Australian adults cooked more and tried new recipes during COVID-19 restrictions and lockdowns.

The lockdowns and restrictions due to COVID-19 caused changes in both food accessibility and availability for people around the globe resulting in changes in food habits and behaviours. To enable a better public health response to the next pandemic, lessons must be learnt from this most recent emergency. This study aimed to examine self-reported changes in food habits and behaviours, of Australian adults during COVID-19 restrictions in 2020. A cross-sectional, convenience, Australia-wide survey, with open-ended and closed-ended questions was conducted online. Respondents were asked to report their demographic characteristics, positive food habit development, worst food-related experiences, changes in food habits and behaviours and cooking and food preparation practices during the COVID-19 restriction period. Adult Australian residents, recruited through social media advertising of the survey. Respondents (n = 764) were mostly female (86%), over 55 years of age (57%, mean age (SD) 53.4 (18.1) years), and half (51%) were not in paid employment. Nearly two-thirds (63%) developed positive food habits, including trying new recipes (54%), eating less take-away (53%) and cooking from scratch (46%) during the COVID-19 restrictions. Furthermore, respondents reported including family members in food preparation and eating together as a family. Negative experiences included being unable to buy certain foods (due to lack of stock and store limits), cooking at home, and being unable to access some food outlets. Australians experienced both positive and negative food experiences during the COVID-19 pandemic and associated lockdown periods, with most experiencing positive changes such as cooking at home from scratch and trying new recipes and relying on less take-away. Females and those who experienced a change in employment status were more likely to develop positive new food habits.

Misfit simulation on implant-supported prostheses with different combinations of engaging and nonengaging titanium bases: Part 3: A radiographic evaluation.

STATEMENT OF PROBLEM: The fit of implant-supported prostheses plays an important role in their mechanical and biological stability. Clinically, the prosthetic fit is typically assessed radiographically, but this method relies on the operator's subjective evaluation. Whether available digital tools could optimize the evaluation of the prosthetic fit is uncertain. PURPOSE: The purpose of this in vitro study was to evaluate the influence of an image processing program on the radiographic detection of discrepancies in the active and passive fit of implant-supported prostheses. Two-implant-supported screw-retained prostheses were analyzed by simulating the vertical and horizontal misfits of 3 different implant abutment configurations. MATERIAL AND METHODS: Seven casts were fabricated using 2 internal-connection titanium implants: 1 control; 3 with vertical (V) misfit of 50 µm, 100 µm, 150 µm; and 3 with horizontal (H) misfit of 35 µm, 70 µm, 100 µm. Thirty bar-shaped zirconia frameworks were fabricated and divided into 3 groups (n=10) according to their attachment to 2 engaging (E-E), 2 nonengaging (NE-NE), and engaging and nonengaging (E-NE) titanium bases. Digital parallel periapical radiographs were made of each specimen in the passive and active fit situation on each cast (1-screw test), except for the E-E specimens, which were only seated on the control, H35, and H70 casts because the fit on the remaining casts was poor. The mean gray value (MGV) was measured at the chosen regions of interest on the second implant (side B) using the ImageJ software program. Differences in the MGV measurements between the passive and active conditions were tested using a t test (α=.05) and compared the different misfit levels using analysis of variance (1-way ANOVA), followed by the Tukey HSD test (α=.05). RESULTS: The highest values for the differences between passive and active fit were found for the V150 and H100 misfit simulations (P<.05). Statistical differences between the MGVs were found with some exceptions: the smallest simulated misfits (H35 and V50) revealed statistically significant MGV differences from the highest simulated misfits (V150, H100) and from the H70 in the groups where an engaging component was present (P>.05). In the horizontal misfit group of NE-NE abutment configuration, H70 revealed no significant difference from the control group cast (P>.05). CONCLUSIONS: Measuring MGV differences between passive and active fit could be a promising alternative for detecting 70- to 150-µm gaps in the implant-abutment connection that result from the misfit. However, the procedure was not adequate for detecting <50 µm gaps, cannot be uniformly applied to all types of implant-abutment connections, and requires 2 exposures to X-radiation.

Survival of fixed prosthetic restorations on vital and nonvital teeth: A systematic review.

