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PURPOSE OF REVIEW: Pharmacokinetics of local anesthetics are one of the main determinants of success and safety of regional anesthesia and comprise local and systemic distribution phases. This review aims to summarize the latest research findings on this topic in the context of various regional blocks performed for different surgeries and patient populations. RECENT FINDINGS: Research into local kinetics and systemic absorption of local anesthetics has chiefly been focused on novel fascial plane blocks, especially the erector spinae plane block, as these are increasingly adopted for regional anesthesia and pain management. As their clinical efficacy is very dependent on injection of large volumes of local anesthetic, doses over typically recommended limits are often administered. SUMMARY: Fascial plane blocks are the regional anesthesia techniques in need of the most pharmacokinetic characterization, not only to better understand their complex mechanisms of action but also to avoid harm from excessive doses of local anesthetics. Further mapping of risk factors for systemic toxicity from administration in different block sites is crucial. Extremes of age and pregnancy are vulnerable patient populations but in whom regional anesthesia, including novel techniques, has been performed with few complications.
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Refractory pediatric intraoperative cardiac arrest is a rare but challenging situation for the anesthesiologist. This case describes an intraoperative extracorporeal cardiopulmonary resuscitation (ECPR) in a 16-year-old male who suffered a sudden cardiac arrest during elective thoracolumbar stabilization. The patient recovered to his pre-operative baseline without any neurological sequela secondary to cardiac arrest. Good quality of conventional resuscitation measures, prompt activation of the extracorporeal membrane oxygenation (ECMO) team, and a multidisciplinary coordinated approach were key factors in ECPR success. Despite the lack of robust evidence in pediatrics, case reports like ours outline the life-saving potential of intraoperative ECPR in refractory cardiac arrest scenarios.
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BACKGROUND: Different processing techniques are employed to obtain poly (methyl methacrylate) (PMMA) with consistent surface quality in terms of topography and tribological function. The purpose of this research is to evaluate its influence on the surface height distribution. METHODS: In this research, samples of conventional and CAD/CAM acrylic resins were prepared. The following surface roughness parameters were extracted from the profilometric readings: arithmetic mean roughness (Pa), skewness (Psk) and kurtosis (Pku). Profilometric profiles were additionally obtained. RESULTS: The average roughness (Pa) with the conventional technique was significantly higher compared to CAD/CAM (t = 4.595; P < 0.001). Heat-cured resins presented the highest mean Pa (F = 6.975; P = 0.06). Heat-cured and milled resins show lower coefficient variation (CV) values, indicating more consistent surface finishing. The surface profiles revealed distinct characteristics in terms of skewness and kurtosis. CONCLUSIONS: The surface processing method, chemical composition and resin type significantly influence the surface finishing of the resin. The CAD/CAM resins exhibited superior results in terms of surface arithmetic mean roughness (Pa). However, heat-cured resin revealed to present the better surface consistency.
Subject(s)
Acrylic Resins , Computer-Aided Design , Materials Testing , Polymethyl Methacrylate , Surface Properties , Acrylic Resins/chemistry , Polymethyl Methacrylate/chemistry , Dental Materials/chemistry , Humans , Hot TemperatureABSTRACT
PURPOSE: This study aimed to assess the accuracy and precision of prosthetically-driven implant placement achieved through static computer-aided implant surgery. The primary objective was to analyze the linear and angular deviations of dental implants in patients treated at a university dental clinic. Various types of surgical techniques and templates were utilized to optimize implant positioning. MATERIALS AND METHODS: A total of fiftythree dental implants were included in this study. The implants were positioned using either tooth-supported templates or tooth-tissue-supported templates with fixation pins. Two distinct guided surgery approaches were used, these being pilot drill guided and fully guided. Three-dimensional (3D) data from the implant planning phase was superimposed with the 3D data from the final implant positions using the 'Treatment Evaluation' tool within CoDiagnostix. implant planning software (Straumann AG). This enabled the automatic calculation of deviations in implant placement accuracy. RESULTS: Average angular deviation observed was 3.90 degrees. For linear deviations, the mean 3D deviation at the most coronal point of the implants was 1.04 mm, while at the implant apex it was 1.56 mm. CONCLUSION: This research demonstrates the feasibility of a digital workflow for guided implant surgery, offering a promising treatment option. Nonetheless, it is important to note that deviations do occur, with the apical region of the implant being the most affected area. Care should be taken, particularly in cases of limited bone availability.
