The effect of systemic antibiotics on clinical and patient‐reported outcome measures of oral implant therapy with simultaneous guided bone regeneration

Publisher's version (útgefin grein)Objectives: The aim of the present superiority study was to determine the effect of systemic antibiotics primarily on patient-reported outcome measures (PROMs) and post-surgical complications in patients undergoing oral implant therapy with simultaneous guided bone regeneration (GBR). Materials and Methods: A total of 236 medically and periodontally healthy patients received oral implants with simultaneous GBR at seven centres. Pre-operative antibiotics of 2 g amoxicillin were prescribed to the test group 1 hr prior to surgery and 500 mg thrice daily on days 1–3 after surgery. The control group was given a placebo. Group allocation was performed randomly. Primary outcome variables were PROMs recorded as visual analogue scale scores assessed on days 1–7 and 14 on pain, swelling, haematoma and bleeding. Post-operative complications as secondary outcome variables were examined at 1, 2, 4 and 12 weeks from surgery. Chi-square tests and repeated measures of analysis of variance (ANOVA) were performed for statistical evaluation. Results: No statistically significant differences (p >.05) between the two groups were detected for the evaluated PROMs. The same was noted with respect to post-surgical complications. Four implants were lost—three in the test group and one in the control group. Conclusion: In this trial, systemic antibiotics did not provide additional benefits to PROMs, nor the prevention of post-surgical complications in medically and periodontally healthy patients undergoing oral implant therapy with simultaneous GBR. However, further studies with larger sample sizes are still required to support the clinical outcomes of this study.This study has been supported by a research grant of the ITI Foundation (ITI Grant‐No: No. 962_2013). Further, we want to thank the Geistlich AG, Wolhusen, Switzerland, for providing bone substitutes and collagen membranes (Bio‐Oss® and Bio‐Gide®); Medochemie Limassol, Cyprus, for providing the study medication; and the Straumann AG (Basel, Switzerland) for granting a 50% discount on all the implant materials used in the presented study. The co‐operation of the staff of the centres involved in the study is highly appreciated: (1) Peking University, School of Stomatology, Beijing PR China (2) Medical University Graz, University Clinic of Dental Medicine & Oral Health, Department of Oral Surgery and Orthodontics, Graz Austria (3) Griffith University, Gold Coast, School of Dentistry and Oral Health, Queensland, Australia (4) The University of Hong Kong, Faculty of Dentistry, Hong Kong SAR PR China (5) University of Iceland, Faculty of Odontology, Reykjavik, Iceland (6) Shanghai Jiao Tong University, Shanghai Ninth People's Hospital, Department of Implant Dentistry, Shanghai PR China (7) National Dental Centre Singapore, SingaporePeer Reviewe

Information Technology and Interaction in Learning

Learning is an interactive process between the learner and thesurrounding structures, the so-called learning environment. Several typesof instructional interaction - such as the learner-tutor, the learner-learner, the learner-content, and recently, the learner-interface interactions - have been identified in higher education. The design execution of these interactions may significantly influence the learning impact of an academic educational session. Information and communication technology (ICT), and especially the Internet, has affected learning in many ways, but most significantly through introducing new possibilities for instructional interaction. The overriding aim of this thesis has been to elucidate the relative role of certain types of interaction between the learner and his or her environment in academic oral health education. In this thesis, ICT is studied in two distinct roles: as a mediator of communication?that is, as the mediator in learner-instructor and learner-learner interaction?and as a partner in interaction through the educational interface?the so-called learner-interface interaction (human?computer interaction). ICT as a mediator of communication was studied during two Internet-based problem-based learning (PBL) courses and one Internet-based examination of undergraduate students. The potential of ICT as a partner in interaction through the educational interface was investigated through an interactive software application, which aimed to improve the self-assessment ability of students. The results of these studies suggest that computer-mediated interaction (CMI) has an important role to play in higher education, can facilitate complex instructional methodologies such as PBL, and can effectively supplement and enhance face-to-face instruction. However, CMI presented several methodological differences when compared with face-to-face interaction, in terms of both quality as well as quantity of interaction. CMI was received less positively than face-to-face interaction by the students, when used in examination settings. In addition, it remains unclear if computer applications are able to constitute an effective, short-term, remedial support for the improvement of complex cognitive skills in students?such as self-assessment skills?without human feedback. At the basis of these findings and currently available technology, the most beneficial scenario from an educational point of view would include both computer-mediated and face-to-face interaction, with a considerable degree of user-determined flexibility. Future studies should focus on the roles of the various factors that affect learning through the process of interaction

