The relationship between subjective difficulty in interoceptive processing and accuracy of heartbeat perception in autistic individuals.

Most autistic people experience difficulties in sensory processing, including interoceptive processing. For example, they often report subjective difficulties in the interoceptive processing of interoceptive input, such as difficulty in interpreting bodily signals, including hunger, thirst, and fatigue. However, whether these subjective interoceptive difficulties are from underlying problems in interoceptive accuracy remains unclear. This study investigated the relationship between subjective interoceptive difficulty and behavioral interoceptive accuracy in autistic adults and a control group. Subjective interoceptive accuracy was measured using an interoceptive sensitivity questionnaire, and behavioral interoceptive accuracy was measured using a heartbeat counting task. The results showed no significant relationship between subjective interoceptive difficulty and behavioral interoceptive accuracy in the autistic or control groups. This suggests that subjective interoceptive difficulty and behavioral interoceptive accuracy reflect different aspects of interoceptive processing. One possible interpretation is that autistic adults can identify individual local sensory inputs, such as heartbeats, however, they have difficulty integrating multiple inputs and recognizing internal body states such as hunger and fatigue.

A Comparative Assessment of Primary Implant Stability Using Osseodensification vs. Conventional Drilling Methods: A Systematic Review.

Osseodensification is a novel biomechanical bone preparation technique that has been established to replace conventional bone drilling and therefore will optimize the implant site. The purpose of this systematic review was to compare the implant stability obtained by osseodensification drilling to those associated with conventional drilling techniques. An electronic search was performed in the PubMed, Scopus, EMBASE, Cochrane Oral Health Group, and Dentistry and Oral Science Source databases searched through Elton B. Stephens Company (EBSCO) for potentially relevant publications in the English language from January 2013 to December 2022. Randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs), contrasting osseodensification drilling with conventional drilling, studies documenting implant stability quotient (ISQ), and studies reporting the immediate outcome and at least three months of follow-up after dental implant placement were included. Two independent investigators evaluated the quality of the reviewed studies to determine the risk of bias using the version 2 of Cochrane risk-of-bias (RoB) tool for RCTs (RoB 2) and RoB for NRSIs (ROBINS-I). Majority of the studies showed that bone density was significantly higher in the osseodensification group. The overall RoB for the NRSIs was reported to be low with respect to confounding, selection, classification, incomplete data, deviance from interventions, outcome evaluation, and selective reporting. The quality assessment of the RCT studies included in the review using the RoB 2 tool showed a high overall risk. The findings of the current review reveal that osseodensification drilling exhibited higher resonance frequency analysis (RFA) and ISQ values than conventional drilling protocols. Similarly, when osseodensification regions were contrasted with traditional drilling, bone density at the implant surface was augmented.

Influence of Implant Macro-Design, -Length, and -Diameter on Primary Implant Stability Depending on Different Bone Qualities Using Standard Drilling Protocols-An In Vitro Analysis.

(1) Background: Primary implant stability is vital for successful implant therapy. This study explores the influence of implant shape, length, and diameter on primary stability in different bone qualities. (2) Methods: Three implant systems (two parallel-walled and one tapered) with various lengths and diameters were inserted into polyurethane foam blocks of different densities (35, 25, 15, and 10 PCF) using standard drilling protocols. Primary stability was assessed through insertion torque (IT) and resonance frequency analysis (RFA). Optimal ranges were defined for IT (25 to 50 Ncm) and RFA (ISQ 60 to 80). A comparison of implant groups was conducted to determine adherence to the optimal ranges. (3) Results: Implant macro-design, -length, and -diameter and bone block density significantly influenced IT and RFA. Optimal IT was observed in 8/40 and 9/40 groups for the parallel-walled implants, while the tapered implant achieved optimal IT in 13/40 groups (within a 25-50 Ncm range). Implant diameter strongly impacted primary stability, with sufficient stability achieved in only one-third of cases despite the tapered implant's superiority. (4) Conclusions: The findings highlight the need to adapt the drilling protocol based on diverse bone qualities in clinical practice. Further investigations should explore the impact of these adapted protocols on implant outcomes.

Immediate implant placement with and without provisionalization: A comparison of a one-year longitudinal study.

