Transcriptomics and proteomics reveal distinct biology for lymph node metastases and tumour deposits in colorectal cancer.

Both lymph node metastases (LNMs) and tumour deposits (TDs) are included in colorectal cancer (CRC) staging, although knowledge regarding their biological background is lacking. This study aimed to compare the biology of these prognostic features, which is essential for a better understanding of their role in CRC spread. Spatially resolved transcriptomic analysis using digital spatial profiling was performed on TDs and LNMs from 10 CRC patients using 1,388 RNA targets, for the tumour cells and tumour microenvironment. Shotgun proteomics identified 5,578 proteins in 12 different patients. Differences in RNA and protein expression were analysed, and spatial deconvolution was performed. Image-based consensus molecular subtype (imCMS) analysis was performed on all TDs and LNMs included in the study. Transcriptome and proteome profiles identified distinct clusters for TDs and LNMs in both the tumour and tumour microenvironment segment, with upregulation of matrix remodelling, cell adhesion/motility, and epithelial-mesenchymal transition (EMT) in TDs (all p < 0.05). Spatial deconvolution showed a significantly increased abundance of fibroblasts, macrophages, and regulatory T-cells (p < 0.05) in TDs. Consistent with a higher fibroblast and EMT component, imCMS classified 62% of TDs as poor prognosis subtype CMS4 compared to 36% of LNMs (p < 0.05). Compared to LNMs, TDs have a more invasive state involving a distinct tumour microenvironment and upregulation of EMT, which are reflected in a more frequent histological classification of TDs as CMS4. These results emphasise the heterogeneity of locoregional spread and the fact that TDs should merit more attention both in future research and during staging. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Effect of Dentin Contamination with Hemostatic Agents and Cleaning Techniques on Bonding with Self-Adhesive Resin Cement.

BACKGROUND Dentin contamination with hemostatic agents before bonding indirect restorations negatively affects the bond strength. However, the consensus on which materials could be used to clean contamination of hemostatic agents has not been explored. The aim of this study was to assess the effect of Katana Cleaner applied on the surface of dentin contaminated with hemostatic agents on the shear bond strength (SBS) of self-adhesive resin cement by comparing it with three other surface cleaners. MATERIAL AND METHODS Ninety dentin specimens were divided into a no contamination group (control) (n=10), 4 groups contaminated with 25% aluminum chloride (Viscostat Clear) (n=40), and 4 groups contaminated with 20% ferric sulfate (Viscostat) (n=40). Subsequently, 4 different cleaners were used for each contamination group (water rinse, phosphoric acid, chlorhexidine, and Katana Cleaner). Then, self-adhesive resin cement was directly bonded to the treated surfaces. All specimens were subjected to 5000 thermal cycles of artificial aging. The shear bond strength was measured using a universal testing machine. RESULTS Two-way analysis of variance showed that the contaminant type as the main factor was statistically non-significant (p=0.655), cleaner type as the main factor was highly significant (p<0.001), and interaction between the contaminant and cleaner was non-significant (p=0.51). The cleaner type was the main factor influencing the bond strength. Phosphoric acid and chlorhexidine showed better performance than Katana Cleaner. CONCLUSIONS Cleaning dentin surface contamination with phosphoric acid and chlorhexidine had better performance than with Katana Cleaner.

The effect of salbutamol sulphate inhalation (an anti-asthmatic medication) on the surfaces of orthodontic Archwires.

