Effect of Photobiomodulation on Crestal Bone Density Around Dental Implants: A Case Report.

Dental implants are becoming a necessary component of the dental profession. The first bone resorption at the implant surface has an impact on implant success. Bone alterations surrounding the implant are a significant factor in determining the implant's effectiveness. Reducing the loss of peri-implant crestal bone has been a constant goal. In dental implantology, several procedures are carried out to improve implant stability and the healing of the bone. The ability of photobiomodulation techniques or low-level laser therapy (LLLT) to speed up osseointegration by inducing cellular metabolism and stimulating tissue healing has made them popular. This case study details the implant loading in a patient treated with photobiomodulation to achieve implant stability and who has compromised bone type or D4.

A case report of BIA-ALCL: Diagnostic, treatment, and mammary reconstruction.

INTRODUCTION AND IMPORTANCE: BIA-ALCL is a non-Hodgkin lymphoma occurring primarily in women with textured breast implants, typically presenting as late seroma. Diagnosis involves ultrasound-guided fine-needle aspiration or core needle biopsy, followed by cytologic and immunohistochemical evaluation. Positive results show CD30 cell expression and lack ALK expression. Treatment includes removing breast implants and the periprosthetic capsule. If the lymphoma has spread, en bloc capsulectomy, immunotherapy, and chemotherapy are required. Reconstruction can be done with smooth implants or autologous tissue. PRESENTATION OF CASE: We present here the case of a woman with a 12-year history of microtextured breast implants, without any cancer family background, who presented with peri-implant effusion in the left breast, which tested positive for BIA-ALCL at stage IA. The patient underwent breast implant removal with total capsulectomy and posterior successful autologous tissue reconstruction, demonstrating that outcomes can be satisfactory when properly treated. CLINICAL DISCUSSION: Paying attention to signs in women with breast implants, beyond imaging tests, can aid in the early diagnosis of BIA-ALCL and ensure a not aggressive treatment. This approach allows the reconstruction with autologous tissue without the need of further implants. CONCLUSION: BIA-ALCL is a rare disease, further studies about this lymphoma can help with early diagnosis and potential prevention.

Multi-layered computational gene networks by engineered tristate logics.

So far, biocomputation strictly follows traditional design principles of digital electronics, which could reach their limits when assembling gene circuits of higher complexity. Here, by creating genetic variants of tristate buffers instead of using conventional logic gates as basic signal processing units, we introduce a tristate-based logic synthesis (TriLoS) framework for resource-efficient design of multi-layered gene networks capable of performing complex Boolean calculus within single-cell populations. This sets the stage for simple, modular, and low-interference mapping of various arithmetic logics of interest and an effectively enlarged engineering space within single cells. We not only construct computational gene networks running full adder and full subtractor operations at a cellular level but also describe a treatment paradigm building on programmable cell-based therapeutics, allowing for adjustable and disease-specific drug secretion logics in vivo. This work could foster the evolution of modern biocomputers to progress toward unexplored applications in precision medicine.

Asymmetry in the Perception of Electrical Chirps Presented to Cochlear Implant Listeners.

INTRODUCTION: Although a broadband acoustic click is physically the shortest duration sound we can hear, its peripheral neural representation is not as short because of cochlear filtering. The traveling wave imposes frequency-dependent delays to the sound waveform so that in response to a click, apical nerve fibers, coding for low frequencies, are excited several milliseconds after basal fibers, coding for high frequencies. Nevertheless, a click sounds like a click and these across-fiber delays are not perceived. This suggests that they may be compensated by the central auditory system, rendering our perception consistent with the external world. This explanation is difficult to evaluate in normal-hearing listeners because the contributions of peripheral and central auditory processing cannot easily be disentangled. Here, we test this hypothesis in cochlear implant listeners for whom cochlear mechanics is bypassed. METHOD: Eight cochlear implant users ranked in perceived duration 12 electrical chirps of various physical durations and spanning the cochlea in the apex-to-base or base-to-apex direction (Exp. 1). Late-latency cortical potentials were also recorded in response to a subset of these chirps (Exp. 2). RESULTS: We show that an electrical chirp spanning the cochlea from base-to-apex is perceived as shorter than the same chirp spanning the cochlea in the opposite direction despite having the same physical duration. Cortical potentials also provide neural correlates of this asymmetry in perception. CONCLUSION: These results demonstrate that the central auditory system processes frequency sweeps differently depending on the direction of the frequency change and that this processing difference is not simply the result of peripheral filtering.