Background/purpose: Immediate implant placement (IIP) with and without immediate provisionalization (Ipro) may yield satisfactory results in appropriate indications and treatment, especially in the esthetic zone. The aim of this study was to compare implant stability, marginal bone loss (MBL), survival rates, and patient satisfaction between IIP with Ipro and IIP without Ipro. Materials and methods: Seventy patients, each with a failed maxillary anterior tooth, were randomly assigned to IIP with Ipro (Group A: n = 35) or IIP without Ipro (Group B: n = 35). Implant stability quotient (ISQ) and standardized periapical radiographs were performed at surgery and at 3, 6, 9, and 12 months postoperatively to investigate implant stability and MBL, respectively. Survival was assessed 1 year after surgery. Patient satisfaction was evaluated with a visual analogue scale (VAS). Results: Primary ISQ and MBL were not significantly different between groups A and B immediately after surgery (P ＞ 0.05). Implant survival was 100% in both groups, and only one mechanical complication was observed. Patient satisfaction was good at definitive crown delivery and postoperatively 1-year in both groups. However, the immediate postoperative VAS score in Group A was significantly higher than that in Group B (P < 0.05). Conclusion: Group A revealed significantly higher secondary ISQ than Group B at postoperatively 3, 6, 9, and 12 months. There were no significant differences between groups A and B in terms of MBL and survival. Notably, patient satisfaction in Group A was significantly higher than in Group B immediately after surgery.

Implant stability and marginal bone level changes: A 2-year prospective pilot study.

Background/purpose: Implant stability is crucial for successful osseointegration. Marginal bone level is considered an important indicator of long-term implant success and stability. The purposes of this study were to investigate 1) the effect of age, gender, bone density, implant length, and implant diameter on insertion torque (IT), primary implant stability quotient (ISQ), and secondary ISQ, 2) the impact of age, gender, bone density, implant length, implant diameter, IT, and ISQ on marginal bone loss (MBL). Materials and methods: Ninety patients who needed implant therapy were enrolled and overall 156 implants were installed to support single crowns. IT and ISQ were recorded for all implants during surgery and ISQ measurements were performed at follow-up visits. Age, gender, bone density, implant length and diameter were also registered. Radiographic evaluation of MBL was performed postoperative immediate (baseline), 3, 6, 9, 12, 18, and 24 months using digital periapical radiographs. Results: Age had little effect on IT and primary ISQ (P > 0.05). Generally, males had higher IT and primary ISQ, but no significant differences between genders were detected. Bone density showed significant effects on IT and primary ISQ. Correlation analysis revealed high positive correlations between IT/bone density and primary ISQ/implant diameter. Significant impacts of bone density and IT on MBL were found. Conclusion: Implant diameter had a more profound impact than length on IT/primary ISQ. Bone density played a considerable role in IT/primary ISQ determination. Bone density and IT had more impacts than primary ISQ on MBL.

Comparison of Implant Stability Between Conventional Drilling and Piezosurgical Implant Bed Preparation Techniques.

This prospective study compared the stability of implants placed using piezoelectric surgery (piezo group) and those placed using conventional rotary drills (bur group) during the first 90 days postoperatively. Teeth in the posterior maxillary regions of 21 patients were randomly assigned to 2 groups. The implant stability quotient (ISQ) was measured at days 0, 7, 14, 21, 28, 42, 56, and 90 postoperatively. Twenty-eight of 29 implants were successfully integrated at day 90 (1 implant in the test group was lost). Although both groups showed a significant overall increase in implant stability with time (P < .0001) and a high final mean ISQ value, no statistically significant difference in stability was seen between the groups. The bur group showed greater variance in ISQ values than the piezo group did (P < .001) at all time points. Long-term studies with larger samples are needed to investigate the bone response to the use of piezoelectric surgery for implant preparation.

Influence of Multiple Sterilization on Performance of Titanium Pegs When Measuring Implant Stability With Resonance Frequency Analyses.

This in vitro study was conducted to investigate the repeatability of the implant stability quotients (ISQ) measured with multipegs after numerous sterilizations and to detect the exact time when the readings start to deviate. Multipegs were sterilized with 3 different methods (autoclaved, autoclaved + ultrasonic cleaner, chemical disinfection + autoclaved) and grouped according to the method applied. All specimens were put into the autoclave with sealed packages every time they were sterilized. Each specimen was sterilized 50 times according to the technique described in its group after an ISQ measurement was performed. Results of the 2-way analysis of variance showed that neither the sterilization method nor the cycles, nor their interaction, were statistically significant. A multipeg may be reused multiple times after sterilization procedures and may be more cost-effective than a disposable smartpeg for checking implant stability after confirming these results in further investigations.