OBJECTIVES: This study aimed to compare the surface roughness and friction of different orthodontic archwires after exposure to salbutamol sulphate inhalation, an anti-asthmatic medication. METHODS: Orthodontic archwires (stainless-steel [StSt], nickel-titanium [NiTi], beta-titanium [ß-Ti], and copper-NiTi [Cu-NiTi]) were equally divided into two groups. The exposed groups were subjected to 20 mg salbutamol sulphate for 21 days and kept in artificial saliva. The control groups were only kept in artificial saliva. Surface changes were visualized using scanning electron microscopy (SEM). The average surface roughness (Ra) was evaluated using atomic force microscopy (AFM), and friction resistance forces were assessed using a universal testing machine. Statistical analyses were performed using t-tests and ANOVA followed by post hoc tests. RESULTS: Salbutamol sulphate did not change the surface roughness of StSt and NiTi archwires (p > .05). However, the change in the surfaces of ß-Ti and Cu-NiTi archwires was significant (p < .001). The frictional forces of exposed StSt, NiTi, and Cu-NiTi archwires did not change (p > .05). However, the frictional forces of ß-Ti archwires increased significantly after exposure to salbutamol sulphate (p = .021). Brushing with fluoride after exposure to salbutamol sulphate increased the frictional forces of ß-Ti only (p = .002). CONCLUSIONS: Salbutamol sulphate inhalation significantly affected the surface texture of ß-Ti and Cu-NiTi orthodontic archwires and increased the friction of ß-Ti archwires. These deteriorating effects were not detected on the surface of StSt and NiTi archwires. Therefore, we suggest that ß-Ti and copper titanium archwires should be used cautiously in individuals under salbutamol sulphate inhalation treatment.

Person Re-Identification Using Local Relation-Aware Graph Convolutional Network.

Local feature extractions have been verified to be effective for person re-identification (re-ID) in recent literature. However, existing methods usually rely on extracting local features from single part of a pedestrian while neglecting the relationship of local features among different pedestrian images. As a result, local features contain limited information from one pedestrian image, and cannot benefit from other pedestrian images. In this paper, we propose a novel approach named Local Relation-Aware Graph Convolutional Network (LRGCN) to learn the relationship of local features among different pedestrian images. In order to completely describe the relationship of local features among different pedestrian images, we propose overlap graph and similarity graph. The overlap graph formulates the edge weight as the overlap node number in the node's neighborhoods so as to learn robust local features, and the similarity graph defines the edge weight as the similarity between the nodes to learn discriminative local features. To propagate the information for different kinds of nodes effectively, we propose the Structural Graph Convolution (SGConv) operation. Different from traditional graph convolution operations where all nodes share the same parameter matrix, SGConv learns different parameter matrices for the node itself and its neighbor nodes to improve the expressive power. We conduct comprehensive experiments to verify our method on four large-scale person re-ID databases, and the overall results show LRGCN exceeds the state-of-the-art methods.

Content-Seam-Preserving Multi-Alignment Network for Visual-Sensor-Based Image Stitching.

As an important representation of scenes in virtual reality and augmented reality, image stitching aims to generate a panoramic image with a natural field-of-view by stitching multiple images together, which are captured by different visual sensors. Existing deep-learning-based methods for image stitching only conduct a single deep homography to perform image alignment, which may produce inevitable alignment distortions. To address this issue, we propose a content-seam-preserving multi-alignment network (CSPM-Net) for visual-sensor-based image stitching, which could preserve the image content consistency and avoid seam distortions simultaneously. Firstly, a content-preserving deep homography estimation was designed to pre-align the input image pairs and reduce the content inconsistency. Secondly, an edge-assisted mesh warping was conducted to further align the image pairs, where the edge information is introduced to eliminate seam artifacts. Finally, in order to predict the final stitched image accurately, a content consistency loss was designed to preserve the geometric structure of overlapping regions between image pairs, and a seam smoothness loss is proposed to eliminate the edge distortions of image boundaries. Experimental results demonstrated that the proposed image-stitching method can provide favorable stitching results for visual-sensor-based images and outperform other state-of-the-art methods.

Cross-Modality Person Re-Identification via Local Paired Graph Attention Network.

Cross-modality person re-identification (ReID) aims at searching a pedestrian image of RGB modality from infrared (IR) pedestrian images and vice versa. Recently, some approaches have constructed a graph to learn the relevance of pedestrian images of distinct modalities to narrow the gap between IR modality and RGB modality, but they omit the correlation between IR image and RGB image pairs. In this paper, we propose a novel graph model called Local Paired Graph Attention Network (LPGAT). It uses the paired local features of pedestrian images from different modalities to build the nodes of the graph. For accurate propagation of information among the nodes of the graph, we propose a contextual attention coefficient that leverages distance information to regulate the process of updating the nodes of the graph. Furthermore, we put forward Cross-Center Contrastive Learning (C3L) to constrain how far local features are from their heterogeneous centers, which is beneficial for learning the completed distance metric. We conduct experiments on the RegDB and SYSU-MM01 datasets to validate the feasibility of the proposed approach.

