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Objectives: The aims of this study were to assess the morphologic features of peri-implant defects, as measured on 2D intraoral radiographs, and to investigate the possible correlation between such morphology and other parameters related to the position and characteristics of the implant or the implant-supported prosthesis. Materials and Methods: Implants with peri-implantitis were included in this retrospective study. Data collected were related both to the patients and to the position/characteristics of the implants and the implant-supported prosthesis. Measurements of the morphologic defects were performed by two operators on digitalized intraoral periapical radiographs. Results and Conclusion. In total, 73 implants in 27 patients were included. The measurements of the periapical radiograph suggested that the most common defect conformation was crateriform, with both intraosseous and horizontal components. An inverse correlation was found between the extension of the peri-implant lesion and the time between the radiographic assessment and the implant placement. The total lesion area was strongly correlated to oral hygiene levels. No correlations between lesion extension and smoking, diabetes, history of periodontal were found. In conclusion, the results from this 2D radiographic study showed the prevalence of crateriform peri-implant defects, with a hygiene-correlated extension, perceptible on the mesial and distal aspects; 3D imaging could be used when available for further research and clinical investigation.
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This study shows that social and political trust may diverge in the face of shared threats, and that this pattern is driven by negative information about crisis management. Leveraging a three-wave panel survey and an information-provision experiment in the USA during the COVID-19 crisis, our research reveals that negative perceptions of pandemic management lead to a decline in political trust and a parallel increase in social trust. This dynamic is pronounced among government supporters, who, confronted with COVID-19 challenges, experience a substantial erosion of political trust. Simultaneously, there is a notable rise in social trust within this group. Our analysis suggests that, as government supporters attributed more responsibility for the crisis to their political leader, political trust was supplanted by social trust. Disenchanted voters, feeling let down by institutions, sought support in society. Both the survey and the experiment underscore that societal shocks can prompt individuals to shift from relying on formal institutions to informal ones as a coping strategy. This research contributes a generalizable framework explaining how negative perceptions of crisis management can lead societies to substitute political trust with social trust, advancing our understanding of societal responses to shared threats and adaptive strategies during crises.
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COVID-19 , Confianza , Humanos , COVID-19/epidemiología , Habilidades de Afrontamiento , Emociones , GobiernoRESUMEN
OBJECTIVE: This systematic review aims to assess the available literature on the clinical efficacy of hand versus power-driven instruments for subgingival instrumentation during surgical periodontal therapy (ST). MATERIALS AND METHODS: A search of the literature was carried out on MEDLINE via Ovid, Embase, Web of Science, the Cochrane Database, LILACS, and Scopus. RCTs comparing the use of powered instruments (test) to hand scalers (control) for subgingival instrumentation in terms of changes in probing pocket depth (PPD) after surgical periodontal treatment were included and screened in duplicate. Descriptive synthesis of the data and risk of bias assessment were undertaken. RESULTS: Four RCTs met the inclusion criteria and were included in this systematic review. ST in all studies was performed by means of open flap debridement. Gracey curettes were the most commonly used hand instruments, while sonic and ultrasonic devices were used in the test group. Sites with initial PPD ≥ 6 mm had pocket reduction ranging from 2.93 to 4.89 mm in the control group and from 2.77 to 3.86 mm in the test group. All studies found no significant difference between the different types of instruments/devices in terms of PPD reduction. CONCLUSIONS: Despite the limited number of studies, both manual and power-driven instruments appear to be effective in reducing PPD after surgical treatment of periodontitis. CLINICAL RELEVANCE: Based on the findings of this systematic review, the clinician may make a decision whether to use manual or powered instruments during ST on a case-by-case basis and considering other factors, such as the risk of creating high concentrations of aerosols.