Developing a Problem Based Learning model for Internet-based teaching in academic oral health education

Problem Based Learning (PBL) has been fully or partly adopted by several medical and dental schools throughout the world, but only few attempts have been made to adjust this method to Distance Learning (DL) environments. It appears that the interaction demands of PBL could not be easily facilitated by the technologies used for DL in the past. The recent introduction of Virtual Learning Environments or Virtual Classrooms, is suggested by many as the development that could allow Distance Learning to utilise highly structured collaborative learning methods such as PBL. A literature review and two pilot studies were undertaken, in an attempt to investigate the possibility of adjusting an existing in-classroom PBL model to Internet-based environments for distance learning. There is a strong need of a conceptual theoretical framework and research results to support the function and effectiveness of distance learning in health education. Drop-out rates are still high in all kinds of distance education. Accreditation, team-work and personal contact, appear to be factors of importance for increasing motivation and minimising drop-out rates in distance learning. During the pilot studies it was evident that both postgraduate and undergraduate students were very positive towards the PBL method, as they experienced it while working over the network. However, it is very difficult to introduce inexperienced students to PBL through distance. Students? competence with computers seems to be an important factor for the success of a virtual classroom and their computer literacy has to be objectively assessed prior to any course. Significant differences were identified between in-classroom and over the Internet communication. These differences, although measured in the quantity of interaction, appear to influence the quality and depth of discussion as well. Tutor involvement was higher in the Internet discussions than the in-classroom ones. It was concluded that an entirely Internet-based PBL course is possible, if properly organised. However, such a model might constitute a compromise over the quality standards of in-classroom PBL, at least with the currently available Internet technology. A hybrid approach, which will combine personal contact with network-based interaction, might be the safest and most beneficial option right now

Information Technology and Interaction in Learning

Learning is an interactive process between the learner and thesurrounding structures, the so-called learning environment. Several typesof instructional interaction - such as the learner-tutor, the learner-learner, the learner-content, and recently, the learner-interface interactions - have been identified in higher education. The design execution of these interactions may significantly influence the learning impact of an academic educational session. Information and communication technology (ICT), and especially the Internet, has affected learning in many ways, but most significantly through introducing new possibilities for instructional interaction. The overriding aim of this thesis has been to elucidate the relative role of certain types of interaction between the learner and his or her environment in academic oral health education. In this thesis, ICT is studied in two distinct roles: as a mediator of communication?that is, as the mediator in learner-instructor and learner-learner interaction?and as a partner in interaction through the educational interface?the so-called learner-interface interaction (human?computer interaction). ICT as a mediator of communication was studied during two Internet-based problem-based learning (PBL) courses and one Internet-based examination of undergraduate students. The potential of ICT as a partner in interaction through the educational interface was investigated through an interactive software application, which aimed to improve the self-assessment ability of students. The results of these studies suggest that computer-mediated interaction (CMI) has an important role to play in higher education, can facilitate complex instructional methodologies such as PBL, and can effectively supplement and enhance face-to-face instruction. However, CMI presented several methodological differences when compared with face-to-face interaction, in terms of both quality as well as quantity of interaction. CMI was received less positively than face-to-face interaction by the students, when used in examination settings. In addition, it remains unclear if computer applications are able to constitute an effective, short-term, remedial support for the improvement of complex cognitive skills in students?such as self-assessment skills?without human feedback. At the basis of these findings and currently available technology, the most beneficial scenario from an educational point of view would include both computer-mediated and face-to-face interaction, with a considerable degree of user-determined flexibility. Future studies should focus on the roles of the various factors that affect learning through the process of interaction