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PURPOSE: To evaluate the accuracy of complete-arch digital implant impressions using different intraoral scan body (ISB) materials and intraoral scanners (IOSs). MATERIALS AND METHODS: The mandibular dental cast of an edentulous patient with six tissue-level dental implants was used as master cast. Two types of ISBs, polyether-ether-ketone (PEEK) and plasma-coated medical titanium, were used with five IOSs: TRIOS 4 (T4), Virtuo Vivo (VV), Medit i700 (Mi700), iTero5D (i5D), and Primescan (PS). To assess accuracy, digital impressions (n=10) with each IOS and ISB were compared to two reference models obtained by digitizing the master cast with each ISB type using a desktop scanner (IScan4D LS3i) and importing the scan data into metrology software (Geomagic Control X). Root-mean-square (RMS) error was employed to evaluate overall deviation values (trueness), while precision was determined using the standard deviation (SD) of RMS values. Statistical significance was set at P < 0.05. The Kruskal-Wallis test was used, followed by the pairwise comparison method with Bonferroni correction (α=.05). RESULTS: An interaction between ISB material and IOS was found (P=0.001). Plasma-coated medical titanium ISBs demonstrated significantly higher trueness and precision compared to PEEK ISBs with T4 (P=0.001), Mi700 (P=0.001; P=0.004), and i5D (P=0.001). Conversely, VV exhibited higher trueness and precision values with PEEK ISBs (P=0.005; P=0.003). PS provided the highest trueness and precision regardless of the ISB material (P=0.912). T4 showed the lowest accuracy for PEEK ISBs, and VV for plasma-coated medical titanium ISBs. CONCLUSION: Except for PS, all IOSs showed significant differences between ISB materials. PS demonstrated the highest accuracy with both ISB materials, whereas T4 had the lowest accuracy for PEEK ISBs, and VV showed the lowest accuracy for plasma-coated medical titanium ISBs.
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STATEMENT OF PROBLEM: The absence of fixed reference points can affect the trueness of complete-arch intraoral digital implant scans. The effect of splinting intraoral scan bodies (ISBs) or the inclusion of artificial landmarks (AL) on the trueness of complete-arch digital implant scans is still unclear. PURPOSE: The purpose of this study was to analyze the effect of splinting ISBs or the inclusion of AL on the trueness of complete-arch digital implant scans with 5 intraoral scanners (IOSs). MATERIAL AND METHODS: Six tissue-level dental implants (Straumann Tissue Level) were placed in an edentulous patient, and the correspondent definitive cast was digitized with a desktop scanner (IScan4D LS3i) to obtain the reference digital cast. Digital scans (n=10) were performed with 5 IOSs: TRIOS 4, Virtuo Vivo, Medit i700, iTero Element 5D, and Cerec Primescan. Three different scanning techniques were evaluated: conventional (cIOSs), splinted (sIOSs), and AL (AL-IOSs). The scan data obtained were imported into a metrology software program and superimposed to the reference digital cast by using a best-fit algorithm. The overall deviations of the positions of the ISBs were evaluated by using the root-mean-square (RMS) error (α=.05). RESULTS: The mean ±standard deviation trueness values for the cIOSs, sIOSs, and AL-IOSs groups were 48 ±8 µm, 53 ±7 µm, and 49 ±11 µm, respectively, with no statistically significant differences (P=.06). Significant differences were found for the IOSs used with each technique (P<.001). Primescan (27 ±4 µm cIOSs; 28 ±3 µm sIOSs; 31 ±3 µm AL-IOSs) showed significantly higher trueness than iTero 5D (47 ±5 µm cIOSs; 47 ±4 µm sIOSs; 50 ±6 µm AL-IOSs) (P=.002) and TRIOS 4 (93 ±18 µm cIOSs; 76 ±18 µm sIOSs; 107 ±13 µm AL-IOSs) (P=.001) for all techniques. In addition, no significant differences were found between the techniques by using iTero 5D or Primescan (P=.348 and P=.059, respectively). CONCLUSIONS: The cIOSs, sIOSs, and AL-IOSs techniques showed similar trueness. The IOS used influenced the trueness of complete-arch digital implant scans.