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Periodontitis , Terapia por Ultrasonido , Humanos , Raspado Dental , Periodontitis/terapia , Resultado del Tratamiento , Ultrasonido , Aplanamiento de la RaízRESUMEN
A longstanding theory indicates that the threat of a common enemy can mitigate conflict between members of rival groups. We tested this hypothesis in a pre-registered experiment where 1670 Republicans and Democrats in the United States were asked to complete an online social learning task with a bot that was labeled as a member of the opposing party. Prior to this task, we exposed respondents to primes about (a) a common enemy (involving Iran and Russia); (b) a patriotic event; or (c) a neutral, apolitical prime. Though we observed no significant differences in the behavior of Democrats as a result of priming, we found that Republicans-and particularly those with very strong conservative views-were significantly less likely to learn from Democrats when primed about a common enemy. Because our study was in the field during the 2020 Iran Crisis, we were able to further evaluate this finding via a natural experiment-Republicans who participated in our study after the crisis were even less influenced by the beliefs of Democrats than those Republicans who participated before this event. These findings indicate common enemies may not reduce inter-group conflict in highly polarized societies, and contribute to a growing number of studies that find evidence of asymmetric political polarization in the United States. We conclude by discussing the implications of these findings for research in social psychology, political conflict, and the rapidly expanding field of computational social science.
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Política , Estados Unidos , Irán , Federación de RusiaRESUMEN
The success of mass vaccination programs against SARS-CoV-2 hinges on the public's acceptance of the vaccines. During a vaccine roll-out, individuals have limited information about the potential side-effects and benefits. Given the public health concern of the COVID pandemic, providing appropriate information fast matters for the success of the campaign. In this paper, time-trends in vaccine hesitancy were examined using a sample of 35,390 respondents from the Eurofound's Living, Working and COVID-19 (LWC) data collected between 12 February and 28 March 2021 across 28 European countries. The data cover the initial stage of the vaccine roll-out. We exploit the fact that during this period, news about rare cases of blood clots with low blood platelets were potentially linked to the Oxford/AstraZeneca vaccine (or Vaxzeveria). Multivariate regression models were used to analyze i) vaccine hesitancy trends, and whether any trend-change was associated with the link between the AstraZeneca vaccine ii) and blood clots (AstraZeneca controversy), and iii) the suspension among several European countries. Our estimates show that vaccine hesitancy increased over the early stage of the vaccine roll-out (0·002, 95% CI: [0·002 to 0·003]), a positive shift took place in the likelihood of hesitancy following the controversy (0·230, 95% CI: [0·157 to 0·302]), with the trend subsequently turning negative (-0·007, 95% CI: [-0·010 to -0·005]). Countries deciding to suspend the AstraZeneca vaccine experienced an increase in vaccine hesitancy after the suspensions (0·068, 95% CI: [0·04 to 0·095]). Trust in institutions is negatively associated with vaccine hesitancy. The results suggest that SARS-CoV-2 vaccine hesitancy increased steadily since the beginning of the vaccine roll-out and the AstraZeneca controversy and its suspension, made modest (though significant) contributions to increased hesitancy.
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COVID-19 , Trastornos Urinarios , Vacunas , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19 , Humanos , SARS-CoV-2 , Suspensiones , Vacunación , Vacilación a la VacunaciónRESUMEN
This study analyses the changes in mental health in the UK that occurred as a result of the 2016 referendum on UK membership of the EU (Brexit). Using the Household Longitudinal Study, we compare the levels of self-reported mental distress, mental functioning and life satisfaction be-fore and after the referendum. A linear fixed effects analysis revealed an overall decrease in mental health post-referendum with higher levels of mental distress, and a decline in the SF-12 Mental Component Summary score. Furthermore, the study does not find evidence of significant changes in overall life satisfaction in the two years after the referendum. Younger men, highly educated and Natives, especially those living in stronger "Remain areas", seem to be the groups most affected by the Brexit in terms of mental health. Overall, the results of this study suggest that the outcome of the referendum and the economic uncertainty that it brought impacted the mental health of voters in a negative and diverging way.
