C-peptide in dried blood spots.

The aim was to evaluate if the Dried Blood Spot (DBS)-technique can be used to analyse C-peptide. S-C-peptide and paired whole blood clotted on filters, dried, punched out and eluted were sampled from 198 healthy subjects. Six subjects with S-C-peptide values outside the reference range were excluded. A conversion formula using log-DBS-C-peptide was generated in a subset of 156 (∼80%) subjects with predictions made using also storage time (eluates) and age of subjects: (log S-C-peptide = 1.696 + 1.367 log DBS-C-peptide + 0.058 (storage time/month) + 0.014 (age/10 years). This formula was cross validated into the original population. Using Bland-Altman plots, mean difference between converted log DBS-C-peptide and log S-C-peptide at baseline was 0 and limits of agreements were -0.18 to +0.18. Mean difference between converted log DBS-C-peptide values after six months and log S-C-peptide value from baseline was -0.01 and limits of agreement were -0.20-0.19. The lowest value detected with the DBS-technique corresponded to serum C-peptide 0.44 nmol/L. We concluded that DBS-C-peptide can be used as a first line screening test to monitor normal beta cell function. C-peptide on filters remained stable for six months.

Implant treatment in the edentulous maxillae: a 15-year follow-up study on 76 consecutive patients provided with fixed prostheses.

BACKGROUND: Few long-term follow-up studies are available on implant treatment based on patient level data related to time. PURPOSE: The aim of this study was to report 15-year patient-based data in relation to time of follow up after treatment with fixed prostheses supported by implants in the edentulous upper jaw. MATERIALS AND METHODS: Seventy-six edentulous consecutive patients, provided with 450 turned Brånemark implants, were followed up with regard to maintenance, complications, and radiographs taken during the follow-up period. RESULTS: Forty-four patients provided with 247 implants were lost to follow up. Patients followed up for 15 years showed as a group a trend of better implant survival than patients lost to follow up (p > .05). Altogether, 37 implants and 5 fixed prostheses failed during the follow-up period. Most implants were lost at abutment surgery (n- 15) and another nine during the first year of function. The 15-year implant and fixed prosthesis cumulative survival rate was 90.9 and 90.6%, respectively. Resin veneer fractures caused most problems, more frequent in the earlier stage while severe wear increased in the later stage of follow up. No implant fractures or loosening of abutment/bridge locking screws were noted. The mean marginal bone loss was 0.5 mm (SD 0.47) after 5 years, followed by only minimal average changes during the following years. No radiographic parameter showed any time-dependent relationship. The percentage of patients presenting at least one implant with more than 2.0-mm bone loss was 4.9% in the interval from 0 to 5 years and 4.0% between 10 and 15 years. Only 1.3% of implants showed >3.0 mm accumulated bone loss after 15 years. CONCLUSION: Implant treatment in the edentulous upper jaw functions well in a 15-year time perspective, but an insignificant trend of higher implant failures was observed for patients lost to follow up. Besides wear and fractures of veneers, no other parameter showed any time-related relationship, indicating an increased risk for more complications during later stages of follow up. However, accumulation of smaller amount of bone loss during the years resulted in an increasing number of implants and patients with bone levels below the third thread, which could be speculated to increase future maintenance after 15 years.