Esthetic evaluation of single implant restorations, adjacent single implant restorations, and implant-supported fixed partial dentures: A 1-year prospective study.

BACKGROUND: Peri-implant soft tissues esthetics varies and depends on the restoration type such as implant-supported single crowns, adjacent multiple single crowns, and fixed partial dentures (FPD). PURPOSE: The aim of this prospective study was to assess the esthetic outcome of the peri-implant soft tissues of (NobelBiocare™) implant-supported single crowns, adjacent multiple single crowns, and FPD. A potential association between the esthetic risk profile and the esthetic outcome was assessed. MATERIALS AND METHODS: Between 03/11 and 03/17, 300 NobelActive implants were installed in 153 partially edentulous patients. Prior to the fabrication of the final restoration, the esthetic risk profile (ERP) of the patient was determined. The pink esthetic score (PES) and white esthetic score (WES) were assessed by three investigators at 6 and 12 months post-insertion of the final restoration. Patients' appreciation was assessed on a visual analogue scale (VAS) at the 1-year follow-up. RESULTS: The clinical acceptable limit for PES (≥6) was achieved in 56% to 68% of the single crowns at 6 and 12 months, respectively. Clinically unacceptable PES scores were recorded for 48% of the adjacent multiple single crowns and 63% of the FPDs at both time points. The association of a high ERP with WES and PESWES was noticed for single implant-supported crowns. For the latter restoration type, a ≤5 mm distance between the crestal bone level and the proximal contact positively influenced the PES and combined PESWES scores. No correlation was found between PES or WES and patient satisfaction. Mesial papilla formation was more pronounced compared to the distal one for the single implant crowns and for implant-supported FPD. CONCLUSION: When high esthetic demands are expected, assessment of ERP prior to implant treatment is advised in order to estimate a realistic outcome.

Is PPARα intron 7 G/C polymorphism associated with muscle strength characteristics in nonathletic young men?

Peroxisome proliferator-activated receptor alpha (PPARα), a ligand-dependent transcription factor, regulates fatty acid metabolism in heart and skeletal muscle. The intron 7 G/C polymorphism (rs4253778) has been associated with athletic performance. The rare C-allele was predominant in power athletes, whereas the G-allele was more frequent in endurance athletes. In the present study, we investigated the association between this polymorphism and strength characteristics in nonathletic, healthy young adults (n = 500; age 24.2 ± 4.4 years). Knee torque was measured during concentric knee flexion and extension movements at 60°/s, 120°/s, and 240°/s during 3, 25, and 5 repetitions, respectively. Also, resistance to muscle fatigue (i.e. work last 20% repetitions/work first 20% repetitions *100) was calculated. Differences in knee strength phenotypes between GG homozygous individuals and C-allele carriers were analyzed. The polymorphism did not influence the ability to produce isometric or dynamic knee flexor or extensor peak torque during static or dynamic conditions in this population (0.23 < P < 0.95). Similar results were found for the endurance ratio, a measure for resistance to muscle fatigue. In conclusion, the PPARα intron 7 G/C polymorphism does not seem to influence strength characteristics in a nonathletic population.

Genome-wide linkage scan for resistance to muscle fatigue.

Repeated, intense use of muscles leads to a decline in performance known as muscle fatigue. Resistance to muscle fatigue depends on age, sex, muscle fiber type, activation by the nervous system and training. Heritability of muscle strength phenotypes ranges between 31% and 78%, although little is known about heritability of muscle fatigue. A first aim of this study was to estimate the heritability for fatigue resistance after a short bout of intense exercise of the knee musculature. The main purpose was to identify chromosomal regions linked to muscle fatigue applying genome-wide linkage analyses. A selection of 283 informative male siblings (17-36 years old), belonging to 105 families, was used to conduct a genome-wide SNP-based multipoint linkage analysis. Heritabilities for resistance to muscle fatigue ranged from 21% to 54%. The strongest linkage signal was found at 19q13.11 (LOD=2.158; P<0.0001) and at 1q32.1 (LOD=2.142; P<0.0001) for resistance to fatigue of the knee flexors; however, no marker reached genome-wide significance. Several other regions with LOD>1.5 were found (1p31.3, 3q29, 8p22, 11q25 and 19q12). When replicated in an independent sample, these results warrant further fine mapping studies aiming to detect genes that underlie variation in muscle fatigue.

Genome-wide linkage scan for maximum and length-dependent knee muscle strength in young men: significant evidence for linkage at chromosome 14q24.3.

BACKGROUND: Maintenance of high muscular fitness is positively related to bone health, functionality in daily life and increasing insulin sensitivity, and negatively related to falls and fractures, morbidity and mortality. Heritability of muscle strength phenotypes ranges between 31% and 95%, but little is known about the identity of the genes underlying this complex trait. As a first attempt, this genome-wide linkage study aimed to identify chromosomal regions linked to muscle and bone cross-sectional area, isometric knee flexion and extension torque, and torque-length relationship for knee flexors and extensors. METHODS: In total, 283 informative male siblings (17-36 years old), belonging to 105 families, were used to conduct a genome-wide SNP-based multipoint linkage analysis. RESULTS: The strongest evidence for linkage was found for the torque-length relationship of the knee flexors at 14q24.3 (LOD = 4.09; p<10(-5)). Suggestive evidence for linkage was found at 14q32.2 (LOD = 3.00; P = 0.005) for muscle and bone cross-sectional area, at 2p24.2 (LOD = 2.57; p = 0.01) for isometric knee torque at 30 degrees flexion, at 1q21.3, 2p23.3 and 18q11.2 (LOD = 2.33, 2.69 and 2.21; p<10(-4) for all) for the torque-length relationship of the knee extensors and at 18p11.31 (LOD = 2.39; p = 0.0004) for muscle-mass adjusted isometric knee extension torque. CONCLUSIONS: We conclude that many small contributing genes rather than a few important genes are involved in causing variation in different underlying phenotypes of muscle strength. Furthermore, some overlap in promising genomic regions were identified among different strength phenotypes.