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Trastornos Mentales , Salud Mental , Unión Europea , Humanos , Estudios Longitudinales , Masculino , Reino UnidoRESUMEN
Drawing on past pandemics, scholars have suggested that the COVID-19 pandemic will bring about fertility decline. Evidence from actual birth data has so far been scarce. This brief report uses data on vital statistics from a selection of high-income countries, including the United States. The pandemic has been accompanied by a significant drop in crude birth rates beyond that predicted by past trends in 7 out of the 22 countries considered, with particularly strong declines in southern Europe: Italy (-9.1%), Spain (-8.4%), and Portugal (-6.6%). Substantial heterogeneities are, however, observed.
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Tasa de Natalidad , Pandemias/estadística & datos numéricos , COVID-19/epidemiología , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Pandemias/economía , Crecimiento Demográfico , Embarazo , Estados Unidos/epidemiologíaRESUMEN
This paper explores the relationship between the spatial distribution of excess deaths and the presence of care home facilities during the first wave of the COVID-19 outbreak in Italy. Using registry-based mortality data for Lombardy, one of the areas most severely hit by the pandemic we show that the presence of a care home in a municipality is associated with significantly higher excess death rates in the population. This effect appears to be driven by excess mortality in the elderly population of 70 years old and older. Our results are robust to controlling for the number of residents in each care home, suggesting that the presence of such facilities may have acted as one of factors contributing to the diffusion of COVID-19 at the local level.
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COVID-19/mortalidad , Infecciones por Coronavirus , Casas de Salud/estadística & datos numéricos , Sistema de Registros/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Causas de Muerte/tendencias , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/mortalidad , Femenino , Humanos , Italia/epidemiología , MasculinoRESUMEN
OBJECTIVES: The growth of COVID-19 infections in England raises questions about system vulnerability. Several factors that vary across geographies, such as age, existing disease prevalence, medical resource availability and deprivation, can trigger adverse effects on the National Health System during a pandemic. In this paper, we present data on these factors and combine them to create an index to show which areas are more exposed. This technique can help policy makers to moderate the impact of similar pandemics. DESIGN: We combine several sources of data, which describe specific risk factors linked with the outbreak of a respiratory pathogen, that could leave local areas vulnerable to the harmful consequences of large-scale outbreaks of contagious diseases. We combine these measures to generate an index of community-level vulnerability. SETTING: 91 Clinical Commissioning Groups (CCGs) in England. MAIN OUTCOME MEASURES: We merge 15 measures spatially to generate an index of community-level vulnerability. These measures cover prevalence rates of high-risk diseases; proxies for the at-risk population density; availability of staff and quality of healthcare facilities. RESULTS: We find that 80% of CCGs that score in the highest quartile of vulnerability are located in the North of England (24 out of 30). Here, vulnerability stems from a faster rate of population ageing and from the widespread presence of underlying at-risk diseases. These same areas, especially the North-East Coast areas of Lancashire, also appear vulnerable to adverse shocks to healthcare supply due to tighter labour markets for healthcare personnel. Importantly, our index correlates with a measure of social deprivation, indicating that these communities suffer from long-standing lack of economic opportunities and are characterised by low public and private resource endowments. CONCLUSIONS: Evidence-based policy is crucial to mitigate the health impact of pandemics such as COVID-19. While current attention focuses on curbing rates of contagion, we introduce a vulnerability index combining data that can help policy makers identify the most vulnerable communities. We find that this index is positively correlated with COVID-19 deaths and it can thus be used to guide targeted capacity building. These results suggest that a stronger focus on deprived and vulnerable communities is needed to tackle future threats from emerging and re-emerging infectious disease.