Elucidating the role of TLR2 in STAT3-mediated gastric tumourigenesis

Gastric cancer (GC) is the second most lethal form of cancer world-wide, which represents a subset of inflammation-associated carcinogenesis. While it is accepted that deregulated interactions between gastric microbes (i.e. Helicobacter pylori) and the host innate immune system are likely to be involved in the pathogenesis of gastric inflammation (gastritis) and the development GC, the identity of oncogenic inflammatory regulators in the host gastric mucosa remains obscure. On this note, uncontrolled activation of cytokine signalling pathways, especially the pro-inflammatory and oncogenic transcription factor signal transducer and activator of transcription (STAT) 3, is implicated in various inflammation-associated cancers, including up to 50% of human GC cases. However, the downstream molecular consequences of aberrant STAT3 activation in promoting gastritis and subsequently gastric tumorigenesis are ill-defined. This thesis addresses the role of toll-like receptors (TLRs) which are key components of the innate immune system primarily known to trigger an inflammatory response upon pathogen detection during gastric tumourigenesis. Our mouse model for GC, was generated by a specific “knock-in” phenylalanine substitution at tyrosine 757 in the interleukin (IL)-6 cytokine family co-receptor gp130 (gp130F/F), which abolishes the negative feedback mechanism, thus leading to gp130-STAT3 hyper-activation. These mice spontaneously developed gastric hyperplasia and adenomatous lesions that resembled histopathological features similar to human intestinal-type GC. Notably, aberrant STAT3 activation in the gastric compartment of these mice directly caused a significant increase in the expression of TLR2, a receptor that is responsible for recognising a broad range of microbial products. In addition, genetic deletion of TLR2 in gp130F/F mice severely reduced the gastric tumour mass by approximately 50%. However, unexpectedly, the level of gastritis was comparable to gp130F/F mice. Interestingly, immunohistochemical analyses revealed that gp130F/F:Tlr2-/- mice had increased TUNEL-positive apoptotic cells and reduced PCNA-positive cells in the gastric mucosal epithelium, therefore implicating a role for TLR2 in gastric epithelial cell proliferation and survival. Consistent with our mouse data, we identified that activating TLR2, using synthetic lipopeptides, in human gastric epithelial cell lines promoted gastric epithelial cell proliferation. Collectively, our data depicts an unexpected role for TLR2 in gastric tumourigenesis, whereby increased STAT3 activation resulted in over-expression of TLR2 to promote gastric tumour cell growth

An investigation of computer literacy and attitudes amongst Greek post-graduate dental students

An accurate assessment of the computer skills of students is a pre-requisite for the success of any e-learning interventions. The aim of the present study was to assess objectively the computer literacy and attitudes in a group of Greek post-graduate students, using a task-oriented questionnaire developed and validated in the University of Malmö, Sweden. 50 post-graduate students in the Athens University School of Dentistry in April 2005 took part in the study. A total competence score of 0-49 was calculated. Socio-demographic characteristics were recorded. Attitudes towards computer use were assessed. Descriptive statistics and linear regression modeling were employed for data analysis. Total competence score was normally distributed (Shapiro-Wilk test: W = 0.99, V = 0.40, P = 0.97) and ranged from 5 to 42.5, with a mean of 22.6 (+/-8.4). Multivariate analysis revealed 'gender', 'e-mail ownership' and 'enrollment in non-clinical programs' as significant predictors of computer literacy. Conclusively, computer literacy of Greek post-graduate dental students was increased amongst males, students in non-clinical programs and those with more positive attitudes towards the implementation of computer assisted learning