Automated Analysis of MUTEX Algorithms with FASE

In this paper we study the liveness of several MUTEX solutions by representing them as processes in PAFAS s, a CCS-like process algebra with a specific operator for modelling non-blocking reading behaviours. Verification is carried out using the tool FASE, exploiting a correspondence between violations of the liveness property and a special kind of cycles (called catastrophic cycles) in some transition system. We also compare our approach with others in the literature. The aim of this paper is twofold: on the one hand, we want to demonstrate the applicability of FASE to some concrete, meaningful examples; on the other hand, we want to study the impact of introducing non-blocking behaviours in modelling concurrent systems.Comment: In Proceedings GandALF 2011, arXiv:1106.081

Comparative evidence of different surgical techniques for the management of vertical alveolar ridge defects in terms of complications and efficacy: A systematic review and network meta-analysis

Aim: To systematically appraise the available evidence on vertical ridge augmentation (VRA) techniques and estimate a treatment-based ranking on the incidence of complications as well as their clinical effectiveness. // Materials and Methods: Searches were conducted in six databases to identify randomized clinical trials comparing VRA techniques up to November 2022. The incidence of complications (primary) and of early, major, surgical and intra-operative complications, vertical bone gain (VBG), marginal bone loss, need for additional grafting, implant success/survival, and patient-reported outcome measures (secondary) were chosen as outcomes. Direct and indirect effects and treatment ranking were estimated using Bayesian pair-wise and network meta-analysis (NMA) models. // Results: Thirty-two trials (761 participants and 943 defects) were included. Five NMA models involving nine treatment groups were created: onlay, inlay, dense-polytetrafluoroethylene, expanded-polytetrafluoroethylene, titanium, resorbable membranes, distraction osteogenesis, tissue expansion and short implants. Compared with short implants, statistically significant higher odds ratios of healing complications were confirmed for all groups except those with resorbable membranes (odds ratio 5.4, 95% credible interval 0.92–29.14). The latter group, however, ranked last in clinical VBG. // Conclusions: VRA techniques achieving greater VBG are also associated with higher incidence of healing complications. Guided bone regeneration techniques using non-resorbable membranes yield the most favourable results in relation to VBG and complications

Bone Remodelling in BioShape

AbstractMany biological phenomena are inherently multiscale, i.e. they are characterised by interactions involving different scales at the same time. This is the case of bone remodelling, where macroscopic behaviour (at organ and tissue scale) and microstructure (at cell scale) strongly influence each other. Consequently, several approaches have been defined to model such a process at different spatial and temporal levels and, in particular, in terms of continuum properties, abstracting in this way from a realistic – and more complex – cellular scenario. While a large amount of information is available to validate such models separately, more work is needed to integrate all levels fully in a faithful multiscale model.In this scenario, we propose the use of BioShape, a 3D particle-based, scale-independent, geometry and space oriented simulator. It is used to define and integrate a cell and tissue scale model for bone remodelling in terms of shapes equipped with perception, interaction and movement capabilities. Their in-silico simulation allows for tuning continuum-based tissutal and cellular models, as well as for better understanding – both in qualitative and in quantitative terms – the blurry synergy between mechanical and metabolic factors triggering bone remodelling

Immediate Nonocclusal Versus Early Loading of Dental Implants in Partially Edentulous Patients – —15-year Follow-up of a Multicentre Randomised Controlled Trial

