Search

To evaluate the performance of fixed complete dental prostheses supported by axial and tilted implants after at least 3 years of follow-up.An electronic search plus a hand search up to April 2021 was undertaken. Clinical studies were selected using specific inclusion criteria, independent of the study design. The main outcomes were cumulative implant survival rate, marginal bone level changes, and complications, after ≥ 3 years of follow-up. The difference in outcomes between axial and tilted implants and between the maxilla and mandible was evaluated using meta-analysis and the Mantel-Cox test.Out of 824 articles retrieved, 24 were included. In total, 2,637 patients were rehabilitated with 2,735 full prostheses (1,464 maxillary, 1,271 mandibular), supported by 5,594 and 5,611 tilted and axial implants, respectively. In a range between 3 and 18 years of follow-up, 274 implants failed. The cumulative implant survival rate was 93.91% and 99.31% for implants and prostheses, respectively. The mean marginal bone level change was moderate, exceeding 2 mm in only two studies. Marginal bone loss was significantly lower around axial compared with tilted implants (P.0001), whereas it was not affected by arch (maxilla vs mandible; P = .17).Fixed complete dental prostheses supported by tilted and axially placed implants represent a predictable option for the rehabilitation of edentulous arches. Further randomized trials are needed to determine the efficacy of this surgical approach and the remodeling pattern of marginal bone in the long term.

To assess clinical, radiological performance of novel navigation guided socket-shield technique (NSS) with immediate implant placement and loading.Eighteen patients (12 females; age 52.54 ± 4.92; 33-72) treated between January 2018 and June 2019, were investigated, and followed for at least 1 year after definitive prosthesis placement (mean 20.1 months, 18-23). Primary outcomes: implant and prosthetic success rates, surgical, biologic, prosthetic complications.marginal bone loss (MBL), implant stability quotient (ISQ), pink esthetic score (PES), plaque and bleeding indexes.Sixty-nine navigation guided socket-shield procedures were performed (27 implant-sites and 42 pontic-sites) and 27 implants (NobelParallel, NobelBiocare AG) positioned and immediately loaded. Mean insertion torque and ISQ at implant positioning were 49 ± 5.34 Ncm (36-74), 73 ± 5.72 (68-81). No implant failure was experienced. Two root-shield exposures with mucositis, ulceration and bleeding were reported at two pontic-sites (2.9%) and successfully treated. No complications were experienced at implant-site leading to an overall NSS success-rate of 100%. No prosthetic complications occurred. Mean MBL was -0.72 ± 0.26 mm (-0.42 to -1.06 mm). PES final at the last follow-up 12.84 ± 0.92. The plaque and bleeding scores were 18.5 ± 6.12 and 3.15 ± 2.21.Within study limitations, dynamic navigation was effective to streamline execution of socket-shield technique at implant and pontic sites, shortening treatment time and reducing complications. Navigation guided socket-shield technique was reliable to achieve digitally planned shield-to-implant distance, facilitate immediate implant placement and loading and establish the mucosal dimension needed for underlying bone-to-implant protection and esthetic integration.The investigated NSS technique overcomes the difficulties related to root preparation at implant and pontic-sites, facilitating immediate implant placement and loading. Dynamic guided surgery contributed to make socket-shield technique less technical-sensitive, shortening time for execution, reducing complication rate.

Robotic tasks featuring interaction with other bodies are increasingly required in industrial contexts. The manipulators need to interact with the environment in a compliant way to avoid damage, but, at the same time, are often required to accurately track a reference force. To this aim, interaction controllers are typically employed, but they either need human tinkering for parameter tuning or precise modeling of the environment the robot will interact with. The former is a time-consuming procedure, while the latter is necessarily affected by approximations, which often lead to failure during the actual application. Both these aspects are problematic if it were often necessary to change the contact environment.Current research is concentrating on devising high-performance force controllers that are simple to tune and quick to adapt to changing environments. Along this line, this work proposes a novel control strategy, that we term ORACLE (Optimized Residual Action for interaction Control with Learned Environments). It exploits an ensemble of neural networks to estimate the force generated by the robot-environment interaction. This estimate is input to an optimal residual action controller that locally corrects the main action, output of a base force controller, which guarantees stability. The ORACLE strategy has been implemented and tested in the MuJoCo dynamic simulator and in a real-case scenario, both foreseeing a Franka Emika Panda robot used as a test platform. A reduction in terms of force tracking error is achieved by deploying the proposed strategy, with a short setup time.

This paper presents a case study regarding the simulation of a robotic workstation to virtually test objects detection and obstacle avoidance. Testing these features inside a virtual environment is useful, especially when human-robot cooperation and interaction are involved. Indeed, it allows users to avoid real dangerous conditions, lowering the possible risks of injuries by the users and cutting down the costs compared to a real testing environment. The work presented here exploits a framework where a virtual environment is connected to a Robot Operating System (ROS) able to simulate the kinematic of the robot and, on the other side, a physical ultrasonic sensor acts as the bridge with the real world. The latter, driven by an Arduino board, allows the virtual robot to recognize static obstacles in the real world, mapping the surrounding environment and computing a suitable trajectory to accomplish the given task. Thanks to the sensing capability, the virtual robot is also able to react to the presence of other obstacles (e.g. humans) entering the workspace at runtime. The seamless connection between the virtual and the physical world makes the framework suitable for the fast testing of new algorithms driving the behavior of the robot when interacting with dynamic environments.

