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PurposeDuring the COVID-19 pandemic people worldwide in the same household spent more time together and school children engaged in remote learning throughout extended lockdowns and restrictions. The present study aimed to explore parents' perceptions of their involvement and enjoyment in food-related interactions with their children during coronavirus disease 2019 (COVID-19)-associated lockdowns/restrictions and changes in their children's food intake, especially children's lunches during the remote learning period.Design/methodology/approachData from parents (n = 136) were collected via an online survey in 2020. Parents' responses to closed-ended questions were analysed via descriptive statistics and open-ended responses were analysed thematically.FindingsMost parents (62%) reported that they interacted more with their school-aged (5–17 years) children about food during COVID-19 compared to pre-pandemic times. These interactions included cooking, menu planning, eating, conversations around food, and gardening. Most parents (74%) prepared meals with their children during the pandemic and most of them (89%) reported that they enjoyed it. Most parents (n = 91 out of 121) perceived that their children's lunches during remote learning were different to when attending school in person and these changes included eating hot and home-cooked food and more elaborate meals.Originality/valueThis study sheds important insights into a sample of Australian parents' food-related interactions with their school-aged children during the COVID-19 pandemic and associated lockdowns and parents' observations and perceptions of changes in the children's food intake during the remote learning period.

To assess and compare the clinical outcomes of three different types of all-ceramic posterior monolithic tooth-supported crowns.A total of 71 patients received 90 all-ceramic crowns randomized to be either high-translucency zirconia (ZC), high-translucency zirconia with a partial buccal veneer (ZC-V), or lithium disilicate glass-ceramic (LDS). All treatments were performed by four general dentists. Choice of material was blinded. Baseline and subsequent annual evaluation were based on modified California Dental Association (CDA) criteria. A questionnaire was used to include patient-reported outcomes and to compare them to the crown quality rating performed by dentists.A total of 66 patients with 84 crowns were examined after 3 years. The survival rate was 98.8%. No crowns fractured during the observation period. One ZC-V crown failed due to loss of retention, and three complications were noted: loss of retention occurred in one ZC crown, and two ZC crowns needed to be endodontically treated. There was no significant difference between the different crowns regarding marginal integrity, surface, or anatomical form. Both patients and examining dentists rated the crowns favorably regarding esthetics, patients more than dentists.Posterior lithium disilicate glass-ceramic crowns and translucent zirconia crowns with or without a partial buccal veneer show excellent and promising clinical outcomes from a short-term perspective. Patients and dentists rate the restorations favorably concerning esthetics and function.

Objective:The Keyhole is an internationally recognised front-of-pack nutrition label, guiding consumers to healthier food options. It indicates products in accordance with specific criteria for dietary fats, sugars, fibres, salt and wholegrains. The objective of this study was to simulate the potential impact of the Keyhole on adolescents’ energy and nutrient intakes by modelling a shift from reported food intakes to foods meeting the Keyhole criteria.Design:Self-reported dietary intake data were derived from a cross-sectional survey. Multiple replacement scenarios were calculated, where foods meeting the Keyhole criteria replaced reported non-compliant foods with varying proportions of replacement.Setting:Dietary survey ‘Riksmaten Adolescents 2016–2017’ in schools across Sweden.Participants:A nationally representative sample of 3099 adolescents in school years 5, 8 and 11 (55 % girls).Results:Overall, replacement with foods meeting the Keyhole criteria led to more adolescents meeting nutrition recommendations. Largest median intake improvements were seen for wholegrains (+196 %), SFA (-13 %), PUFA (+17 %) and fibres (+15 %). Smallest improvements were seen for free sugars (-3 %) and salt (-2 %), partly explained by the ineligibility of main food sources of free sugars for the Keyhole, and non-inclusion of ready meals that are often high in salt. Most micronutrient intakes were stable or improved. Unintentional effects included decreases in vitamin A, MUFA and energy intakes. Largest potential improvements in fat and fibre sources were observed in the youngest age group.Conclusions:A shift to Keyhole alternatives for everyday foods would improve adolescents’ nutrient intakes, even with smaller exchanges.

Purpose After some initial setbacks in the 1970s, ceramic implants seem to be a promising alternative to titanium implants. Since the surface of an implant system represents the interface to surrounding biologic structures, the study focuses on cleanliness and surface topography. Clinical documentation of the corresponding systems completes the picture and allows a better evaluation of zirconia implant systems. Materials and methods Five different ceramic implant systems were selected randomly and purchased via blind-shopping: Z5s (Z-Systems), ZiBone (COHO), W implant (TAVDental), ceramic. implant (vitaclinical), and BioWin!/Standard Zirkon Implantat (Champions-Implants/ZV3 system). Three samples of each implant system underwent scanning electron microscopy (SEM) imaging and elemental analysis (EDS). Where appropriate, subsequent Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS) was performed to identify the chemical nature of impurities. Surface topography was evaluated, and a search for clinical trials in the PubMed database, on the websites and by written request to each dental implant manufacturer, was performed. Results Surfaces of Champions implants (ZV3) and Z-Systems implants were relatively clean, whereas the other investigated surfaces of vitaclinical, TAV Dental, and ZiBone implants all displayed organic contaminations on their surfaces. Four of the investigated ceramic implants showed a moderately rough implant surface. Only the vitaclinical ceramic.implant had minimal surface roughness. Three ceramic designs-vitaclinical, ZV3, and Z-Systems-had clinical trials documented with up to 3 years of follow-up and results varying between 82.5% and 100% survival. TAV Dental W and ZiBone implant systems lacked properly conducted clinical recording of results. Conclusion The results of this study showed that it is technically possible to produce zirconia implants that are largely residue-free. On the other hand, the variety of significant residues found in this analysis raises concerns, as contamination may lead to undesirable biologic effects. The lack of clinical studies in peer-reviewed journals does not seem to be relevant for the approval of marketing, nor does the lack of surface cleanliness. In the authors' opinion, a critical analysis of these aspects should be included in a more stringent future analysis prior to the marketing of oral implant systems.

