The effect of steam sterilization on the accuracy of spring-style mechanical torque devices for dental implants

Minoo Mahshid,1 Aboulfazl Saboury,1 Ali Fayaz,1 Seyed Jalil Sadr,1 Friedrich Lampert,2 Maziar Mir2,31Department of Prosthodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Department of Conservative Dentistry, Aachen RWTH Hospital, Aachen, Germany; 3Beckman Laser Institute, UCI, Irvine, CA, USABackground: Mechanical torque devices (MTDs) are one of the most commonly recommended devices used to deliver optimal torque to the screw of dental implants. Recently, high variability has been reported about the accuracy of spring-style mechanical torque devices (S-S MTDs). Joint stability and survival rate of fixed implant supported prosthesis depends on the accuracy of these devices. Currently, there is limited information on the steam sterilization influence on the accuracy of MTDs. The purpose of this study was to assess the effect of steam sterilization on the accuracy (±10% of the target torque) of spring-style mechanical torque devices for dental implants.Materials and methods: Fifteen new S-S MTDs and their appropriate drivers from three different manufacturers (Nobel Biocare, Straumann [ITI], and Biomet 3i [3i]) were selected. Peak torque of devices (5 in each subgroup) was measured before and after autoclaving using a Tohnichi torque gauge. Descriptive statistical analysis was used and a repeated-measures ANOVA with type of device as a between-subject comparison was performed to assess the difference in accuracy among the three groups of spring-style mechanical torque devices after sterilization. A Bonferroni post hoc test was used to assess pairwise comparisons.Results: Before steam sterilization, all the tested devices stayed within 10% of their target values. After 100 sterilization cycles, results didn't show any significant difference between raw and absolute error values in the Nobel Biocare and ITI devices; however the results demonstrated an increase of error values in the 3i group (P < 0.05). Raw error values increased with a predictable pattern in 3i devices and showed more than a 10% difference from target torque values (maximum difference of 14% from target torque was seen in 17% of peak torque measurements).Conclusion: Within the limitation of this study, steam sterilization did not affect the accuracy (±10% of the target torque) of the Nobel Biocare and ITI MTDs. Raw error values increased with a predictable pattern in 3i devices and showed more than 10% difference from target torque values. Before expanding upon the clinical implications, the controlled and combined effect of aging (frequency of use) and steam sterilization needs more investigation.Keywords: accuracy, steam sterilization, mechanical torque devices, spring-style, dental implant

Microbial Contamination of Tray, Light Handle, and Dental Chair Handles before and after Disinfection with Deconex : Microbial Contamination before and after Disinfection with Deconex

Objectives Surfaces commonly touched during dental procedures can serve as a reservoir of microorganisms and lead to cross-infection. The aim of the present study was to assess the microbial contamination of tray, light handle and dental chair handles before and after disinfection with Deconex (Solarsept). Methods Samples were randomly collected from the tray, light handle and dental chair handles of active dental units in the Periodontics, Prosthodontics and Oral and Maxillofacial Surgery Departments of Dental School of Shahid Beheshti University of Medical Sciences. The samples were collected at two time points before and after daily surface disinfection with Deconex. The collected samples were sent to a microbiology laboratory to determine the type and number of microorganisms. Data were analyzed by Wilcoxon signed rank test (α=0.05). Results Based on the culture results and according to microscopic examination and Gram staining, the highest level of bacterial contamination before disinfection with Deconex (Solarsept) was found on dental units of the Oral and Maxillofacial Surgery Department (handles and tray), with Gram-positive Bacillus spp. Fixed and removable prosthodontics departments did not have any bacterial contamination. Overall, a reduction in bacterial load was detected after Deconex decontamination (P=0.05). Conclusion Spraying and wiping of dental unit components with Deconex at the end of working hours decreased the bacterial growth, and this effect remained until the next working day

Demographic determinants of obesity, and adherence to dietary and physical activity guidelines among 4 to 6-year-old children in Behbahan city, southwest Iran, 2016