PURPOSE: To evaluate the survival rate of full-coverage tooth-supported fixed prosthetic restorations, single crowns (SCs), and fixed dental prostheses (FDPs), taking into consideration the potential influence of tooth-vitality, presence and type of post, and type of prosthetic restoration material. MATERIALS AND METHODS: In October 2022, two authors independently conducted a search in PubMed, Web of Science, and Scopus electronic databases as well as a hand search to identify clinical human studies on full-coverage SCs and FDPs supported by vital and/or non-vital abutments and/or a combination of both, with a minimum observation period of 24 months. RESULTS: Out of 4198 studies identified through the database search and 22 through hand searching, 26 studies fulfilled the inclusion criteria and were included in the analysis of the present systematic review. Included studies scored six points and more according to Newcastle-Ottawa Scale (NOS). The highest estimated 5-year survival rate was observed for (metal-ceramic and all-ceramic) SCs on vital teeth (98.3%; 95% CI [98.1, 98.6%]) and all ceramic SCs on non-vital teeth with fiber post (95.0%; 95% CI [94.5-95.4%]). Metal-ceramic SCs on vital teeth (97.1%; 95% CI [95.6-98.7%]) showed a statistically significant higher estimated 5-year survival rate compared to metal-ceramic SCs with cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001), fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001) and without post (85.7%; 95% CI [80.7, 90.6%], P < 0.032). All-ceramic SCs with fiber post had a statistically significant higher estimated 5-year survival rate (95.0%; 95% CI [94.5-95.4%]) compared to metal-ceramic SCs on non-vital teeth with fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001). SCs (all-ceramic and metal-ceramic) with fiber post had a statistically significantly higher estimated 5-year survival rate of (92.7%; 95% CI [92.4-92.9%]) than SCs made of metal-ceramic and retained by cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001). For FDPs, the 5-year survival rate was significantly higher for FDPs on vital abutments (84.9%; 95% CI [75.9, 93.9%]) compared to FDPs retained by non-vital abutment/s (81.3%; 95% CI [80.3, 82.2%], P = 0.049) irrespective to presence, type of post, and FDPs material. The results are limited by the limited number of studies and the presence of uncontrolled confounding clinical variables. CONCLUSIONS: Within the limitations of the study, tooth vitality is suggested to contribute positively to the survival of SCs and FDPs.

Food literacy and diet quality in young vegans, lacto-ovo vegetarians, pescatarians, flexitarians and omnivores.

OBJECTIVE: To investigate whether food literacy competencies and diet quality vary between 16-to-24-year-olds vegans, lacto-ovo vegetarians, pescatarians, flexitarians and omnivores and to assess whether food literacy is associated with diet quality. DESIGN: Cross-sectional study. Food literacy (general nutrition knowledge, critical nutrition literacy and food skills) and diet quality were measured using an electronic questionnaire. SETTING: Southern Norway, September 2021 - March 2022. PARTICIPANTS: Healthy 16-24-year-olds (n 165). RESULTS: Overall, the mean general nutrition knowledge score was moderate (48·0 out of 67·0); the lowest mean score was found in omnivores and the highest in flexitarians (45·6 v. 51·5) (P = 0·034). The mean score of critical nutrition literacy was also moderate (3·7 out of 5·0); vegans showed higher scores compared to other dietary practices (P = 0·018). No difference was observed in food skills between the different dietary practices. The overall median diet quality score was 46·0 out of 80·0, lowest in omnivores and highest in vegans (42·0 v. 56·0) (P =< 0·001). In multivariate regression analyses, general nutrition knowledge, food skills and vegan dietary practice were significantly associated with higher diet quality. CONCLUSIONS: We found moderate levels of food literacy across all dietary practices. The food literacy competencies, general nutrition knowledge and food skills were associated with higher diet quality in our sample. Omnivores showed both the lowest general nutrition knowledge level and lowest diet quality scores. In contrast, both flexitarians and vegans scored highest on general nutrition knowledge and diet quality scores, despite being one of the less restrictive and one of the strictest plant-based dietary practices, respectively.

Loss of pulp vitality correlated with the duration of the interim restoration and the experience of the dentist: A retrospective study.

STATEMENT OF PROBLEM: The second most common biological complication in fixed prosthodontics is loss of pulp vitality, which may lead to restoration loss. While reasons for loss of pulp vitality are unclear, 2 potential contributing factors, duration of the interim restoration and operator experience, have not been fully investigated. PURPOSE: The purpose of this retrospective study was to investigate whether the duration of the interim restoration or the experience of the dentist was correlated with loss of pulp vitality. MATERIAL AND METHODS: Fixed prosthetic restorations placed between 2005 and 2012 were retrospectively analyzed. Abutment teeth supporting single-unti or multiunit restorations were evaluated regarding loss of pulp vitality. The Mann-Whitney U test and simple logistic regression were used, with α=.05 for the subsequent multiple logistic regression. The experience of dental professionals was defined by the number of treatments performed and coupled with failure rate by using an analysis of variance. RESULTS: One hundred seventy-four dentists made 15 879 restorations, of which 1136 failed during the observation period, a failure rate of 7.2%. Two hundred fifty restorations were randomly selected from the failed restorations, and a corresponding 250 restorations were randomly selected from nonfailed restorations for the control group. Increased duration with interim replacement was linked to a higher risk of loss of pulp vitality (P<.001). Failure rate in the dentist group varied from 0% to 100%. No significant differences in failure rate were found among dentists who did few restorations and those who performed larger numbers of restorations. CONCLUSIONS: The results of the present study suggest that operator experience does not affect failure rate. However, extended time with an interim restoration was a contributing factor to the loss of pulp vitality.

