Implant survival and success rates in patients with risk factors: results from a long-term retrospective study with a 10 to 18 years follow-up

OBJECTIVE: Risk factors for implant therapy are represented by all general and local conditions that through various mechanisms can increase either short-term and long-term failure risk. The aim of this study is to assess the implant survival and implant success rates with single and multiple risk factors. PATIENTS AND METHODS: To address the research purpose, a retrospective cohort study was designed and implemented, including a sample of 225 patients with a total of 871 implants placed. The following risk factors were considered: smoking, bruxism, bone augmentation procedures and the presence of load risk (implants with crown/implant relation > 0.8; angulation > 25°; presence of cantilever). Follow-up ranged from 10 years to 18 years (average follow-up 13.6 years). Failures were subdivided into short-term failures, before the prosthetic phase, and long-term failures, after definitive prosthesis. The success criteria published by Albrektsson and Zarb were adopted. A Cox proportional hazard regression model was used to calculate hazard ratio, with a statistically significant p-value <0.05. RESULTS: Out of the 871 implants placed, 138 did not meet the success criteria, (success rate 84.16%), sixty (43.47%) were classified as "early failure" and seventy-eight as "late failure" (56.53%). A total of 70 dental implants were removed, with a survival rate of 91.96%. CONCLUSIONS: The presence of a single risk factor does not imply a marked increase of failure risk. Among the analyzed factors, the one that proved to be the most dangerous was bruxism, even when presented as the only risk factor. Bruxism with load risk proved to be the most dangerous association (success rate 69.23%) and could be included among the absolute contraindications for implant treatment

A randomized clinical trial about presence of pathogenic microflora and risk of peri-implantitis: comparison of two different types of implant-abutment connections

OBJECTIVE: The aim of this in vivo study was to evaluate two different types of implant-abutment connections: screwed connection and cemented connection, analyzing peri-implant bacteria microflora as well as other clinical parameters. PATIENTS AND METHODS: Twenty implants were selected, inserted in 20 patients, 10 with a screwed implant-abutment connection (Group 1) and 10 with a cemented implant-abutment connection (Group 2). The peri-implant microflora was collected, after at least 360 days from the prosthetic rehabilitation, using paper points inserted in peri-implant sulcus for 30 s. Polymerase chain reaction (PCR) Real-time analyzed the presence of 9 bacteria periodontal-pathogens and Candida albicans. RESULTS: Our findings showed that bacteria colonized all Groups analyzed, the average bacterial count was 3.7 E +08 (±1.19) in Group 1, compared to 2.1 E +08 (±0.16) in Group 2; no statistically significant differences were observed (p>0.0.5). In Group 1, however, bacterial colonization of peri-implant sulci was over the pathogenic threshold for 5 bacteria, indicating a high-risk of peri-implantitis. Also in Group 2, results showed a microflora composed by all bacteria analyzed but, in this case, bacterial colonization of peri-implant sulci was over the pathogenic threshold for only 1 bacterium, indicating a lower risk of peri-implantitis. Moreover, clinical parameters (PPD > 3 mm and m SBI > 0) confirmed a greater risk of peri-implantitis in Group 1 compared to Group 2 (p<0.05). CONCLUSIONS: We concluded that, also after only 360 days, implants with screwed connection showed a higher risk of peri-implantitis that implants with cemented connection

The relevance of point defects in studying silica-based materials from bulk to nanosystems

The macroscopic properties of silica can be modified by the presence of local microscopic modifications at the scale of the basic molecular units (point defects). Such defects can be generated during the production of glass, devices, or by the environments where the latter have to operate, impacting on the devices’ performance. For these reasons, the identification of defects, their generation processes, and the knowledge of their electrical and optical features are relevant for microelectronics and optoelectronics. The aim of this manuscript is to report some examples of how defects can be generated, how they can impact device performance, and how a defect species or a physical phenomenon that is a disadvantage in some fields can be used as an advantage in others

Can a microscopic stochastic model explain the emergence of pain cycles in patients?

A stochastic model is here introduced to investigate the molecular mechanisms which trigger the perception of pain. The action of analgesic drug compounds is discussed in a dynamical context, where the competition with inactive species is explicitly accounted for. Finite size effects inevitably perturb the mean-field dynamics: Oscillations in the amount of bound receptors spontaneously manifest, driven by the noise which is intrinsic to the system under scrutiny. These effects are investigated both numerically, via stochastic simulations and analytically, through a large-size expansion. The claim that our findings could provide a consistent interpretative framework to explain the emergence of cyclic behaviors in response to analgesic treatments, is substantiated.Comment: J. Stat. Mech. (Proceedings UPON2008

Efficacy and toxicity of bevacizumab in recurrent ovarian disease: an update meta-analysis on phase III trials