Background and aim: The world is experiencing an alarming increase in prevalence of childhood obesity. The aim of this study was to determine the demographic determinants of obesity and adherence to dietary and physical activity guidelines among children aged 4 to 6 years old in Behbahan city, southwest Iran, in 2016. Methods: This cross-sectional study was conducted on 120 preschool children aged 4 to 6 years old in Behbahan city, southwest Iran, in 2016. Multi-stage random sampling was done. The weight and height of the children were measured with standard methods. The demographic and behavioral factors data were collected in self report questionnaires which were completed by the children’s mothers. The Chi-square test, Independent-samples ttests, One-way analysis of variances and logistic regression analysis were used for data analysis. SPSS software (version 22) was employed. Results: This study showed that 88.3% of the children did not meet the guideline of 5 servings per day of fruit and vegetables. Only 2.5% met the guideline of 60 minutes of structured physical activity every day. Sex and mother’s occupation status were associated with adhering to screen time guideline. This study found a significant difference in the mean of screen time between sexes. Boys were more likely to meet the screen time guideline. A significant association between adhering to physical activity guidelines and mother’s occupation status was revealed. Significant statistical relationship between demographic factors and BMI categories was not illustrated. Demographic covariates were not significantly related to adherence to dietary and physical activity guidelines. Conclusion: In preventive programs of obesity among 4 to 6-year-old children key lifestyle behaviors and demographic factors need to be considered

Effect of Procedure and Coronary Lesion Characteristics on Clinical Outcomes Among Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention: Insights From the PIONEER AF-PCI Trial

Contains fulltext : 190509.pdf (publisher's version ) (Closed access)OBJECTIVES: This study sought to assess whether there were significant interactions of procedural access strategies and lesion characteristics with bleeding and ischemic events among atrial fibrillation (AF) patients anticoagulated with rivaroxaban or warfarin following a percutaneous coronary intervention. BACKGROUND: Among stented AF patients, the impact of procedural access strategies or lesion characteristics on antithrombotic safety and efficacy outcomes is unclear. METHODS: In the PIONEER AF-PCI (An Open-label, Randomized, Controlled, Multicenter Study Exploring Two Treatment Strategies of Rivaroxaban and a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy in Subjects With Atrial Fibrillation Who Undergo Percutaneous Coronary Intervention) trial, 2,124 patients were randomized to 3 groups and followed for 12 months: 1) rivaroxaban 15 mg once daily plus a P2Y12 inhibitor (n = 709); 2) rivaroxaban 2.5 mg twice a day plus dual antiplatelet therapy (DAPT) (n = 709); and 3) dose-adjusted warfarin plus DAPT (n = 706). Kaplan-Meier rates of clinically significant bleeding and major adverse cardiovascular events were compared between treatments stratified by subgroups of procedure type and lesion characteristics. RESULTS: Compared with warfarin, both rivaroxaban regimens consistently reduced clinically significant bleeding across subgroups of radial versus femoral arterial access and by vascular closure device use. Treatment effect of rivaroxaban on major adverse cardiovascular events did not vary when stratified by ischemia-driven revascularization, urgency of revascularization, location of culprit artery, presence of bifurcation lesion, presence of thrombus, type, and length of stent or number of stents (interaction p > 0.05 for all subgroups). CONCLUSIONS: Among stented AF patients requiring long-term oral anticoagulation, there was no effect modification by procedure or lesion characteristics of either clinically significant bleeding or major adverse cardiovascular events. Rivaroxaban-based therapy was superior to warfarin plus DAPT in bleeding outcomes regardless of the type of stent or arterial access during the index coronary revascularization. (A Study Exploring Two Strategies of Rivaroxaban [JNJ39039039; BAY-59-7939] and One of Oral Vitamin K Antagonist in Patients With Atrial Fibrillation Who Undergo Percutaneous Coronary Intervention [PIONEER AF-PCI]; NCT01830543)

Betrixaban for first-line venous thromboembolism prevention in acute medically ill patients with risk factors for venous thromboembolism.

Compared to other direct oral anticoagulants, betrixaban has a longer half-life, smaller peak-trough variance, minimal renal clearance, and minimal hepatic Cytochrome P (CYP) metabolism. The Acute Medically Ill VTE Prevention with Extended Duration Betrixaban (APEX) trial evaluated the efficacy and safety of extended duration betrixaban compared to standard duration enoxaparin in acutely ill hospitalized patients. Areas covered: This article describes the role of betrixaban in the prevention of venous thromboembolism (VTE) in acutely ill medical patients. This article provides a consolidated summary of the primary APEX study findings as well as prespecified and exploratory substudies. This article also provides a review of the results of studies in which other direct factor Xa inhibitors have been evaluated in an extended duration regimen in this patient population. Expert commentary: While previous agents have demonstrated that extended duration VTE prophylaxis can be efficacious, betrixaban is the first agent to demonstrate efficacy without an increase in major bleeding. The totality of the data from the APEX trial supports extended duration betrixaban for VTE prophylaxis in the acute medically ill patient population. As such, betrixaban has been approved in the USA for extended VTE prophylaxis in at-risk acute medically ill patients