RESUMEN
OBJECTIVES: The effect of the implant position within the prosthesis on bone remodeling is scarcely documented so far. Thus, the aim of the present study was to investigate whether central implants may suffer higher peri-implant marginal bone levels (MBL) compared to laterals in case of fixed splinted bridges supported by ≥ three implants. MATERIALS AND METHODS: Partially edentulous subjects rehabilitated with at least one fixed bridge supported by ≥ three dental implants were enrolled. MBL was assessed radiographically by means of intraoral radiographs acquired with phosphor plates and imported in a dedicated software. MBL was calculated as the distance between the implant platform level and the most coronal visible bone-to-implant contact. A three-level linear mixed effects model was used for investigating the fixed effect of patient-, prosthesis-, and implant-level variables on the MBL. RESULTS: Overall, 90 patients rehabilitated with 130 splinted fixed bridges supported by 412 implants were included. The median follow-up was 136 months. The mean peri-implant MBL resulted statistically significantly higher at central implants if compared to lateral implants (p < .01). The estimated MBL averages for central and external implants were 1.68 and 1.18 mm, respectively. The prosthesis-level variables suggested that a cement-retained bridge was prone to a significant 0.82 mm higher MBL than a screw-retained one. Implant surface showed an association with MBL changes, although less pronounced than implant retention. CONCLUSIONS: In case of ≥3 adjacent implants supporting splinted bridges, central implants were more predisposed to MBL compared to laterals. At the prosthesis level, implants supporting cement-retained bridges were statistically more susceptible to MBL compared to screw-retained ones. Surface characteristics can also influence MBL stability at the implant level.
Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Dentadura Parcial Fija , Humanos , Estudios Retrospectivos , Femenino , Masculino , Persona de Mediana Edad , Anciano , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Arcada Parcialmente Edéntula/cirugía , Arcada Parcialmente Edéntula/rehabilitación , AdultoRESUMEN
BACKGROUND: Oral Health-Related Quality of Life (OHRQoL) is a comprehensive concept covering daily comfort, self-esteem, and satisfaction with oral health, including functional, psychological, and social aspects, as well as pain experiences. Despite abundant research on OHRQoL related to oral diseases and hygiene, there is limited data on how patients perceive changes after implant-prosthetic rehabilitation. This study aimed to evaluate OHRQoL and aesthetic perception using OHIP-14 and VAS scales respectively, before (baseline-TB), during (provisional prostheses-TP), and after (definitive prostheses-TD) implant-prosthetic rehabilitation. It also explored the impact of biological sex, substitution numbers, and aesthetic interventions on OHRQoL and VAS scores, along with changes in OHIP-14 domains. METHODS: A longitudinal prospective single-center observational cohort study was conducted with patients requiring implant-prosthetic rehabilitation. Quality of life relating to dental implants was assessed through the Italian version of Oral Health Impact Profile-14 (IOHIP-14), which has a summary score from 14 to 70. Patients' perceived aesthetic was analyzed through a VAS scale from 0 to 100. Generalized Linear Mixed Effect Models, Linear Mixed Effect Models, and Friedman test analyzed patient responses. RESULTS: 99 patients (35 males, 64 females) aged 61-74, receiving various prosthetic interventions, were enrolled. Both provisional and definitive prosthetic interventions significantly decreased the odds of a worse quality of life compared to baseline, with odds ratios of 0.04 and 0.01 respectively. VAS scores increased significantly after both interventions, with estimated increases of 30.44 and 51.97 points respectively. Patient-level variability was notable, with an Intraclass Correlation Coefficient (ICC) of 0.43. While biological sex, substitution numbers, and aesthetic interventions didn't significantly affect VAS scores, OHRQoL domains showed significant changes post-intervention. CONCLUSIONS: These findings support the effectiveness of implant-prosthetic interventions in improving the quality of life and perceived aesthetics of patients undergoing oral rehabilitation. They have important implications for clinical practice, highlighting the importance of individualized treatment approaches to optimize patient outcomes and satisfaction in oral health care.
Asunto(s)
Prótesis Dental de Soporte Implantado , Estética Dental , Salud Bucal , Calidad de Vida , Humanos , Masculino , Femenino , Estudios Prospectivos , Prótesis Dental de Soporte Implantado/psicología , Persona de Mediana Edad , Anciano , Estudios LongitudinalesRESUMEN
Frailty is an age-related syndrome that drives multiple physiological system impairments in some older adults, and its pathophysiological mechanisms remain unclear. We evaluated whether frailty-related biological processes could impair stem cell compartments, specifically the renal stem compartment, given that kidney dysfunctions are frequent in frailty. A well-characterized in vitro nephrosphere model of human adult renal stem/progenitor cells has been instrumental to and was appropriate for verifying this hypothesis in our current research. Evaluating the effects of plasma from older individuals with frailty (frail plasma) on allogeneic renal stem/progenitor cells, we showed significant functional impairment and nuclear DNA damage in the treated cells of the renal stem compartment. The analysis of the frail plasma revealed mitochondrial functional impairment associated with the activation of oxidative stress and a unique inflammatory mediator profile in frail individuals. In addition, the plasma of frail subjects also contained the highest percentage of DNA-damaged autologous circulating hematopoietic progenitor/stem cells. The integration of both molecular and functional data obtained allowed us to discern patterns associated with frailty status, irrespective of the comorbidities present in the frail individuals. The data obtained converged toward biological conditions that in frailty caused renal and hematopoietic impairment of stem cells, highlighting the possibility of concomitant exhaustion of several stem compartments.