Systematic Literature Reviews Comparing the Long-Term Safety Outcomes for the Port Delivery System with Ranibizumab (PDS) Versus Other Ocular Implants.

OBJECTIVES: To determine whether the types and rates of post-surgical complications associated with the Port Delivery System with ranibizumab (PDS) are comparable with those reported for other ocular implants that cross the sclera. METHODS: Systematic literature reviews were conducted to determine the long-term (≥ 18-month) safety of ocular implants that cross the sclera in clinical trials and real-world studies. Complication types and rates were compared with those reported for the PDS in phase III clinical trials (Archway, Pagoda, and Pavilion). RESULTS: Sixteen clinical trials (24 publications) and 43 real-world studies were identified reporting 30 complications in eyes with 15 implant types and 8 ocular diseases. Implants were associated with an acceptable, well-characterized safety profile, with most complications resolving spontaneously or with treatment. Device-related complications were reported in 0.7% (0.0-5.0%) of study eyes in clinical trials and 1.3% (0.0-14.5%) of eyes in real-world studies. Rates of conjunctival complications were 2.1% (0.0-22.8%) and 2.2% (0.9-4.6%), respectively. The overall types and rates of adverse events of special interest reported for the PDS in phase III trials (cataract, conjunctival bleb, vitreous hemorrhage, conjunctival erosion, conjunctival retraction, endophthalmitis, implant dislocation, retinal detachment, and hyphema) were within the ranges reported for other ocular implants. CONCLUSIONS: The rates of complications reported in phase III clinical trials for the PDS were within the ranges reported for other ocular implants that cross the sclera. This suggests that the long-term safety of the PDS is consistent with other ocular devices established in ophthalmology clinical practice. TRIAL REGISTRATION: PROSPERO international prospective register of systematic reviews: CRD5202234129, CRD42022343129.

Characterization of oral biomarkers during early healing at augmented dental implant sites.

AIM: The aim of this study is to assess early wound healing expression of local angiogenic biomarkers following connective tissue graft (CTG) at dental implant sites. METHODS: Twenty-eight subjects with single dental implants exhibiting a soft tissue dehiscence were included and randomly treated with CTG, either with coronally advanced flap (CAF) or with tunnel technique (TUN). Peri-implant crevicular fluid (PICF) was collected at the midfacial and midlingual aspect of the implant sites at baseline and at 3, 7, 14, 30, and 90 days after the surgical intervention. The expression of angiogenin (ANG), fibroblast growth factor-2 (FGF-2), platelet-derived growth factor (PDGF), tissue inhibitor of metalloproteinases-2 (TIMP-2), and vascular endothelial growth factor (VEGF) was investigated over a period of 3 months. Patient-reported outcomes, clinical measurements, and ultrasonography scans at multiple time points were also evaluated. RESULTS: The longitudinal regression revealed a significant difference in the expression of VEGF and TIMP-2 between CAF- and TUN-treated sites over 3 months (p = .033 and p = .004, respectively), whereas no significant differences were observed for ANG, FGF-2 and PDGF between the two groups. At 7 days, a direct correlation was observed between ANG levels and ultrasonographic color velocity in the CAF group (p < .001) and between ANG levels and ultrasonographic color power in the TUN group (p = .028). VEGF levels and ultrasonographic mean perfused area of the CTG were significantly correlated at the 7-day time point (p < .001 for both CAF and TUN). The expression of VEGF at 7 days was directly associated with mucosal thickness gain at 1 year (p < .001 for both groups). Early TIMP-2 expression showed an inverse correlation with time to recovery (p = .002). TIMP-2 levels at 3 months exhibited inverse correlations with mean dehiscence coverage (p = .004) and the rate of complete dehiscence coverage (p = .012). CONCLUSION: PICF biomarkers can be used to monitor early wound healing events following soft tissue grafting at implant sites. VEGF and TIMP-2 showed correlations with the 1-year clinical and volumetric outcomes, as well as with post-operative patient-reported outcomes and Doppler Ultrasonographic tissue perfusion-related parameters.