Background: To analyze the efficacy and toxicity of bevacizumab on survival outcomes in recurrent ovarian cancer. Results: Bevacizumab was associated with significant improvement of PFS and OS compared with standard treatment with HRs of 0.53 (95% CI 0.44 - 0.63; p &lt; 0.00001) and 0.87 (95% CI, 0.77 to 0.99; p = 0.03), respectively. Bevacizumab increased the incidence of G3/G4 hypertension (RR 19.01, 95% CI 7.77 - 46.55; p &lt; 0.00001), proteinuria (RR 17.31, 95% CI 5.42 - 55.25; p &lt; 0.00001), arterial thromboembolic events (ATE) (RR 4.99, 95% CI 1.29 - 19.27; p = 0.02) and bleeding (RR 3.14, 95% CI 1.35 - 7.32; p = 0.008). Materials and Methods: Three randomized phase III trials representing 1502 patients were identified. Pooled hazard ratio (HR), odd ratio (OR), risk ratio (RR) with 95% confidence interval (CI) were calculated using fixed or random effects model. Conclusions: Adding bevacizumab to standard chemotherapy improved ORR, PFS and OS, and it had a higher, but manageable, incidence of toxicities graded 3 to 4

Stochastic Turing patterns in the Brusselator model

A stochastic version of the Brusselator model is proposed and studied via the system size expansion. The mean-field equations are derived and shown to yield to organized Turing patterns within a specific parameters region. When determining the Turing condition for instability, we pay particular attention to the role of cross diffusive terms, often neglected in the heuristic derivation of reaction diffusion schemes. Stochastic fluctuations are shown to give rise to spatially ordered solutions, sharing the same quantitative characteristic of the mean-field based Turing scenario, in term of excited wavelengths. Interestingly, the region of parameter yielding to the stochastic self-organization is wider than that determined via the conventional Turing approach, suggesting that the condition for spatial order to appear can be less stringent than customarily believed.Comment: modified version submitted to Phys Rev. E. 5. 3 Figures (5 panels) adde

Correlation of test results and influence of a mass balance constraint on risks in conformity assessment of a substance or material

When components of a substance or material are subject to a mass balance constraint, test results of the components’ contents are intrinsically correlated because of the constraint. This so-called ‘spurious’ correlation is observed in addition to possible metrologically-related correlation of test results, and natural and/or technological correlation of the components’ contents. Such correlations may influence understanding of test results and evaluation of risks of false decisions, due to measurement uncertainty, in conformity assessment of the substance or material. The objective of the present paper is the development of a technique for appropriate evaluation of the risks. A Bayesian multivariate approach to evaluate the conformance probability of materials or objects and relevant risks is discussed for different scenarios of the data modelling, taking into account all observed correlations. A Monte Carlo method, including the mass balance constraint, written in the R programming environment, is provided for the necessary calculations

Trattamento con ormone della crescita in età pediatrica. Importanza dell’aderenza alla terapia nelle varie indicazioni, con particolare riferimento alla sindrome di Turner

Riassunto L’ormone della crescita ricombinante (recombinant human Growth Hormone - rhGH) viene utilizzato da 30 anni per il trattamento di varie forme di bassa statura. Tuttavia, ancora oggi vi è un’ampia variabilità di risposta alla terapia con GH, tanto che un cospicuo numero di pazienti mostra una insoddisfacente risposta alla terapia, non raggiungendo una statura adulta normale. Da qui la necessità di un’ottimizzazione della terapia con GH e, soprattutto, di un’analisi dei vari fattori che intervengono nella risposta alla terapia stessa. Uno di questi fattori può essere la scarsa aderenza al trattamento. È stata infatti dimostrata una correlazione diretta tra il grado di aderenza e la velocità di crescita. Diversi studi hanno cercato di valutare la prevalenza della non-aderenza alla terapia con GH in età pediatrica, che risulta essere molto variabile (dal 5 all’82%), a seconda dei metodi e delle definizioni utilizzate. L’elevata frequenza, talvolta riscontrata, di scarsa aderenza alla terapia può essere dovuta al fatto che il trattamento con GH è cronico e deve essere somministrato durante differenti stadi di sviluppo del bambino, fino all’adolescenza. Numerosi fattori possono ostacolare l’aderenza alla terapia con GH nei pazienti pediatrici, come difficoltà legate al farmaco o problemi cognitivi/ emozionali. Da qui la necessità di ottimizzare la compliance, individuando degli interventi efficaci per migliorare l’aderenza alla terapia. Discutendo dell’aderenza al trattamento con ormone della crescita, una menzione particolare deve essere fatta alla sindrome di Turner, in cui la dimensione psico-sociale, considerata in tutta la sua complessità, ha un ruolo fondamentale e l’aspetto della compliance deve essere particolarmente monitorato da parte del pediatra endocrinologo. Concludendo, affrontare il problema della scarsa aderenza alla terapia con ormone della crescita in età pediatrica è fondamentale al fine di migliorare il risultato del trattamento. La valutazione dell’aderenza dovrebbe essere effettuata impiegando misure oggettive e dovrebbero essere individuati interventi efficaci per migliorare i risultati in termini di efficacia e contenimento dei costi