Implant supported cantilevered fixed dental rehabilitations in partially edentulous patients : systematic review of the literature. Part I

Objectives: To investigate in which clinical situations a cantilever fixed implant supported restorations can be a treatment alternative and which complications are reported. Materials and Methods: Two operators screened the literature (MEDLINE, EMBASE) and performed a hand search on the main journals dealing with implantology and prosthetics until 31 December 2017. Only articles that considered cantilever implant fixed restorations with at least 10 patients and with a mean follow-up of at least 5\ua0year were selected. The outcome variables were survival of implants and prosthesis, mechanical, technical and biological complications, marginal bone loss. The review was performed according to the PRISMA statements. Risk of bias assessment was evaluated. Failure and complication rates were analysed using random effect Poisson regression models to obtain summary estimate of 5- and 10-year survival and complication rates. Results: A total of nine papers were selected for partially edentulous patients and reported high survival rate of the prosthesis. The estimated survival rate for 5\u201310\ua0years was calculated to be 98.4% for the implants and 99.2% for the rehabilitations. Mechanical, technical and biological complications were reported with a cumulative 5\u201310\ua0years complication rate of 28.66% and 26.57% for the patients and for the prosthesis, respectively. Two papers for single implant supporting 2-unit cantilever were not sufficient to draw conclusions. Conclusions: There is evidence that cantilever can be successful treatment in partially edentulous patients. In two adjacent edentulous sites, data are not yet sufficient

Identification of most relevant variables and processes to assess the environmental impacts of remediation technologies along their life cycles: Focus on the waste management scenarios

The application of Life Cycle Assessment (LCA) to remediation technologies is still not a consolidated practice and it is especially lacking in the assessment of the environmental impacts associated to the management of the waste produced during remediation. This study aims at addressing these methodological gaps by identifying the typologies of waste typically generated during the remediation of a contaminated site and classifying them according to the European Waste Catalogue (EWC) codes. Thereafter, the following steps are: (i) the identification of the waste management scenarios (WMSs) applicable to the identified waste typologies, (ii) the selection of Life Cycle Assessment processes that can be used to assess the impacts of the different WMSs and (iii) the quantification and comparison of the environmental impacts caused by the different WMSs applied considering hazardousness levels to which the same waste may belong in relation to its contamination levels and characteristics: inert, non-hazardous and hazardous waste (Waste Framework Directive 2008/98/EC). As results, a matrix reporting the classes and typologies of waste, their EWC codes, their different WMSs and the suitable LCA processes from the Ecoinvent database that can be applied to each EWC within a specific WMS, has been developed. Additionally, the comparative assessment of the impacts caused by the Ecoinvent processes applicable to the same waste typology within the same WMS has been performed to support the selection of the most appropriate WMS case by case

Bacterial melanin production by heterologous expression of 4 hydroxyphenylpyruvate dioxygenase from Pseudomonas aeruginosa

Pyomelanin is a reddish-brown pigment produced by bacteria of different genera and plays a variety of physiological roles. Proposals have been regarding the use of pyomelanin in various environmental, industrial and, more recently, cosmetic applications. In Pseudomonas aeruginosa, the enzyme 4\u2011hydroxyphenylpiruvate dioxygenase (Hpd) converts 4-hydroxyphenylpiruvate into homogentisic acid, which represents the key intermediate for melanin biosynthesis. This work aimed to obtain Escherichia coli cells overexpressing hpd gene from the PAO1 strain to produce large amounts of pyomelanin for biotechnological purposes. The recombinant dioxygenase expression gave E. coli JM109 the ability to produce pyomelanin. A series of biotransformations led us to choose the best experimental conditions for pyomelanin production. Cells were grown at the mid-exponential phase in a mineral medium with added glucose 10 mM as carbon and energy sources and casamino acid 0.2% w/v as an amino acid source. The administration of tyrosine 1 mM after 30 min of exposure to arabinose 1% w/v made it possible to purify 213 mg/L of pyomelanin after 6 days of biotransformation. In addition to the interesting biotechnological outcomes, the resulting expression system supports the correlation between the hpd gene from P. aeruginosa PAO1 and pyomelanin synthesis

Six-mm versus 10-mm long implants in the rehabilitation of posterior edentulous jaws : a 5-year follow-up of a randomised controlled trial