Role of meteorological parameters with the spread of Covid-19 in Pakistan: application of autoregressive distributed lag approach.

This research focuses on the impacts of different meteorological parameters (temperature, humidity, rainfall, and evapotranspiration) on the transmission of Covid-19 in the administrative regions and provinces of Pakistan, i.e., Azad Jammu and Kashmir, Gilgit Baltistan, Khyber Pakhtunkhwa, Islamabad, Punjab, Sindh, and Balochistan from June 10, 2020, to August 31, 2021. This study analyzes the relation between Covid-19-confirmed cases and the meteorological parameters with the help of the autoregressive distributed lag model. In this research, additional tools (t-statistics, f-statistics, and time series analysis) are used for the motive of examining the linear relationship, the productivity of the model, and for the significant association between dependent and independent variables, lnccc and lnevp, lnhum, lnrain, lntemp, respectively. Values of t-statistics and f-statistics reveal that variables have a connection and individual significance for the model exist. Time series display that the Covid-19 spread increased from June 10, 2020, to August 31, 2021, in Pakistan. Temperature positively influenced the Covid-19-confirmed cases in all provinces of Pakistan in the long run. Evapotranspiration and rainfall influenced positively, while specific humidity influenced negatively on the confirmed Covid-19 cases in Azad Jammu Kashmir, Khyber Pakhtunkhwa, and Punjab. Specific humidity had a positive impact, while evapotranspiration and rainfall had the negative impact on the Covid-19-confirmed cases in Sindh and Balochistan. Evapotranspiration and specific humidity influenced positively, while rainfall influenced the Covid-19-confirmed cases negatively in Gilgit Baltistan. Evapotranspiration influenced positively, while specific humidity and rainfall influenced negatively on the Covid-19-confirmed cases in Islamabad. Supplementary Information: The online version contains supplementary material available at 10.1007/s13762-023-04997-4.

Extended Reality-Assisted Surgery as a Surgical Training Tool: Pilot Study Presenting First HoloLens-Assisted Complex Penile Revision Surgery.

BACKGROUND: Extended reality-assisted urologic surgery (XRAS) is a novel technology that superimposes a computer-generated image on the physician's field to integrate common elements of the surgical process in more advanced detail. An extended reality (XR) interface is generated using optical head-mounted display (OHMD) devices. AIM: To present the first case of HoloLens-assisted complex penile revision surgery. METHODS: We describe our pilot study of HoloLens-assisted penile revision surgery and present a thorough review of the literature regarding XRAS technology and innovative OHMD devices. OUTCOMES: The ability of XRAS technology to superimpose a computer-generated image of the patient and integrate common elements of the surgical planning process with long-distance experts. RESULTS: XRAS is a feasible technology for application in complex penile surgical planning processes. CLINICAL TRANSLATION: XRAS and OHMD devices are novel technologies applicable to urological surgical training and planning. STRENGTHS AND LIMITATIONS: Evidence suggests that the potential use of OHMD devices is safe and beneficial for surgeons. We intend to pioneer HoloLens technology in the surgical planning process of a malfunctioning penile implant due to herniation of the cylinder. This novel technology has not been used in prosthetic surgery, and current data about XRAS are limited. CONCLUSION: OHMD devices are effective in the operative setting. Herein, we successfully demonstrated the integration of Microsoft HoloLens 2 into a penile surgical planning process for the first time. Further development and studies for this technology are necessary to better characterize the XRAS as a training and surgical planning tool. Quesada-Olarte J, Carrion RE, Fernandez-Crespo R, et al. Extended Reality-Assisted Surgery as a Surgical Training Tool: Pilot Study Presenting First HoloLens-Assisted Complex Penile Revision Surgery. J Sex Med 2022;19:1580-1586.