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INTRODUCTION: we aimed to explore dentists' perceptions toward the implementation of a dental informatics risk assessment tool which estimates the risk for a patient to develop periimplantitis. MATERIALS AND METHODS: the Implant Disease Risk Assessment Tool (IDRA) was presented to a convenience sample of seven dentists working in a university clinic, whom were asked to use IDRA with the information of three clinical cases whilst thinking aloud and then fill the System Usability Scale (SUS). A semi-structured interview technique was used with audio record to allow free expression of participants' perceptions related to the IDRA. The interviews information was categorized and analyzed by the authors. RESULTS: to our knowledge, this is the first study conducted to develop a qualitative usability test of IDRA, evaluating the effectiveness, efficiency, and users' satisfaction. There were more variations in responses the greater the degree of complexity of the clinical case. Generally, the participants classified the tool as good, getting usability values of 77,2 (SD 19,8) and learnability 73,2 (SD 24,5). CONCLUSION: four additional factors should be considered to improve IDRA tool: 1) considering the relation between contour angle and peri-implant tissue height; 2) automatic periodontal classification in the IDRA tool after completing the periodontogram in the clinical software; 3) presentation of a flowchart to assist therapeutic decisions alongside the final score defined by the IDRA tool; 4) integrating of precision tests such as Implantsafe® DR (dentognostics gmbh, Jena) and Oralyzer®(dentognostics gmbh, Jena). CLINICAL SIGNIFICANCE: etiology and pathogenesis of periimplant diseases is multifactorial. These tools must follow a natural integration to be easily applied in a clinical setting. It is important to study their usability from the clinicians' point of view, evaluating the effectiveness, efficiency, and users' satisfaction.
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Peri-Implantitis , Humans , Peri-Implantitis/diagnosis , Peri-Implantitis/etiology , Peri-Implantitis/prevention & control , User-Computer Interface , User-Centered Design , Risk Assessment , DentistsABSTRACT
Gingival recession is a common manifestation in most populations. The mechanism by which gingival recession occurs is not well understood, but it seems to be complex and multifactorial. The main etiological factors are the accumulation of dental plaque biofilm with the resulting inflammatory periodontal diseases and mechanical trauma due to faulty oral hygiene techniques, especially in thin biotypes. This case report describes the treatment of a vestibular recession associated with interdental bone loss, with the VISTA technique associated with a connective tissue graft. The case was evaluated at 3, 9 months and 48 months after the surgery clinically complete root coverage and increased thickness of keratinized tissue were achieved, and the interdental papilla was augmented improving the soft tissue quality for future orthodontic treatment. VISTA technique associated with a connective tissue graft to reconstruct vertically papilla is a promising alternative for minimally invasive treatment and stable after 4 years.
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Gingival Recession , Humans , Gingival Recession/etiology , Gingival Recession/surgery , Treatment Outcome , Follow-Up Studies , Tooth Root/surgery , Esthetics, Dental , Gingiva/surgery , Connective TissueABSTRACT
BACKGROUND: The diagnosis of peri-implantar and periodontal relies mainly on a set of clinical measures and the evaluation of radiographic images. However, these clinical settings alone are not sufficient to determine, much less predict, periimplant bone loss or future implant failure. Early diagnosis of periimplant diseases and its rate of progress may be possible through biomarkers assessment. Once identified, biomarkers of peri-implant and periodontal tissue destruction may alert the clinicians before clinical signs show up. Therefore, it is important to consider developing chair-side diagnostic tests with specificity for a particular biomarker, indicating the current activity of the disease. METHODS: A search strategy was created at Pubmed and Web of Science to answer the question: "How the molecular point-of-care tests currently available can help in the early detection of peri-implant diseases and throws light on improvements in point of care diagnostics devices?" RESULTS: The PerioSafe® PRO DRS (dentognostics GmbH, Jena) and ImplantSafe® DR (dentognostics GmbH, Jena ORALyzer® test kits, already used clinically, can be a helpful adjunct tool in enhancing the diagnosis and prognosis of periodontal/peri-implantar diseases. With the advances of sensor technology, the biosensors can perform daily monitoring of dental implants or periodontal diseases, making contributions to personal healthcare and improve the current status quo of health management and human health. CONCLUSIONS: Based on the findings, more emphasis is given to the role of biomarkers in diagnosing and monitoring periodontal and peri-implant diseases. By combining these strategies with traditional protocols, professionals could increase the accuracy of early detection of peri-implant and periodontal diseases, predicting disease progression, and monitoring of treatment outcomes.