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Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa/prevención & control , Recursos en Salud/provisión & distribución , Accesibilidad a los Servicios de Salud/normas , Pandemias , Neumonía Viral , Betacoronavirus , COVID-19 , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Inglaterra/epidemiología , Disparidades en el Estado de Salud , Humanos , Evaluación de Necesidades , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Prevalencia , Salud Pública/métodos , Salud Pública/tendencias , Mejoramiento de la Calidad/organización & administración , Factores de Riesgo , SARS-CoV-2 , Análisis EspacialRESUMEN
BACKGROUND: Non-surgical periodontal treatment (NSPT) is widely employed for the treatment of periodontal disease and yields significant clinical improvements. Gingival crevicular fluid (GCF) can be used to profile health and disease, and recent technological advances, such as multiplex bead immunoassays, are promising in identifying a wider array of GCF factors with the ultimate aim to predict the treatment response. OBJECTIVE: The aim of this systematic review was to compare the expression of GCF markers using multiplex bead immunoassays before treatment and during early, average, or late healing period, following non-surgical periodontal treatment (NSPT). METHODS: An electronic literature search was conducted by two independent examiners (VK and NC) in MEDLINE, EMBASE, OpenGrey, LILACS, and Cochrane Library up to January 2020. The PICO question formulated was as follows: "In patients with periodontal disease, does the expression of gingival crevicular fluid (GCF) markers detected using multiplex bead immunoassay differ at baseline compared with early (≤30 days), average (6-8 weeks), or late (≥3 months) healing after intervention?" RESULTS: A total of 366 publications were obtained and reviewed for eligibility for inclusion. Of these, 12 publications fulfilled the inclusion criteria and were included in the present review. Data for a total of 31 different GCF markers were extracted and summarized for early, average, or late healing after NSPT. Early healing following NSPT (≤ 30 days) indicated an increase in IL-1ß, TNFα, and IL-10. At the average healing period (6-8 weeks), IL-1ß, IL-1α, IL-6, TNF-α, IFN-γ, GM-CSF, MCP-1, and MIP-1α were all reduced, compared to their respective baseline values. Three months after NSPT, IL-1ß, IL-4, IL-6, IL-10, TNF-α, and IFN-γ were detected at reduced levels, compared to pre-treatment levels. Overall, the changes following treatment indicated a reduction of inflammation present at baseline. CONCLUSION: Following non-surgical periodontal treatment, an upregulation of inflammation markers is noted early post-operatively and a subsequent reduction of their levels three months following treatment. The investigation of levels of GCF markers associated with inflammation and regeneration, especially using multiplex bead immunoassay technologies, is a valuable tool to better understand the processes associated with healing following periodontal treatment.
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Biomarcadores , Citocinas , Líquido del Surco Gingival , Citocinas/metabolismo , Líquido del Surco Gingival/química , Líquido del Surco Gingival/metabolismo , Humanos , Péptidos y Proteínas de Señalización Intercelular , Periodoncia , Factor de Necrosis Tumoral alfa/análisisRESUMEN
Peri-implantitis is a biofilm-related disease whose characteristics are peri-implant tissues inflammation and bone resorption. Some clinical trials report beneficial effects after implantoplasty, namely the surgical smoothening of the implant surface, but there is a lack of data about the development of the bacterial biofilm on those smoothened surfaces. The aim of this study is to evaluate how implantoplasty influences biofilm formation. Three implants with moderately rough surfaces (control) and three implants treated with implantoplasty (test) were set on a tray reproducing the supra- and sub-gingival environment. One volunteer wore this tray for five days. Every 24 h, plaque coverage was measured and, at the end of the period of observartion, the implant surfaces were analyzed using scanning electron microscopy and confocal laser scanning microscopy. The proportion of implant surface covered with plaque was 65% (SD = 7.07) of the control implants and 16% (SD = 0) of the test implants. Untreated surfaces showed mature, complex biofilm structures with wide morphological diversity, and treated surfaces did not show the formation of mature biofilm structures. This study supports the efficacy of implantoplasty in reducing plaque adhesion and influencing biofilm formation. These results can be considered a preliminary proof of concept, but they may encourage further studies about the effects of implantoplasty on biofilm formation.
