The Asian Society of Endometriosis and Adenomyosis guidelines for managing adenomyosis.

This is the first guidelines for adenomyosis from the Asian Society of Endometriosis and Adenomyosis.

Clinical Comparison of Screw-Retained and Screwless Morse Taper Implant-Abutment Connections: One-year Postloading Results.

PURPOSE: The purpose of this study was to clinically evaluate the screwless Morse taper implant-abutment connection type, in which the retention screw is totally eliminated, in terms of stability, success, periodontal parameters, and marginal bone levels after 1 year of function by comparing it with a passive fit internal implant-abutment connection, wherein a space exists between the matching components. MATERIALS AND METHODS: Each edentulous subject received an implant with a screwless Morse taper connection (MT) in the left canine area of the mandible and an implant with a screw-retained implant-abutment connection (SR) in the right canine area of the mandible. All implants were loaded 6 weeks later. All cases were restored with a cemented bar-retained mandibular overdenture opposing a maxillary complete denture. Clinical recalls at 6 months and 12 months postloading were scheduled and the MT and SR implants were compared in terms of success, survival, primary and secondary implant stability, marginal bone loss, soft tissue response, and mechanical complications. The results were statistically analyzed. RESULTS: A total of 20 subjects were included (10 females, 10 males; average age: 61.60 years) and a total of 40 implants were inserted. No implant failure or technical problem was detected for either MT or SR implants. Marginal bone loss around MT and SR implants did not show any significant differences at 6 weeks after surgery (time of loading) or at 6 months or 12 months postloading (P > .05). Periodontal parameters such as gingival index and probing pocket depth of MT and SR implants likewise did not differ significantly at 6 months and 12 months postloading (P > .05). Primary stability values of MT and SR implants did not differ significantly when measured with the insertion torque device (mean of 68.10 Ncm for MT and 64.20 Ncm for SR implants; P = .564), nor when measured with the electronic percussive testing device (mean of -5.30 for the MT and -5.35 for the SR implants; P = .398). However, MT implants showed lower stability at the time of loading (6 weeks) and 6 months postloading (P = .037 and P = .003, respectively). Stability values did not show any significant differences 12 months postloading (P > .05). CONCLUSIONS: Within the limitations of this clinical study, it can be concluded that implants with screwless Morse taper and passive fit internal connections show comparable technical and biologic results after 1 year of function.

Luteal phase support in intrauterine insemination cycles: a prospective randomized study of 300 mg versus 600 mg intravaginal progesterone tablet.

Vaginal progesterone (P) has been suggested to be used for luteal phase support (LPS) in controlled ovarian stimulation (COH)-intrauterine insemination (IUI) cycles, however, no concensus exists about the best P dose. Therefore, considering the fecundability rate as the primary end point, our main objective was to find the optimal dose of P in COH-IUI cycles, comparing the two groups of women, each of which comprised of 100 women either on 300 mg or 600 mg of intravaginal P tablets, in a prospective randomized study design. The mean age of the women, duration of infertility, basal and day of hCG injection hormone levels in the female and sperm parameters were similar in the two study groups. Also, duration and dose of gonadotropin given, number of follicles, endometrial thickness, the total, ongoing and multiple pregnancy rates were comparable in both groups. We, therefore, claim that 300 mg of intravaginal micronized P should be the maximum dose of LPS in IUI cycles.

Effect of attachment types and number of implants supporting mandibular overdentures on stress distribution: a computed tomography-based 3D finite element analysis.

The objective of this study was to calculate stresses in bone tissue surrounding uncoupled and splinted implants that are induced by a bite force applied to the mandible and to determine whether the number of mandibular overdenture supporting implants in mandibular bone influence the stress distribution. A human adult edentulous mandible retrieved from a formalin fixed cadaver was used to define the geometry of finite element (FE) model and the FE model was verified with experimental measurements. Following the FE model validation, three different biting situations were simulated for the 2-, 3- and 4-implant retentive anchor as well as bar attachment overdentures under vertical loading of 100 N. As a result of the analyses, it was concluded that an increment in implant number and the splinted attachment type tended to cause lower stresses and the use of two single attachments seems to be a safe and sufficient solution for the treatment of mandibular edentulism with overdentures.

Mechanical resistance of screwless morse taper and screw-retained implant-abutment connections.

OBJECTIVE: The screwless morse taper (SMT) implant-abutment connection is an alternative to conventional external or internal screw-retained (ISR) connections. The aim of this in vitro study was to evaluate mechanical resistance of the SMT connection and to compare it with three different ISR connections. MATERIALS AND METHODS: Four implant systems were tested in this study: SMT system; Tasarimmed Octo (Istanbul, Turkey), ISR systems; Straumann Bone Level (Basel, Switzerland), Biohorizons Internal (Birmingham, AL, USA), and Dentsply Friadent Xive (Mannheim, Germany). Overall, 64 specimens with stylized single crowns were prepared: 32 for dynamic loading (DL) and 32 for static loading (SL). DL was carried out using a chewing simulator with 120 N at 1.75 Hz for 1.2 × 10(6) cycles, and SL was performed with a universal testing machine at a crosshead speed of 2 mm/min with an angulation of 30°. Cycles until failure from DL and fracture/bending loads at SL were recorded. Statistical analyses were made with Dunn's multiple comparison. RESULTS: Median cycles until failure in DL were as follows: Octo 86,354 (24,810-153,875), Straumann 1,200,000 (1,156,618-1,200,000), Biohorizons 539,719 (437,224-858,732), Xive 139,411 (139,411-139,411). Median fracture/bending loads in Newton at SL were as follows: Octo 429.6 (404.5-482.7), Straumann 574.6 (544.6-629.9), Biohorizons 548.7 (532.9-567.3), Xive 431.5 (412.5-520.5). There were significant differences between the implant systems under both loading conditions (P ≤ 0.05) revealing that the Octo implant system's SMT connection showed significantly lower cycles to failures and lower fracture/bending loads compared with the ISR connections of the Straumann and Biohorizons implant systems. However, there was no significant difference compared with the Xive implant system. CONCLUSION: The mechanical resistance of the screwless morse taper implant system is lower than that of the ISR implant systems that might result in more frequent clinical complications.

