Consensus on the terminologies and methodologies for masticatory assessment

A large number of methodological procedures and experimental conditions are reported to describe the masticatory process. However, similar terms are sometimes employed to describe different methodologies. Standardisation of terms is essential to allow comparisons among different studies. This article was aimed to provide a consensus concerning the terms, definitions and technical methods generally reported when evaluating masticatory function objectively and subjectively. The consensus is based on the results from discussions and consultations among world-leading researchers in the related research areas. Advantages, limitations and relevance of each method are also discussed. The present consensus provides a revised framework of standardised terms to improve the consistent use of masticatory terminology and facilitate further investigations on masticatory function analysis. In addition, this article also outlines various methods used to evaluate the masticatory process and their advantages and disadvantages in order to help researchers to design their experiments

Reliability of a face scanner in measuring the vertical dimension of occlusion.

OBJECTIVE This study evaluated the reliability of a face scanner in measuring the vertical dimension of occlusion (VDO). METHODS Fully dentate volunteers (n=20; mean-age=30.0±10.7 years) were recruited. Clinical facial measurements were obtained using a digital caliper and a face scanner (Class 1 LASER, Obiscanner, Fifthingenium, Italy). The scans were imported into a mesh-processing software, and the distances were measured digitally. Measurements were obtained for each participant with the jaws positioned in maximal intercuspation (MI) and with increased vertical distances of 2, 4, and 6 mm. Vertical and horizontal measures were obtained using facial anatomical landmarks: Glabella (GL), Pronasale (PrN), Subnasale (SbN), inferior border of the right and left Alare, Labiale superius (Ls), right and left Cheilion (Ch), Soft Pogonion (SPg), right and left Tragus of the ear (Tr), for all selected vertical positions. Data analysis included intra-class correlation coefficient (ICC), pairwise comparison tests, Bland-Altman plots, and Passing-Bablok regression. RESULTS 120 VDO measurements (clinical=60, digital=60) were recorded by two independent evaluators. Mean differences between digital and clinical measurements ranged from 0.054±0.14mm to 0.203±0.13mm. All parameters were strongly correlated (r>0.93; p<0.001). ICC estimates revealed excellent reliability, and the measuring procedure yields the same results on repeated trials irrespective of the raters and measurement methods. Bland-Altman plots revealed a difference between digital and clinical measurements of 1.7% for the vertical measurements. Regression analysis revealed no significant proportional difference between the two methods, so both can be used interchangeably. CONCLUSIONS The findings of this study demonstrate that VDO can be measured accurately from face scans using 3D mesh-processing software and that even small changes in the VDO could be detected using the digital methods. CLINICAL SIGNIFICANCE Findings provide evidence about the reliability of a digital method for jaw relation registrations and may be applied towards incorporating this method into clinical workflows for CAD-CAM dentures

The Potential Role of Dental Patient-Reported Outcomes (dPROs) in Evidence-Based Prosthodontics and Clinical Care: A Narrative Review

Oral health problems are associated with poor quality of life, with the potential to cause functional, aesthetic, nutritional, and psychological difficulties, in addition to pain and suffering. Traditionally, dental treatment outcomes are measured using purely clinical parameters; however, this may be ineffective as these parameters cannot adequately capture the full impact of poor oral health on the patient, or their respective coping strategies. From this perspective, there are significant benefits when the patient’s perception of their care is considered, and included in treatment planning and delivery. The impacts perceived by the patient on their treatment outcomes can be measured using patient-reported outcomes (PROS), or more specifically with dPROS, focused on dental patient-reported outcomes. Although there are some instruments available for measuring these outcomes in clinical trials, very little information is available for explaining the context in which these outcomes are considered, and also how to capture this information using appropriate instruments, specially in evidence-based dental practice. This article aims to review the literature, seeking to describe what has been considered about assessing patient’s outcomes, as well as how to measure them, and explore the potential benefits of using dPROS in evidence-based prosthodontics and clinical care of partially and fully edentulous patients