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The nature of transportation has fundamentally transformed in recent years with the rise of ridehailing providers such as Uber. Yet, few studies have examined whether there is an association between ridehailing and rates of road accident injuries, and virtually all of the existing studies focus on the exceptional case of the United States. In this study, we exploit differences in the timing of the deployment of Uber across Britain to test the association between the advent of Uber's ridehailing services and rates of fatal and non-fatal road accidents. We find that the deployment of Uber in Great Britain is associated with a marginally significant reduction in the number of serious road accident injuries (e.g., fractures and internal injuries), although not the number of serious accidents. Slight injuries (e.g., sprains and bruises) declined outside of London after the rollout of Uber, but increased within London. We do not observe a statistically significant association between Uber and traffic fatalities. One interpretation for the decline in serious road injuries is that Uber may be a substitute form of transportation for risky drivers, including drink-drivers. However, ridehailing is also a substitute for public transit, particularly buses. The increase in the number of cars on the road may explain why slight injuries increased in London following Uber's rollout.
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Gingival and osseous augmentations are reported as hypertrophic or hyperplastic reactions to different factors including chronic traumatisms and surgeries such as free gingival graft (FGG) that induce an abnormal growth of both hard and soft tissues in genetically predisposed subjects. Since an imbalance in collagen turnover plays a key role in the development of gingival overgrowth leading to an accumulation of collagen in gingival connective tissue, in this study we described the histological and molecular features of three oral overgrowths obtained from a 34-year-old woman previously operated for FGG in order to evaluate a possible relationship between exostoses and overgrown tissue. Healthy and overgrown gingiva were analyzed by histological methods, and the expression of genes and proteins involved in collagen synthesis, maturation, and degradation was assessed in cultured fibroblasts obtained from gingival fragments at the molecular level. Our results show that general morphology and collagen content were similar in healthy and overgrown gingivae. However, fibroblasts obtained from the overgrown gingiva revealed an anabolic phenotype characterized by an increased collagen turnover and maturation. These findings indicate that an exostosis could act as a mechanical stimulus stretching the overlying connective tissue and triggering an anabolic phenotype of gingival fibroblasts and suggest to use minimally invasive surgical techniques to avoid traumatizing the periosteal tissues for the eradication of the exostosis with minimal relapses.
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OBJECTIVES: The aim of the present paper was to present medium- and long-term data on implant survival and on the prevalence of peri-implantitis in a cohort of patients treated with full-arch rehabilitations. MATERIALS AND METHODS: Clinical records of all patients treated with immediately loaded full-arch rehabilitation in the Dental Clinic of the IRCCS Istituto Ortopedico Galeazzi in Milan, Italy, supported by moderately rough implants were retrospectively examined to calculate survival curves for implant loss and for the occurrence of peri-implantitis (both at implant- and at patient level). Regression methods were used to evaluate the correlation between the presence of periodontitis and smoking habits with the outcomes. RESULTS: A total of 384 implants placed in 77 patients (96 rehabilitations) were evaluated for a mean period of 8.0 years (range 1.0-13.7 years) from loading. After 10 years, the cumulative survival rate was 96.11% (95% CI: 99.17%-93.05%; 84 implants) while the cumulative rate of implants free from peri-implantitis was 86.92% (95% CI: 82.14%, 91.71%; 60.69% [95% CI: 44.19%, 77.19%] at patient level). The cumulative proportion of implants without peri-implantitis after 10 years was significantly higher in mandible (89.76%, 95% CI: 84.49%, 95.03%) than in maxilla (81.71%, 95% CI: 71.91%, 91.51%; p = 0.028). No correlation was found between periodontal and smoking status and outcomes. CONCLUSIONS: The study reported high 10-year implant survival rate for full-arch rehabilitations since implant loss was relatively rare. Peri-implantitis was relatively frequent in the examined population although the number of subjects available for 10-year evaluation was limited.
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Implantes Dentales , Periimplantitis , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Italia , Prevalencia , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
PURPOSE: The aim of the present case report was to describe the retreatment of the single gingival recession in aesthetic area, in the presence of scar formation and consequent impairment of aesthetic appearance. METHODS: A young patient with one single recession of 4 mm of 2.1 was treated with coronally advanced flap and subepithelial connective tissue graft, through a microsurgical approach that aimed at the removal of the scarred fibrous tissue. The intervention was performed using a surgical microscope as a magnification device. RESULTS: Fifteen years after the surgical treatment, a substantial stable resolution of the gingival recession could be observed. Moreover, a further improvement of the aesthetic appearance could be observed. CONCLUSIONS: This case report suggests that periodontal microsurgery could be an effective approach for the retreatment of gingival recessions and, in long-term evaluation, to reduce the aesthetic problem due to the presence of scar formation. Further studies with a larger sample size are needed to better evaluate its efficacy.