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Dental Implants , Peri-Implantitis , Periodontal Diseases , Humans , Peri-Implantitis/diagnosis , Peri-Implantitis/therapy , Periodontal Diseases/diagnosis , Periodontal Diseases/therapy , Prognosis , BiomarkersABSTRACT
STATEMENT OF PROBLEM: The use of bioinformatic strategies is growing in dental implant protocols. The current expansion of Omics sciences and artificial intelligence (AI) algorithms in implant dentistry applications have not been documented and analyzed as a predictive tool for the success of dental implants. PURPOSE: The purpose of this scoping review was to analyze how artificial intelligence algorithms and Omics technologies are being applied in the field of oral implantology as a predictive tool for dental implant success. MATERIAL AND METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist was followed. A search strategy was created at PubMed and Web of Science to answer the question "How is bioinformatics being applied in the area of oral implantology as a predictive tool for implant success?" RESULTS: Thirteen articles were included in this review. Only 3 applied bioinformatic models combining AI algorithms and Omics technologies. These studies highlighted 2 key points for the creation of precision medicine: deep population phenotyping and the integration of Omics sciences in clinical protocols. Most of the studies identified applied AI only in the identification and classification of implant systems, quantification of peri-implant bone loss, and 3-dimensional bone analysis, planning implant placement. CONCLUSIONS: The conventional criteria currently used as a technique for the diagnosis and monitoring of dental implants are insufficient and have low accuracy. Models that apply AI algorithms combined with precision methodologies-biomarkers-are extremely useful in the creation of precision medicine, allowing medical dentists to forecast the success of the implant. Tools that integrate the different types of data, including imaging, molecular, risk factor, and implant characteristics, are needed to make a more accurate and personalized prediction of implant success.
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Dental Implants , Artificial Intelligence , Dental Restoration Failure , Dental Implantation, Endosseous/methods , AlgorithmsABSTRACT
Interommatidial sensilla have been explored for their taxonomic value and other aspects in Diptera and Lepidoptera. In Heteroptera, Eurystethus is the only genus where these structures were examined in delimiting subgenera and species. This study investigates the presence, distribution, and morphology of interommatidial sensilla in Discocephalinae species and discusses the sensilla's value for cladistic and taxonomic appraisals. Twenty species of 18 genera were analyzed: 16 Discocephalini genera, one genus in Ochlerini, and one genus in Edessinae. Species' heads were observed from photographs taken with light microscopy (LM) and scanning electron microscopy (SEM). From these images, we identified eleven types of sensilla, classified into chaetica, trichoidea and coeloconica. In LM, only sensilla chaetica with a length of 40-100 µm were visible, present in six species. Under the SEM at least one type of sensillum was visible in 19 of the 20 species analyzed. No difference between the various kinds of sensilla were apparent between males and females or adults and nymphs of a given species. Both subgenera of Eurysthetus have the same type of sensillum (chaeticum type I), which suggests this is not a delimiting feature. We conclude that sensilla chaetica can be a valuable character to delimit groups of genera within Discocephalini.