Biomechanical characteristics of maxillary anterior incisor, conventional immediate implantation and socket shield technique--a finite element analysis and case report.

BACKGROUND: To prevent the absorption and collapse of the labial bone plate of the anterior teeth, immediate implantation and socket shield technique have been increasingly applied to anterior dental aesthetic implant restoration. OBJECTIVE: To provide a biomechanical basis for implant restoration of maxillary anterior teeth, finite element analysis was used to investigate the stress peak and distribution in different anatomical sites of natural teeth, conventional immediate implantation and socket shield technique. METHODS: Three maxillary finite element models were established, including a maxillary incisor as a natural tooth, a conventional immediate implantation and a socket shield technique. A mechanical load of 100N was applied to simulate and analyze the biomechanical behavior of the root, periodontal ligament (PDL), implant and surrounding bone interface. RESULTS: The stress distribution of the natural tooth was relatively uniform under load. The maximum von Mises stress of the root, periodontal ligament, cortical bone and cancellous bone were 20.14MPa, 2.473MPa, 19.48MPa and 5.068MPa, respectively. When the conventional immediate implantation was loaded, the stress was mainly concentrated around the neck of implant. Maximum stress on the surface of the implant was 102MPa, the cortical bone was 16.13MPa, and the cancellous bone was 18.29MPa. When the implantation with socket shield technique was loaded, the stress distribution of the implant was similar to that of immediate implantation. Maximum stress on the surface of the implant was 100.5MPa, the cortical bone was 23.11MPa, the cancellous bone was 21.66MPa, the remaining tooth fragment was 29.42MPa and the periodontal ligament of the tooth fragment was 1.131MPa. CONCLUSIONS: 1. Under static loading, both socket shield technology and conventional immediate implantation can support the esthetic restoration of anterior teeth biomechanically. 2.Under short-term follow-up, both immediate implant and socket shield technology achieved satisfactory clinical results, including bone healing and patient satisfaction. 3.The stress distribution is mainly located on the buccal bone surface of the implant and is associated with resorption of the buccal bone plate after implant replacement in both socket shield technology and conventional immediate implantation. 4.The presence of retained root fragment had an impact on the bone graft gap. In immediate implantation, the peak stress was located in the cortical bone near the implant position, while in socket shield technology, the peak stress was at the neck of the cortical bone corresponding to the retained root fragment.

Post sterilization of intraoral scan body and the effect it has on the axes and distances between three adjacent implants: in-vitro study.

BACKGROUND: The purpose of this pilot in-vitro study was to assess the effect of sterilization on the intra-implant axis, inter-implant axis, intra-implant distance and inter-implant distance of three implants in a straight line by using laboratory scanner (LBS) versus intra-oral scanner (IOS) with intra-oral scan bodies (ISB). METHODS: A printed 3D model with three internal hex analogs in the positions 15#,16#,17# was used. Zirkonzhan (ZZ) intra-oral scan body (ISB), two-piece titanium was used. The ZZ ISBs were scanned by 7 Series dental wings (LBS) and 30 times by Primescan (IOS) pre sterilization and 30 times post sterilization. For each scan (pre and post) stereolithography (STL) file was created and a comparison between all the scans pre sterilization and post sterilization were superimposed on the laboratory scan by using a 3D analyzing software. A Kolmogorov-Smirnov test performed followed by Wilcoxon Signed Ranks tests. (p < 0.05) Results: Post sterilization of the ZZ ISB, the mean errors were significantly increased for the inter-implant distances (p < 0.0005), intra-implant distances 1,2,3 (p < 0.0005), intra-implant axis 1,3 (p < 0.0005) and inter-implant axes 13,23 (p < 0.05). In contrast, the mean errors for intra-implant axis 2 (p < 0.0005) and inter-implant axis 12 (p < 0.0005) were significantly reduced. CONCLUSIONS: ZZ ISB showed changes in all four parameters after sterilization. The middle ISB had the largest changes in mean error regarding all four parameters. Sterilization process may affect the three-dimensional (3D) structure of the ZZ ISB after three cycles. There is a lack in the literature in this field and there is a need for further studies to explore the effect of sterilization (multiple cycles) on different ISBs and for creating an approved guidelines regarding the amount of sterilization for each ISB in the industry.