The Prevalence and Patterns of Menopausal Symptoms in Women Living with HIV.

Increasing numbers of women with HIV are experiencing menopause. We use data from a large, representative sample of women with HIV to describe the prevalence and clustering of menopausal symptoms amongst pre-, peri- and post-menopausal women using hierarchical agglomerative cluster analysis. Of the 709 women included, 21.6%, 44.9% and 33.6% were pre-, peri- and post-menopausal, respectively. Joint pain (66.4%) was the most commonly reported symptom, followed by hot flashes (63.0%), exhaustion (61.6%) and sleep problems (61.4%). All symptoms were reported more commonly by peri- and post-menopausal women compared to pre-menopausal women. Psychological symptoms and sleep problems clustered together at all menopausal stages. Somatic and urogenital symptom clusters emerged more distinctly at peri- and post-menopause. We recommend regular and proactive assessment of menopausal symptoms in midlife women with HIV, with an awareness of how particular patterns of symptoms may evolve over the menopausal transition.

The association between severe menopausal symptoms and engagement with HIV care and treatment in women living with HIV.

Using data from the PRIME Study, an observational study of the menopause in women living with HIV in England, we explored the association between menopausal symptoms and: (i) antiretroviral therapy (ART) adherence and (ii) HIV clinic attendance. We measured menopausal symptom severity with the Menopause Rating Scale (MRS, score ≥17 indicating severe symptoms), adherence with the CPCRA Antiretroviral Medication Adherence Self-Report Form, and ascertained HIV clinic attendance via self-report. Odds ratios were obtained using logistic regression. Women who reported severe menopausal symptoms had greater odds of suboptimal ART adherence (adjusted odds ratio (AOR) 2.22; 95% CI 1.13, 4.35) and suboptimal clinic attendance (AOR 1.52; 95% CI 1.01, 2.29). When psychological, somatic and urogenital domains of the MRS were analysed individually there was no association between adherence and severe symptoms (all p > 0.1), however there was an association between suboptimal HIV clinic attendance and severe somatic (AOR 1.98; 95% CI 1.24, 3.16) and psychological (AOR 1.76; 95% CI 1.17, 2.65) symptoms. Severe menopausal symptoms were significantly associated with sub-optimal ART adherence and HIV clinic attendance, however we cannot infer causality, highlighting the need for longitudinal data.

"Support for the supporters": a qualitative study of the use of WhatsApp by and for mentor mothers with HIV in the UK.

Third-sector organizations, an important support for people living with HIV, increasingly use digital technology to improve service efficiency and reach. However, there is limited empirical evidence on this use by women living with HIV. The 4M Network (4MNet) is a peer-run UK-wide network of trained Mentor Mothers (MMs) living with HIV; it uses the WhatsApp platform as its primary digital communication tool. We report on a qualitative study about 4MNet MMs' experiences of using WhatsApp, to inform the design of future digital support services. Seven telephone interviews were conducted with five MMs and two project management team (PMT) members in February 2019. Interviews were analyzed using Interpretive Phenomenological Analysis (IPA). WhatsApp was found to have several key features that provided both positive and negative use considerations. WhatsApp eased communication among MMs and supported participation in group activities despite differing schedules and geographic locations. Challenges encountered with WhatsApp included: financial restrictions to data storage and continual access; self-confidence using technology; and security and privacy concerns. Peer-led digital communication is found to be acceptable and effective for women living with HIV. Understanding barriers and valued features of existing digital platforms increasingly used among potentially marginalized groups is vital for informing inclusive innovation.

Effects of Gingival Retraction Paste and Subsequent Cleaning with Hydrogen Peroxide on the Polymerization of Three Elastomeric Impression Materials: An In Vitro Study.