Subject(s)
Heteroptera , Animals , Female , Male , Arthropod Antennae/anatomy & histology , Heteroptera/anatomy & histology , Microscopy, Electron, Scanning , Nymph , Sensilla/anatomy & histologyABSTRACT
The synergy between dentistry and informatics has allowed the emergence of new technologies, specifically 3D printing, which has led to the development of new materials. The aim of this research was to compare the mechanical properties of dental base resins for 3D printing with conventional ones. This systematic review was developed using the PRISMA guidelines, and the electronic literature search was performed with the PubMed/MEDLINE, Web of Science-MEDLINE and EMBASE databases, until 30 April 2022. Two researchers selected the studies independently, and thus eight articles were found eligible for analysis. A meta-analysis was developed to estimate flexural strength. The Cohen's kappa corresponding to this review was 1.00, and the risk assessment was considered low for the included studies. The 3D printing resin presented lower values of flexural strength and hardness compared with the heat-cured resin. Regarding impact strength, a lower value was recorded for the heat-cured resin compared with the 3D printing resin. Three-dimensional printing resins are viable materials for making prosthetic bases but need further clinical research.
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Hydrophilic and nanotextured surfaces for dental implants have been reported as relevant properties for early osseointegration. However, these surface characteristics are quite sensitive to oral interactions. Therefore, this pilot study aimed to investigate the superficial alterations caused on hydrophilic nanotubular surfaces after early human saliva interaction. Titanium disks were treated using an anodization protocol followed by reactive plasma application in order to achieve nanotopography and hydrophilicity, additionally; surfaces were stored in normal atmospheric oxygen or wet conditioning. Following, samples were interacted with saliva for 10 min and analyzed regarding physical-chemical properties and cellular viability. Saliva interaction did not show any significant influence on morphological characteristics, roughness measurements and chemical composition; however, hydrophilicity was statistically altered compromising this feature when the samples were stored in common air. Cellular viability tested with pre-osteoblasts cell line (MC3T3-E1) reduced significantly at 48 h on the samples without wet storage after saliva contamination. The applied wet-storage methodology appears to be effective in maintaining properties such as hydrophilicity during saliva interaction. In conclusion, saliva contamination might impair important properties of hydrophilic nanotubular surfaces when not stored in wet conditions, suggesting the need of saliva-controlled sites for oral application of hydrophilic surfaces and/or the use of modified-package methods associated with their wet storage.
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This investigation aims to determine the effect of the same polishing protocol on the surface roughness (Ra) of different resins obtained by different processing techniques. Acrylic resins obtained by CAD/CAM technology overcame the disadvantages identified in conventional materials. A total of thirty samples (six of each resin): self-cured, heat-polymerized, injection molded, CAD/CAM 3D-printed and CAD/CAM milled were prepared. JOTA® Kit 1877 DENTUR POLISH was used to polish the samples by two techniques: manual and mechanized, with a prototype for guided polishing exclusively developed for this investigation. The Ra was measured by a profilometer. The values were analyzed using ANOVA, Games−Howell post-hoc test and One-sample t-test, with p < 0.05. Manual polishing produces lower values of Ra compared to mechanized polishing, except for injected molded resins (p = 0.713). Manual polishing reveals significant differences between the resin pairs milling/3D-printing (p = 0.012) and thermopolymerizable/milling (p = 0.024). In the mechanized technique only, significant differences regarding the Ra values were found between the self-cured/3D-printed (p = 0.004) and self-cured/thermopolymerizable pair resins (p = 0.004). Differences in surface roughness values can be attributed to the inherent characteristics of the resin and the respective processing techniques.
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Purpose: Within this context, this pilot study aimed to evaluate the healing dynamics process of the hard palate after free gingival graft harvesting in the short term (3 months), utilizing digital imaging technology and tridimensional analysis software. Furthermore, assessing the results found to verify the existence of a relationship between gender or age with tissue loss. Materials and Methods: For connective-tissue harvesting, fifteen patients with gingival recessions type (RT) 1 and RT2 were selected. On the surgery day (before the procedure) and after three months, palatal impressions were taken in all patients, and cast models were done for posterior model scanning. The following variables were analyzed: mean thickness alterations (x¯ TA), maximum thickness loss (MTL), mean maximum thickness loss (x¯ MTL), and volume alterations (VA). A descriptive and bivariate analysis of the data was done. The data were submitted for statistical evaluation and were significant if p < 0.05. Results: Fifteen patients were analyzed, 11 females (73.3%) and four males (26.7%). The patients' average age was 28 ± 8.52 years (ranging between 16 and 48 years old). The palatal wound region's mean thickness and volume changes were −0.26 mm (±0.31) and 46.99 mm3 (±47.47 mm3) at three months. There was no statistically significant result correlating age/gender with any variable evaluated. Conclusions: Connective tissue graft harvesting promoted changes with a standard volume and thickness loss of palatal soft tissue. A 3D digital evaluation was a non-invasive method with a reproducible technique for measuring thickness or volume after connective tissue is collected. There was no relationship between age/gender and any variables analyzed.