Effects of a palaeolithic diet on obstructive sleep apnoea occurring in females who are overweight after menopause-a randomised controlled trial.

BACKGROUND/OBJECTIVES: Obesity is the main risk factor for obstructive sleep apnoea, commonly occurring in females who are overweight after menopause. We aimed to study the effect of a palaeolithic diet on sleep apnoea in females with overweight after menopause from the population. METHODS: Seventy healthy, non-smoking females with a mean age of 60 years and a mean BMI of 33 kg/m2 were randomised to a palaeolithic diet or to a control low-fat diet according to Nordic Nutritional Recommendations, for 2 years. The apnoea-hypopnoea index was measured and daytime sleepiness was estimated during the intervention. RESULTS: The mean apnoea-hypopnoea index at baseline was 11.6 (95% CI 8.6-14.5). The mean weight loss was 7.2 kg (95% CI 5.3-9.2 kg) in the palaeolithic diet group and 3.9 kg in the control group (95% CI 1.9-5.9 kg); p < 0.021 for the group difference. The reduction in weight corresponded to a reduction in the apnoea-hypopnoea index in the palaeolithic diet group (r = 0.38, p = 0.034) but not in the control group (r = 0.08, p = 0.69). The apnoea-hypopnoea index was reduced in the palaeolithic diet group when the weight was reduced by more than 8 kg. Daytime sleepiness according to the Epworth Sleepiness Scale score and the Karolinska Sleepiness Scale score was unaffected by dietary group allocation. CONCLUSIONS: A substantial decrease in body weight of 8 kg was needed to achieve a reduction in sleep apnoea in this small trial of women who are overweight after menopause. The palaeolithic diet was more effective for weight reduction than a control low-fat diet and the reduction in sleep apnoea was related to the degree of weight decrement within this diet group. TRIAL REGISTRATION: Clinicaltrials.gov: NCT00692536.

Retrospective clinical study of tooth-supported single crowns: A multifactor analysis.

The purpose of the study was to investigate the influence of multiple factors on the survival of tooth-supported single crowns and assess the biological and technical complications. This retrospective study included patients rehabilitated with single crowns with a minimum follow-up time of 6 months after delivery. The cumulative survival rate was calculated over the maximum period of follow-up time and reported in a life-table survival analysis. Univariate and multivariate Cox regression was used to evaluate the associations between clinical covariates and crown failure. The included cohort group consisted of 1037 single crowns delivered in 401 patients and followed for a mean of 134.8 ± 80.2 months. Cumulative survival rate was 89.9% and 80.9% after 5 and 10 years and 70.5% and 61.8% after 15 and 20 years, respectively. The main reasons for single crown failure were loss of retention, tooth loss, and fracture. Anterior placement, non-vital abutments, and bruxism significantly influenced the survival of single crowns. The survival of single crowns was not influenced by patient's age and sex, location of the crowns in relation to the jaws, type of tooth, presence of post and core, and type of crown material, treatment providers, or smoking. Anterior placement, non-vital abutments, and bruxism are factors suggested to increase the risk of single crown failure and the prevalence of technical and biological complications.

Consumption of foods with the Keyhole front-of-pack nutrition label: potential impact on energy and nutrient intakes of Swedish adolescents.

OBJECTIVE: The Keyhole is an internationally recognised front-of-pack nutrition label, guiding consumers to healthier food options. It indicates products in accordance with specific criteria for dietary fats, sugars, fibres, salt and wholegrains. The objective of this study was to simulate the potential impact of the Keyhole on adolescents' energy and nutrient intakes by modelling a shift from reported food intakes to foods meeting the Keyhole criteria. DESIGN: Self-reported dietary intake data were derived from a cross-sectional survey. Multiple replacement scenarios were calculated, where foods meeting the Keyhole criteria replaced reported non-compliant foods with varying proportions of replacement. SETTING: Dietary survey 'Riksmaten Adolescents 2016-2017' in schools across Sweden. PARTICIPANTS: A nationally representative sample of 3099 adolescents in school years 5, 8 and 11 (55 % girls). RESULTS: Overall, replacement with foods meeting the Keyhole criteria led to more adolescents meeting nutrition recommendations. Largest median intake improvements were seen for wholegrains (+196 %), SFA (-13 %), PUFA (+17 %) and fibres (+15 %). Smallest improvements were seen for free sugars (-3 %) and salt (-2 %), partly explained by the ineligibility of main food sources of free sugars for the Keyhole, and non-inclusion of ready meals that are often high in salt. Most micronutrient intakes were stable or improved. Unintentional effects included decreases in vitamin A, MUFA and energy intakes. Largest potential improvements in fat and fibre sources were observed in the youngest age group. CONCLUSIONS: A shift to Keyhole alternatives for everyday foods would improve adolescents' nutrient intakes, even with smaller exchanges.