Intervenções interdependentes de enfermagem como indicadores sensíveis de qualidade - cuidados em ventilação mecânica não invasiva / Interdependent nursing interventions as sensitive indicators of quality - care in non-invasive mechanical ventilation

Durante os estágios, para aquisição de competências enquanto enfermeira especialista em Enfermagem Médico-cirúrgica, na vertente do doente crítico, o planeamento dos cuidados de enfermagem à pessoa em situação crítica, consubstanciado numa metodologia científica inerente ao processo de enfermagem, permitiu sustentar o processo de tomada de decisão e a implementação das intervenções, incorporando na prática os conhecimentos teóricos baseados em evidência científica. Após a identificação das necessidades, prescrevem-se intervenções de enfermagem de forma a detetar precocemente complicações e problemas potenciais e resolver ou minorar problemas reais identificados, mediante um paradigma de atuação preciso, concreto eficiente e em tempo útil, por exemplo, na "apropriada implementação de medidas de suporte avançado de vida" e na "gestão adequada de protocolos terapêuticos complexos" (OE, 2017). O enfermeiro possui formação humana, técnica e científica adequada para a prestação de cuidados em todo o contexto, particularmente em situação de elevada complexidade que lhe permita atuar de forma interdependente. Neste domínio, as competências específicas do enfermeiro especialista em Enfermagem Medico Cirúrgica na vertente da pessoa em situação critica, estão regulamentadas e publicadas em Diário da República a 16 de julho de 2018, pelo regulamento 429/2018, pa.19359. Para a OE (2015) a melhoria contínua dos cuidados implica a qualidade dos cuidados. A avaliação da qualidade dos cuidados de enfermagem pretende determinar o cumprimento das orientações estabelecidas pelos enfermeiros e a utilização dessa análise para tomar decisões acerca das mudanças que devem ser implementadas nos cuidados. No ano de 2001, a OE devido à necessidade de criar sistemas de qualidade para a profissão, definiu os "Padrões de Qualidade dos Cuidados de Enfermagem", sendo um referencial que regula e orienta o exercício profissional. Nos padrões de qualidade foram definidos seis enunciados descritivos de qualidade do exercício profissional dos enfermeiros ­ satisfação dos clientes, promoção da saúde, prevenção de complicações, bem-estar e autocuidado, readaptação funcional e organização dos cuidados de enfermagem, que pretendem ser um instrumento que clarifica o papel do enfermeiro junto das pessoas, dos demais profissionais e dos políticos (OE, 2001). No domínio da melhoria contínua da qualidade, das competências comuns do enfermeiro especialista, o enfermeiro deve "desenvolver práticas de qualidade, gerindo e colaborando em programas de melhorias contínua.". Os projetos de melhoria contínua da qualidade dos cuidados de enfermagem envolvem o planeamento e implementação de ações, visando a melhoria de forma a oferecer cuidados de enfermagem que atendam as expetativas da pessoa. As Intervenções Interdependentes de Enfermagem (IIE) e os constrangimentos na Ventilação Mecânica não Invasiva (VMNI) ao doente crítico, são essenciais para a segurança dos cuidados e qualidade em saúde. Sendo assim, são legalmente reconhecidas ao enfermeiro dois tipos de intervenções: autónomas e interdependentes, segundo (OE/REPE, 2015). As intervenções interdependentes referem-se a uma atuação de complementaridade funcional relativamente aos demais profissionais de saúde, intervenções essas realizadas pelos enfermeiros de acordo com as respetivas qualificações profissionais, em conjunto com outros técnicos, para atingir um objetivo comum, e são decorrentes de planos de ação previamente definidos pelas equipas multidisciplinares onde estão integrados as prescrições ou orientações previamente formalizadas. No que concerne à tomada de decisão do enfermeiro, também o REPE, é perentório em afirmar, que os cuidados de enfermagem se caracterizam pela presença e estabelecimento de uma relação de ajuda com o utente (abordagem sistémica e sistemática), cuja interação é objetivamente documentada, em processo de enfermagem, mediante a aplicação de metodologia científica (OE, 2015). O objetivo, da presente investigação, é identificar as IIE ao doente crítico com VMNI, que pela sua consistência executória, se assumem, como Indicadores de processo Sensíveis de Qualidade (IPSQ) aos cuidados, e a sua relação com as variáveis sociodemográficas e profissionais. Os indicadores que aqui se colocam em estudo, são os de processo, porque a literatura atual (Migote, 2022) menciona que através da análise de indicadores de estrutura e processo, se pode aceder à monitorização aprofundada dos resultados de saúde, razão que torna pertinente a relação em estudo. Na metodologia, foi desenvolvido um estudo exploratório, quantitativo descritivo, a partir da análise às respostas a um questionário elaborado com base em pesquisa bibliográfica com evidencia científica para o efeito, numa amostra de 76 enfermeiros, de urgência e medicina intensiva, maioritariamente, do sexo feminino (82,9%), com idades entre 36 e 45 anos (51,3%). As IIE ao doente crítico com VMNI, que pela sua consistência executória, se assumem, como ISQ aos cuidados, são: "doente é monitorizado segundo as recomendações" e "(...) é informado e pedida a sua colaboração" e os constrangimentos mais sentidos foram: "presença de secreções excessivas (...)", "a ocorrência de PCR é contraindicação" e "o nível de consciência do doente influencia o sucesso (...)". Foram verificadas relações estatisticamente significativas entre: a IIE "recurso à sedação" e o tempo de serviço, e o constrangimento "nível de consciência" e as varáveis: formação específica e tempo de serviço. Reafirma-se a importância de um protocolo de atuação na VMNI, para uniformização de cuidados.

