Topographic characterisation of dental implants for commercial use

To characterize the surface topography of several dental implants for commercial use. Dental implants analyzed were Certain (Biomet 3i), Tissue Level (Straumann), Interna (BTI), MG-InHex (MozoGrau), SPI (Alphabio) and Hikelt (Bioner). Surface topography was ascertained using a confocal microscope with white light. Roughness parameters obtained were: Ra, Rq, Rv, Rp, Rt, Rsk and Rku. The results were analysed using single-factor ANOVA and Student-Neuman-Keuls(p<0.05) tests. Certain and Hikelt obtained the highest Ra and Rq scores, followed by Tissue Level. Interna and SPI obtained lower scores, and MG-InHex obtained the lowest score. Rv scores followed the same trend. Certain obtained the highest Rp score, followed by SPI and Hikelt, then Interna and Tissue Level. MG-InHex obtained the lowest scores. Certain obtained the highest Rt score, followed by Interna and Hikelt, then SPI and Tissue Level. The lowest scores were for MG-InHex. Rsk was negative (punctured surface) in the MG-InHex, SPI and Tissue Level systems, and positive (pointed surface) in the other systems. Rku was higher than 3 (Leptokurtic) in Tissue Level, Interna, MG-InHex and SPI, and lower than 3 (Platykurtic) in Certain and Hikelt. The type of implant determines surface topography, and there are differences in the roughness parameters of the various makes of implants for clinical use

Influence of cavity preparation technique (rotary vs. ultrasonic) on microleakage and marginal fit of six end-root filling materials

Objectives: To evaluate in vitro the effect of cavity preparation with microburs and diamond-coated ultrasonic tips on the microleakage and marginal fit of six end-root filling materials. Study Design. The following materials were assessed: amalgam (Amalcap), zinc oxide eugenol (IRM), glass ionomer (Vitrebond), compomer (Cavalite), mineral particle aggregate (MTA) and composite (Clearfil). Cavity preparation was performed with microburs or diamond ultrasonic tips in single-root teeth. The seal was evaluated in two experiments: a microleakage assay on the passage of dye to the interface; and a scanning electron microscopy study and analysis of epoxy resin replicas, measuring the size of gaps in the interface between filling material and cavity walls. Multifactorial ANOVA, multiple comparison test and Student?s t test were used for statistical analyses of the data, considering p<0.05 to be significant. Results: Clearfil and MTA achieved a hermetic seal. Leakage and interface gap size was greater with Cavalite than with Clearfil and MTA, followed by Vitrebond and IRM. The worst seal was obtained with Amalcap. The use of diamond-coated ultrasonic tips improved the seal and reduced the gap when using materials that did not hermetically seal the cavity (Amalcap, IRM, Cavalite, Vitrebond). The preparation technique did not affect materials that achieved a hermetic seal (Clearfil, MTA). Conclusions: Clearfil and MTA obtained a hermetic seal due to their excellent marginal fit and are the most recommended materials for clinical use, taking account of their sealing capacity. Ultrasonic cavity preparation is preferable because it improves the seal and marginal fit of materials that do not achieve a hermetic seal of the cavity (Amalcap, IRM, Cavalite, Vitrebond)

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 &lt; 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