bovine bone plates. Five groups were analyzed using XRF-spectrometry: groups 1–4 (titanium implants) and group 5 (zirconia implants). The implants were inserted into two bone blocks held together by a vice. The blocks were separated, and the insertion sites were analyzed for titanium (Ti) and zirconium (Zr). Statistical descriptive analyses of Ti and Zr concentrations in the coronal, middle and apical bone interface were performed. A comparative analysis confirmed differences between the implant’s surface stability and Ti accumulation within the insertion sites of the bone block. There was a direct relationship between implant length and the quantity of titanium found on the bone block. The data generally indicates greater quantities of titanium in the coronal thirds of the implants, and less in the apical thirds. The titanium and zirconium found in the bone samples where the group 5 implants were inserted was not of statistical significance when compared to control osteotomies. The results of this study confirm wear from metallic, but not ceramic, dental implants at the time of insertion

Dental Academic Degrees in Germany Compared to the USA

There are different avenues for obtaining postgraduate doctoral/Ph.D. degrees in Germany and abroad. Depending on their interests and career plans, candidates can choose a postgraduate doctorate/Ph.D. that focuses on a career in academia or a doctorate that does not involve all elements of a Ph.D. and is obtained for the title’s sake. Germany offers this type of diversity and flexibility, whereas the USA postgraduate doctorate model presents a more structured doctorate. The current article provides insight regarding various and more flexible pathways for obtaining a postgraduate doctorate by comparing the German and the American model. The diversity of academic degrees in dentistry and medicine, such as postgraduate doctoral degrees and the higher postdoctoral degrees available in Germany for graduates interested in academia, makes educational evaluation processes and credentials recognition challenging. The lack of transparency and a systematic approach for the academic acknowledgment of the different scientific values of each doctorate type is creating confusion, primarily when German postgraduate doctorate holders pursue academic careers internationally. The current article aims to enhance the knowledge about the different academic degrees and facilitate the educational evaluations, specialty applications, and employment processes. Understanding the additional scientific value of each doctorate type offered in Germany is imperative for their credential recognition internationally

Allograft Customized Bone Blocks for Ridge Reconstruction: A Case Report and Radiological Analysis

The aim of the present case report was to demonstrate the vertical gain in the posterior resorbed mandible utilizing the use of an Allograft Customized Bone Block. The case presents a 66-year-old healthy female nonsmoker who lost her right mandibular molars long time ago. In the past, she had an implant placement, which failed due to a fracture of the implant. Due to the high risk of mandibular nerve damage, the implant was left in the jaw and was completely covered with bone. Since the jaw was completely atrophic and short implants were not an option, a vertical ridge augmentation was required. This case report presents the use of an Allograft Customized Bone Block as a good option in patients with an atrophic mandible, showing no vertical bone resorption five months after placement and great osseointegration of the placed implants