Objective To assess clinical and radiological performance of novel digital workflow integrating dynamic guided surgery, to streamline execution of implant placement, soft and bone tissue sculpturing, and immediate delivery of navigation guided complete-arch prosthesis. Materials and methods This proof of concept prospective single cohort study investigated 10 consecutive patients (three males, seven females; mean age 62.5 ± 8.9 years; range, 48-75) requiring at least one complete-arch fixed dental prostheses (FDP) in both jaws, treated between January and August 2019. Primary outcomes were implant and prosthetic success rates, surgical and prosthetic complications. Secondary outcomes were marginal bone loss (MBL), implant stability quotient (ISQ), periodontal parameters (plaque and bleeding indexes). Results Sixty implants (32 NobelParallel TiUltra and 28 NobelActive TiUltra, Nobel Biocare) were placed and 14 complete-arch FDPs immediately loaded (mean follow-up 16.2 ± 1.7 months, 14-18). One implant failed and was immediately replaced. No other surgical or biological complications occurred, accounting for a cumulative success rate of 98.3%. No prosthetic complication occurred, leading to 100% prosthetic success rate. Mean ISQ at implant placement was 71 ± 2.8 (65-78). The mean MBL was -0.53 ± 0.28 mm (-0.22 to -1.12 mm). Plaque and bleeding scores were 14.4 ± 8.18 and 7.15 ± 4.4, respectively. Conclusion Within the limitations of this proof-of-concept dynamic navigation was effective to deliver in the planned coordinates both implants and prosthesis and guide bone and soft tissue sculpturing. Immediate loading of digitally prefabricated esthetically driven complete-arch FDP was facilitated, resulting in high implant and prosthetic success rates. Clinical significance The investigated digital workflow integrating dynamic navigation may overcome the difficulties related to immediate positioning and loading of digitally prefabricated complete-arch FDP. The navigation guided soft and bone tissues sculpturing, associated to xenogeneic collagen matrix grafting, represented a predictable technique to achieve the digitally planned interface, reestablishing the mucosal dimension required for the protection of underlying bone while maintaining tissue health.

IntroductionMental and stress-related disorders such as depression, anxiety and burnout are highly prevalent and often managed in primary care. These conditions often impact people's ability to work and are a primary cause of sick leave. Family physicians are the main prescribers of sick leave and play a critical role in managing their patients' mental health problems and deciding on the timing and conditions for a return to work. Yet, family physicians receive little training in work-related issues and their practices related to mental and occupational health issues can vary widely.Aims Objectives Theory or MethodsThe aims of our study were to co-design new digital tools to support a person-centered, evidence-based and integrated approach to the primary care management of mental health-related sick leave and to evaluate the implementation of these tools. This study is taking place in three primary care clinics in Quebec, Canada. In study phase 1, our interdisciplinary team used a user-centred design approach to develop EMR templates that could be used to improve the management of sick leave at the point of care. In phase 2, we are conducting a multiple case study examining implementation of the tools by family physicians.Highlights or Results or Key FindingsOur co-design approach involved five design cycles that took place over an 18-month period. We have developed two digital tools (EMR templates): a) a tool to support the initial assessment and treatment of common mental disorders and the need for a sick leave from work, and b) a tool to support a systematic follow-up of the patient's sick leave and the preparation for a return to work. Phase 2 involves family physicians at each study site testing the tools with 10 of their patients experiencing a common mental disorder and work-related issues (e.g. sick leave, return to work). We are assessing organizational readiness for knowledge translation at each site and are performing ongoing interviews and follow-ups with physicians to collect data on their adoption of the tools, their acceptability, and the barriers and facilitators to their use in routine care. Phase 2 is currently ongoing.ConclusionsThis study emerged from the concerns of family physicians and other primary care providers who recognized a need for greater supports to manage mental health-related sick leave and to improve the integration of mental health and occupational health care in primary care.Implications for applicability/transferability sustainability and limitations The digital tools that our team has created are available in both French and English and can be adapted to various electronic medical record (EMR) platforms. They can thus be easily integrated within the busy practices of family physicians and offer an evidence-based source of support at the point-of-care.

to evaluate the trueness of seven different intra-oral scanners (IOSs) in making a completearch digital scan with and without splinting the scan bodies.A polyurethane model of an edentulous mandible with 4 dental implant analogues was prepared. Reference scan was made using a laboratory scanner. The reference model was scanned with each of the seven investigated IOSs (control groups, n=10 per scanner) and scanned again after splinting the scan bodies (study groups, n=10 per scanner). Each scan was exported as standard tessellation language (STL) file and transferred to a comprehensive metrology program (Geomagic Control X). In order to measure the trueness, four points (A, B, C and D) were determined on the scan bodies and the distance between point A and other points (DAB, DAC, DAD) was measured. The measurements were tested for normality using Kolmogrov- Smirnov test and probability plots. Trueness was compared using Three-way ANOVA and pairwise comparisons were performed using post-hoc Tukey and paired sample T-test. Statistical analyses were two sided, and the significance level was set at 5%.Splinting the scan bodies improved the trueness of the digital scans while increasing the inter-implant distance decreased the trueness values. Significant association was found between the trueness values and all three tested variables including splinting the scan bodies, type of IOS, and inter-implant distance (P0.001).Based on the present findings, splinting the scan bodies can improve the trueness of digital complete arch implant scans due to the improvement in morphological landmarks do the stitching process regardless of the type of the IOS or the inter-implant distance.

To assess accuracy of implant complete-arch digital impression with intraoral scanner (IOS) and implant scanbody splinting (ISS).An edentulous mandibular model with 4 analogues was fabricated. Four polyetheretherketone (PEEK) implant scanbodies (ISBs) were scanned, according to a randomized sequence, by investigated IOS with (ISS+) and without implant scanbody splinting (ISS-), resulting in 30 test and 30 control files. The model was digitized by industrial optical scanner and the related file superimposed to the test and control files by a best fit algorithm. Linear (ΔX, ΔY and ΔZ-axis) and angular deviations (ΔANGLE) were evaluated for each analogue. A global measure of linear absolute error (ΔASS) was calculated considering the sum of absolute linear discrepancies. Influence of ISS and implant position on IOS accuracy was assessed using General Linear Model and possible interaction between ISS and implant position evaluated.Implant position showed a significant main effect (p0.0001) and interaction with ISS (p=0.0454) when ΔASS was considered as response variable. Posterior implants resulted as less accurate. ISS was able to reduce ΔASS for both distal analogues (4.7, p=0.0188). When ΔANGLE was considered as a response variable, implant position and ISS showed significant main and interactive effects (p=0.0039, p0.0001, p0.0001). Analogue 3.6 was associated with highest angular discrepancy. This error was significantly reduced by ISS (p0.0001).Complete-arch implant digital impression with scanbody splinting showed a significant improvement of the overall accuracy, particularly reducing linear and angular deviations at the most critical posterior implant positions.Intraoral scanner accuracy for implant complete-arch digital impression could be improved by a low cost, easy to assemble and use implant scanbodies splinting 3D printed modular chain.