Polymorphisms in the vitamin D receptor gene are associated with muscle strength in men and women.

INTRODUCTION: Vitamin D receptor (VDR) polymorphisms have been associated with fracture risk and muscle strength, although evidence for the latter is limited and conflicting. METHODS: BsmI, TaqI and FokI VDR polymorphisms were genotyped in 253 men (54.9 +/- 10.2 yr) and 240 women (41.5 +/- 13.2 yr). Haplotypes were constructed for BsmI and TaqI. Handgrip, isometric (at 60 degrees , 120 degrees and 180 degrees joint angle) and eccentric torques (60 degrees /s) of knee extension and flexion were analysed using AN(C)OVA. Torque-velocity curves were constructed for concentric torques at 60 degrees /s, 180 degrees /s and 240 degrees /s and analysed using multivariate AN(C)OVA. Age, height and fat-free mass were included as covariates. RESULTS: Quadriceps isometric and concentric strength were higher in female f/f homozygotes compared to F allele carriers. Adjustment for confounding factors rendered results for quadriceps isometric strength at 120 degrees non-significant. No significant association was found with BsmI-TaqI haplotype in women. In contrast, male Bt/Bt homozygotes had higher isometric quadriceps strength at 150 degrees and higher concentric quadriceps strength than bT allele carriers without and with adjustment for confounding factors. No association was observed with FokI in men. In both genders, no interaction effect was present between BsmI-TaqI haplotype and FokI. CONCLUSIONS: Different VDR gene polymorphisms are associated with quadriceps strength in men and women.

A prospective split-mouth comparative study of two screw-shaped self-tapping pure titanium implant systems.

Clinical data indicate different medium and long-term outcomes of endosseous implants for different implant configurations and in particular implant surfaces. The present study compares 2 very similar implant systems but with different surface characteristics in a split-mouth-randomized design. The Astra-Tech (A) system (Astra-Tech AB, Mölndal, Sweden) consisted of selftapping TiO2-blasted screw-shaped implants made of commercially pure titanium, and the Brånemark (B) System (Nobel Biocare, Gothenburg, Sweden) comprised selftapping Mark II implants with machined surface irregularities. Throughout the 2-years' observation period, no significant differences could be found concerning probing depths, presence of plaque or change in marginal bone level. A statistically significant difference in location of the marginal bone level in relation to the shoulder of the implant was found in favor of the A system both at baseline and after 2 years. Cumulative success rates of 100% (A) and 97.7% (B) were not statistically different. From a prosthetic point of view, more soldering points were needed for A compared to B to reach clinical acceptable fit. More years of observation are needed to compare the fate of the soft and hard tissues surrounding two different implant surfaces.

The rehabilitation of the severely resorbed maxilla by simultaneous placement of autogenous bone grafts and implants: a 10-year evaluation.

The long-term success of Brånemark implants has been previously reported. The success rate of the same implants, when associated with autologous grafts, seemed much less predictable. In the present study it is demonstrated that when these implants are installed in conjunction with an autologous corticocancellous hip graft, either onlay or inlay, the cumulative success rate remains at 95% for individual implants in non-smokers. The short extracorporal time might be an explanation. On the other hand, the same approach in patients with congenital defects or who underwent radiotherapy is deceptive. The use of hyperbaric oxygen may dramatically improve these results.

The rehabilitation of oral defects by osseointegrated implants.

So far, preprosthetic surgery for oral defects improved prosthetic retention problems for only a limited amount of time and led to many side-effects. The alternative offered by the osseointegration technique developed by P.-I. Brånemark changed the concept of preprosthetic surgery dramatically. By means of a few permucosal titanium screws, bridges or overdentures can be retained even in cases of advanced jaw bone resorption. When the latter is extreme, an autologous free bone graft fixed by means of self-tapping titanium implants can offer the necessary support for sometimes elaborate prosthetic reconstructions. The marginal bone loss around Brånemark implants is very limited after a 1st year of bone remodelling, even when an autologous transplant has been used.

[The use of antibiotics]. / L'usage des antibiotiques.

Antibiotic therapy should be oriented towards sensitive pathogenic strains. The problem in most periodontal infections is that the latter are not clearly identified and that culturing techniques to document sensitivity are time-consuming (at least 5 days for anaerobes) and cumbersome. Thus for chronic periodontal infections, the choice is based on the clinical diagnosis: juvenile, post-juvenile, chronic adult, periodontitis.... It is known from longitudinal studies that mechanical plaque control can cope with nearly all periodontal infections. Antibiotic therapy should thus be limited to refractory or very aggressive cases, acute complications, immunologically compromised patients and patients with a need for antibiotic coverage during surgical procedures. If needed tetracyclines, metronidazole, clindamycin, bacampicillins are the appropriate adjuvants in different types of infections. Considering the side-effects and the increasing resistance of bacterial species, dentists should never use antibiotics without the appropriate local treatment and without a clear-cut indication. Postoperative swelling certainly is not one.