36 research outputs found

    Ledelse og integrering i dagligvarebransjen

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    Master i kunnskapsledelse - Nord universitet 202

    On the Clinical Outcome of Different Single Implant Treatment Modalities

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    Today there are several treatment techniques available to replace a missing tooth. Since the beginning of the 1990s, it has become increasingly common to treat individual tooth loss with dental implants. Important patient factors are survival, success, functionality, aesthetics, oral health and quality of life. The range of indications and possibilities for implant treatment has broadened compared to the originally proposed treatment indications. A variety of methods, components and materials are available today. Improvements of the implant surface have led to shorter healing periods, which has affected the overall treatment time. Methods for computer-assisted implant planning and surgical guides have been developed to improve treatment planning. Several techniques are involved in the manufacturing of implant-supported single crowns, from the traditional plaster models, wax, casting and porcelain veneering to 3D scanning, computer aided design and manufacturing. It is important that all these treatment modalities are evaluated in a systematic and scientific way to ensure that the treatment given is the best one possible according to the individual conditions that exist. The general aim of this project was to evaluate the treatment outcome between different treatment modalities for single dental implants. Study I aims to retrospectively evaluate implant survival. Patient reported outcome measures, marginal bone loss (MBL), clinical and esthetic outcomes following conventional single implant treatment. The aim of study II, a prospective randomized clinical study, was to compare the overall treatment outcome following immediate loading (IL) and delayed loading (DL) of single implants. In study III the aim was to in a vitro setting evaluate the deviation in final dental implant position after the use of surgical guides fabricated from two different desktop 3D printers using a digital workflow. For study IV the aim was to, in a non-randomized study, compare clinical and aesthetic outcomes between immediately loaded single implants placed with and without a fully guided-surgery procedure (DIL). In study I a total of 85 implants were examined after a mean follow-up time of 7.51 years. The 5-year implant survival rate was98.4% (95% CI: 96.3% - 100%), with a crown survival rate of91.8% (95% CI: 86.3%-97.3%). Overall mean MBL was -0.13 mm. Final and initial total Pink esthetic score (PES) were 9.61 and 11.49 (P<.001) Mean White esthetic score (WES) was 6.48 at final follow-up. Visual analog scale (VAS) score for soft tissue and implant-supported crown aesthetics were 73.5 and 82.1 (maximum score 100). A oral health impact profile-14 (OHIP-14) 14 score of 16.11 was observed at the final follow-up. Study II and IV found implant survival rates of 100%, 96% and 90.5 % for IL, DL and DIL, respectively, after 1-year. No statistically significant differences were found for MBL, PES, WES and OHIP-14after 1-year. Statistically significant lower papilla index scores were found for the IL. Overall statistically significant improvement inPES, WES and OHIP-14 were found over time. In the DIL group a moderate correlation between aesthetics and deviation in fixture position was found. For Study III a statistically significant difference between stereolithography and direct light processing (DLP) was found fordeviation at entry point (P = .023) and the vertical implant position(P = .009). Overall lower deviations were found for the guides from the DLP printer, with the exception of deviation in horizontal implant position.The results from these studies suggest that good clinical results can be achieved with different treatment modalities for single implants. Positive advantages with immediate loading and guided surgery is primarily seen in the early faces of the treatment procedure only. Care needs to be exerted with technically complicated treatment procedures as the effect on implant survival should not be underestimated. Further studies have to be performed to evaluate guided surgery and immediate loading to identify possible factors effecting survival

    Bruk mobilen oftere på jobb -om bruk av mobile enheter ved blodtransfusjoner

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    Elektroniske pasientjournaler er i sykehusene i hovedsak installert på lokale maskiner, og mye av arbeidsdagen går med på registrere informasjon i flere system. Det kliniske arbeidet rundt pasienten er i liten grad stasjonær, og foregår ikke ved de stasjonære maskinene. For å dokumentere behandling, må klinikere og helsearbeidere ofte samle med seg utskrifter og notater og føre informasjonen inn i pasientjournalen når en stasjonær maskin er tilgjengelig. Det brukes mye tid i helsesektoren på identitetssikring, for å unngå feilbehandling. Det at en pasient får feil legemiddel eller blodprodukt er farlig, og i verste fall livstruende. Det viser seg at mange feil skjer ved identitetskontroll. Digitalisering kan brukes for å unngå slike feil, og med digitalisering kan man blant annet oppnå forenkling av arbeidsoppgaver, økt sikkerhet, fleksibilitet og effektivisering. I denne masteroppgaven har jeg undersøkt om bruk av mobile enheter kan bidra med bedre sikkerhet og bedre arbeidsflyt og effektivitet ved at det utføres en elektronisk identitetskontroll før blodtransfusjon. Studien er gjennomført som et kvalitativt casestudie ved Universitetssykehuset Nord-Norge. For å samle forskningsdata har jeg intervjuet sykepleiere som har tatt i bruk mobil enhet ved blodtransfusjoner, og jeg har vært observert løsningen i bruk på mobil enhet og på stasjonær maskin. I tillegg har jeg brukt survey, møter og undervisning for datainnsamling. Forskningsprosjektet mitt har vist at innføring av mobile enheter kan bidra med bedre sikkerhet og bedre arbeidsflyt og effektivitet ved blodtransfusjoner

    Angled Screw Channel : An Alternative to Cemented Single-Implant Restorations-Three Clinical Examples