This multicenter retrospective study assessed clinical and radiographic outcomes of 686 parallel-walled conical-connection implants consecutively placed in 281 partially and fully edentulous patients. Implants were placed in healed and postextraction sites and subjected to immediate, early, or delayed loading. With a mean follow-up of 10 ± 6.7 months, the implant survival rate was 97.7%, while mean marginal bone loss was 0.7 ± 1.5 mm between implant placement and 1 year (n = 290 implants) and 0.1 ± 0.6 mm between 1 and 2 years (n = 72 implants). Advanced patient age and longer implants were associated with fewer implant failures, while different crestal positions at implant placement were not associated with differences in implant survival or changes in marginal bone level over time.

Objectives This open, single-cohort, multicenter, prospective study investigated the efficacy of immediately provisionalized tapered conical connection implant for single-tooth restorations in the anterior and premolar regions of the maxilla after 5 years of function. Materials and methods All implants were placed in healed sites and immediately provisionalized. MBLs, soft-tissue parameters, and oral-health impact profile (OHIP) were evaluated at implant insertion, 6, 12, 24, 36, and 60 months. Paired Wilcoxon signed-rank tests and Kaplan–Meier survival analysis was used for statistical and implant survival/success analyses, respectively. Results Seventy-seven patients (81 implants) completed the 5-year follow-up. The 5-year cumulative survival and success rates were 97.8%, and the mean MBL change from implant insertion to 5 years was − 0.80 ± 1.13 mm. Optimal papilla index scores were observed at 90.1% of sites at 5 years compared with 32.8% of sites at insertion. Pink esthetic score, modified bleeding and plaque indices, and OHIP showed statistically significant improvement at the 5-year follow-up. Conclusions Immediately provisionalized tapered conical connection implants promote marginal bone stability and excellent esthetic outcomes after 5 years of function. Clinical relevance This treatment is a viable option for patients requiring immediately provisionalized single-tooth restorations in the esthetic zone and shows favorable long-term clinical outcomes, including marginal bone stability and excellent esthetics.

The correct assessment of maximum temperatures experienced by rocks is an essential tool to unravel the evolution of the thermal structure of the crust during the main phases of an orogenesis. Given to broad P-T stability field of classical metamorphic mineralogical indicators, maximum temperatures derived from the analyses of carbonaceous material dispersed in rocks by means of Raman spectroscopy has shown to be a suitable alternative to classical geothermometer. Initially developed for high metamorphic rocks the use of this tools has recently been extended also at lower metamorphic degree and diagenesis. This allowed us to extend the analyses of paleotemperatures experienced by rocks from Ghomarides and Sebtides from the Internal Rif in North Morocco with respect to previous works. Ghomaride and Sebtides in this portion of the Rif-Betic-Tell chain, represent respectively the upper and lower plates of a metamorphic core complex and are composed, the first, by Paleozoic rocks with a partially preserved Mesozoic-Cenozoic cover and the second by lower Paleozoic to Triassic deep-crustal mica-schists, migmatites and granulites associated with peridotites (Beni Bousera complex).Our data suggest that the uppermost Tiszgarine Unit of the Upper Sebtides experienced warmer condition than previously observed. Moreover, we calculate the maximum temperatures experienced by the Ghomarides during both the Eo and Late Variscan cycles showing that differences in temperature exist among the vary units that compose the complex. Finally, in the southern area our data suggest a less severe alpine heating related to the emplacement of the Beni Bousera peridotite, than previously calculated.

Purpose To introduce a digitally assisted technique to achieve the ideal soft and bone tissue interface for anatomic-driven pink free implant supported fixed prosthesis, and prefabricate an interim prosthesis to be used the day of the surgery as a prosthetic scaffold to condition the healing. Methods The digital assisted soft tissue sculpturing (DASS) technique allows the previsualization of the ideal soft and bone tissue interface and fabricate a computer aided design computer aided manufacturing (CAD-CAM) anatomic-driven pink free complete arch interim prosthesis for the immediate loading. Bone and soft tissue interface as well as the interim prosthesis design are performed in a segmented multiple standard tessellation language (STL) file embedding the bone anatomy, the intraoral surface anatomy (dental and soft tissue), the digital wax-up and the implant positioning. The interim prosthesis is used as a prosthetic scaffold to guide the soft and bone tissue surgical sculpturing and regeneration. Conclusions The DASS technique is a predictable integrated digital workflow that simplifies the achievement of a scalloped tissue interface for pink free fixed implant prosthesis, reestablishing the mucosal dimension required for the protection of underlying bone while maintaining tissue health. The surgical sculpturing and maturation of the soft and bone tissue is driven and enhanced by the xenogeneic collagen matrix grafting and prosthetic scaffold effect of the digitally prefabricated interim prosthesis delivered the day of the surgery.