Importance of local and systemic factors in preventing implant displacement in the mandibular body: a scoping review of existing literature.

BACKGROUND: The aim of this research was to analyse the current literature on displaced dental implants in the mandibular body, including local and systemic variables related to their cause, and to identify the most frequent location. METHODS: The study conducted a search of three databases (Pubmed, Scopus, and Web of Science) using specific index terms such as 'dental implant', 'displacement', 'dislocation', 'displaced', and 'mandible'. The analysis focused on the direction of displacement and the characteristics of the bone tissue (bone quality, density, and quantity) in cases where dental implants were displaced. RESULTS: A total of 371 articles were obtained. Thirteen of these articles were selected and read in full. To define bone quality, the Lekholm and Zarb classification, modified by Rosas et al., was used. The type II-B bone, which is characterized by thick cortical bone surrounding cancellous bone with extremely wide medullary spaces, presented the largest number of complications. Twenty-two cases were found in which the displacement direction was horizontal. Of these, four were displaced vestibularly, fourteen lingually, and four remained in the center. Additionally, 24 cases presented vertical displacement, with 12 displaced towards the inferior border of the mandible, 9 towards the middle or adjacent to the inferior dental nerve canal, and 3 above the inferior dental nerve canal. CONCLUSION: The accidental displacement of implants within the mandibular body is associated with various risk factors, including the characteristics of the bony trabeculum and the size of the medullary spaces. It is reasonable to suggest that only an adequate pre-surgical diagnostic evaluation, with the help of high-resolution tomographic images that allow a previous evaluation of these structures, will help to have better control over the other factors, thus minimizing the risk of displacement.

Fracture rate and risk factors associated with the fracture of narrow diameter implants: A long-term retrospective analysis.

OBJECTIVES: The objective of this long-term retrospective study was to evaluate the fracture rate and the risk factors associated with the fracture of 3.3 mm narrow diameter implants (NDIs). MATERIALS AND METHODS: A total of 524 records of patients rehabilitated with 3.3 mm NDIs between 1997 and 2015 were assessed. Data on patients, implants, and prostheses were collected, and descriptive analysis of the variables was performed. NDIs were separated into 2 groups: "fractured" and "non-fractured", and a multilevel logistic regression model was applied to identify the risk factors associated with NDI fracture. RESULTS: Eighty-four patients were removed from the analysis for interrupting follow-up or presenting failures other than fractures. Of the 440 patients included (64.66 ± 13.4 years), 272 were females (61.8%), and 168 males (38.2%), and mean follow-up time was 129 ± 47.1 months. Of the 1428 NDIs, 15 (1.05%) in 9 patients (2.04%) fractured during the studied period. Ten fractures (66.66%) happened in 6 patients (66.66%) showing signs of parafunction. NDI with modified sandblasted, large grit, acid-etched surface was the only implant variable to show a protective statistical significance (p = .0439). CONCLUSIONS: NDI fracture was a rare event in the studied sample. NDIs manufactured with modified sandblasted, large grit, acid-etched surface may provide extra protection against NDI fracture. Patient-specific factors and implant characteristics should be carefully considered to limit the risk of fracture of 3.3 mm NDIs.

The Fatigue Behavior of Narrow Single-body Titanium Implants in Saline and Acidic Media.