During internships, in order to acquire skills as a specialist nurse in Medical-surgical Nursing, in terms of critically ill patients, the planning of nursing care for people in critical situations, embodied in a scientific methodology inherent in the nursing process, allowed sustaining the decision-making process and the implementation of interventions, incorporating theoretical knowledge based on scientific evidence into practice. After identifying needs, nursing interventions are prescribed in order to detect complications and potential problems early and solve or alleviate real problems identified, through a precise, concrete, efficient and timely paradigm of action, for example, in the "appropriate implementation of advanced life support measures" and in the "adequate management of complex therapeutic protocols" (OE, 2017). Nurses have adequate human, technical and scientific training to provide care in any context, particularly in highly complex situations that allow them to act interdependently. In this domain, the specific competences of the specialist nurse in Medical-Surgical Nursing in terms of the person in a critical situation, are regulated and published in Diário da República on July 16, 2018, by regulation 429/2018, pa.19359. For OE (2015) the continuous improvement of care implies quality of care. The assessment of the quality of nursing care aims to determine compliance with the guidelines established by nurses and the use of this analysis to make decisions about the changes that must be implemented in care. In 2001, the OE, due to the need to create quality systems for the profession, defined the "Nursing Care Quality Standards", being a reference that regulates and guides professional practice. In the quality standards, six descriptive statements of the quality of nurses' professional practice were defined - client satisfaction, health promotion, prevention of complications, well-being and self-care, functional readaptation and organization of nursing care, which are intended to be a instrument that clarifies the nurse's role with people, other professionals and politicians (OE, 2001). In the field of continuous quality improvement, one of the common skills of specialist nurses, nurses must "develop quality practices, managing and collaborating in continuous improvement programs.". Continuous improvement projects in the quality of nursing care involve the planning and implementation of actions, aimed at improving in order to offer nursing care that meets the person's expectations. Continuous quality improvement results from the intention to promote change to obtain higher standards (OE, 2019). Interdependent Nursing Interventions (IIE) and constraints on Non-Invasive Mechanical Ventilation (NIMV) for critically ill patients are essential for safe care and quality in health. Therefore, two types of interventions are legally recognized for nurses: autonomous and interdependent, according to (OE/REPE, 2015). The interdependent interventions refer to a performance of functional complementarity in relation to the other health professionals, interventions carried out by the nurses according to the respective professional qualifications, together with other technicians, to reach a common objective, and are resulting from action plans previously defined by the multidisciplinary teams which include the previously formalized prescriptions or guidelines. With regard to the nurse's decision-making, REPE is also peremptory in stating that nursing care is characterized by the presence and establishment of a helping relationship with the user (systemic and systematic approach), whose interaction is objectively documented, in the nursing process, through the application of scientific methodology (OE, 2015). The aim of this investigation is to identify the IIE for critically ill patients with NIMV, which, due to their enforceable consistency, are assumed to be Quality Sensitive Process Indicators (IPSQ) for care, and their relationship with sociodemographic and professional variables. The indicators that are studied here are those of process, because the current literature (Migote, 2022) mentions that through the analysis of structure and process indicators, it is possible to access the in-depth monitoring of health outcomes, reason that makes the relationship under study relevant. In terms of methodology, an exploratory, quantitative and descriptive study was carried out, based on the analysis of responses to a questionnaire prepared on the basis of bibliographical research with scientific evidence for the purpose, in a sample of 76 nurses, in emergency and intensive medicine, mostly male and female. female (82.9%), aged between 36 and 45 years (51.3%). The IIE for critically ill patients with NIMV, which, due to their enforceable consistency, are assumed, as ISQ for care, are: "patient is monitored according to recommendations" and "(...) is informed and asked for their collaboration" and the constraints more senses were: "presence of excessive secretions (...)", "the occurrence of CA is a contraindication" and "the patient's level of consciousness influences success (...)". Statistically significant relationships were verified between: the SII "use of sedation" and length of service, and the embarrassment "level of consciousness" and the variables: specific training and length of ser- vice. The importance of an action protocol in NIMV is reaffirmed, in order to standardize care.

