The Significance of the Lingual Nerve During Periodontal/Implant Surgery

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141105/1/jper0372.pd

Tissue Biotype and Its Relation to the Underlying Bone Morphology

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142069/1/jper0569.pd

Clinical, microbiological, and salivary biomarker profiles of dental implant patients with type 2 diabetes

Objective Regulators of peri‐implant bone loss in patients with diabetes appear to involve multiple risk factors that have not been clearly elucidated. This study was conducted to explore putative local etiologic factors on implant bone loss in relation to type 2 diabetes mellitus, including clinical, microbial, salivary biomarker, and psychosocial factors. Materials and methods Thirty‐two subjects (divided into type 2 diabetes mellitus and non‐diabetic controls), having at least one functional implant and six teeth, were enrolled in a 1‐year longitudinal investigation. Analyses of clinical measurements and standardized intra‐oral radiographs, saliva and serum biomarkers (via protein arrays for 20 selected markers), and plaque biofilm (via q PCR for eight periodontal pathogens) were performed at baseline and 1 year. In addition, the subjects were asked to respond to questionnaires to assess behavioral and psychosocial variables. Results There was a significant increase from baseline to 1 year in the probing depth of implants in the diabetes group (1.95 mm to 2.35 mm, P  = 0.015). The average radiographic bone loss during the study period marginally increased at dental implants compared to natural teeth over the study period (0.08 mm vs. 0.05 mm; P  = 0.043). The control group harbored higher levels of T reponema denticola at their teeth at baseline ( P  = 0.046), and the levels of the pathogen increased significantly over time around the implants of the same group ( P  = 0.003). Salivary osteoprotegerin ( OPG ) levels were higher in the diabetes group than the control group at baseline only; in addition, the salivary levels of IL ‐4, IL ‐10, and OPG associated with host defense were significantly reduced in the diabetes group ( P  = 0.010, P  = 0.019, and P  = 0.024), while controls showed an increase in the salivary OPG levels ( P  = 0.005). For psychosocial factors, there were not many significant changes over the observation period, except for some findings related to coping behaviors at baseline. Conclusions The study suggests that the clinical, microbiological, salivary biomarker, and psychosocial profiles of dental implant patients with type 2 diabetes who are under good metabolic control and regular maintenance care are very similar to those of non‐diabetic individuals. Future studies are warranted to validate the findings in longer‐term and larger clinical trials ( ClinicalTrials.gov # NCT00933491).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107497/1/clr12139.pd

Blood flow changes using a 3D xenogeneic collagen matrix or a subepithelial connective tissue graft for root coverage procedures: a pilot study.

BACKGROUND: The study investigated the early healing process following the treatment of single Miller class I and II recessions with a 3D xenogeneic collagen matrix (CMX) or connective tissue graft (CTG). METHODS: This pilot investigation was designed as a single-center randomized controlled parallel trial. A total of eight subjects (four per group) were treated with either CMX or CTG in the anterior maxilla. Vascular flow changes were assessed by laser Doppler flowmetry (LDF) before and after surgery and at days 1, 2, 3, 7, 14, and 30 while clinical evaluations took place at baseline and at days 60 and 180. Pain intensity perception was evaluated by the short-form McGill pain questionnaire (SF-MPQ), at days 1 and 14. RESULTS: The vascular flow fluctuated similarly in both groups pre- and post-operatively, but the CTG exhibited a more homogeneous pattern as opposed to CMX that showed a second phase of increased blood flow at 14 days. Clinically, the CTG led to greater change in mean root coverage and keratinized tissue gain but CMX was associated with lower early pain intensity scores. CONCLUSIONS: Within the limits of the study, the vascular flow alterations during the early healing of both graft types followed a similar pattern. The CMX was associated with a second peak of increased blood flow. CLINICAL RELEVANCE: The vascular flow changes after the application of CMX for single tooth recession root coverage did not show major differences from those observed after the use of a CTG. A trend for better clinical performance in terms of root coverage and keratinized tissue gain was noted for the CTG, but the initial patient morbidity was less for CMX

Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial

BACKGROUND: Chronic inflammation is believed to be a major mechanism underlying the pathophysiology of type 2 diabetes. Periodontitis is a cause of systemic inflammation. We aimed to assess the effects of periodontal treatment on glycaemic control in people with type 2 diabetes. METHODS: In this 12 month, single-centre, parallel-group, investigator-masked, randomised trial, we recruited patients with type 2 diabetes, moderate-to-severe periodontitis, and at least 15 teeth from four local hospitals and 15 medical or dental practices in the UK. We randomly assigned patients (1:1) using a computer-generated table to receive intensive periodontal treatment (IPT; whole mouth subgingival scaling, surgical periodontal therapy [if the participants showed good oral hygiene practice; otherwise dental cleaning again], and supportive periodontal therapy every 3 months until completion of the study) or control periodontal treatment (CPT; supra-gingival scaling and polishing at the same timepoints as in the IPT group). Treatment allocation included a process of minimisation in terms of diabetes onset, smoking status, sex, and periodontitis severity. Allocation to treatment was concealed in an opaque envelope and revealed to the clinician on the day of first treatment. With the exception of dental staff who performed the treatment and clinical examinations, all study investigators were masked to group allocation. The primary outcome was between-group difference in HbA1c at 12 months in the intention-to-treat population. This study is registered with the ISRCTN registry, number ISRCTN83229304. FINDINGS: Between Oct 1, 2008, and Oct 31, 2012, we randomly assigned 264 patients to IPT (n=133) or CPT (n=131), all of whom were included in the intention-to-treat population. At baseline, mean HbA1c was 8·1% (SD 1·7) in both groups. After 12 months, unadjusted mean HbA1c was 8·3% (SE 0·2) in the CPT group and 7·8% (0·2) in the IPT group; with adjustment for baseline HbA1c, age, sex, ethnicity, smoking status, duration of diabetes, and BMI, HbA1c was 0·6% (95% CI 0·3-0·9; p<0·0001) lower in the IPT group than in the CPT group. At least one adverse event was reported in 30 (23%) of 133 patients in the IPT group and 23 (18%) of 131 patients in the CPT group. Serious adverse events were reported in 11 (8%) patients in the IPT group, including one (1%) death, and 11 (8%) patients in the CPT group, including three (2%) deaths. INTERPRETATION: Compared with CPT, IPT reduced HbA1c in patients with type 2 diabetes and moderate-to-severe periodontitis after 12 months. These results suggest that routine oral health assessment and treatment of periodontitis could be important for effective management of type 2 diabetes. FUNDING: Diabetes UK and UK National Institute for Health Research.Diabetes UK and UK National Institute for Health Researc

Differentially Private Federated Learning

Federated Learning is a way of training neural network models in a decentralized manner; It utilizes several participating devices (that hold the same model architecture) to learn, independently, a model on their local data partition. These local models are then aggregated (in parameter domain), achieving equivalent performance as if the model was trained centrally. On the other hand, Differential Privacy is a well-established notion of data privacy preservation that can provide formal privacy guarantees based on rigorous mathematical and statistical properties. The majority of the current literature, at the intersection of these two fields, only considers privacy from a client’s point of view (i.e., the presence or absence of a client during decentralized training should not affect the distribution over the parameters of the final (central) model). However, it disregards privacy at a single (training) data-point level (i.e., if an adversary has partial, or even full access to the remaining training data-points, they should be severely limited in inferring sensitive information about that single data-point, as long as it is bounded by a differential privacy guarantee). In this thesis, we propose a method for end-to-end privacy guarantees with minimal loss of utility. We show, both empirically and theoretically, that privacy bounds at a data-point level can be achieved within the proposed framework. As a consequence of this, satisfactory client-level privacy bounds can be realized without making the system noisier overall, while obtaining state-of-the-art results.Federated Learning är ett sätt att träna neurala nätverksmodeller på ett decentraliserat sätt. Metoden använder flera deltagande enheter med samma modellarkitektur för att självständigt lära sig en modell på sin egen lokala datapartition. Dessa lokala modeller aggregeras sedan i parameterdomänen och uppnår motsvarande prestanda som om modellen tränats centralt. Å andra sidan är Differential Privacy ett väletablerat begrepp inom integritetsskydd som kan ge formella integritetsgarantier baserade på rigorösa matematiska och statistiska egenskaper. Majoriteten av den aktuella litteraturen, i korsningen mellan dessa två områden, beaktar bara integritet ur en klients synvinkel. Närvaron eller frånvaron av en klient under decentraliserad träning bör inte påverka fördelningen över parametrarna för den slutliga, centrala, modellen. Emellertid bortser man från sekretess på nivån för enskilda tränings-datapunkter, dvs. om en angripare har delvis eller till och med full tillgång till de återstående träningsdatapunkterna, bör dess möjlighet att dra slutsatser om känslig information rörande den enskilda datapunkten vara starkt begränsad, förutsatt att den omfattas av en differentierad integritetsgaranti. I det här examensarbetet föreslår vi en metod för integritetsgarantier med minimal förlust av användbarhet. Vi visar, både empiriskt och teoretiskt, att integritetsgränser på en datapunkt kan uppnås inom det föreslagna ramverket. Som en följd av detta kan tillfredsställande sekretessgränser på klientnivå realiseras utan att göra systemet brusigare på en övergripande nivå, samtidigt som man uppnår bästa möjliga resultat