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    This article presents three cases of single labially tilted implants restored with screw-retained single crowns. Individualized abutments with an angled screw channel were used to avoid an unesthetic vestibular access channel. This individualized abutment allows the dentist and dental technician to use the screw-retained restorations where a cemented reconstruction would otherwise have been needed

    A Randomized Clinical Trial Comparing Immediate Loading and Delayed Loading of Single-Tooth Implants : 5-Year Results

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    The aim of this prospective randomized clinical study was to compare the clinical treatment outcome for single dental implants submitted to either immediate loading (IL) or delayed loading (DL) after 5 years of follow-up. Fifty patients with a missing maxillary tooth (15-25) were randomly allocated to either the IL or DL. The treatment procedures included implant installation in healed sites, temporary screw-retained crown and replacement with a permanent single implant crown. The two groups were evaluated with regard to implant survival, marginal bone level, papillae index, pink and white esthetic score (PES, WES). At the 5-year follow-up the implant survival rate was 100% and 95.8% for IL and DL, respectively. Implant success rate was 91.7% and 83.3% for IL and DL, respectively. The mean +/- SD marginal bone loss for IL and DL was -0.50 +/- 0.73 mm and -0.54 +/- 0.65 mm, respectively. (p = 0.782). Statistically significant less marginal bone loss was found non-smokers (p = 0.021). No statistically significant differences were found for IL and DL concerning papillae index PES and WES after 5 years. This study suggests that implant-supported single crowns in the maxillary aesthetic zone can present similar results with respect to either IL or DL after 5 years

    A morphometric analysis of the mandibular canal by cone beam computed tomography and its relevance to the sagittal split ramus osteotomy

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    PURPOSE: The aim of the present study was to morphometrically analyze the mandibular canal through the mandibular ramus by cone beam computed tomography (CBCT) and to relate the findings to performing sagittal split ramus osteotomy. METHODS: CBCT of 200 patients were analyzed. Five parameters were measured at the axial scan, from the mandibular foramen to 21 mm below it (3-mm intervals). The canal was classified according to the position within the bone marrow space. Variations were evaluated according to age, sex, side, and number of mandibular teeth. RESULTS/CONCLUSIONS: The following measurements increased gradually towards the most inferior level of measurement: the total thickness of the mandibular ramus through the center of the mandibular canal, the width of the bone marrow space (both buccal and lingual), and the narrowest width from the mandibular canal inner cortical to the mandibular ramus external cortical. The inner diameter of the mandibular canal slightly decreased to the same direction. Concerning the mandibular canal position within the bone marrow space, the percentage of the separate type increased towards the most inferior level of measurement, and the contact and fusion types decreased. Age, number of teeth, and sex had no significant influence on the total thickness of the mandibular ramus and on the narrowest width from the mandibular canal inner cortical to the mandibular ramus external cortical

    Clinical and radiographic outcome following immediate loading and delayed loading of single-tooth implants : Randomized clinical trial

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    Background: Immediate loading of single implants is generally considered a reliable procedure. Purpose: The objective of the present prospective randomized clinical study was to compare the overall treatment outcome following immediate loading (IL) and delayed loading (DL) of single implants after 1 year of follow-up. Materials and Methods: Patients with a missing maxillary tooth (15-25) were randomly assigned to IL or DL. The protocol included implant installation in healed sites, immediate loading, delayed loading, temporary screw-retained restoration, and replacement with a permanent single implant crown. Outcome measures were implant survival, marginal bone level, soft tissue changes, papillae index, pink, and white esthetic score (PES and WES), patient judged aesthetics, and oral health impact profile (OHiP-14). Results: Implant survival rate was 100% and 96% for IL and DL, respectively. Implant success rate was 96% and 88% for IL and DL, respectively. Statistically significant lower papilla index scores were found in the IL group at temporary crown and definitive crown placement. An overall statistically significant improvement after 12 months for PES, WES and OHIP-14 was found. Conclusion: This prospective randomized study showed that single implants in the maxilla can present satisfactory results with respect to either immediate loading or delayed loading after 12 months

    Immediate implant placement in the posterior mandible : A cone beam computed tomography study

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    Objective: To determine the longest upright and tilted implant that can be placed in posterior mandibular teeth (second premolars [2PM], first molars [1M], and second molars [2M]) in case of immediate implant placement (IIP), respecting a safe distance from the inferior alveolar canal (IAC) and the submandibular fossa, using cone beam computed tomography (CBCT) scans. Method and Materials: In CBCT scans of 118 subjects, the following were measured: distance from the tooth apex to the IAC (DTC), lateromedial width of the mandible, classification of mandibular cross-sectional morphology, upright and tilted implant placement simulation, tilting angle that allowed placement of the longest implant. Results: The DTC has shown to be greater for 1M, shorter for 2PM, and even shorter for 2M. Between 70% and 88% of all 2PM, 1M, and 2M present less than 6 mm of DTC. The cross-sectional morphology of the mandible had a tendency to be classified as "undercut" in more posterior regions. For both 4.0- and 5.0-mm implants, more posterior regions resulted in a greater difference in length between the upright and tilted implants. The tilting angle was greater for the more posterior regions. Most of the relationships between age/sex and the morphometric parameters were weak. Conclusion: Lingual concavity is a common clinical finding at the posterior mandibular region, and its occurrence varies according to the tooth type. The great majority of the 2PM, 1M, and 2M present limited available bone between the root apex and the IAC, which stresses the need for careful attention when IIP is planned in this area
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