PURPOSE: The objective of this study was to examine how the saline and acidic environment affects the mechanical integrity of narrow single-body titanium implants for oral rehabilitation. MATERIALS AND METHODS: Thirty titanium-base alloy implants with 2.5 mm diameter were placed into a polyacetal holder and coupled to a stainless-steel prosthetic cap for fatigue testing in three different environments, as follows: dry air; saline solution (pH at 7.6); and lactic acid solution (pH at 3.4). The fracture surfaces were analyzed using a Scanning Electron Microscope (SEM). Also, finite element analysis was carried out to estimate the maximum von Mises stresses. RESULTS: The fatigue resistance was higher in the group tested in dry air (60%), followed by saline solution (30%) and lactic acid (10%). Regardless of the environment, fracture occurred at the same region of the failed specimens in line with the highest stress concentration spots, according to the finite element analysis. SEM analyses revealed two distinct failure regions, both with the presence of fatigue streaks: fatigue and overload. A high incidence of secondary cracks was also noticed on the specimens exposed to the solutions. CONCLUSIONS: The present study revealed that both saline and acidic solutions significantly affect the fatigue resistance of narrow dental implants. Critical regions of the narrow implants were also susceptible to cracks and plastic deformation that should be taken into consideration in planning for oral rehabilitation.

Tailored Bioactive Glass Coating: Navigating Devitrification Toward a Superior Implant Performance.

The development of well-adherent, amorphous, and bioactive glass coatings for metallic implants remains a critical challenge in biomedical engineering. Traditional bioactive glasses are susceptible to crystallization and exhibit a thermal expansion mismatch with implant materials. This study introduces a novel approach to overcome these limitations by employing systematic Na2O substitution with CaO in borosilicate glasses. In-depth structural analysis (MD simulations, Raman spectroscopy, and NMR) reveals a denser network with smaller silicate rings, enhancing thermal stability, reducing thermal expansion, and influencing dissolution kinetics. This tailored composition exhibited optimal bioactivity (in vitro formation of bone-like apatite within 3 days) and a coefficient of thermal expansion closely matching Ti-6Al-4V, a widely used implant material. Furthermore, a consolidation process, meticulously designed with insights from crystallization kinetics and the viscosity-temperature relationship, yielded a crack-free, amorphous coating on Ti-6Al-4V substrates. This novel coating demonstrates excellent cytocompatibility and strong antibacterial action, suggesting superior clinical potential compared with existing technologies.

Dimensional changes in free gingival grafts at implant sites in the reconstructed mandible: a retrospective study.

OBJECTIVE: To evaluate the dimensional changes in free gingival grafts (FGG) at implant sites in mandibular reconstruction patients. METHODS: Patients who received FGG 4 months after implant placement in the reconstructed mandible with no keratinized mucosa (KM) present were invited for re-examination after 36.7 ± 16.8 months (3.06 ± 1.4 years). Immediately after graft extraction (T0), graft width (GW), graft length (GL), graft thickness (GT), graft dimension (GD), and vertical bone height were documented. Re-examination (T1) included clinical examinations (GW, GL, GD, peri-implant probing depths, and modified Sulcus Bleeding Index), radiographic examination (marginal bone level), and medical chart review. RESULTS: Twenty patients and 62 implants (47 in fibula flaps and 15 in iliac flaps) were included. A significant decrease in GW (51.8%), GL (19.2%), and GD (60.2%), were found between T0 and T1 (p < .001). The univariate analysis showed that GW change was not significantly associated with reconstruction technique, baseline GL, baseline GT, baseline GD, implant location, or type of prosthesis. Implant survival rate of 100% was observed at follow-up. CONCLUSIONS: Within the limitations of the study, free gingival grafts at implant sites in the reconstructed mandible undergo dimensional change that result in a reduction of approximately 60% of the original graft dimension. Graft width decreased over 50%. CLINICAL RELEVANCE: FGG is the standard of care intervention for increasing the amount of KM around implants. This study was the first to evaluate the dimensional change in FGG at implant sites in mandibular reconstruction patients after a medium-term follow-up. CLINICAL TRIAL REGISTRATION: Clinical trial registration is not applicable as this study comprehends a retrospective analysis.