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AIM: The main aim of the present investigation was to evaluate clinical and patient-centered outcomes of supragingival scaling performed with or without the use of 2.5× magnification loupes and illumination. METHODS: A total of 30 patients, divided into three groups, were treated with 2.5× loupes and 2.5× loupes and illumination, and without any magnification device. Full-mouth plaque score percentage (FMPS%) and full-mouth bleeding score percentage (FMBS%) were registered before and after the treatment. Moreover, perceived pain and quality of the treatment were recorded using a visual analog scale. Appropriate statistical analysis was adopted to analyze between-group differences for the investigated parameters. RESULTS: All of the patients completed the study protocol. All the groups were homogeneous at baseline. Supragingival scaling caused a significant reduction of FMPS% and FMBS% in all groups without differences among them. Moreover, no differences could be found for patient-centered outcomes. The duration of the treatment was significantly higher in the group in which loupes and illumination was used than in the control group. CONCLUSIONS: The use of magnification loupes (with or without illumination) did not significantly improve clinical and patient-centered outcomes of supragingival scaling procedures.
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Raspado Dental , Anteojos , Adulto , Anciano , Anciano de 80 o más Años , Índice de Placa Dental , Humanos , Lentes , Iluminación , Persona de Mediana Edad , Dimensión del Dolor , Índice Periodontal , Resultado del TratamientoRESUMEN
BACKGROUND: The objective of the study was to evaluate the prevalence of peri-implant mucositis and peri-implantitis in non-smoking patients rehabilitated with a fixed prosthesis supported by two axial and two tilted implants. METHODS: Forty-three patients with a total of 49 rehabilitations were included in the study. Each patient was included in a follow-up schedule consisting in a visit every six months during the first two years and every year thereafter in which professional oral hygiene was performed and data about bleeding on probing, probing depth and bone resorption were collected. Diagnoses of peri-implant mucositis (Bleeding Index>1) and peri-implantitis (Bleeding Index>1, probing depth >4, bone resorption radiographically detectable) were made. RESULTS: The considered observational time was from 1 to 10 years. The prevalence of peri-implant mucositis detected ranged from 0 to 12.2% of patients (8.7% of implants), while that of peri-implantitis varied between 0 and 9.1% of patients (6.8% of implants) in the different follow-up considered. CONCLUSIONS: The prevalence of peri-implant mucositis and peri-implantitis was lower than in most of the studies in literature suggesting the feasibility of this kind of rehabilitation, in combination with a strict hygiene recall protocol, in preventing the onset of these diseases.
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Implantes Dentales , Prótesis Dental de Soporte Implantado , Periimplantitis/epidemiología , Estomatitis/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Implantación Dental Endoósea , Implantes Dentales/efectos adversos , Femenino , Estudios de Seguimiento , Hemorragia Gingival/epidemiología , Hemorragia Gingival/etiología , Humanos , Arcada Edéntula/rehabilitación , Arcada Parcialmente Edéntula/rehabilitación , Masculino , Persona de Mediana Edad , Higiene Bucal , Periimplantitis/etiología , Prevalencia , Estudios Retrospectivos , Estomatitis/etiologíaRESUMEN
OBJECTIVES: The aim of this retrospective study was to assess the incidence and prevalence of peri-implant mucositis and peri-implantitis in patients with a fixed full-arch prosthesis supported by two axial and two tilted implants. MATERIALS AND METHODS: Sixty-nine patients were included in the study. Each patient received a fixed full-arch prosthesis supported by two mesial axial and two distal tilted implants to rehabilitate the upper arch, the lower arch, or both. Three hundred thirty-six implants for 84 restorations were delivered. Patients were scheduled for follow-up visits every 6 months in the first 2 years and yearly after. At each follow-up visit peri-implant mucositis and peri-implantitis were diagnosed if present. RESULTS: The overall follow-up range was from 12 to 130 months (mean 63,2 months). Three patients presented peri-implantitis. The prevalence of peri-implant mucositis ranged between 0 and 7,14% of patients (5,06% of implants) while the prevalence of peri-implantitis varied from 0 to 4,55% of patients (3,81% of implants). CONCLUSIONS: The prevalence and incidence of peri-implant mucositis and peri-implantitis are lower than most of the studies in literature. Therefore this kind of rehabilitation could be considered a feasible option, on the condition of adopting a systematic hygienic protocol.