Enough time for lunch? The duration and governance of lunch eating times in Australian primary schools: A mixed-methods study.

Developing healthy eating behaviours is important to assist children in maintaining good health and decrease the risk of chronic health conditions. Recent nutrition promotion efforts in Australian primary schools have mainly focused on canteen guideline compliance and obesity prevention interventions. The aim of this study was to investigate the primary school food environment, specifically, allocated lunch eating duration and the governance of children's lunch breaks. Parents (n = 402) and teachers (n = 123) were asked via an online survey, about school allocated lunch eating duration and its adequacy. Respondents were asked about the supervision, monitoring and feedback of children's lunches, as well as how they felt about these practices. Parents (n = 308) and teachers (n = 102) also responded to the open-ended question "What could be done to improve the school food environment at your school?". Ten minutes was the allocated lunch eating duration reported by most parents and teachers and 58% of those parents and 30% of those teachers rated this as inadequate. Increasing the allocated lunch eating duration was frequently cited as a way to improve the school food environment. A similar proportion of parents and teachers agreed with teachers monitoring food intake, not providing feedback on food brought to school, and that parents should decide what children eat. More parents (44%) than teachers (23%) believed that teachers should eat their own lunch with the children. These findings provide an insight into the primary school lunch environment and the views of two key stakeholder groups. School food policies should consider these findings in future revisions, particularly with regards to eating times.

Misfit simulation on implant prostheses with different combinations of engaging and nonengaging titanium bases. Part 2: Screw resistance test.

STATEMENT OF PROBLEM: Prosthesis fit is 1 of the main factors influencing the success and survival of an implant-supported screw-retained restoration. However, scientific validation of the performance of engaging and nonengaging components in a fixed partial denture (FPD) and the effect of their combinations on the fit of FPDs is lacking. The screw resistance test has been used for the fit assessment of screw-retained FPDs. However, objective assessments by using analog and digital devices are now available. PURPOSE: The purpose of this in vitro study was to investigate the effect of engaging and nonengaging components on the fit of screw-retained frameworks, supported by 2 conical connection implants with simulated vertical and horizontal misfits, by performing 2 different screw resistance tests (analog and digital). MATERIAL AND METHODS: Thirty 2-implant-supported bar-shaped zirconia frameworks cemented on two 2-mm titanium bases were fabricated and divided into 3 groups (n=10) according to different abutment combinations: both engaging, engaging and nonengaging, both nonengaging. The fit of each framework was tested on the control cast and on 6 definitive casts simulating 50-, 100-, and 150-µm vertical and 35-, 70-, and 100-µm horizontal misfit levels. The abutment screws were tightened on each implant, and the screw rotation angle was measured both digitally, with a custom-made digital torque wrench and a computer software program, and conventionally, with an analog torque wrench and protractor. Clearly ill-fitting specimens were excluded. The data were statistically analyzed by 1-way analysis of variance (ANOVA) and the Tukey post hoc test (α=.05). RESULTS: Both engaging specimens on the 100-µm horizontal misfit group and on all vertical misfit groups were clearly ill-fitting and excluded. Statistically significant differences among groups with different combinations of abutments were found (P<.05). The engaging abutments had a higher angle of rotation than the nonengaging abutments on all casts. In the horizontal misfit group, both engaging specimens had the highest angle of rotation, followed by engaging and nonengaging and both engaging specimens. In the vertical misfit group, the engaging and nonengaging specimens had the highest angle of rotation on the side of the engaging abutment. The angle of rotation increased with the increasing level of misfit. CONCLUSIONS: Both nonengaging frameworks showed superiority in misfit tolerance, as the angle of rotation was lower than that of the engaging and nonengaging and both engaging frameworks. Conventional and digital torque wrenches showed similar results.

Impact of design elements of the implant supracrestal complex (ISC) on the risk of peri-implant mucositis and peri-implantitis: A critical review.