To compare the clinical outcome of 6-mm and 10-mm long implants in partially edentulous posterior areas. MATERIALS AND METHODS: Twenty-four patients, with a partially edentulous area in the jaws with a height and width allowing the positioning of 2 to 3 adjacent 10 7 4.1 mm implants without any augmentation procedure, were randomly allocated according to a parallel group design to receive 6-mm long or 10-mm long implants. A total of 54 implants were placed (26 7 6 mm and 28 7 10 mm implants). Patients were restored 8 weeks after surgery and were followed for 5 years. Outcome measures were prosthesis and implant survival, as well as marginal bone level changes and complications. RESULTS: After 5 years, 18 patients were available. One 6 mm implant failed during the healing period and its related prosthesis could not be placed. No implants were lost after loading. The 6 mm group registered 5 complications (1 mucositis, 3 prosthesis decementations and 1 chipping), while only 3 were registered in the 10 mm group (2 decementations and 1 chipping). The difference in complications between the two groups was not statistically significant (P = 0.39). Marginal bone loss at 5 years was 0.43 and 0.24 mm with the 6 mm and 10 mm groups, respectively (not statistically significant; difference between the two groups 0.19 mm; SD 0.23 mm; 95% CI -0.34;0.73; t test P = 0.42) CONCLUSIONS: Implant and prosthetic survival and success rates were similar between prostheses supported by 6-mm or 10-mm long implants. Conflict-of-interests statement: The present study was supported by grant 369_2004 from ITI, Basel, Switzerland used to provide free implants and prosthetic components to the patient. Authors declare no conflict of interest

Stratification of prosthetic complications by manufacturer in implant-supported restorations with a 5 years’ follow-up: systematic review of the literature

INTRODUCTION: Prosthetic complications on implant-supported restorations have been documented in several papers published in the literature. Several manufacturers are present on the market but results are often cumulated and may thus be misleading. The objective of the present review is to assess the prosthetic complications of implant-supported restorations with particular interest of the results obtained with prostheses from different manufacturers. EVIDENCE ACQUISITION: A manual search of Medline/PubMed was carried out up to June 2016, yielding a total of 6832 articles, which were narrowed down to 1450, then 347 abstracts to include 55 papers after full text reading. Papers with at least 5 years of follow-up reporting on prosthetic complications of single and fixed partial prosthesis were included. Prosthetic complications were divided into mechanical and technical complications, and reported in a table. EVIDENCE SYNTHESIS: Overall 14.4% of prosthetic complication was found for a total of 6623 restorations followed for an average of 7.4 years (range 5-16 years). Results where then sorted and compared. Single crowns were affected by 1.4% of mechanical complications and 10.9% of technical complications after a mean of 7.4 years. Fixed partial prosthesis were affected by 2.5% of mechanical complications and 18% of technical complications. Screw-retained and cemented restorations were calculated to have a 5 years rate of complications of 21.2% and 9.3%, respectively, which demonstrated a statistically difference with fisher exact test with P<0.1. Only 3 manufacturers presented more than 10 articles and were directly compared with Fisher's exact test with P<0.1. The incidence of overall complications was estimated to be after 5 years of 11.2%, 10.8% and 13.8% for Straumann, Nobel, and Astratech, respectively, but dividing results in mechanical and technical complications, gave different results. Straumann was estimated to have less mechanical complications after 5 years in respect to Nobel and Astratech, but the three were similar for technical complications. CONCLUSIONS: although studies present very different material and methods and do not report all data, some conclusions can be made. The difference between mechanical complications lead the authors to suppose that there might be a difference in results obtained by different implant abutment connections. It is also noticed that all papers were published by expert clinicians and universities research centers that apply rigid surgical and prosthetic protocols and use original abutments

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Implant-supported cantilevered fixed dental rehabilitations in fully edentulous patients : Systematic review of the literature. Part II

AIM: To investigate fully edentulous patients rehabilitated with cantilever-fixed implant-supported restorations and to analyse which complications are reported for this type of treatment. MATERIALS AND METHODS: Two operators screened the literature (MEDLINE, EMBASE) and performed a hand search on the main journals dealing with implantology and prosthetics until 31 December 2017. Only articles that considered cantilever implant-fixed restorations with at least 10 patients and with a mean follow-up of at least 5 years were selected. The outcome variables were survival of implants and prosthesis, mechanical, technical and biological complications, marginal bone loss. The review was performed according to the PRISMA statements. The risk of bias was evaluated for each article. Failure and complication rates were analysed using random effect Poisson regression models to obtain summary estimate of 5- and 10-year survival and complication rates. RESULTS: Fourteen papers for fully edentulous patients were selected. The estimated 5 to 10 years survival rate was calculated to be 99.00% and 96.7% for the implants and the prosthesis, respectively. A total of 299 complications (technical and biological) were reported with a cumulative 5-10 years complication rate of 44.41% and 39.46% for the patients and for the prosthesis, respectively. CONCLUSIONS: There is evidence that cantilever can be successful treatment in fully edentulous patients