Knowledge, views and values of farmers towards organic agriculture issues: a case study on the island of Rhodes, with approaches from the field of Education

This dissertation investigates the knowledge, views and values of the farmers of Rhodes, in relation to organic crops, which are crucial for the implementation of an environmentally friendly, sustainable agriculture. To conduct the doctoral research, a questionnaire was prepared containing 21 main questions, with many sub-questionsSome results : The farmers of Rhodes, believe that the environment is being destroyed today and is not an exaggeration. They also believe in the existence of climate change and want immediate action to be taken to address its adverse effects. They are informed about classical - conventional agriculture, but not well informed about integrated agriculture. As far as organic farming is concerned, they are well informed and believe that organic products contribute to the protection of consumer health, their individual health and the protection of the environment. At the same time, they want state funds to be made available exclusively for organic farming research.Η παρούσα διατριβή ερευνά, τις γνώσεις, απόψεις και αξίες των αγροτών της Ρόδου, σε σχέση με τις βιολογικές καλλιέργειες, που είναι καθοριστικές για την εφαρμογή μιας, φιλοπεριβαλλοντικής, αειφορικής γεωργίας. Για τη διεξαγωγή της διδακτορικής έρευνας, συντάχθηκε ερωτηματολόγιο που περιείχε 21 κύριες ερωτήσεις, με πολλές υποερωτήσεις. Ορισμένα αποτελέσματα είναι: Οι αγρότες της Ρόδου, πιστεύουν ότι το περιβάλλον καταστρέφεται στη σημερινή εποχή και δεν είναι μια υπερβολική εκτίμηση. Επίσης πιστεύουν στην ύπαρξη της κλιματικής αλλαγής και επιθυμούν να γίνουν άμεσα ενέργειες για την αντιμετώπιση των δυσμενών αποτελεσμάτων της. Είναι ενημερωμένοι για την κλασική – συμβατική γεωργία, όχι όμως καλά ενημερωμένοι για την ολοκληρωμένη γεωργία. Όσον αφορά τη βιολογική γεωργία, είναι αρκετά ενημερωμένοι και πιστεύουν ότι τα βιολογικά προϊόντα, συμβάλουν στην προστασία της υγείας του καταναλωτή, στην ατομική τους υγεία και στην προστασία του περιβάλλοντος. Επιθυμούν συγχρόνως να διατίθενται κρατικά κονδύλια, αποκλειστικά για την έρευνα στη βιολογική γεωργία

Elastoplastic study of nanosecond-pulsed laser interaction with metallic films using 3D multiphysics fem modeling