Bridging the Gap: Soft Tissue Considerations in Dental Implants From Microscopic to Macroscopic Levels.

Successful dental implant therapy not only relies on osseointegration but also on the health and stability of the surrounding soft tissues. Soft tissue concerns are critical to the long-term success of dental implants, influencing both function and appearance. This review looks at soft tissue integration with dental implants from both microscopic and macroscopic viewpoints. It investigates the biological mechanisms, therapeutic management, and factors that influence soft tissue health around implants. By exploring these issues, the review hopes to provide a full understanding of the importance of soft tissue considerations in dental implantology.

Bacterial reduction and temperature increase of titanium dental implant models treated with a 445 nm diode laser: an in vitro study.

In this in vitro study, the use of a 445 nm diode laser was investigated for the decontamination of titanium dental implants. Different irradiation protocols and the effect of repetitive laser irradiation on temperature increase and decontamination efficacy were evaluated on titanium implant models. An automated setup was developed to realize a scanning procedure for a full surface irradiation to recapitulate a clinical treatment. Three irradiation parameter sets A (continuous wave, power 0.8 W, duty cycle (DC) 100%, and 5 s), B (pulsed mode, DC 50%, power 1.0 W, and 10 s), and C (pulsed mode, DC 10%, power 3.0 W, and 20 s) were used to treat the rods for up to ten consecutive scans. The resulting temperature increase was measured by a thermal imaging camera and the decontamination efficacy of the procedures was evaluated against Escherichia coli and Staphylococcus aureus, and correlated with the applied laser fluence. An implant's temperature increase of 10 °C was set as the limit accepted in literature to avoid thermal damage to the surrounding tissue in vivo. Repeated irradiation of the specimens resulted in a steady increase in temperature. Parameter sets A and B caused a temperature increase of 11.27 ± 0.81 °C and 9.90 ± 0.37 °C after five consecutive laser scans, respectively, while parameter set C resulted in a temperature increase of only 8.20 ± 0.53 °C after ten surface scans. The microbiological study showed that all irradiation parameter sets achieved a complete bacterial reduction (99.9999% or 6-log10) after ten consecutive scans, however only parameter set C did not exceed the temperature threshold. A 445 nm diode laser can be used to decontaminate dental titanium rods, and repeated laser irradiation of the contaminated areas increases the antimicrobial effect of the treatment; however, the correct choice of parameters is needed to provide adequate laser fluence while preventing an implant's temperature increase that could cause damage to the surrounding tissue.

Glial scarring around intra-cortical MEA implants with flexible and free microwires inserted using biodegradable PLGA needles.

Introduction: Many invasive and noninvasive neurotechnologies are being developed to help treat neurological pathologies and disorders. Making a brain implant safe, stable, and efficient in the long run is one of the requirements to conform with neuroethics and overcome limitations for numerous promising neural treatments. A main limitation is low biocompatibility, characterized by the damage implants create in brain tissue and their low adhesion to it. This damage is partly linked to friction over time due to the mechanical mismatch between the soft brain tissue and the more rigid wires. Methods: Here, we performed a short biocompatibility assessment of bio-inspired intra-cortical implants named "Neurosnooper" made of a microelectrode array consisting of a thin, flexible polymer-metal-polymer stack with microwires that mimic axons. Implants were assembled into poly-lactic-glycolic acid (PLGA) biodegradable needles for their intra-cortical implantation. Results and Discussion: The study of glial scars around implants, at 7 days and 2 months post-implantation, revealed a good adhesion between the brain tissue and implant wires and a low glial scar thickness. The lowest corresponds to electrode wires with a section size of 8 µm × 10 µm, compared to implants with the 8 µm × 50 µm electrode wire section size, and a straight shape appears to be better than a zigzag. Therefore, in addition to flexibility, size and shape parameters are important when designing electrode wires for the next generation of clinical intra-cortical implants.

Trends and Early Complications in Direct-to-Implant Breast Reconstruction: An Updated Analysis of the ACS-NSQIP Database.