Statement of problem Despite the broad clinical application of zirconia for fixed implant-supported prostheses, evidence of long-term performance is sparse. Purpose The purpose of this retrospective study was to evaluate the long-term clinical and radiographic outcomes of zirconia-based partial and complete screw-retained implant-supported zirconia fixed dental prostheses (ISZFDPs). Material and methods Records of patients treated with dental implants and ISZFDPs between December 2004 and June 2017 were screened. Eligible study participants, according to inclusion criteria, were contacted and invited to undergo clinical and radiographic examinations. Outcomes were evaluated as implant and prosthetic survival rates, prosthetic success rate, complications, marginal bone level (MBL) change, and soft tissue condition. Along with the effects of zirconia prosthesis type and level, the effects of implant type and connection, type of loading, and follow-up on MBL were tested with a generalized linear effects model (GLEM) (α=.05). Results A total of 118 patients were identified, of whom 20 (16.9%) were not available for clinical examination for various reasons. Ninety-eight participants (mean age 60.7 ±11.7 years) with 337 implants were included, of which 176 (52.2%) had been immediately loaded. A total of 111 ISZFDPs (96 zirconia connection and 15 titanium base) were investigated: 24 complete ISZFDPs with a zirconia connection (12.9 ±0.97 dental units, minimum 12, maximum 14), 72 partial with a zirconia connection (3.11 ±1.12, minimum 2, maximum 7), 15 partial with a titanium base (3.62 ±1.02, minimum 2, maximum 5). Forty ISZFDPs had been in function for ≥10 years (36%), 38 for 5 to 9 years (34.2%), and 33 for 2 to 4 years (22.8%). The mean follow-up time was 7.2 ±3.4 years. No zirconia fractures were identified. Two implants and 2 ISZFDPs failed, with chipping being the most common complication (13.5%). The implant survival rate was 99.4%, and the prosthetic survival rate was 98.2%. The cumulative prosthetic success rate was 91.9%. MBL change was -0.18 ±0.59 mm. Thirteen implants were treated for peri-implantitis (3.8%), and 9 for mucositis (2.7%), but presented healthy peri-implant soft tissues at the follow-up examination. A significant difference was found between the implant-level and abutment-level prostheses (P=.013), with less marginal bone loss observed in ISZFDPs delivered at the implant level. Conclusions Zirconia-based screw-retained implant-supported prosthesis can be considered a reliable long-term treatment option for partial and complete edentulism. No zirconia fractures were experienced. Stable bone levels and low peri-implantitis rates were reported regardless of the ISZFDP type and level, implant type and connection, and type of loading.

A hyperinflammatory syndrome (HIS) may cause a life-threatening acute respiratory distress syndrome (ARDS) in patients with COVID-19 pneumonia. A prospective series of 100 consecutive patients admitted to the Spedali Civili University Hospital in Brescia (Italy) between March 9th and March 20th with confirmed COVID-19 pneumonia and ARDS requiring ventilatory support was analyzed to determine whether intravenous administration of tocilizumab (TCZ), a monoclonal antibody that targets the interleukin 6 (IL-6) receptor, was associated with improved outcome. Tocilizumab was administered at a dosage of 8 mg/kg by two consecutive intravenous infusions 12 h apart. A third infusion was optional based on clinical response. The outcome measure was an improvement in acute respiratory failure assessed by means of the Brescia COVID Respiratory Severity Score (BCRSS 0 to 8, with higher scores indicating higher severity) at 24-72 h and 10 days after tocilizumab administration. Out of 100 treated patients (88 M, 12 F; median age: 62 years), 43 received TCZ in the intensive care unit (ICU), while 57 in the general ward as no ICU beds were available. Of these 57 patients, 37 (65%) improved and suspended noninvasive ventilation (NIV) (median BCRSS: 1 [IQR 0-2]), 7 (12%) patients remained stable in NIV, and 13 (23%) patients worsened (10 died, 3 were admitted to ICU). Of the 43 patients treated in the ICU, 32 (74%) improved (17 of them were taken off the ventilator and were discharged to the ward), 1 (2%) remained stable (BCRSS: 5) and 10 (24%) died (all of them had BCRSS≥7 before TCZ). Overall at 10 days, the respiratory condition was improved or stabilized in 77 (77%) patients, of whom 61 showed a significant clearing of diffuse bilateral opacities on chest x-ray and 15 were discharged from the hospital. Respiratory condition worsened in 23 (23%) patients, of whom 20 (20%) died. All the patients presented with lymphopenia and high levels of C-reactive protein (CRP), fibrinogen, ferritin and IL-6 indicating a HIS. During the 10-day follow-up, three cases of severe adverse events were recorded: two patients developed septic shock and died, one had gastrointestinal perforation requiring urgent surgery and was alive at day 10. In conclusion, our series showed that COVID-19 pneumonia with ARDS was characterized by HIS. The response to TCZ was rapid, sustained, and associated with significant clinical improvement.

This multicenter prospective clinical trial investigated immediately provisionalized, anodized, conical connection, tapered implants with platform shifting in maxillary anterior and premolar sites. Patients requiring single-tooth implant-supported restorations in maxillary anterior and premolar sites were enrolled. Implants were immediately provisionalized and evaluated at insertion, 6 months, and annually thereafter. Outcome measures were marginal bone level change (ΔMBL), cumulative survival rate (CSR), and success rate, soft-tissue parameters, and oral health impact profile (OHIP). ΔMBL and Pink Esthetic Score were analyzed using Wilcoxon signed-rank tests. CSR was calculated using life table analysis. Other soft-tissue parameters were analyzed using sign tests. Of 94 enrolled patients (99 implants), 84 (88 implants) attended the 3-year follow-up. After an initial bone loss between implant insertion and 6 months (− 0.92 ± 1.23 mm), bone levels stabilized from 6 months to 3 years (0.13 ± 0.94 mm) with no significant change. The 3-year CSR was 98.9%, and the cumulative success rate was 96.9%. Papilla index scores of 2 or 3 were observed at 88.6% of sites at the 3-year visit compared with 32.8% at implant insertion. Improvements were observed for all other outcomes, including bleeding on probing, esthetics, plaque, and OHIP. This restorative protocol was associated with high primary stability, patient satisfaction, stable bone levels, and an overall improvement of the soft tissue outcomes over a 3-year period. The presented treatment is a viable option for single-tooth restorations of maxillary anterior teeth and premolars with successful short- to mid-long-term clinical outcomes.

This report shows a multi-compartmental lipoma that occupied a vast area of the hand volar compartment, the distal aspect of the Parona’s space and infiltrated the dorsal compartment between the IV and V metacarpal bones. The mass was entirely removed through a dorsal approach, minimizing risks of neurovascular and tendinous lesions.