Cylindrical Implant Versus Tapered Implant: A Comparative Study.

AIMS AND OBJECTIVES: The aim of this study is to compare the efficacy of tapered implants with cylindrical implants by evaluating the implant stability using the Osstell implant stability quotient (ISQ) instrument (W&H Dental India PVT Ltd., Bangalore, India) postoperative pain using the visual analog scale (VAS) score, and the peri-implant health using implant mobility scale. MATERIALS AND METHODS: This study included 30 patients who were partially edentulous with single or bilateral missing teeth and received 30 tapered implants on the one side and 30 cylindrical implants on the other side. Implant stability, postoperative pain, and peri-implant health were evaluated. RESULTS: In the evaluation of 30 tapered implants and 30 cylindrical implants, the implant stability quotient (ISQ) value for the tapered implants was higher when compared to that of cylindrical implants, and the group that received tapered implants had the least pain and good peri-implant health than the group that received cylindrical implants. CONCLUSION: On the basis of our clinical findings, it can be concluded that tapered implants provide greater primary stability than cylindrical implants. With the popularity of loading protocols in implant dentistry, the implant surgeon can increase predictability and success by selecting a tapered implant.

The Construction and Evaluation of a Multi-Task Convolutional Neural Network for a Cone-Beam Computed-Tomography-Based Assessment of Implant Stability.

Objectives: Assessing implant stability is integral to dental implant therapy. This study aimed to construct a multi-task cascade convolution neural network to evaluate implant stability using cone-beam computed tomography (CBCT). Methods: A dataset of 779 implant coronal section images was obtained from CBCT scans, and matching clinical information was used for the training and test datasets. We developed a multi-task cascade network based on CBCT to assess implant stability. We used the MobilenetV2-DeeplabV3+ semantic segmentation network, combined with an image processing algorithm in conjunction with prior knowledge, to generate the volume of interest (VOI) that was eventually used for the ResNet-50 classification of implant stability. The performance of the multitask cascade network was evaluated in a test set by comparing the implant stability quotient (ISQ), measured using an Osstell device. Results: The cascade network established in this study showed good prediction performance for implant stability classification. The binary, ternary, and quaternary ISQ classification test set accuracies were 96.13%, 95.33%, and 92.90%, with mean precisions of 96.20%, 95.33%, and 93.71%, respectively. In addition, this cascade network evaluated each implant's stability in only 3.76 s, indicating high efficiency. Conclusions: To our knowledge, this is the first study to present a CBCT-based deep learning approach CBCT to assess implant stability. The multi-task cascade network accomplishes a series of tasks related to implant denture segmentation, VOI extraction, and implant stability classification, and has good concordance with the ISQ.

Evaluation of Correlation between Vitamin D Levels and Implant Stability in Indian Population: A Prospective Study in Bangalore.

Purpose: Dental implants have become a definitive method for the esthetic and functional rehabilitation of both partially and completely edentulous arch. There is a significant role of vitamin D in bone metabolism and there are only few human studies that evaluate the effect of vitamin D deficiency on stability of dental implants. The study thus aims to evaluate the correlation of vitamin D deficiency and implant stability in delayed endosseous implant. Methods: The study included 20 subjects of either gender in the age group of 20-50 years, who required implant placement for rehabilitation of partially edentulous condition. Vitamin D status was evaluated for all subjects preoperatively. Implant stability was checked postoperatively at three months and six months using Electronic Technology Resonance Frequency Analysis. Results: The study found that for every 1 ng/ml increase in Vitamin D levels, the implant stability Quotient value (ISQ) significantly increased by 0.48 at 3 months and 0.62 units at 6 months, which was statistically significant at P = 0.01 and P = 0.002, respectively. Statistical analysis was done using Student Paired t test, Pearson Correlation test and Simple Linear regression analysis. Conclusion: Albeit the smaller sample size, the results of the study showed the positive influence of vitamin D on stability of implant. The study thus emphasizes on the significance of screening the vitamin D status of subjects prior to implant placement.

The effect of an information brochure on patients undergoing cardiac catheterization on their anxiety, knowledge and fear: A randomized controlled study.