Background: Rates of direct-to-implant (DTI) breast reconstruction, in which breast implants are placed at the time of mastectomy, have been consistently rising. Advances in surgical adjuncts and technology, such as acellular dermal matrices (ADM), have made DTI reconstruction safer and more reliable. However, few studies have characterized early (30-day) postoperative complications following DTI. The aim of this study was to obtain a current understanding of early postoperative outcomes following DTI breast reconstruction. Methods: Using data from the American College of Surgeons-National Surgical Quality Improvement Program, we analyzed complications for female patients who underwent DTI reconstruction from 2017 to 2019, as well as trends in DTI reconstruction from data on mastectomy and DTI reconstruction from 2010 to 2019. We grouped complications into major surgical (including return to the operating room) or medical complications. Statistical analysis was performed using Fischer's exact test for categorical variables, Student's t-test for continuous variables, and logistic regression. Results: DTI breast reconstruction rates have increased since 2010. Among our 2017-2019 cohort of 4204 patients, the early major surgical complication rate was approximately 10% (422 patients) and the major medical complication rate was 0.83% (35 patients). Regression modeling identified body mass index, smoking status, hypertension, bleeding disorders, and intraoperative blood transfusion as having a relationship with surgical complications (P < .001). Conclusions: Despite increased use of ADM and indocyanine green angiography, compared to prior studies, early postoperative complications have remained stable. Further studies are needed to assess long-term complications and patient-reported outcomes in DTI breast reconstruction.

Historique: Le taux de reconstructions mammaires immédiates, c'est-à-dire que les implants mammaires sont installés au moment de la mastectomie, augmentent régulièrement. Grâce aux progrès des adjuvants chirurgicaux et de la technologie, tels que les matrices dermiques acellulaires (MDA), la reconstruction mammaire immédiate est désormais plus sécuritaire et plus fiable. Cependant, peu d'études ont caractérisé les complications précoces suivant une telle intervention (dans les 30 jours). La présente étude visait à comprendre les résultats postopératoires précoces actuels après une reconstruction mammaire immédiate. Méthodologie: À l'aide des données de l'American College of Surgeons-National Surgical Quality Improvement Program, les chercheurs ont analysé les complications qu'ont subies les femmes après une reconstruction mammaire immédiate entre 2017 et 2019, de même que les tendances de ce type de reconstruction à partir des données sur la mastectomie et la reconstruction mammaire immédiate entre 2010 et 2019. Ils ont divisé les complications entre les complications chirurgicales majeures (y compris le retour en salle opératoire) et les complications médicales. Ils ont effectué les analyses statistiques à l'aide de la méthode exacte de Fischer pour les variables nominales, du test de Student pour les variables continues et de la régression logistique. Résultats: Le taux de reconstructions mammaires directes a augmenté depuis 2010. Dans la cohorte de 4 204 patients de 2017 à 2019, le taux de complications chirurgicales majeures précoces s'élevait à environ 10% (422 patients) et le taux de complications médicales majeures, à 0,83% (35 patients). Selon la modélisation de régression, l'indice de masse corporelle, le tabagisme, l'hypertension, les troubles hémorragiques et la transfusion sanguine intraopératoire sont liés aux complications chirurgicales (P < 0001). Conclusions: Malgré le recours accru aux MDA et l'angiographie au vert d'indocyanine, par rapport aux études antérieures, les complications postopératoires précoces sont demeurées stables. D'autres études devront être réalisées pour évaluer les complications à long terme et les résultats cliniques déclarés par les patientes après une reconstruction mammaire immédiate.

Accuracy of dynamic computer-assisted implant surgery in fully edentulous patients: An in vitro study.