The aim of this interim analysis of a 5-year prospective multicenter study is to evaluate clinical and radiological performance of immediately provisionalized 3.0-mm-diameter tapered implants. Patients needing implant rehabilitation of maxillary lateral incisors or mandibular lateral and central incisors were treated with 3.0-mm-diameter implants placed in extraction or healed sites and immediately provisionalized. Clinical and radiographic examinations were performed at implant insertion, 6 months thereafter, and are ongoing. Marginal bone levels and changes, complications, the papilla, plaque, and bleeding indices, and the pink esthetic score (PES) were evaluated at each follow-up visit. Of 112 enrolled patients, 77 patients (91 implants) met the inclusion criteria. Seventy-one patients with 82 implants completed the 1-year follow-up. Three implants failed yielding a CSR of 96.7%. All failures occurred within the first 3 months after implant insertion. Marginal bone level changes from insertion to 6 months was − 0.57 ± 1.30 mm (n = 75) and from insertion to 12 months − 0.25 ± 1.38 mm (n = 72). Fifteen non-serious complications were recorded. Papilla index score and PES improved at the 1-year follow-up. Plaque formation and bleeding-on-probing showed no statistically significant differences between the 6-month and the 1-year visit. This 1-year analysis demonstrated high survival, stable bone levels, and healthy soft tissue with 3.0-mm-diameter implants. Narrow diameter implants are a safe and predictable treatment option in patients with limited bone volume and/or limited interdental space and eligible for immediate loading protocols.

Objectives The aim of this multicenter prospective clinical study was to evaluate anodized tapered implants with a conical connection and integrated platform shifting placed in the anterior and premolar maxilla. Materials and methods The study enrolled patients requiring single-tooth restorations in healed sites of maxillary anterior and premolar teeth. All implants were immediately temporized. Clinical and radiographic evaluations were conducted at implant insertion, 6 months, and 1 year. Outcome measures included bone remodeling, cumulative survival rate (CSR), success rate, soft-tissue health and esthetics, and patient satisfaction. Bone remodeling and pink esthetic score were analyzed using Wilcoxon signed-rank tests. CSR was calculated using life table analysis. Other soft-tissue outcomes were analyzed using sign tests. Results Out of 97 enrolled patients (102 implants), 87 patients (91 implants) completed the 1-year visit. Marginal bone remodeling was −0.85 ± 1.36 mm. After the expected initial bone loss, a mean bone gain of 0.11 ± 1.05 mm was observed between 6 months and 1 year. The CSR was 99.0%, and the cumulative success rate was 97.0%. Partial or full papilla was observed at 30.8% of sites at baseline, 87.2% at 6 months, and 90.5% at 1 year. Soft-tissue response, esthetics, and patient satisfaction all improved during the study period. Conclusions Bone gain was observed following the expected initial bone loss, and soft-tissue outcomes improved suggesting favorable tissue response using anodized tapered conical connection implants. Clinical relevance Rapid stabilization of bone remodeling and robust papilla regeneration indicate favorable tissue healing promoted by the conical connection, platform-shift design. Trial registration clinicaltrials.gov NCT02175550

To evaluate the influence of implant scanbody (ISB) material, position and operator on the accuracy of a confocal microscopy intraoral scanning (IOS) for complete-arch implant impression.An edentulous maxillary model with 6 internal hexagonal connection analogues was scanned with an extraoral optical scanner to achieve a reference file. Three ISBs made of different materials (polyetheretherketone (Pk), titanium (T) and Pk with a titanium base (Pkt)) were scanned with IOS by 3 operators. The resulting 45 test files were aligned to the reference file with a best fit algorithm. Linear (ΔX, ΔY and ΔZ-axis) and angular deviations (ΔANGLE) were assessed. Absolute values of the linear discrepancies were summed up to obtain a global measure of linear absolute error (ΔASS). Influence of ISB material, position and operator was statistically assessed using the mixed general linear model.At multivariate analysis, whenΔASS was considered as response variable, it was identified a significant influence of material (p0.0001) and position (p=0.0009) while no significant operator effect was detected. When ΔANGLE was considered as response variable, material and position significantly influenced the expected ΔANGLE (p=0.0232 and p0.0001) and no operator effect was identified.The investigated IOS for complete-arch digital impression was influenced by the ISB material with peek reporting the best results on both linear and angular measurements followed by titanium, peek-titanium resulting as the less accurate. Implant angulation affected significantly the linear deviations while implant position the angular deviations. Operator did not show any significant effect on the IOS accuracy.

Inadequate restorative space can result in mechanical, biologic, and esthetic complications with full-arch fixed implant-supported prosthetics. As such, clinicians often reduce bone to create clearance. The aim of this paper was to present a protocol using stacking computer-aided design/computer-assisted manufacturing (CAD/CAM) guides to minimize and accurately obtain the desired bone reduction, immediately place prosthetically guided implants, and load a provisional that replicates predetermined tissue contour. This protocol can help clinicians minimize bone reduction and place the implants in an ideal position that allows them to emerge from the soft tissue interface with a natural, pink-free zirconia fixed dental prostheses.

Purpose To introduce a proof of concept technique and new integrated workflow to optimize the functional and esthetic outcome of the implant-supported restorations by means of a 3-dimensional (3D) facially-driven, digital assisted treatment plan. Methods The Smiling Scan technique permits the creation of a virtual dental patient (VDP) showing a broad smile under static conditions. The patient is exposed to a cone beam computed tomography scan (CBCT), displaying a broad smile for the duration of the examination. Intraoral optical surface scanning (IOS) of the dental and soft tissue anatomy or extraoral optical surface scanning (EOS) of the study casts are achieved. The superimposition of the digital imaging and communications in medicine (DICOM) files with standard tessellation language (STL) files is performed using the virtual planning software program permitting the creation of a VDP. Conclusions The smiling scan is an effective, easy to use, and low-cost technique to develop a more comprehensive and simplified facially driven computer-assisted treatment plan, allowing a prosthetically driven implant placement and the delivery of an immediate computer aided design (CAD) computer aided manufacturing (CAM) temporary fixed dental prostheses (CAD/CAM technology).