Introduction: Patients who undergo coronary angiography experience a rather stressful situation. They need information about this invasive procedure which most of the times find either from the internet, their referring physicians, acquaintances or friends with past experience of an invasive procedure. Aim: The aim of the study was on the one hand to test the potential beneficial effects of an information brochure on undergoing a cardiac catheterization for the first time and on the other hand to highlight the importance of informing patients before coronary angiography and its beneficial effects on both reducing their fear and anxiety. Methods: Patients were randomly assigned to an experimental group receiving the brochure at least 1 day before the cardiac catheterization (N = 44), or to a control group not receiving the brochure (N = 44). The SFQ, ISQ and STAI tools were distributed to both groups. Results: All experimental subjects in the intervention group read the brochure. The intervention group had significantly lower scores on both short-term and overall fear compared to the control group. However, the fear of the long-term consequences of cardiac catheterization was similar in both groups. Women had higher fear of the short-term consequences of catheterization than men. The control group experienced a mean satisfaction score of 10.9 points (SD= 2.5 points) while the intervention group had a score of 11.1 points respectively (SD= 2.3 points). In addition, 95, 5% of the control group and 88, 6% of the intervention group patients considered that the provision of information could have been improved. In terms of stress, patients with co-morbidities scored 7.39 points higher, meaning they experienced more symptoms of permanent anxiety, compared to patients who did not have an underlying disease. In addition, the more the patients were satisfied with the information provided, the fewer the symptoms of transient anxiety they experienced. Conclusions: Providing information in the form of a brochure regarding cardiac catheterization before the procedure, is of great importance and constitutes an efficient intervention.

Validation of an implant stability measurement device using the percussion response: a clinical research study.

BACKGROUND: Several devices have been developed to measure implant-bone stability as an indicator of successful implant treatment; these include Osstell®, which measures the implant stability quotient (ISQ), and the more recent AnyCheck®, which relies on percussion for the implant stability test (IST). These devices make it possible to measure implant stability. However, no studies have compared the performance of AnyCheck® and Osstell® (i.e., IST and ISQ values) in clinical practice. Therefore, this study aimed to determine the correlation between primary and secondary implant stability using the Osstell® and AnyCheck® devices. METHODS: Ten patients (7 women; age [mean ± standard deviation]: 49.1 ± 13.3 years) with partially edentulous jaws who received a total of 15 implants were included. IST (AnyCheck®) and ISQ (Osstell®) values were measured immediately after implantation and at 1, 2, 3, 4, and 6 weeks post-implantation. Each measurement was performed three times, and the average value was used as the result. The correlation between measurements obtained using the two devices was determined using Spearman's rank correlation coefficient. RESULTS: The IST values ranged from 79.1 ± 2.87 to 82.4 ± 2.65. The ISQ values ranged from 76.0 ± 2.8 to 80.2 ± 2.35. Spearman's rank correlation coefficient was r = 0.64 immediately after implantation, r = 0.29 at 1 week, r = 0.68 at 2 weeks, r = 0.53 at 3 weeks, r = 0.68 at 4 weeks, and r = 0.56 at 6 weeks. A positive correlation was found in all cases, except at week 1 when the correlation was weak; the IST and ISQ values decreased the most during the first postoperative week and increased during the second week. The IST values were also slightly higher at all measurement points. CONCLUSION: The ability to assess implant stability without removing the abutment during healing is essential for determining the timing of loading without the risk of bone resorption. The results of this study suggest that AnyCheck® is useful for determining primary and secondary implant stability.

Ridge augmentation using autologous concentrated growth factors enriched bone graft matrix versus guided bone regeneration using native collagen membrane in horizontally deficient maxilla: A randomized clinical trial.

BACKGROUND: Facial resorption of maxillary alveolar ridges is a challenging situation for implant rehabilitation, which mandates a preparatory surgery of bone augmentation. Guided bone regeneration using a 1:1 mixture of autogenous particulate and anorganic bovine bone mineral (ABBM) showed reliable outcomes in treating horizontally deficient ridges. METHODS: Twenty-eight patients were randomly assigned into two groups; in the control group, the 1:1 mixture of particulate autogenous bone and ABBM was covered with native collagen membrane, while in the study group, it was mixed with autologous fibrin glue (AFG) to make a sticky bone that was covered by concentrated growth factor (CGF) membrane. For each proposed implant site, the average bone width gain was calculated preoperatively, immediately after augmentation and after 6 months. Implants were placed after 6 months and the implant stability quotient (ISQ) was measured after insertion and after 6 more months. RESULTS: The graft consolidation period went uneventful in both groups; however, two cases in the sticky bone group showed total resorption of the graft upon re-entry. The mean horizontal bone width after 6 months was 9 mm ± 0.71 in the guided bone regeneration (GBR) group which was higher than 7.9 mm ± 0.92 for the sticky bone group. The mean primary stability was higher in the GBR group; 67.19 ± 2.23 compared to 66.7 ± 3.22 for the sticky bone group, while the mean secondary stability was higher in the sticky bone group; 72 ± 2.15 compared to 71.7 ± 2.27 for the GBR group. Results of Shapiro-Wilk's for bone width data and model residuals were both statistically not significant (p > 0.05). CONCLUSION: Comparing CGF membrane versus native collagen membrane as barriers for GBR showed no statistically significant difference regarding bone gain. However, from a clinical point of view, CGF membrane is not a predictable barrier for guided bone regeneration.