OBJECTIVE: The aim of this review was to investigate the evidence correlating the emergence profile (EP) and emergence angle (EA), peri-implant tissue height, implant neck design, abutment and/or prosthesis material, retention and connection types with risk of peri-implant mucositis and peri-implantitis. METHODS: Seven focus questions were identified, and seven electronic search queries were conducted in PubMed. Human studies reporting on bleeding on probing, probing depth or case definitions of peri-implant mucositis and peri-implantitis were included. RESULTS: Emerging evidence with bone-level implants suggests a link between EA combined with convex EP and peri-implantitis. Depth of the peri-implant sulcus of ≥3 mm is shown to be reducing the effectiveness of treatment of established peri-implant mucositis. Modification of the prosthesis contour is shown to be an effective supplement of the anti-infective treatment of peri-implant mucositis. Limited evidence points to no difference with regard to the risk for peri-implant mucositis between tissue- and bone-level implants, as well as the material of the abutment or the prosthesis. Limited evidence suggests the use or not of prosthetic abutments in external connections and does not change the risk for peri-implantitis. Literature with regard to prosthesis retention type and risk for peri-implantitis is inconclusive. CONCLUSIONS: Limited evidence indicates the involvement of EA, EP, sulcus depth and restricted accessibility to oral hygiene in the manifestation and/or management of peri-implant mucositis/peri-implantitis. Conclusions are limited by the lack of consensus definitions and validated outcomes measures, as well as diverse methodological approaches. Purpose-designed studies are required to clarify current observations.

Retrospective evaluation of implant-supported full-arch fixed dental prostheses after a mean follow-up of 10 years.

OBJECTIVE: To assess the outcomes of implant-supported full-arch fixed dental prostheses (ISFAFDPs) and the supporting implants. MATERIAL AND METHODS: This retrospective study included patients treated with ISFAFDPs at one specialist clinic. Implant/prosthesis failure and complications were the outcomes analyzed. Survival analysis methods were used. RESULTS: A total of 709 patients with 869 ISFAFDPs (4,797 implants) were included, with a mean ± SD follow-up of 10.7 ± 7.2 years. A total of 353 implants and 62 prostheses failed. Estimated cumulative survival rates were as follows: 93.3% (95% CI 91.3, 95.3) after 10 years and 87.1% (95% CI 83.4, 90.8) after 20 years. Implants installed in bruxers, smokers, and maxilla had a lower survival than implants installed in non-bruxers, non-smokers, and mandible, respectively. A total of 415 ISFAFDPs (47.8%) presented technical complications, of which 67 (7.7%) presented only occurrences of loss/fracture of implant access hole sealing. Bruxism was a factor to exert a higher risk of screw loosening (HR 3.302; also in younger patients), screw fracture (HR 4.956), ceramic chipping/fracture (HR 5.685), and loss/fracture of acrylic teeth (HR 2.125; this last complication with higher risk also in men, in maxillae, and when the opposing jaw presented natural dentition or fixed prostheses). Patients with bruxism had a statistically significant higher risk of prosthesis failure than non-bruxers (HR 3.276). CONCLUSIONS: ISFAFDPs presented good long-term prognosis. Failure of several supporting implants was the main reason for failure. The results of the present study strongly suggest that bruxism is an important contributor to implant and prosthesis failure, as well as to an increased prevalence of technical complications in ISFAFDPs.

Dieting, body weight concerns and health: trends and associations in Swedish schoolchildren.

BACKGROUND: Dieting is a risk factor of both eating disorders and obesity. The aim was to examine time trends of dieting in Swedish adolescents, and explore how dieting and body weight dissatisfaction are related to self-reported health, wellbeing and health behaviours. METHODS: Analyses of cross-sectional Swedish data from HBSC (Health Behaviour in School-aged Children) surveys 1994-2014. In total, about 30,000 girls and boys in the age of 11, 13 and 15 years participated. Data was collected by using classroom administered questionnaires in 5th, 7th and 9th grade. Logistic regressions was used to analyse secular trends of dieting, and how dieting and body dissatisfaction were associated with self-reported overall health, health behaviours, BMI and various physical, psychological and social aspects of health in 2014. RESULTS: Dieting increased from 1994 to 2014 in both girls and boys in all age groups, and in 2014, the prevalence was 14% in girls and 8% in boys. The prevalence of body satisfaction was 65% respectively 69%. Body weight dissatisfaction and dieting were present in all body weight classes and were associated with self-reported poor health and many other negative health aspects. In comparison with the participants that were satisfied with their body weight the odds ratio (95% CI) for self-reported poor health was 3.4 (2.6-4.4) in dieters, 4.9 (3.8-6.4) in participants who perceived a need to lose weight and 2.1 (1.5-2.8) in those who perceived a need to gain weight, when adjusting for age, sex and body weight class. CONCLUSIONS: When promoting health among school age children body weight dissatisfaction and dieting ought to be considered. Furthermore, it is important to support girls and boys in all weight classes to reach and maintain a healthy body image and weight.