OBJECTIVES: To compare miniscrew versus bone tracing registration methods on dental implant placement accuracy and time efficiency in edentulous jaws using a dynamic computer-assisted implant surgery (d-CAIS) system. METHODS: Twelve fully edentulous maxillary models were allocated into two groups: miniscrew tracing (MST) group, where registration was performed by tracing four miniscrews; and bone tracing (BT) group, where registration was conducted by tracing maxillary bone fiducial landmarks. Six implants were placed on each model using the X-Guide® d-CAIS system. Pre- and postoperative cone-beam computed tomography (CBCT) scans were superimposed to evaluate implant placement accuracy. The time required for registration and the overall surgery time were also recorded. RESULTS: Thirty-six implants were placed in each group. The MST group showed significantly lower mean angulation deviations (mean difference (MD): -3.33°; 95% confidence interval (CI): -6.56 to -0.09); p = 0.044), 3D platform deviations (MD: -1.01 mm; 95%CI: -1.74 to -0.29; p = 0.006), 2D platform deviations (MD: -0.97 mm; 95%CI: -1.71 to -0.23; p = 0.010), and 3D apex deviations (MD: -1.18 mm; 95%CI: -1.92 to -0.44; p = 0.002) versus the BT group. The overall surgery time was similar for both groups (MD: 6.10 min.; 95%CI: -0.31 to 12.51; p = 0.06), though bone tracing required significantly more time compared with miniscrew registration (MD: 4.79 min.; 95%CI: 2.96 to 6.62; p < 0.05). CONCLUSIONS: Registration with MST increases the accuracy of implant placement with a d-CAIS system in edentulous jaws compared with the BT method, and slightly reduces the overall surgery time. CLINICAL SIGNIFICANCE: Miniscrew tracing registration improves implant placement accuracy in comparison with bone tracing registration.

Digital wear analysis and retention of poly-ether-ether-ketone retentive inserts versus conventional nylon inserts in locator retained mandibular overdentures: in-vitro study.

OBJECTIVE: this study aimed to digitally compare wear behavior and retention between PEEK and nylon retentive inserts used in locator-retained, mandibular implant overdentures when attachment design and size were standardized. MATERIALS AND METHODS: A total of sixty-four inserts (32 PEEK and 32 nylon inserts); were picked-up in implant overdentures. Overdentures of both groups were submerged in artificial saliva and mounted to chewing simulator. After 480,000 chewing cycles (equivalent to 2 years of clinical use) all inserts were scanned by scanning electron microscope (SEM), then all acquired images were digitally analyzed by software to detect and compare quantitative and qualitative changes of inserts in both groups. On the other hand, retention of both groups was measured by universal testing machine and the collected data was statistically analyzed using one-way Analysis of Variance (ANOVA) test with significance level set at P ≤ 0.05. RESULTS: PEEK inserts showed significantly higher mean retentive values compared to the nylon inserts in the control group. Also, PEEK retentive inserts exhibited statistically lower mean wear values than the control group P ≥ 0.000. Qualitative investigation revealed significant and more pronounced changes in the surface roughness of nylon inserts compared to PEEK ones. CONCLUSIONS: Regarding retention, wear behavior and dimension stability, PEEK can be recommended as retentive insert material in cases of locator-retained mandibular implant overdentures. CLINICAL RELEVANCE: PEEK inserts offer enhanced retention, reduced wear, and greater dimensional stability over two years time interval. Clinically, this reduces prosthodontic maintenance and adjustments, improving patient satisfaction and long-term prosthetic success.

Oxygen-generating biomaterials for cardiovascular engineering: unveiling future discoveries.

Oxygen-generating biomaterials are emerging as a groundbreaking solution for transforming cardiovascular engineering. These biomaterials generate and release oxygen within various biomedical applications, marking a new frontier in healthcare. Most cardiovascular treatments face a significant challenge, ensuring a consistent oxygen supply to nurture engineered tissues or even implanted devices. Traditional methods relying on passive oxygen diffusion often fall short, hindering functional cardiovascular tissue development. Oxygen-generating biomaterials, incorporating agents like calcium peroxide, provide a controlled oxygen source to the surrounding cells. This innovation potentially enhances cell viability, stimulates growth and boosts metabolic activity crucial for tissue health. Applications include repairing cardiac and vascular tissues, disease modeling, drug testing and personalized medicine, promising tailored treatments. Challenges like material toxicity and oxygen release control need consideration. As research progresses, the use of these innovative biomaterials in clinical translation could reshape cardiovascular healthcare, revolutionizing patient outcomes in heart disease treatment.