The Middle Jurassic strata of the NE Arabian Plate compose part of the largest world-class petroleum system, with more than 250 billion barrels of proven hydrocarbons. The Najmah Formation, one of those productive strata located in Kuwait, represents a transgressive deposition within a deep basinal settings and anoxic environments; with its black shales interbedded with bituminous limestones the Najmah Formation works as both reservoir and source rock. Due to its organic richness and maturity, the middle Jurassic formation can be considered the best potential conventional/unconventional play in the Kuwaiti Province.Evaporates of Gotnia, a HPHT formation overlaying the Najmah reservoir, are dealt with high mud weight (19-21 ppg), to counter the high pressured patches. The identification of Najmah stratigraphic top is crucial for setting the casing point, then reducing the mud weight for the final drilling phase. Missing this critical casing point may lead to several rig NPT and related operational cost increments, such as cement jobs and, in extreme cases, may lead to missing and abandoning the well. When the standard investigation methods, as the optical microscopy, or Gamma Ray failed in identifying the Najmah top, due to the similarity between its limestones and those of Gotnia Formation, the ED X-ray fluorescence (XRF) and X-ray diffraction (XRD) established distinctive formations geochemical ‘fingerprints’, as well as their sedimentary patterns, providing absolute certainties about the casing point position despite a misleading stratigraphy.The technique of Chemostratigraphy, applied in this study on five exploratory wells, can increase the value of such geochemical fingerprints, providing not only applications as critical casing points ID but also a means to unify stratigraphic schemes, i.e. develop stable reference stratigraphic frameworks: changes in rock geochemistry reflect changes in the relative sea level, thus sediment supply/accommodation, oxygenation and diagenetic conditions.Once inside the Najmah Formation, the elemental and mineralogical patterns point out different formation sublayers, corroborating many sedimentological and stratigraphic evidences obtained from outcrops and cores analyses. Some redox-sensitive trace metals are delivered to the sediment in presence of organic matter (Ni, Mo, V and U) under anoxic-euxinic conditions and tend to exhibit covariation with TOC, highlighting the best pay zones in the Najmah Kerogen sublayers. Some other metals such as Mn, Fe and Zn, in carbonate sequences, can evaluate the amount of carbonate cement (sparite) among the microcrystalline matrix (micrite); such metals, correlated with mud gas concentration, reveal the most porous sections within calcareous sublayers.Having access to more detailed rock properties allow for one time decisions making, such as the identification of casing/coring points and the characterization of a reservoir in all its sublayers. Chemostratigraphy has led the operational team to minimize NPT and related costs, the completion team to the right well profiles and the production team to a better overview of the reservoir.

Our objective is to demonstrate the analytical capabilities of Advanced Surface Logging or Advanced Mud Logging (AML), the results borne from an extensive use of wellsite techniques and their use in time- critical situations. The work revolves around ascertaining and characterizing from the surface the nature of fluids found downhole using a number of integrated analytical techniques on oil samples and rock cuttings. We aim to evaluate the reservoir fluid properties flowing from the fractures and fluids which are suspected to be present within the pores of the reservoir matrix via cross-referencing multiple sample mediums. The work studies data collected from a well in the Middle East; "Well-A", which was drilled as a producer from the Upper-Middle Jurassic (UMJ) Formations and an appraisal from the porous interval of the Lower Jurassic formation (LJ). The primary target of the operating company was to determine the in-situ fluid characteristics of the UMJ Formations. The communication between these two intervals as well as the contact depth is unknown and crucial at the current stage of the field development. Reservoir and hydrocarbon fluid characterization was investigated using cuttings samples taken from Well-A. All samples were analyzed in-lab, post-drilling using Advanced Mudlogging (AML) techniques such as Thermal Extraction Gas Chromatography (TEGC), Chemical Elemental Analysis and Mineralogical analysis (the latter two performed using X-Ray based techniques). Additional Mudlogging datasets gathered in real-time during drilling were integrated within the interpretation including Advanced Mud Gas (Methane to Toluene), together with the Computer Processed Image Logs and PVT test data provided by the operator. Finally, three dead oil samples from the tested intervals were analyzed in-lab with TEGC. The chromatographic analysis of the commercially produced oil from the UJ showed a bimodal distribution which was interpreted as a mix of two different maturity fluids. We were able to trace the individual levels from which these two fluids were most probable to originate, by comparing the chromatographic characteristics of these oils across the TEGC results from the cuttings analysis. Furthermore, the in-lab geochemical analysis supported the understanding of the fluid mechanism within this reservoir interval. This interpretation resulted in potentially identifying a sub interval which could yield a higher gravity oil than initially tested and potentially transform this, now unproductive interval, into a prospect. The innovative workflow, integrating all formation evaluation data collected from rock cuttings and mud gas data was applied for the first time at this level of complexity. Although prior studies investigated the potential of integrating multiple datasets to determine reservoir fluid characteristics, never before, was such an integrated approach utilized based specifically on surface logging solutions. The case study demonstrated the value of supporting interpreters to bolster their interpretations thanks to data coming from separate independent sources.

The growing interest in minimally invasive implant placement and delivery of a prefabricated provisional prosthesis immediately, thus minimizing "time to teeth," has led to the development of numerous 3-dimensional (3D) planning software programs. Given the enhancements associated with fully digital workflows, such as better 3D soft-tissue visualization and virtual tooth rendering, computer-guided implant surgery and immediate function has become an effective and reliable procedure. This article describes how modern implant planning software programs provide a comprehensive digital platform that enables efficient interplay between the surgical and restorative aspects of implant treatment. These new technologies that streamline the overall digital workflow allow transformation of the digital wax-up into a personalized, CAD/CAM-milled provisional restoration. Thus, collaborative digital workflows provide a novel approach for time-efficient delivery of a customized, screw-retained provisional restoration on the day of implant surgery, resulting in improved predictability for immediate function in the partially edentate patient.

Certain(e)s chercheur(euse)s attribuent l’inefficacité des politiques environnementales à différents facteurs cognitifs. Cependant, leurs mécanismes sous-jacents sont encore méconnus. Une récente proposition théorique suggère l’existence d’une origine commune entre plusieurs de ces distorsions cognitives. Afin de tester cette proposition, la présente étude vise à établir une relation entre deux biais cognitifs, soient les croyances compensatoires vertes et l’illusion d’empreinte écologique négative. Pour ce faire, 114 participant(e)s remplissent quatre questionnaires portant respectivement sur chacun des deux biais, ainsi que sur la désirabilité sociale et l’identité verte. Les résultats aux questionnaires ne montrent aucune relation entre les croyances compensatoires vertes et le biais d’illusion d’empreinte écologique négative, remettant en question l’idée qu’un biais de moyennage soit à l’origine de ces deux phénomènes. Sans réfuter l’existence de ce mécanisme, il semble que l’identité verte pourrait davantage prédire la présence de croyances compensatoires vertes, tandis que la désirabilité sociale permettrait de prévoir, du moins en partie, la manifestation de l’illusion d’empreinte écologique négative. Des études futures pourraient ainsi considérer l’ajout de variables médiatrices au cadre théorique.