Evaluation of Stress Distribution in Tooth-Supported Fixed Dental Prostheses Made of Translucent Zirconia with Variations in Framework Designs: A Three-Dimensional Finite Element Analysis.

PURPOSE: To evaluate the influence of the framework designs on the stress distribution within tooth-supported partially veneered fixed dental prostheses (FDPs) made of translucent zirconia under simulated loads using a three-dimensional finite element analysis (3D-FEA). MATERIAL AND METHODS: For a linear 3D-FEA, simplified 3D solid models of prepared abutment teeth (first premolar and first molar) with different 3-unit FDPs were created. The models with different FDP designs-monolithic zirconia (control); semi-monolithic zirconia with 0.3 mm veneer thickness (SM0.3); semi-monolithic zirconia with 0.5 mm veneer thickness (SM0.5); semi-monolithic zirconia with 0.5 mm veneer thickness supported with cap design (SMC), and semi-monolithic zirconia with 0.5 mm veneer thickness supported with wave design (SMW)-were analyzed using 3D-FEA. The elastic properties of the components (bone, dentine, cement, translucent zirconia, and veneering porcelain) were obtained from the published data for FEA. Simulated static loading forces (300 N) were applied at 10° oblique direction over six points in the occlusal surfaces of the FDPs. Maximum principal stress, shear stress, and safety factor were calculated and analyzed among the different models. RESULTS: Semi-monolithic with cap design showed the smallest maximum principal stress levels in the veneering porcelain compared to all other models (SM0.3, SM0.5, SMW). The SM0.3 had lower maximum principal stress levels in the veneering porcelain compared to SM0.5. Regarding stresses in the zirconia framework, all models had comparable results in maximum principal tensile stresses, except SMW had a lower value. Maximum principal stress levels were located in the veneer component of SM0.3, SM0.5, and SMW, whereas, such levels were observed in the cervical areas of the zirconia frameworks of SMC and control. The SM0.3 had the highest maximum shear stress levels at the zirconia-veneer interface, while SMW had the lowest shear values. The 3D-FEA models with different FDP designs showed different minimum safety factor levels. CONCLUSIONS: Framework and veneer designs play a significant role in the stress distribution of the partially veneered zirconia FDPs under loading. The FDPs with zirconia frameworks with cap design minimize the maximum principal tensile stress in the veneering porcelain. The FDPs with 0.3-mm-veneering porcelain show low maximum principal tensile stress in the veneering porcelain, but highest maximum shear stress at the zirconia-veneer interface. The FDPs with wave design of zirconia frameworks minimize the maximum shear stress considerably.

Retrospective clinical evaluation of implant-supported single crowns: Mean follow-up of 15 years.

OBJECTIVE: To retrospectively assess the clinical outcomes of implant-supported single crowns and the supporting implants. MATERIAL AND METHODS: This retrospective study included all patients treated with implant-supported single crowns at one specialist clinic. Implant and prosthesis failure, and mechanical/technical complications (ceramic fracture/chipping; crown loss of retention/mobility; crown failure/fracture; loosening/loss/fracture of prosthetic screw; and implant failure/fracture) were the outcomes analyzed. Any condition/situation that led to the removal/replacement of crowns was considered prosthesis failure. RESULTS: A total of 438 patients with 567 crowns were included. Mean ± SD follow-up of 183.4 ± 69.3 months. A total of 37 implants (6.5%) and 54 crowns (9.5%) failed. If only technical problems were considered, the crown failure rate decreased to 4.1% (23/567). Most common reasons for crown failure: esthetic issue (n = 12), crown constantly mobile (n = 9), change to another type of prosthesis together with other implants (n = 8), crown fracture (n = 7), and crown in infraposition in comparison with adjacent teeth (n = 7). The odds of crown failure were shown to be statistically significantly higher for the following factors: younger patients, maxillary crowns, and screw-retained crowns. Loose prosthetic screw was much more prevalent in screw-retained than in cemented crowns. Ceramic fracture/chipping was more prevalent in screw-retained crowns, maxillae, females. Crown fracture was more prevalent in ceramic crowns, screw-retained crowns, maxillae, posterior region, females. However, these differences were statistically significant only for crown fractures in females. CONCLUSIONS: The odds of crown failure were significant for some factors, but one must keep in mind that non-technical complications are as common as technical ones as reasons for the replacement of implant-supported single crowns.