PURPOSE: It has been hypothesized that there are no effects of Expasyl and subsequent cleaning with hydrogen peroxide on polymerization of selected commonly used impression materials. Therefore, the aim of this study was to evaluate the effect of Expasyl paste on the polymerization of three impression materials with and without subsequent cleaning using 3% hydrogen peroxide (H2 O2 ). MATERIALS AND METHODS: Nine standardized stainless steel specimens were fabricated. One hundred and eighty impressions were made using 3 materials (60 each) as follows: group I: poly(vinyl siloxane) (PVS) (Virtual); group II: polyether (Monophase); group III: polyether (Impregum). Groups were subdivided into 3 categories: control without intervention (n = 20), pre-application of Expasyl and subsequent 1-minute washing with water and air-drying (n = 20), and pre-application of Expasyl and subsequent cleaning with 3% H2 O2 for 10 seconds (n = 20). All impressions were made by one operator using auto-mixing cartridges under standardized conditions at room temperature. Evaluation of the polymerization inhibition was blindly and independently performed by three practitioners with comparable experience using a visual scale. The observation was subjectively categorized as noninhibited or inhibited. Data were tabulated and analyzed using Fisher's exact test with significance level set at p ˂ 0.05. RESULTS: Significant differences were found between the control group and the impressions made after contamination with Expasyl (p < 0.001). Polymerization inhibition of PVS and Impregum was similar (in 85% and 90% of the specimens, respectively) when washed with water. There was a statistically significant reduction in polymerization inhibition in both upon cleaning with H2 O2 (p < 0.001); however, polymerization inhibition occurred in 100% of Monophase specimens when contaminated with Expasyl despite the washing technique used. CONCLUSIONS: Under these in vitro conditions, it can be concluded that the remnants of Expasyl on specimens caused a significant polymerization inhibition of the 3 impression materials tested. Subsequent cleaning with 3% H2 O2 significantly reduced this inhibitory effect on polymerization. Expasyl should not be used with Monophase polyether material.

Biomechanical Comparison of Inflatable Penile Implants: A Cadaveric Pilot Study.

BACKGROUND: Throughout the last decade there has been a growing interest in the biomechanical differences between inflatable penile prostheses (IPPs) and their significance with regard to the patient experience. AIM: To present our findings assessing the biomechanical properties of IPPs with and without rear tip extenders (RTEs). METHODS: This is a biomechanical study of the 3 most commonly used IPPs (AMS CX, AMS LGX, and Coloplast Titan) as assessed by column compression, modified cantilever deflection, and 3-point bending methods. The IPPs were surgically placed into 3 fresh cadavers via an infrapubic technique by a single large-volume implanter. A biomechanical evaluation of the properties of each IPP inside the fibroelastic tunica albuginea was assessed in blinded testing, and analyses were based on industry standard methods for assessment. OUTCOMES: Maximum axial load; kink formation; horizontal stiffness; and resistance to 3-point flexure testing were measured. RESULTS: At maximum inflation, all 3 implants had similar performance. Differences appear to be most affected by fill pressures. In fact, only the AMS LGX at less than maximum inflation (LTMI) was unable to consistently withstand the roughly 0.9 kg (2 lbs) of pressure for column load testing mimicking vaginal intromission. The Coloplast Titan showed slightly better rigidity than the AMS LGX and CX devices in horizontal load testing, and, with 3-point flexure testing, the CX showed the best rigidity in the shortest phallus (A). Overall, the Titan showed slightly better rigidity in the longest phallus (C) and the phallus with mild Peyronie's disease (B). CLINICAL TRANSLATIONS: Penile implants with circumferential expansion had higher rigidity on biomechanical testing and should be considered in a patient's decision during selection of a penile implant. STRENGTHS AND LIMITATIONS: Strengths include blinding of the biomechanical testing and analyses, surgical procedures performed by a highly experienced surgeon, and that this is the "closest to" in vivo evaluation (inside the tunica albuginea) of penile implant function and properties to date. Weaknesses are that this study was performed in cadavers and not in live patients. It also has a small sample size, including the use of only 3 cadavers, and there was no correlation of performance to patient satisfaction. CONCLUSION: The results of this study support the conclusion that all devices are capable of functionally restoring erectile capacity. However, we observed that, in general, the 2 circumferentially expanding penile prosthesis showed greater resistance in biomechanical testing when compared with longitudinal and circumferential expanding devices. This should be considered as a guide during device selection for a patient undergoing penile prosthesis. Wallen JJ, Barrera EV, Ge L, et al. Biomechanical Comparison of Inflatable Penile Implants: A Cadaveric Pilot Study. J Sex Med 2018;15:1034-1040.