L’Ordre des psychologues du Québec met l’accent sur la pratique axée sur les données probantes dans la formation de ses professionnel(le)s. Quoi que cette orientation soit parfaitement justifiée, peut-on réellement faire confiance à tout ce que la science nous apporte ? Bien sûr que non, et nos professeur(e)s de statistiques et de méthodes de recherche seraient plutôt déçu(e)s de nous entendre dire le contraire.

Background Isolated scaphotrapeziotrapezoid is a relatively rare condition, and there is still not complete consensus on the treatment of this pathology. Purpose The aim of the present study is to assess the utility of implant interposition after arthroscopic scaphoid distal pole resection for scaphotrapeziotrapezoid arthritis. Material and Methods The authors present a prospective study after the arthroscopic resection of the distal pole of the scaphoid in 24 patients. In a group of 11 patients, the simple resection was performed while in the other 13 patients the scaphoid resection and pyrocarbone implant interposition. Results All patients were clinically evaluated with disability of arm, shoulder, hand score. Dorsal intercalated segment instability deformity was also measured from X-ray analysis. Grip and pinch strength were measured too, and patients were also given a visual analog scale questionnaire. Both clinical and radiographic assessments were done at 24 months postoperatively. Conclusions The study showed comparable results with both the techniques. Level of Evidence II A prospective comparative study.

With the amazing increasing in number of participants, rock climbing has become a popular sport in the last decade. A growing number of participants, with different skill level, inevitably leads to an increased number of injuries related to this practice. The kind of lesions that can be observed in rock-climbers is very specific and often involves the hand. For this reason is very important for any hand surgeon that is exposed to sport injuries to know which and the most common injuries related to this sport and which are the basic principles for the treatment of those. The aim of this article is to review the literature that has been published in the last ten year in this topic. On the NCBI database 22 articles where found that where related to rock climbing lesion affecting the hand or the whole body. Differences where found according to kind of rock climbing activity that was analyzed, alpine climb leads to more serious injuries, often affecting the lower limb, while in sport and recreational rock climbing the upper limb and the hand are definitely the most affected parts. Flexor pulley lesions, followed by fractures and strains are the most common lesions affecting the hand that are related to this practice.

Purpose: To report the up-to-2-year outcomes of the immediately loaded novel variable-thread tapered implant with an internal conical connection and built-in platform shifting. Materials and Methods: Sixty-four partially and completely edentulous patients were referred to two private centers for implant treatments between December 2010 and June 2012. Clinical and radiographic parameters were assessed retrospectively; the outcomes were implant and prosthetic failure, marginal bone remodeling, and complications. Results: One hundred forty-eight NobelReplace Conical Connection implants were placed in both postextraction sockets (n = 67) and healed sites (n = 81). One maxillary postextractive implant failed before the definitive prosthesis delivery, accounting for a cumulative success rate of 99.3%. No definitive prostheses failed. A mean marginal bone loss (MBL) of 0.42 ± 1.16 mm and 0.71 ± 1.53 mm was observed between implant placement and the 1-year (n = 147) and 2-year (n = 74) follow-up periods, respectively. In the postextraction sites, the mean MBL was 0.28 ± 0.39 mm and 0.69 ± 0.75 mm at the 1-year (n = 66) and 2-year (n = 50) follow-up periods; in the healed sites, the mean MBL was 0.51 ± 0.88 mm (n = 81) and 0.62 ± 0.80 mm (n = 24), respectively. At the 2-year follow-up session (n = 74), bleeding on probing was 8.3%, and the plaque score was 15.7%. No technical complications were observed. One biologic complication (0.8%) was reported. Conclusion: Within the limitations of this study and the relatively short follow-up, the immediately loaded NobelReplace Conical Connection implants demonstrated good treatment outcomes with regard to implant and prosthetic survival rate, MBL, and soft tissue conditions, in both postextraction and healed sites.

Biochar is a carbon-rich soil amendment, obtained from the pyrolysis of organic biomass residues and it is well known to exert beneficial effects on agricultural ecosystems. Biochar has appreciable carbon sequestration value, improves soil functions and reduces emissions from biomass that would otherwise naturally degrade to greenhouse gases. During summer 2013 a field experiment was made at “Azienda Agraria Sperimentale Stuard” San Pancrazio (Pr) to investigate the effect of two different biochars on processing tomato (Lycopersicon esculentum Mill.) cultivar ‘Pietrarossa’. Results showed an increased plant growth in the first stages of crop cycle, but, this significant priming effect disappeared at harvest. Our results suggest that biochar can increase sustainability of intensive crops contributing to carbon storage in soils.

Author(s): Pozzi, Alessandro; Tallarico, Marco; Moy, Peter K | Abstract: PurposeThe study aims to evaluate clinically the thickness of the alveolar ridge mucosa underneath a zirconia implant-supported restoration with a modified ovate pontic.Materials and methodsSixty-five patients, 32 women and 33 men (mean age: 65.5 years; range 38-81), were included. A total of 383 implants (303 in the maxilla; 80 in the mandible), supporting 81 full or partial fixed dental prostheses (65 in the maxilla; 16 in the mandible), were either cement- or screw-retained. Three years after loading, a total of 219 pontic sites (153 in the maxilla; 66 in the mandible) were measured, and the thickness of the alveolar ridge mucosa between the prosthetic surface and the underlying bone crest were recorded.ResultsThe overall implant and prosthesis survival rates at 3 years were 98.7% and 100%, respectively. No implant complications were reported, scoring a cumulative implant success rate of 100%. In the maxilla, the overall mean thickness of the alveolar ridge mucosa was 2.32 ± 0.57 mm. In the mandible, the overall mean thickness of the alveolar ridge mucosa was 2.20 ± 0.62 mm. There was no statistical difference between the overall mean values in the maxilla and mandible (p = .471).ConclusionThis radiologic retrospective study suggests the existence of a physiological barrier, named prosthetic biological width, underneath a novel pontic-designed restoration.