The influence of the attachment type and implant number supporting mandibular overdentures on stress distribution: an in vitro study, part I.

OBJECTIVES: The main goal of this study was to compare the stress distribution of mandibular overdentures (OVD) with different numbers of supporting implants and single versus splinted attachment types. MATERIALS AND METHODS: Four different biting situations were simulated for the 2-, 3-, and 4-implant retentive anchor as well as bar attachment OVDs on a formalin-fixed cadaver mandible, and strains were recorded under vertical loading of 100 N. RESULTS: The calculated von Mises values from measured strains in all measurement sites and loading conditions for nonsplinted attachments (retentive anchor) were higher than splinted (bar) attachments. CONCLUSIONS: It may be concluded that in cases with low quality and quantity of bone, the increase in number of implants and the use of a splinted attachment should be preferred to reduce forces emerging around the implants during function. The use of 2 single attachments in cases with good bone quality and ideal size implants still seems to be a safe and sufficient solution for the treatment of mandibular edentulism with OVDs.

Astra Tech, Brånemark, and ITI implants in the rehabilitation of partial edentulism: two-year results.

PURPOSE: To explore the soft tissue, marginal bone, and prosthetic complications (if any) of Astra Tech, Brånemark, and ITI implants supporting fixed prostheses during an observation period of 2 years. MATERIALS: The study comprised 26 patients, who received 42 Astra Tech, 36 Brånemark, and 29 ITI implants. After 3 months of healing, abutment connections were performed for Astra Tech and Brånemark implants, and fixed prostheses were delivered to the patients at 4 months. At 6-month, 1-year, and 2-year recall appointments, plaque index, periimplant inflammation index, and bleeding index scores, were recorded. The marginal bone levels were also measured at 2-year recall by means of radiographic evaluation, and prosthetic complications were recorded throughout the study. RESULTS: All implants survived during the 2-year observation period. The plaque index and periimplant inflammation index scores around Brånemark implants were higher than ITI and Astra Tech implants in the first year of function (P > 0.05). Marginal bone loss around ITI and Astra Tech implants was similar at 2 years (P > 0.05). The marginal bone loss around Brånemark implants was higher than Astra Tech implants (P < 0.05) but similar to ITI implants at 2-year recall appointment (P > 0.05). Fixed prostheses supported by ITI and Astra Tech implants did not experience prosthetic complications, and only 1 patient of the Brånemark group had porcelain veneer fracture. CONCLUSIONS: Astra Tech, Brånemark, and ITI implants supporting fixed prostheses had same survival rates (100%) in this study. ITI and Astra Tech implants had similar changes in marginal bone levels, whereas Brånemark implants had higher marginal bone loss, particularly in the first year of function.

Influence of platform-switching on marginal bone levels for implants with mandibular overdentures: a retrospective clinical study.

OBJECTIVE: The aim of this study was to compare bone around platform switched and regular platform implants that support removable prostheses and to report of the clinical outcomes after a loading period of 36 months. MATERIAL: Fifty-one patients with a mean age of 59.39 years and 126 implants, appearing in the routine recall sessions consecutively 6, 12, 24, and 36 months after loading with mandibular overdentures, were included in the study group. Bone level measurements were obtained from images of successive radiographs, which were scanned and digitized before, and analyzed at x20 magnification. Statistical analysis was utilized to assess the mean marginal bone level changes at 6, 12, 24, and 36 months as well as to explore the potential effect of platform switching on bone loss. RESULTS: Although mesial and distal marginal bone loss rates differed in the 6th, 12th, and 24th month recalls between both groups, platform switching caused statistically significant lower bone loss at the 36th month on the mesial as well as distal sides. CONCLUSION: Platform switching appears to engender lower marginal bone loss around implants supporting removable dentures.

The role of Candida albicans hyphae and Lactobacillus in denture-related stomatitis.

Denture-related stomatitis (DRS) is still a dilemma in removable prosthodontics. The aim of this study was to investigate the relationship of DRS with the presence of Candida albicans hyphae and Lactobacillus. A total of 91 patients wearing maxillary and mandibular complete dentures were included in the present study and tested mycologically as well as bacteriologically. A statistically significant association of DRS was found with denture age (p = 0.003) and continuous denture wearing (p = 0.015). Presence of C. albicans hyphae was shown to be significantly higher in DRS cases (p < 0.01), and there was a statistically significant positive correlation between presence of hyphae and C. albicans (p < 0.01). Another interesting finding was that DRS patients showed higher Lactobacillus counts in their saliva (p = 0.04), as well as in the palate (p = 0.028). C. albicans is an important factor in the development of DRS. Hyphae seem to facilitate the rise of C. albicans counts and be related to the inflammatory response of the tissues. Lactobacillus seems to play an important role in the presence of DRS, as well. In agreement with many other studies, the results of this study confirm the importance of denture age and continuous denture wearing in the development of DRS.