Mutans Streptococci and Dental Caries: A New Statistical Modeling Approach.

Survival analyses have been used to overcome some of the limitations encountered with other statistical analyses. Although extended Cox hazard modeling with time-dependent variables has been utilized in several medical studies, it has never been utilized in assessing the complex relationship between mutans streptococci (MS) acquisition (time-dependent covariate) and time to having dental caries (outcome). This study involved secondary analyses of data from a prospective study conducted at the University of Alabama at Birmingham. Low socioeconomic status, African-American preschool children from Perry County, AL, USA (n = 95) had dental examinations at age 1 year and annually thereafter until age 6 years by three calibrated dentists. Salivary MS tests were done at ages 1, 1.5, 2, 2.5, 3, and 4 years. The patterns of and relationship between initial MS detection (time-dependent covariate) and dental caries experience occurrence were assessed, using extended Cox hazard modeling. The median time without MS acquisition (50% of the children not having positive MS test) was 2 years. Approximately 79% of the children had positive salivary MS tests by the age of 4 years. The median caries experience survival (50% of the children not having dental caries) was 4 years. During the follow-up period, 65 of the children (68.4%) had their initial primary caries experience. Results of the extended Cox hazard modeling showed a significant overall/global relationship between initial caries experience event at any given time during the follow-up period and having a positive salivary MS test at any time during the follow-up period (hazard ratio = 2.25, 95% CI 1.06-4.75). In conclusion, the extended Cox modeling was used for the first time and its results showed a significant global/overall relationship between MS acquisition and dental caries. Further research using causal mediation analysis with survival data is necessary, where the mediator "presence of MS" is treated as a time-dependent variable.

Influence of povidone-iodine on micro-tensile bonding strength to dentin under simulated pulpal pressure.

BACKGROUND: Previous studies had reported that bond strength deteriorate over time following the dentin surface pretreatment with chlorhexidine. Therefore, further investigations are needed to evaluate the effect of other materials such as povidone iodine. The purpose of this study was to investigate the effects of 10% povidone-iodine pretreatment on the resin-dentin micro-tensile bond strength of a single bond adhesive system in permanent teeth over time, and compare it with 2% chlorhexidine. METHODS: Flat dentin surfaces were prepared in 63 extracted permanent teeth. Teeth were randomly assigned to a 10% povidone-iodine pretreatment, a 2% chlorhexidine pretreatment, or a control group. Composite resin blocks were built up over treated surfaces under pulp pressure simulation. The prepared specimens were assigned to three storage time, 24 h, 1 week, and 2 months. Samples were vertically sectioned to obtain specimens of 0.7 to 1.2 mm2 cross-sectional area. RESULTS: No significant reduction of bond strength of povidone iodine group was found among the three storage times (p = 0.477). A significant reduction of bond strength for both chlorhexidine and control groups was found in the three storage times (p <  0.001). CONCLUSION: Povidone iodine pretreatment of etched dentin was effective in reducing the loss of bond strength over time, while the chlorhexidine pretreatment and negative control showed significant deterioration in micro-tensile bond strength over time in permanent teeth.

Incorporating a Genetic Risk Score Into Coronary Heart Disease Risk Estimates: Effect on Low-Density Lipoprotein Cholesterol Levels (the MI-GENES Clinical Trial).