The aim of the present chapter is to review the most common kick boxing-related injury patterns. As this is a relatively recent practice when compared to other more ancient disciplines, few attention has been given so far to the specific stresses that it causes to the human body. The possible lesions include both ligament and skeletal lesions, embracing in the first group lesions of the triangular fibrocartilaginous complex, rupture of the scapholunate ligament, volar plate tears and less sport-specific capsular lesions. The skeletal lesions include metacarpal fractures or scaphoid fractures. Applying bandages and following a proper warm-up phase are mandatory for a professional athlete that is interested in preventing these injuries, as well as knowing what should be avoided. This chapter may also interest the clinician that approaches for the first time the world of professional kick boxing to better understand the dynamics of these sport-related lesions.

The ultimate patient expectations today for implant rehabilitation are no longer just to improve function by replacing of missing teeth, but also to have the prosthetic rehabilitation appear as natural as possible (Rosenfeld et al., Int J Periodontics Restorative Dent 26:215–221, 2006). The prosthetically driven diagnosis and treatment are mandatory to achieve an optimal implant positioning and deliver the ideal prosthetic reconstruction (Rosenfeld et al., Int J Periodontics Restorative Dent 26:347–353, 2006; Rosenfeld et al., Int J Periodontics Restorative Dent 26:493–499, 2006).

Scaphoid-trapezium-trapezoid (STT) joint arthritis is a common condition consisting of pain on the radial side of the wrist and base of the thumb, swelling, and tenderness over the STT joint. Common symptoms are loss of grip strength and thumb function. There are several treatments, from symptomatic conservative treatment to surgical solutions, such as arthrodesis, arthroplasties, and prosthesis implant. The role of arthroscopy has grown and is probably the best treatment of this condition. Advantages of arthroscopic management of STT arthritis are faster recovery, better view of the joint during surgery, and possibility of creating less damage to the capsular and ligamentous structures.

The painful thumb carpometacarpal joint without arthritic changes with joint laxity is a common condition mainly affecting the female population in their early decades. Despite this, there is a lack of literature on the available treatment options. In the existing literature ligament reconstruction and extension osteotomy have both been described. In these methods the surgical trauma is quite extensive. In this paper, the authors document and present a new minimally invasive procedure for the treatment of this condition. Patients with painful and lax thumb carpometacarpal joint who did not benefit from conservative treatment underwent surgical treatment. The integrity of the cartilage was checked arthroscopically and it was considered an absolute indication to perform the technique consisting of stabilizing the space between the first and second metacarpal base with a suture button device. A standard postoperative protocol followed. No major complications occurred. According to preliminary experience and short-term follow-up results this technique is a comparatively safer, less invasive, and less aggressive procedure.

Purpose The long-term success of machined-surface implants is well documented, whereas the reliability of the moderately rough oxidized implant surface has not been definitively assessed in the long term. The aim of this retrospective study was to assess the long-term clinical and radiologic outcomes of moderately rough oxidized implants supporting fixed prostheses. Materials and methods Seventy-three consecutive patients needing an implant-supported restoration received 1 to 11 implants each (n=167). All implants (82 cylindric and 85 tapered-body implants) had a self-tapping design and a moderately rough oxidized surface and were immediately loaded (n=48) or loaded after a delay (n=113). Patients were followed for up to 10 years. Outcomes were implant and prosthetic survival rates, peri-implant bone level changes, bleeding on probing, and plaque and gingival indices. Results One patient (one implant) dropped out. Seventy-two patients (166 implants) were followed for at least 8 years (mean, 8.82 years; range, 8.0 to 10.4 years. No implants or prostheses were lost, resulting in a cumulative implant and prosthetic survival rate of 100% after up to 10 years in function. At the final follow-up, the accumulated mean marginal bone loss values were -1.72±1.53 mm (n=27) and -1.27±1.67 mm (n=44) for cylindric and tapered implants, respectively, with no statistically significant difference. Bleeding on probing was 12.1%. The cumulative plaque score was 19.7%; 83.8% of patients showed normal gingiva, 10.1% displayed mild inflammation, and 6.1% showed moderate inflammation. Conclusion This retrospective study of 73 patients treated with either cylindric or tapered-body moderately rough oxidized implants and followed for up to 10 years demonstrated good treatment outcomes with regard to implant survival, marginal bone changes, and soft tissue conditions.

Purpose The purpose of this study is to retrospectively evaluate the implant and prosthetic survival and success rates of zirconia-based, implant-supported, screw-retained, cross-arch restorations up to 5 years after placement. Materials and Methods Twenty-two consecutive edentulous patients (11 males and females, each; mean age 68.3 years) received 26 CAD/CAM cross-arch zirconia implant bridges (NobelProcera™ Implant Bridge Zirconia; Nobel Biocare AG, Zurich, Switzerland) supported by 4 to 10 implants each. All patients were followed for at least 3 years (range 36–60 months, mean 42.3 months). Clinical assessments were scheduled every 4 months during hygiene maintenance. Outcomes were implant and prosthetic survival rates, prosthetic success rate, any observed clinical complications, patient satisfaction, and soft tissue parameters. Fisher's exact test was used to assess associations between categorical variables. Results No dropouts occurred. The overall implant and prostheses survival rate up to 5 years was 100%. Three out of 26 restorations (five out of three hundred forty eight dental units) showed an adhesive chip-off fracture of the veneering ceramic, scoring a cumulative prosthetic success rate of 88.5% at the prosthetic level and 98.6% at the unit level. All 22 patients were functionally and aesthetically highly satisfied with their restorations. Successful soft tissue parameters were found around all implants. Conclusions Industrially manufactured, zirconia-based, implant-supported, screw-retained, cross-arch restorations are a viable alternative to conventionally manufactured porcelain-fused-to-metal restorations for rehabilitating the edentulous patient.