Load-Bearing Capacity of Monolithic Zirconia Fixed Dental Prostheses Fabricated with Different Connector Designs and Embrasure Shaping Methods.

PURPOSE: To investigate the load-bearing capacity and failure mode of monolithic zirconia fixed dental prostheses (FDPs) fabricated with different connector designs and embrasure shaping methods. MATERIALS AND METHODS: Seventy four-unit zirconia FDPs (with two premolar pontics) were fabricated and divided into seven groups (n = 10) according to the different connector designs gained by using different embrasure shaping methods. The groups were as follows: monolithic FDPs fabricated with sharp embrasures, monolithic FDPs fabricated with blunt embrasures, monolithic FDPs fabricated with blunt embrasures and no occlusal embrasures, two groups of monolithic FDPs fabricated with blunt embrasures and interproximal separations made with diamond discs at the soft stage and at the fully sintered stage, and monolithic FDPs fabricated with blunt embrasures and interproximal separation accentuated by localized porcelain build-up. A final group was used as a control group, where fully veneered traditional zirconia FDPs were fabricated with default milling settings. The FDPs were artificially aged and loaded to fracture. Load to fracture and failure modes were analyzed by one-way ANOVA, Tukey's post hoc test, and Fisher exact test (α = 0.05). RESULTS: The FDPs fabricated with interproximal porcelain separation showed significantly the highest load to fracture (1038 N ± 82) of all groups (p < 0.001), with no significant difference compared to the FDPs with no occlusal embrasures (934 N ± 175; p ˃ 0.29). The FDPs fabricated with blunt embrasures showed significantly higher load to fracture (873 N ± 115) compared to the FDPs in the control group (689 N ± 75) and the FDPs with sharp embrasures (417 N ± 87; p < 0.001). There were no significant differences between the FDPs with sharp embrasures (417 N ± 87) and the FDPs with interproximal disc separations (467 N ± 94; p ˃ 0.23). Failure mode of the FDPs fabricated with sharp embrasures and interproximal disc separations differed significantly compared to the FDPs in the other groups (p < 0.001). CONCLUSIONS: Sharp embrasures and interproximal separations made with diamond discs significantly decrease the load-bearing capacity of monolithic zirconia FDPs compared to FDPs made with blunt embrasures. Blunt embrasures in combination with localized porcelain build-up produce FDPs with high load-bearing capacity in relation to loads that might be expected under clinical use.

Decreased lipogenesis-promoting factors in adipose tissue in postmenopausal women with overweight on a Paleolithic-type diet.

PURPOSE: We studied effects of diet-induced postmenopausal weight loss on gene expression and activity of proteins involved in lipogenesis and lipolysis in adipose tissue. METHODS: Fifty-eight postmenopausal women with overweight (BMI 32.5 ± 5.5) were randomized to eat an ad libitum Paleolithic-type diet (PD) aiming for a high intake of protein and unsaturated fatty acids or a prudent control diet (CD) for 24 months. Anthropometry, plasma adipokines, gene expression of proteins involved in fat metabolism in subcutaneous adipose tissue (SAT) and lipoprotein lipase (LPL) activity and mass in SAT were measured at baseline and after 6 months. LPL mass and activity were also measured after 24 months. RESULTS: The PD led to improved insulin sensitivity (P < 0.01) and decreased circulating triglycerides (P < 0.001), lipogenesis-related factors, including LPL mRNA (P < 0.05), mass (P < 0.01), and activity (P < 0.001); as well as gene expressions of CD36 (P < 0.05), fatty acid synthase, FAS (P < 0.001) and diglyceride acyltransferase 2, DGAT2 (P < 0.001). The LPL activity (P < 0.05) and gene expression of DGAT2 (P < 0.05) and FAS (P < 0.05) were significantly lowered in the PD group versus the CD group at 6 months and the LPL activity (P < 0.05) remained significantly lowered in the PD group compared to the CD group at 24 months. CONCLUSIONS: Compared to the CD, the PD led to a more pronounced reduction of lipogenesis-promoting factors in SAT among postmenopausal women with overweight. This could have mediated the favorable metabolic effects of the PD on triglyceride levels and insulin sensitivity.

Influence of misfit on the occurrence of veneering porcelain fractures (chipping) in implant-supported metal-ceramic fixed dental prostheses: an in vitro pilot trial.