PURPOSE. To compare peri-implant bone and soft-tissue levels at immediately non-oc-clusally loaded versus non-submerged early-loaded implants in partially edentulous patients 15 years after loading. MATERIALS AND METHODS. Fifty-two patients from five Italian private practices were randomised, 25 to immediate loading and 27 to early loading. To be immediately loaded, single full Osseotite implants had to be inserted with a torque of at least 30 Ncm, and splinted implants with a torque of at least 20 Ncm. Immediately loaded implants were provided with non-occluding temporary restorations within 48 hours, which were brought into full occlusion after 2 months. In the early loading group, implants were loaded after 2 months. Definitive restorations were provided 8 months after implant placement in both groups. Outcome measures were prosthesis failures, implant failures and complica-tions, recorded by non-blinded assessors, and peri-implant bone and soft-tissue levels, as evaluated by blinded assessors. RESULTS. Fifty implants were loaded immediately and 54 early. Twelve patients with 24 implants dropped out from the immediate group versus 11 patients with 22 implants from the early loaded group, but all remaining patients were followed up for at least 15 years after loading. One single implant with its provisional crowns and one definitive prothesis failed in the immediate loading group. Seven patients with immediately loaded and two with early loaded implants reported complications. There were no statistically significant differences between groups in terms of implant failures (Fisher’s exact test P = 0.481; diff. =-0.04, 95% CI:-0.16 to 0.08), prosthesis failures (Fisher’s exact test P = 0.226; diff. =-0.08, 95% CI:-0.21 to 0.06), or complications (Fisher’s exact test P = 0.066; diff. =-0.22, 95% CI:-0.41 to 0.01). There were also no statistically significant differences in peri-implant bone (diff. = 0.28 mm, 95%CI:-0.35 to 0.91; P = 0.368) or soft-tissue level changes (diff. = 0.34 mm, 95%CI:-0.32 to 1.00; P = 0.292) between the two groups. Specifically, after 15 years immediately loaded patients had lost an average of 1.75 mm, and early loaded patients an average of 1.44 mm of peri-implant marginal bone. CONCLUSIONS. The long-term prognosis of prostheses supported by both immediately and early-loaded implants seems favourable

A metanalysis on cabozantinib and bone metastases: True story or commercial gimmick?

Is it true that cabozantinib should be the preferred option treating patients with bone metastases? Are there any reliable comparisons between this drug and other standard options in this subgroup? To address the issue, we performed a systematic review and metanalysis of randomized trials with cabozantinib, to assess its effectiveness, in terms of overall survival, according to the presence of bone metastases. We included (a) randomized controlled trials; (b) any solid tumors and therapeutic line; and (c) overall survival data available according to the site of disease. Cabozantinib improved overall survival both for the group with bone metastases, with risk of death decreased by 53% (hazard ratio, 0.47; 95% confidence interval, 0.26–0.87; P=0.02) and for the group without bone metastases, decreasing the risk of death by 44% (hazard ratio, 0.56; 95% confidence interval, 0.40–0.79; P=0.001) over the standard of care. The difference was not significantly different between the two groups. Despite cabozantinib can be undoubtedly listed as a good therapeutic option for cancer patients with bone metastases, it seems that its preclinical profile against bone remodeling does not translate into an actual clinical relevance, preventing from considering the presence of bone metastases as principal criterion for the choice of this drug

Crestal or 1.5 Mm Subcrestal Positioning of Transmucosal Dental Implants with Cemented or Screw-retained Crowns in Posterior Jaws: 4-month Data from a Single Centre Randomised Controlled Trial

OBJECTIVES. To compare crestal versus 1.5 mm subcrestal positioning of single transmu-cosal dental implants and screw-retained versus cemented crowns. MATERIALS AND METHODS. One hundred and sixty partially edentulous patients requiring one single implant-supported crown in the premolar/molar area were randomly allocated to four arms: crestal positioning and screw-retained crown (Group 1, 40 patients); crestal positioning and cement-retained crown (Group 2, 40 patients); 1.5 mm subcrestal positioning and screw-retained crown (Group 3, 40 patients); or 1.5 mm subcrestal positioning and cement-retained crown (Group 4, 40 patients) by a single operator. After an unloaded healing period of 3 months, definitive metal-ceramic crowns were delivered, and patients were followed up to 4 months after loading. Outcome measures were: crown and implant failures, complications, aesthetics assessed using the pink aesthetic score (PES), peri-implant marginal bone level changes and patient satisfaction, all recorded, when possible, by blinded assessors. RESULTS. At four months post-loading, four patients dropped out (two from Group 1 and one each from Groups 2 and 3, respectively). Two implants each failed in Groups 2 and 4, but there were no statistically significant differences between groups (P = 1.000). Complications affected four patients from Group 1, one from Group 2, two from Group 3 and six from Group 4, but between-group differences were not statistically significant (P = 0.207). The mean pink aesthetic scores were 10.30 ± 2.13 (Group 1), 10.22 ± 2.76 (Group 2), 10.47 ± 2.96 (Group 3), and 10.51 ± 2.24 (Group 4), respectively, with no statistically significant differences between groups (P = 0.9541). Likewise, there were no statistically significant differences in peri-implant marginal bone loss at 4 months after loading between groups (P = 0.9011:-0.21 mm ± 0.28 for Group 1,-0.25 mm ± 0.27 for Group 2,-0.28 mm ± 0.57 for Group 3 and-0.24 mm ± 0.26 for Group 4). Furthermore, there were no differences in patient satisfaction in terms of either function (P = 0.400) or aesthetics (P = 1.000), and all patients would undergo the same intervention again. CONCLUSIONS. No appreciable statistical or clinical differences were found between cre-stal or 1.5 mm subcrestal placement of transmucosal implants in posterior jaws or between rehabilitation with screw-retained or cement-retained crowns. However, longer follow-ups are required in order to formulate reliable clinical recommendations. CONFLICT OF INTEREST STATEMENT. GlobalD (Brignais, France), the manufacturer of the implants used in this investigation, partially funded this trial and donated the implants and the prosthetic components. However, all data belongs to the authors and the sponsor by no means interfered with the conduct of the trial or the publication of its results