Summarization: The elastoplastic dynamic mechanical behavior of thin metallic films excited by a nanosecond laser pulse is studied. The dynamic response of the metal films is numerically described by a coupled thermal-structural, transient three-dimensional model based on the finite element method. The developed finite element model takes into account the temperature-dependent true stress-strain curves, the temperature-dependent thermal properties and matters phase changes. Since the numerical simulations include the dynamic changes of the metallic materials mechanical properties, the obtained spatiotemporal numerical solutions provide detailed descriptions of their elastoplastic response. Thus, the experimentally validated model is able to diagnose and predict spatiotemporally matters elastic and plastic deformations that occur during the interaction with a nanosecond laser pulse. Gold, copper, and aluminum thin metallic films are used as test cases to demonstrate the effectiveness of the proposed finite element modeling and simulation.Παρουσιάστηκε στο: International Journal of Damage Mechanic

Repeated delivery of chlorhexidine chips for the treatment of peri‐implantitis: A multicenter, randomized, comparative clinical trial

BackgroundPeri‐implantitis is a challenging condition to manage and is frequently treated using non‐surgical debridement. The local delivery of antimicrobial agents has demonstrated benefit in mild to moderate cases of peri‐implantitis. This study compared the safety and efficacy of chlorhexidine gluconate 2.5 mg chip (CHX chips) as an adjunctive treatment to subgingival debridement in patients afflicted with peri‐implantitis.MethodsA multicenter, randomized, single‐blind, two‐arm, parallel Phase‐3 study was conducted. Peri‐implantitis patients with implant pocket depths (IPD) of 5‐8 mm underwent subgingival implant surface debridement followed by repeated bi‐weekly supragingival plaque removal and chlorhexidine chips application (ChxC group) for 12 weeks, or similar therapy but without application of ChxC (control group). All patients were followed for 24 weeks. Plaque and gingival indices were measured at every visit whereas IPD, recession, and bleeding on probing were assessed at 8, 12, 16, 24 week.ResultsA total of 290 patients were included: 146 in the ChxC group and 144 in the control. At 24 weeks, a significant reduction in IPD (P = 0.01) was measured in the ChxC group (1.76 ± 1.13 mm) compared with the control group (1.54 ± 1.13 mm). IPD reduction of ≥2 mm was found in 59% and 47.2% of the implants in the ChxC and control groups, respectively (P = 0.03). Changes in gingival recession (0.29 ± 0.68 mm versus 0.15 ± 0.55 mm, P = 0.015) and relative attachment gain (1.47 ± 1.32 mm and 1.39 ± 1.27 mm, P = 0.0017) were significantly larger in the ChxC group. Patients in the ChxC group that were < 65 years exhibited significantly better responses (P < 0.02); likewise, non‐smokers had similarly better response (P < 0.02). Both protocols were well tolerated, and no severe treatment‐related adverse events were recorded throughout the study.ConclusionsPatients with peri‐implantitis that were treated with an intensive treatment protocol of bi‐weekly supragingival plaque removal and local application of chlorhexidine chips had greater mean IPD reduction and greater percentile of sites with IPD reduction of ≥2 mm as compared with bi‐weekly supra‐gingival plaque removal.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/166183/1/jper10672.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/166183/2/jper10672_am.pd

Simulation of the transient behavior of matter with characteristic geometrical variations & defects irradiated by nanosecond laser lulses using FEA

Summarization: The thermomechanical transient response of matter illuminated by nanosecond laser pulses is modeled and simulated using the Finite Element Analysis (FEA). Matter’s behavior is numerically described by a three-dimensional (3D) multiphysics, coupled thermal structural, transient FEA, experimentally validated, model. FEA offers substantial insights into the materials’ micro-mechanical behaviour providing detailed information for the spatiotemporal evolution of acoustic waves. In this computational approach the impact of the geometric characteristics of the modeled metallic films to the generation and propagation of the ultrasonic waves, in relation to temperature, is investigated. The study is expanded to the dynamic reactions of matter in the presence of surface and solid volume defects and enclosures e.g.: gaps, holes or bubbles. The transient behavior of matter in the time and the space solution domains is obtained by the FEA model and presented.Presented on: Key Engineering Material