Intra- and inter-operator concordance of the resonance frequency analysis. A cross-sectional and prospective clinical study.

OBJECTIVE: Resonance frequency analysis (RFA) provides an evaluation of implant stability over time. This analysis is a non-invasive, precise, and objective method. Several studies compare the RFA system with other devices. However, few investigations analyze repeatability and reproducibility between different operators. The aim of this study was to evaluate the intra- and inter-operator concordance of the Osstell® ISQ. MATERIAL AND METHODS: RFA measurements were performed with Osstell® ISQ in a total of 37 implants placed in 21 patients. At the time of implant placement, 6 measurements per implant were taken by three different experienced operators. Three measurements were carried out consecutively and three by removing and placing the SmartPeg-Osstell® to assess intra-operator and inter-operator agreement. RESULTS: Intra-operator concordance according to the intraclass correlation coefficient (ICC) showed high concordance. The ICC values were higher than 0.9 (p < 0.0001) for consecutive measures and alternative measures, being almost perfect of Landis & Koch classification. For inter-operator concordance The ICC was 0.709 (p < 0.0001) and 0.670 (p < 0.0001) for consecutive and alternative measures, respectively, both estimates being in the substantial category. In torque and ISQ values, no statistically significant differences were observed when operators and measurements were compared. CONCLUSIONS: Osstell® ISQ system was stable both in intra-operator and inter-operator measurements. This device has excellent repeatability and reproducibility, demonstrating reliability to measure the stability of dental implants. CLINICAL RELEVANCE: Resonance frequency analysis (RFA) is a non-invasive, objective, and reliable diagnostic method to determine the ideal moment to load the implant, as well as to predict possible failures.

Comparative clinical study of conventional dental implant and mini dental implant-retained mandibular overdenture: A 5- to 8-Year prospective clinical outcomes in a previous randomized clinical trial.

AIM: To compare the long-term prospective clinical outcomes in a previous randomized controlled clinical trial (RCT) of 2 Mini Dental Implant (2MDI), 4 Mini Dental Implant (4MDI), and 2 Conventional Dental Implant (2CDI)-retained mandibular overdenture with follow-up between 5 to 8 years. MATERIALS AND METHODS: Thirty-seven patients formerly participated in the Comparative Clinical Study of CDI and MDI for Mandibular Overdenture were requested for examination of clinical outcomes. A total of 104 implants were placed with mean follow-up periods 6.64 ± 0.60 years. In Group 1 (2MDI) and Group 2 (4MDI), implants were placed and immediately loaded with Equator® attachments to retained mandibular overdenture. In Group 3 (2CDI), implants were placed and delayed 3 months for denture loading with ball attachment. The success rate, survival rate, clinical implant performance scale (CIP scale), peri-implant tissue status, prosthetic complication, implant stability quotient (ISQ), marginal bone level change (MBLC), and patient satisfactions were analyzed. RESULTS: After 5 to 8 years follow-up, the success rate in Groups 1, 2, and 3 were 90.91%, 93.33%, and 54.55%, respectively. The success rate in Group 3 was significantly lesser than Group 1 (p = 0.016) and Group 2 (p < 0.001). The survival rate in Groups 1, 2, and 3 was 100%, 96.67%, and 90.91%, respectively, and showed no significant differences. Mean ISQ reported no significant differences between groups. Mean MBLC were 0.57 ± 1.19 mm, 0.68 ± 0.90 mm, and 1.55 ± 1.60 mm in Groups 1, 2, and 3, respectively. Group 3 reported significantly greater mean MBLC than Group 1 (p = 0.016) and Group 2 (p = 0.011), but Groups 1 and 2 were not significantly differences. The overall patient satisfactions were reported as not significant differences between groups. CONCLUDE: Two MDI-retained mandibular overdentures with immediate loaded protocol performed had favorable clinical outcomes, cost effectiveness, and overall patient satisfactions after 5 to 8 years follow-up.

Evaluation of Implant Stability and Trephination Depth for Implant Removal-An In Vitro Study.