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Objective: To evaluate the relationship between oxidative stress and NGAL levels in blood and urine of amateur athletes after participating in a 100 km ultramarathon. Methodology: The sample was composed of seven athletes, submitted to anthropometric assessment, cardiopulmonary exercise test, collection of urine and blood, measurement of body weight. The rate of perceived exertion (RPE), competition duration, heart rate (HR), energy expenditure and oxygen consumption (V'O2") were also measured during the event. The energy consumption during the race was verified at its end. The analyses were based on the means (M) and respective standard deviations (SD), with statistical significance set at 5% (p < 0.05). Paired t-test was used for comparison between the periods before and after the competition, and Pearson's correlation coefficient was used to measure the linear correlation between quantitative variables. Results: Body mass index (BMI) of the sample was 25.75 kg/m2 ± 3.20, body fat percentage 18.54% ± 4.35% and V'O2"max 48.87% ± 4.78. Glucose, cortisol, and neutrophil gelatinase-associated lipocalin (NGAL) (p < 0.01) as well as glutathione peroxidase (GPx) active were higher after the race when compared to basal values. Moreover, lactate, creatinine, microalbuminuria, and glomerular filtration rate (GFR) (p < 0.001) were also higher after the race. After the competition, there was a significant correlation only between serum NGAL and creatinine, which was classified as strong and positive (r: 0.77; p < 0.05). There was a significant reduction (p < 0.05) of body weight after the event (72.40 kg ± 9.78) compared to before it (73.98 kg ± 10.25). In addition, we found an increase of RPE (p < 0.001) after the race. The competition lasted 820.60 min (±117.00), with a 127.85 bpm (±12.02) HR, a 2209.72 kcal ± 951.97 energy consumption, 7837.16 kcal ± 195.71 energy expenditure, and 28.78 ml/kg/min-1 (±4.66) relative V'O2"max. Conclusion: The lack of correlation between oxidative stress biomarkers and serum and urine NGAL suggests that NGAL is more sensitive to inflammatory processes than to ROS levels.
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PURPOSE: The purpose of this systematic review was to evaluate the survival rate, biological complications, technical complications, and clinical behavior of single crowns supported by teeth made up in monolithic zirconia with CAD/CAM technology. STUDY SELECTION: An extensive electronic search was conducted through Medline/PubMed, Embase, and Cochrane Library databases. Additional manual search was performed on the references of included articles to identify relevant publications. Two reviewers independently performed the selection and electronic and manual search. RESULTS: From nine articles included, there was a total of 594 participants and 1657 single-tooth restorations with a mean exposure time of 1.07 years, and follow-up period between 0.3 and 2.1 years. All studies showed a moderate level of quality, with a consequent moderate possibility of associated bias, using the Newcastle-Ottawa Scale (NOS), with survival rate (SR) ranging between 91% to 100%. Bleeding on probing (BOP) were reported with an average value of 29.12%. Marginal integrity showed high success rate values for the observation periods, except for one that included patients with bruxism which obtained a SR of 31.60%. Failures and/or fractures, mostly total and requiring replacement, were observed in three studies. Linear regression showed that there was no statistical correlation between survival rate and type of cementation and the average years of follow-up (p=0.730 e p=0.454). There was high heterogeneity between studies (I2 = 93.74% and Q = 79.672). CONCLUSION: Within the limitation of this study, monolithic zirconia might be considered as a possible option for restoring single crowns, especially in the posterior zone.