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Implantes Dentales , Prótesis Dental de Soporte Implantado , Periimplantitis/epidemiología , Estomatitis/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Prótesis Dental de Soporte Implantado/efectos adversos , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Periimplantitis/diagnóstico , Prevalencia , Radiografía Panorámica , Estudios Retrospectivos , Factores de Riesgo , Estomatitis/diagnósticoRESUMEN
PURPOSE: The aim of this in vitro study was to evaluate the stress pattern on the abutments in two different full-arch implant-supported clinically equivalent prosthetic rehabilitations. MATERIALS AND METHODS: Two steel master casts were created and titanium implants were inserted in two different configurations. One configuration used four implants, with the distal implants tilted 30 degrees (4IMP configuration), and the other used five axially inclined implants (5IMP configuration). A straight multiunit abutment (MUA) was connected to every axial implant and a 30-degree angulated MUA was connected to each tilted implant. One titanium framework was fabricated for each configuration, with a 5-mm (4IMP configuration) or a 15-mm (5IMP configuration) distal cantilever length. Six cycles of vertical loading between 20 and 200 N were applied unilaterally at the most distal point of the frameworks on both sides. Readings of the deformations at the abutment level were obtained with the use of linear strain gauges. RESULTS: A similar pattern of deformation was seen in both configurations. The greatest compressive stress was measured by the strain gauge on the abutment closest to load application and was similar for the 4IMP and 5IMP configurations. The tensile stress measured on the same abutment was higher in the 5IMP configuration than in the 4IMP configuration. In terms of the distribution of stresses, the deformation measured on the central abutment in the 5IMP configuration was less than 10% of the overall stress in all the tested conditions. CONCLUSION: There was no difference in strain between the two different designs, so the use of tilted implants with angulated abutments to reduce cantilever length could be considered a viable clinical option.
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Pilares Dentales , Implantación Dental Endoósea/métodos , Implantes Dentales , Prótesis Dental de Soporte Implantado , Análisis del Estrés Dental/métodos , Fenómenos Biomecánicos , Diseño de Implante Dental-Pilar/métodos , Humanos , Presión , Acero/química , Estrés Mecánico , Titanio/químicaRESUMEN
PURPOSE: The aim of this retrospective study was to investigate the cumulative success rate, the implant survival rate, and the occurrence of biological complications in implants supporting full-arch immediately loaded rehabilitations supported by upright and tilted implants. METHODS: The clinical records and periapical radiographs of patients who attended follow-up visits were collected, and information was recorded regarding marginal bone loss resorption, the occurrence of peri-implant infectious diseases, and the implant survival rate. Implants were classified as successful or not successful according to two distinct classifications for implant success. RESULTS: A total of 53 maxillary and mandibular restorations including 212 implants were analysed, of which 56 implants were studied over the full five-year follow-up period. After five years, the cumulative success rate was 76.04% according to the Misch classification and 56.34% according to the Albrektsson classification. The cumulative implant survival rate was 100%, although one implant was found to be affected by peri-implantitis at the second follow-up visit. CONCLUSIONS: The cumulative success rate of the implants dropped over time, corresponding to the progression of marginal bone resorption. The prevalence of peri-implantitis was very low, and the implant survival rate was not found to be related to the cumulative success rate.