Malpositioned and broken implants are usually fully osseointegrated; hence, their removal, especially from the lower arch, can be very challenging. Implant removal techniques include reverse torque and trephination. Trephination is an invasive technique that can jeopardize vital structures, cause mandibular fatigue fractures, or lead to osteomyelitis. In this study, we aimed to assess the relationship between trephination depth and implant stability by recording implant stability quotient (ISQ) readings at varying trephination depths in vitro. Materials and methods: Forty-eight implants were inserted into dense synthetic polyurethane foam blocks as artificial bone. Primary implant stability was measured with a Penguin resonance frequency analysis (RFA) device. Implants of two designs with a diameter of 3.75 mm and a length of 13 or 8 mm were inserted. Twenty-four internal hexagon (IH) (Seven®) and twenty-four conical connection (CC) implants (C1®; MIS® Implants, Ltd., Misgav, Israel) were used. The primary implant stability was measured with the RFA device. Trephination was performed, and implant stability was recorded at depths of 0, 3, and 6 mm for the 8 mm implants and 0, 3, 6, 8, 10, and 11.5 mm for the 13 mm implants. Results: Linear regression revealed a significant relation between the trephination depth and the ISQ (F (1, 213) = 1113.192, p < 0.001, adjusted r2 = 0.839). The trephination depth significantly predicted the ISQ (ß = −5.337, p < 0.001), and the ISQ decreased by −5.33 as the trephination depth increased by 1 mm. Conclusion: Implant stability reduction as measured using an RFA device during trephination may be a valuable guide to achieving safe reverse torque for implant removal. Further studies are needed to evaluate these data in clinical settings.

Primary Implant Stability Analysis of Different Dental Implant Connections and Designs-An In Vitro Comparative Study.

Primary implant stability can be evaluated at the time of placement by measuring the insertion torque (IT). However, another method to monitor implant stability over time is resonance frequency analysis (RFA). Our aim was to examine the effect of bone type, implant design, and implant length on implant primary stability as measured by IT and two RFA devices (Osstell and Penguin) in an in vitro model. Ninety-six implants were inserted by a surgical motor in an artificial bone material, resembling soft and dense bone. Two different implant designs-conical connection (CC) and internal hex (IH), with lengths of 13 and 8 mm, were compared. The results indicate that the primary stability as measured by RFA and IT is significantly increased by the quality of bone (dense bone), and implant length and design, where the influence of dense bone is similar to that of CC design. Both the Osstell and Penguin devices recorded higher primary implant stability for long implants in dense bone, favoring the CC over the IH implant design. The CC implant design may compensate for the low stability expected in soft bone, and dense bone may compensate for short implant length if required by the anatomical bone conditions.

The Assessment of Immune Fitness.

Immune fitness (i.e., adequate functioning of the immune system) is essential to maintain health, prevent and resolve disease, and improve quality of life. This article provides an overview of how to assess immune fitness. It discusses how a single-item rating scale can be used to assess immune fitness. The scale can be used in conjunction with a single "yes" or "no" question asking whether the individual is experiencing reduced immune fitness. Retrospective assessments can be complemented with the Immune Status Questionnaire (ISQ) to provide more insight into the type and frequency of experiencing specific immune-related complaints. Momentary assessments of immune fitness can be complemented with biomarker measurements in body fluids. As individuals may be unaware of systemic inflammation (e.g., biomarker concentrations outside the normal range), it remains critical to combine immune fitness assessments with biomarker measurements of immune functioning.

Reliability and Correlation of Different Devices for the Evaluation of Primary Implant Stability: An In Vitro Study.

Our aim was to analyze the correlation between the IT evaluated by a surgical motor and the primary implant stability (ISQ) measured by two RFA devices, Osstell and Penguin, in an in vitro model. This study examines the effect of bone type (soft or dense), implant length (13 mm or 8 mm), and implant design (CC: conical connection; IH: internal hexagon), on this correlation. Ninety-six implants were inserted using a surgical motor (IT) into two types of synthetic foam blocks. Initial measurements for both the peak IT and ISQ were recorded at the point when implant insertion was stopped by the surgical motor, and the final measurements were recorded when the implant was completely inserted into the synthetic blocks using only the RFA devices. Our null hypothesis was that there is a good correlation between the devices, independent of the implant length, design, or bone type. We found a positive, significant correlation between the IT, and the Osstell and Penguin devices. Implant length and bone type did not affect this correlation. The correlation between the devices in the CC design was maintained; however, in the IH design it was maintained only between the RFA devices. We concluded that there is a high positive correlation between the IT and ISQ from a mechanical perspective, which was not affected by bone type or implant length but was affected by the implant design.