BACKGROUND: Whether knowledge of genetic risk for coronary heart disease (CHD) affects health-related outcomes is unknown. We investigated whether incorporating a genetic risk score (GRS) in CHD risk estimates lowers low-density lipoprotein cholesterol (LDL-C) levels. METHODS AND RESULTS: Participants (n=203, 45-65 years of age, at intermediate risk for CHD, and not on statins) were randomly assigned to receive their 10-year probability of CHD based either on a conventional risk score (CRS) or CRS + GRS ((+)GRS). Participants in the (+)GRS group were stratified as having high or average/low GRS. Risk was disclosed by a genetic counselor followed by shared decision making regarding statin therapy with a physician. We compared the primary end point of LDL-C levels at 6 months and assessed whether any differences were attributable to changes in dietary fat intake, physical activity levels, or statin use. Participants (mean age, 59.4±5 years; 48% men; mean 10-year CHD risk, 8.5±4.1%) were allocated to receive either CRS (n=100) or (+)GRS (n=103). At the end of the study period, the (+)GRS group had a lower LDL-C than the CRS group (96.5±32.7 versus 105.9±33.3 mg/dL; P=0.04). Participants with high GRS had lower LDL-C levels (92.3±32.9 mg/dL) than CRS participants (P=0.02) but not participants with low GRS (100.9±32.2 mg/dL; P=0.18). Statins were initiated more often in the (+)GRS group than in the CRS group (39% versus 22%, P<0.01). No significant differences in dietary fat intake and physical activity levels were noted. CONCLUSIONS: Disclosure of CHD risk estimates that incorporated genetic risk information led to lower LDL-C levels than disclosure of CHD risk based on conventional risk factors alone. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01936675.

Comparison of clinical and radiographic status of platform-switched implants placed in patients with and without type 2 diabetes mellitus: a 24-month follow-up longitudinal study.

OBJECTIVE: The purpose of the present 24-month follow-up longitudinal study was to compare the clinical and radiographic status of platform-switched implants placed in patients with and without type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS: In total, 45 male non-smokers were included. In Group-1, there were 23 patients with T2DM, and patients in Group-2 comprised of 22 self-reported non-diabetic controls. Under local anesthesia, platform-switched implants were placed in the mandible. Peri-implant bleeding on probing (BOP), probing depth (PD), marginal bone loss (MBL) and hemoglobin A1c (HbA1c) levels were measured at 12 and 24 months of follow-up. Participants were also enrolled in a biannual oral hygiene maintenance program. RESULTS: The mean age of participants in groups 1 and 2 were 42.4 years (40-46 years) and 41.8 years (39-44 years), respectively. In Group-1, the mean duration of T2DM was 14.5 ± 0.7 months. At 12 and 24 months of follow-up, there was no significant difference in the mean HbA1c levels among patients in groups 1 and 2. At 12 and 24 months of follow-up, there was no significant difference in peri-implant BOP, PD and MBL in both groups. CONCLUSIONS: Platform-switched implants can remain clinically and radiographically stable in patients with T2DM in a manner similar to non-diabetic individuals. However, it is emphasized that bone loss around implants is influenced by several factors (such as oral hygiene status, glycemic control and tobacco smoking) and not merely platform switching.

Comparison of clinical and radiographic status around dental implants placed in patients with and without prediabetes: 1-year follow-up outcomes.

OBJECTIVE: We hypothesized that peri-implant soft tissue inflammation is worse and peri-implant marginal bone loss (MBL) is higher around dental implants placed in patients with prediabetes compared to healthy subjects. The aim of the present 12-month follow-up study was to compare the clinical and radiographic status around dental implants placed in patients with and without prediabetes. MATERIAL AND METHODS: Twelve patients with medically diagnosed prediabetes (Group-1) and 12 controls (Group-2) were included. All patients were indicated for single tooth maxillary or mandibular premolar replacement with the adjacent teeth intact. Success of the restored implants was assessed by comparing clinical (peri-implant bleeding on probing [BOP], and probing pocket depth [PPD]) and radiographic (peri-implant MBL) parameters at baseline and at 12-months follow-up. Statistical analysis was performed using one-way analysis of variance, and P-values <0.05 were considered statistically significant. RESULTS: At 12 months of follow-up, there was no clinical evidence for the presence of plaque, BOP and peri-implant pockets with PPD ≥ 4 mm in both groups. At 12-month follow-up, the mean MBL among implants placed in groups 1 and 2 were 0.2 ± 0.1 mm and 0.1 ± 0.01 mm, respectively. Overall, the periodontal status (PI, BOP and PPD ≥ 4 mm) at 12-month follow-up was comparable among patients in both groups. CONCLUSION: Within the limitations of this study, it is concluded that dental implants inserted in prediabetic and healthy patients have similar success rates and remain clinically and radiographically stable after 1-year follow-up.