Fatores associados ao desempenho acadêmico de estudantes de Nutrição no Enade

Resumo: O desempenho estudantil é de natureza multifatorial. São inexistentes os estudos acerca dos aspectos que interferem no desempenho de estudantes de Nutrição em exames como o Exame Nacional de Desempenho de Estudantes (Enade). Este artigo tem o objetivo de verificar a associação entre o desempenho de estudantes concluintes de Nutrição no Enade e fatores socioeconômicos, trajetória acadêmica e perfil da instituição, mediante a utilização de dados secundários produzidos pelo Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (Inep). Realizou-se análise descritiva das variáveis e, para determinação dos fatores associados ao desempenho acadêmico, aplicaram-se regressão linear simples e regressão múltipla (p<0,05). A variabilidade do desempenho acadêmico pôde ser explicada em 11,7% pelas variáveis testadas no modelo de regressão. Constatou-se menor desempenho entre estudantes negros, que trabalham eventualmente, com renda familiar de até três salários mínimos, de pais e mães com nenhuma escolaridade, que cursaram metade do ensino médio em escola pública e metade em escola privada, que receberam bolsa de estudos ou financiamento e não ingressaram no ensino superior por políticas afirmativas. A categoria administrativa da instituição de educação superior (IES) foi o principal fator associado ao desempenho no Enade. Discentes que ingressaram via políticas afirmativas apresentaram desempenho maior que aqueles que não ingressaram por essas políticas. Observou-se que melhores condições do ensino fundamental e médio são importantes para que todos os estudantes concorram em situação de igualdade ao ensino superior

Marginal bone level changes and implant stability after loading are not influenced by baseline microstructural bone characteristics : 1-year follow-up

ObjectiveThe aim of this study was to investigate the influence of different bone tissue characteristics of implant sites on changes in marginal bone level and implant stability over time. Material and methodsOne hundred and one implants were inserted in 41 patients. Cortical bone thickness of the alveolar ridge was measured on computed tomography (CT) images. Histomorphometric and microtomographic analyses (microCT) were performed in bone specimens obtained by using a trephine bur, at first drilling. Implant stability quotient (ISQ) measured by resonance frequency analysis (RFA) was registered at implant insertion. Implant stability quotient was measured also at the stages of uncovering, loading and at the 1-year follow-up, when standardized periapical radiographs were taken to measure the marginal bone level (MBL). Descriptive statistics, Spearman's rho correlation and multiple linear regression were used for data analysis (P0.05). Bivariate correlation also showed no association among these microstructural parameters and the outcomes evaluated. There was no correlation between cortical thickness and MBL changes (r=-0.029; P=0.832) and between cortical thickness and ISQ changes (r=0.145; P=0.292). ConclusionMicrostructural bone characteristics of implant sites have no effect on changes in marginal bone level and implant stability as measured by RFA. Bone morphology cannot predict implant treatment success over time

Flapped versus flapless surgery and delayed versus immediate loading for a four mini implant mandibular overdentures: a RCT on post-surgical symptoms and short-term clinical outcomes

OBJECTIVE This factorial randomized clinical trial tested the effects of the surgical approach (flapped - FPS versus flapless - FLS surgery) and loading protocol (delayed - DL versus immediate - IL) for treatment with a four mini implant mandibular overdenture. MATERIAL AND METHODS A total of 296 one-piece titanium-zirconium mini implants were inserted in 74 patients (IL/FLS=17; IL/FPS=18; DL/FLS=20; DL/FPS=19). Outcomes included patient's perceived surgical burdens, clinical time, implant survival, and post-surgical symptoms and complications, assessed immediately after surgery, in the 7-day and 6-week follow-ups. RESULTS Perceived surgical burdens were relatively low, higher for females, and no difference was found between flapped and flapless surgery. Surgical time was lower for flapless surgery. Overall symptoms were mild after 24 hours, and higher for females. Less symptoms were recorded for the flapless surgery compared to the flapped for the delayed loading patients, and flapless surgery was associated with lower risk of bleeding. No early implant failure was observed until the 6-week follow-up. Delayed was associated with discontinuous use of the prosthesis and poor function. Lower complaint rates were observed for immediate loading regardless of the surgery protocol. CONCLUSIONS Mini implants for mandibular overdenture is a feasible option regardless of surgical access and loading protocol, with high safety and predictable survival rates, and low incidence of post-insertion complications. Flapless surgery requires less clinical time and result in easier intraoral prosthetic incorporation of attachments compared to flapped surgeries. Immediate loading did not increase the risk of early implant failure when satisfactory primary stability was achieved

Single lateral implant for mandibular overdentures as a fallback solution or a viable treatment alternative: four case reports

This report of four clinical cases aims to illustrate the use of a lateral implant as a solution for implant overdentures in the mandible in different clinical situations. The first two cases describe the clinical situations of patients wearing two-implant mandibular overdentures until the failure of one of the implants, one due to implant loss and the other due to a fracture of an abutment screw, and how the conditions were managed. The third case illustrates the placement of a single implant to retain an overdenture, where a midline implant, as originally planned, was not feasible due to anatomic reasons. The final case describes the use of a lateral implant to support and retain a single-implant mandibular overdenture. The four cases demonstrate that a single lateral implant can be utilized as sole retention in cases of a failing contra-lateral implant and as an alternative to a single implant in the midline