OBJECTIVE: Technical complications such as veneer fractures are more common in implant-supported than tooth-supported restorations. The underlying causes have not been fully identified. The aim of this study was to evaluate whether misfit between the restoration and the implant may affect the risk of veneer fractures. MATERIALS AND METHODS: Twenty standardized five-unit implant-supported metal-ceramic fixed dental prostheses (FDP)s were manufactured and fixed in acrylic blocks. The test group consisted of ten FDPs fixed with a 150-µm misfit at the distal abutment. The remaining ten FDPs were fixed without misfit and acted as a control group. All FDPS underwent cyclic loading for a total of 100,000 cycles at 30-300 N. The FDPs were checked for cracks or chip-off fractures regularly. After cyclic load, the retorque value of all abutment screws was checked. RESULTS: Cracks within the veneering porcelain were noted in nine FDPs in the test group and one FDP in the control group. This difference was statistically significant (P < 0.001). Fractures of the veneering porcelain occurred in three FDPs in the test group. No fractures occurred in the control group. This difference was not statistically significant. There were no significant differences in retorque values neither between the groups nor between different abutment positions in the FDPs. CONCLUSIONS: Within the limitations of this in vitro pilot trial, it is suggested that misfit between a restoration and the supporting implant may increase the risk of cracking and/or chipping of the veneering porcelain for metal-ceramic FDPs.

Levels of physical activity during physical education lessons in Sweden.

AIM: The aim of this study was to measure the percentage of sedentary light and moderate-to-vigorous physical activity (%MVPA) provided by physical education (PE) lessons for Swedish second, fifth and eighth grade students, aged eight, 11 and 14. METHODS: We observed 39 PE lessons and divided them into seven lesson categories: ball play, ball games, dance, fitness, playing games, orienteering and gymnastics. Physical activity (PA) during PE was estimated using accelerometers and the height and weight of the children were measured. RESULTS: We studied 149 children: 63 in the second grade, 66 in the fifth grade and 19 in the eighth grade. On average, 25% of the PE lessons were spent in MVPA and the mean %MVPA varied with the lesson content, with fitness, orienteering and playing games being the most intense. The highest %MVPA was in the fitness category, providing 33% (8-62%) for girls and 37% (7-72%) for boys. With the exception of the second grade, no significant gender differences in %MVPA were seen. CONCLUSION: The content of Swedish PE lessons affected the %MVPA in all age groups. In some content, individuals reached two-thirds of their daily PA recommendations, highlighting the potential that PE contributes to public health goals.

Effect of production method on surface roughness, marginal and internal fit, and retention of cobalt-chromium single crowns.

STATEMENT OF PROBLEM: New production methods have been developed for metal-ceramic restorations. Different production methods may show different surface roughness and fit, which may affect retention and long-term success. PURPOSE: The purpose of this in vitro study was to examine 3 different production methods with regard to surface roughness, marginal and internal fit, and retention of cobalt-chromium alloy single-crown copings. MATERIAL AND METHODS: A master abutment of a premolar mandibular tooth preparation with 4-mm height and a 0.6-mm deep 120-degree chamfer finish line with a 12-degree angle of convergence was replicated in die stone and scanned. Thirty-six cobalt-chromium alloy copings were produced using 3 different production techniques. Twelve copings were produced by laser-sintering, 12 by milling, and 12 by milled wax/lost wax. The surface microstructure of 2 copings in each group was analyzed using interferometry. The remaining 10 copings in each group were used to evaluate marginal and internal fit by using an impression material replica method, and retention was evaluated by using a uniaxial tensile force pull-off test. The copings from each test group were cemented with zinc phosphate cement onto resin abutments. Statistical analyses of differences in marginal and internal fit were performed using 1-way ANOVA and the Mann-Whitney U test. Differences in surface topography were analyzed with the Kruskal-Wallis and Mann-Whitney U tests for nonparametric data. Differences in retentive values were analyzed using the Mann-Whitney U test for nonparametric data (all α=.05). RESULTS: Differences in surface microstructure were seen. The laser-sintered copings showed increased surface roughness compared with milled and milled wax/lost wax copings. Differences in marginal and internal fit were noted. Laser-sintered showed significantly smaller spaces between coping and abutment than milled wax/lost wax copings (P=.003). At the margins, laser-sintered copings showed significantly smaller spaces than either the milled wax/lost wax group (P=.002) or the milled group (P=.002). At the chamfer, laser-sintered copings showed significantly smaller spaces than milled wax/lost wax copings (P=.005). At the center of the axial walls, laser-sintered copings showed significantly smaller spaces than those in the milled wax/lost wax (P=.004) and milled copings (P=.005). No significant differences were noted between milled and milled wax/lost wax copings (P>.05). No significant differences were detected regarding retentive forces in the pull-off tests (P>.05). CONCLUSIONS: Laser-sintered Co-Cr crown copings showed increased surface roughness and better internal and marginal fit than copings produced by milling or milled wax/lost wax technique. However, the crown pull-off tests did not reveal any significant differences.