Clinical efficacy of minimally invasive surgical (MIS) and non-surgical (MINST) treatments of periodontal intra-bony defect. A systematic review and network meta-analysis of RCT's

Objective: The aim of this systematic review was to explore the efficacy of different minimal invasive surgical (MIS) and non-surgical (MINST) approaches for the treatment of intra-bony defect in terms of clinical attachment level (CAL) gain and periodontal pocket depth (PPD) reduction. / Methods: A detailed review protocol was designed according to PRISMA guideline. Online search was conducted on PubMed, Cochrane library and Embase. Only randomized clinical trials (RCTs) testing MIS or MINST procedure, with or without the application of a regenerative tool for the treatment of intra-bony defect, were included. Cochrane checklist for risk of bias assessment was used. Network meta-Analysis (NMAs) was used to rank the treatment efficacy. / Results: Nine RCTs accounting for 244 patients and a total of 244 defects were included. Only two studies were at low risk of bias. CAL gain for included treatment ranged from 2.58 ± 1.13 mm to 4.7 ± 2.5 mm while PPD reduction ranged from 3.19 ± 0.71 mm to 5.3 ± 1.5 mm. On the basis of the ranking curve, MINST showed the lowest probability to be the best treatment option for CAL gain. Pairwise comparisons and treatment rankings suggest superiority for regenerative approaches (CAL difference 0.78 mm, (0.14–1.41); P < 0.05) and surgical treatment elevating only the buccal or palatal flap (CAL difference: 0.95 mm, (0.33–1.57); P < 0.05). / Conclusions: Minimally invasive surgical (MIS) and non-surgical (MINST) periodontal therapy show promising results in the treatment of residual pocket with intra-bony defect. / Clinical relevance: MIS procedures represent a reliable treatment for isolated intra-bony defect

Recurrence and progression of periodontitis and methods of management in long-term care: A systematic review and meta-analysis

Aim: To systematically review the literature to evaluate the recurrence of disease of people in long-term supportive periodontal care (SPC), previously treated for periodontitis, and determine the effect of different methods of managing recurrence. The review focused on stage IV periodontitis. Materials and methods: An electronic search was conducted (until May 2020) for prospective clinical trials. Tooth loss was the primary outcome. Results: Twenty-four publications were retrieved to address recurrence of disease in long-term SPC. Eight studies were included in the meta-analyses for tooth loss, and three studies for disease progression/recurrence (clinical attachment level [CAL] loss ≥2 mm). For patients in SPC of 5–20 years, prevalence of losing more than one tooth was 9.6% (95% confidence interval [CI] 5%–14%), while experiencing more than one site of CAL loss ≥2 mm was 24.8% (95% CI 11%–38%). Six studies informed on the effect of different methods of managing recurrence, with no clear evidence of superiority between methods. No data was found specifically for stage IV periodontitis. Conclusions: A small proportion of patients with stage III/IV periodontitis will experience tooth loss in long-term SPC (tendency for greater prevalence with time). Regular SPC appears to be important for reduction of tooth loss. No superior method to manage disease recurrence was found