Comparison of clinical and radiographic parameters around short (6 to 8 mm in length) and long (11 mm in length) dental implants placed in patients with and without type 2 diabetes mellitus: 3-year follow-up results.

OBJECTIVE: To compare the clinical and radiographic parameters around short (6 to 8 mm in length) and long (11 mm in length) dental implants placed in patients with and without type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS: Forty-five male patients with T2DM (Group-1) and 42 male non-diabetic controls (Group-2) who had undergone implant therapy in the posterior mandible were included. Depending upon the length of the implant, patients were divided into two subgroups: (a) patients with short implants (6-8 mm long) and (b) patients with long implants (11 mm long). Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD) and crestal bone loss (CBL) were measured at 18 and 36 months of follow-up in both groups. Hemoglobin A1c (HbA1c) levels were measured at baseline and after 18 and 36 months of follow-up in both groups. P-values less than 0.05 were considered statistically significant. RESULTS: The mean age of patients in groups 1 and 2 was 42.5 and 40.6 years, respectively. The mean HbA1c levels at baseline among patients in groups 1 and 2 were 7.7% and 4.5%, respectively. At 18 and 36 months of follow-up, the mean HbA1c levels among patients in groups 1 and 2 were 6.6% and 4.5% and 6.5% and 4.4%, respectively. The mean duration of T2DM among patients that received short and long implants was 4.3 years and 4.1 years, respectively. There was no significant difference in PI, BOP, PD and CBL around implants placed in both groups at 18 and 36 months of follow-up. Success rate of short and long dental implants was 100% in both groups. CONCLUSION: Short implants can demonstrate clinical and radiographic stability in a manner similar to conventional long implants in patients with and without T2DM. The role of oral hygiene and glycemic maintenance in this scenario cannot be disregarded.

Soft tissue changes and crestal bone loss around platform-switched implants placed at crestal and subcrestal levels: 36-month results from a prospective split-mouth clinical trial.

OBJECTIVE: The aim of the present 36-month prospective split-mouth clinical trial was to investigate the peri-implant soft tissue changes and crestal bone loss (CBL) around delayed loaded platform-switched implants placed at crestal and subcrestal levels. MATERIAL AND METHODS: Twenty-three individuals with bilaterally missing either mandibular first or second molars were included. The test and control sites were defined as follows: (i) test sites: implants placed 2 mm below the alveolar crest (subcrestal); (ii) control sites: implants placed at bone level (crestal). Forty-six implants (23 implants in test sites and 23 in control sites) were placed in the center of the healed alveolar ridge in the posterior mandible. Peri-implant bleeding on probing (BOP), probing depth (PD ≥ 4 mm), and CBL was compared at 6, 18, and 36 months of follow-up. P < 0.05 was considered statistically significant. RESULTS: Sixteen males and seven females with a mean age of 43.5 years (29-50) were included. In the control group (n = 23), the highest mean percentage of sites that showed BOP and PD ≥ 4 mm were at 6 months (7.4% and 1.4%, respectively). In the test group (n = 23), the highest mean percentage of sites that showed BOP and PD ≥ 4 mm were at 6 months (2.4% and 1.2%, respectively). The total amount of CBL around crestal and subcrestal implants after 36 months of loading was 0.45 ± 0.2 and 0.3 ± 0.2 mm, respectively. At all follow-up intervals, all intragroup and intergroup comparisons showed no significant differences in BOP, PD ≥ 4 mm, and CBL around implants placed at crestal and subcrestal levels. CONCLUSION: Up to 36 months of follow-up, soft tissue parameters and crestal bone levels can remain equally stable around dental implants placed at crestal and subcrestal levels. The need for long-term follow-up clinical trials is also emphasized.