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Dental Prosthesis Design , Zirconium , Computer-Aided Design , Crowns , Dental Restoration Failure , HumansABSTRACT
OBJECTIVE: The purpose of this study was to assess the effect of a telehealth-delivered nutritional intervention via telephone in maintenance hemodialysis (HD) patients during the coronavirus outbreak. METHODS: This was a multicenter, observational, prospective, and longitudinal study of 156 patients undergoing maintenance HD from 15 dialysis units conducted during the COVID-19 pandemic. We assigned patients to receive dietary counseling through a phone call, according to their biochemical and nutritional parameters. Dry weight, intradialytic weight gain percentage (%IDWG), body mass index, potassium, phosphorus, calcium, calcium/phosphorus product, normalized protein catabolic rate, albumin, and hemoglobin were recorded at baseline and 1 month after nutrition counseling. RESULTS: The prevalence of hyperkalemia and hyperphosphatemia decreased significantly after dietary advice. A statistically significant reduction in serum potassium and phosphorus levels was observed in patients receiving counseling for hyperkalemia and hyperphosphatemia. In addition, there was a statistically significant decrease in the prevalence of hypophosphatemia. We also observed a significant decrease in %IDWG, although no statistically significant differences were detected in patients with high %IDWG. The data demonstrated statistically significant differences in potassium and phosphorus values when the person receiving the phone contact was the patient or the caregiver. The main statistically significant differences in hypophosphatemia %IDWG were only observed when contact was made directly with the patient. No differences were observed when the contact was made through nursing homes. CONCLUSION: Our results suggest that telehealth-delivered dietary interventions can improve the clinical and nutritional parameters of HD patients. Consequently, this strategy may be effective for promoting continuous nutritional monitoring in these patients, in particular when conducting a face-to-face option is not crucial.
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COVID-19 , Hyperkalemia , Hyperphosphatemia , Hypophosphatemia , Kidney Failure, Chronic , Telemedicine , COVID-19/epidemiology , Calcium , Counseling , Female , Humans , Hyperphosphatemia/epidemiology , Longitudinal Studies , Male , Nutritional Status , Pandemics , Phosphorus , Potassium , Prospective Studies , Renal DialysisABSTRACT
Surface treatments are designed to promote modified implant surfaces with positive interactions with the surrounding living tissues. However, the inadvertent early contact of these surfaces with oral fluids during surgery may lead to undesired conditions affecting osseointegration. This study aimed to investigate the possible alterations in the physico-chemical properties of modified-surfaces caused by early saliva exposure. Titanium (Ti) surfaces were exposed to three different samples of human saliva and later analyzed for protein adhesion, physico-chemical surface alterations, and osteogenic cell-viability. The results indicated that surface roughness was the most significant factor influencing saliva protein adsorption; moreover, hydrophilic surfaces had critically lost their characteristics after contact with saliva. Decreased cell viability was observed in cultures after contact with saliva. Early contact with saliva might negatively influence modified surface properties and local cell viability. Careful surgical insertion of implants with hydrophilic surfaces is recommended, particularly in sites where saliva interaction is prone to occur.
Subject(s)
Dental Implants , Osseointegration , Humans , Saliva , Surface Properties , TitaniumABSTRACT
PURPOSE: This intra-patient retrospective study of up to 10 years evaluated the clinical success and risk factors of 6- and 8-mm long implants and their respective prostheses. MATERIALS AND METHODS: The sample consisted of patients treated at a Military Polyclinic dental service, who received both 6- and 8-mm long tissue level implants in the posterior region of the same arch. Data were collected from the dental charts, clinical and radiographic exams, self-report of sleep bruxism, measurement of maximum occlusal force, and clinical crown-to-implant (C/I) ratio. Data were analyzed by descriptive and inferential statistics with univariate and hierarchical multivariate models, at the 0.05 significance level. RESULTS: The 30 patients (27 women) had 85 implants and 83 prostheses. Two implants were lost before prosthesis installation (implant survival: 97.6%). Ten events of prosthetic complication (screw tightening loss) occurred in five patients (success rate: 87.9%) in a single moment. Only the variable C/I ratio had a significant effect for repairable prosthesis complication (P<.05). CONCLUSION: The results suggest that 6- and 8-mm long implants have similar long-term clinical success for implants and prostheses.