Purpose To investigate the impact of different extents of misfit between a restoration and the supporting implant on veneer fractures in screw-retained implant-supported metal-ceramic fixed dental prostheses (FDPs). Materials and methods A finite element analysis (FEA) model of a five-unit screw-retained metal-ceramic FDP supported by three implants was constructed, replicating a previous in vitro study. Eight different gap configurations at the single terminal implant, ranging from 0 to 150 μm, were tested. All setups were tested after clamping and with a load of 200 N applied. Maximum stress within the FDP was calculated. Results The stress increased with each increase in misfit size above 30 μm, with the relationship between gap size and stress being linear up to 100-μm misfit. Above 100 μm, the stress increase accelerated. The stress pattern within the FDP changed with increasing gap size, confirming the findings of a previously conducted in vitro experiment for a misfit of 150 μm. Conclusion The results of the FEA were in agreement with in vitro observations, validating the predictive value of FEA for technical complications. A misfit between an FDP and a supporting implant implies an increased risk of veneer fracture. Above a misfit of 30 μm, the stress levels are likely to be high enough to cause veneer fracture, and the risk increases disproportionately for misfit above 100 μm.

To assess the influence of several factors on the survival of tooth-supported fixed partial dentures (FPDs) with vital and non-vital abutments.The present retrospective cohort study was based on the records of patients treated with 3-to-7-unit tooth-supported FPDs with a minimum follow-up time of 6 months after prosthesis delivery. Cumulative survival rate (CSR) was calculated over the maximum follow-up period. Cox regression models were used to evaluate the association between the clinical covariates and prosthesis failure.A total of 331 FPDs in 229 patients were included. The CSRs were 90.1% and 77.6% after 5 and 10 years and 67.9% and 52.1% after 15 and 20 years, respectively. Tooth-supported FPD failure was more prevalent within the first years of prosthesis delivery. Loss of one or more abutment teeth and loss of prosthesis retention were the main reasons for failure. Smoking and type of prosthesis material significantly influenced the survival of FPDs. Abutment vitality, position of the non-vital abutment, or prosthesis length did not show any significant influence on the occurrence of prosthesis failure.Smoking and the type of prosthesis material are suggested to contribute to an increased rate of FPD failure irrespective of abutment vitality.

Background Implant-supported fixed partial dentures (ISFPDs) are one of the most common options to rehabilitate partially edentulous patients. Purpose To assess the clinical outcomes of ISFPDs. Methods This retrospective study included all patients treated with ISFPDs with 2 to 6 prosthetic units at one specialist clinic. Implant/prosthesis failure and technical complications were the outcomes analyzed. Results Six hundred and forty-two patients with 876 ISFPDs (2241 implants) were included, followed up for 108.0 ± 76.2 months. Eighty-eight prostheses and 112 implants (26 before, 86 after prosthesis installation) failed. The estimated CSR of ISFPDs at 30 years was 72.7%. Smokers presented lower implant survival than nonsmokers. Two hundred and ninety-nine ISFPDs (33.2%) presented technical complications. Bruxism was a factor to exert a higher risk of screw and implant fracture, and ceramic chipping. ISFPDs with cantilever presented higher risk of failure, and screw loosening/fracture. Prostheses supported by implants with internal abutment connection or with two pontics had higher risk of presenting ceramic chipping. Extension of the prosthesis did not seem to exert influence on prosthesis failure/complications. Conclusions ISFPDs presented good long-term prognosis. Implant failure was the main reason for ISFPD failure. The results suggest that bruxism and the presence of cantilever may contribute to the increased rate of mechanical complications and prosthesis failure.

The purpose of the study was to investigate the influence of multiple factors on the survival of tooth-supported single crowns and assess the biological and technical complications. This retrospective study included patients rehabilitated with single crowns with a minimum follow-up time of 6 months after delivery. The cumulative survival rate was calculated over the maximum period of follow-up time and reported in a life-table survival analysis. Univariate and multivariate Cox regression was used to evaluate the associations between clinical covariates and crown failure. The included cohort group consisted of 1037 single crowns delivered in 401 patients and followed for a mean of 134.8 ± 80.2 months. Cumulative survival rate was 89.9% and 80.9% after 5 and 10 years and 70.5% and 61.8% after 15 and 20 years, respectively. The main reasons for single crown failure were loss of retention, tooth loss, and fracture. Anterior placement, non-vital abutments, and bruxism significantly influenced the survival of single crowns. The survival of single crowns was not influenced by patient's age and sex, location of the crowns in relation to the jaws, type of tooth, presence of post and core, and type of crown material, treatment providers, or smoking. Anterior placement, non-vital abutments, and bruxism are factors suggested to increase the risk of single crown failure and the prevalence of technical and biological complications.

Tooth-supported fixed dental prosthesis (FDP) is one of the most reliable treatment options to replace missing teeth. The longevity of the treatment could, however, be affected by several general and local factors, especially bruxism.To investigate the influence of bruxism on the long-term survival of tooth-supported FDPs in bruxers compared to a matched group of nonbruxers, taking several clinical variables into account.The present retrospective cohort study was based on records of patients treated with 3-7-unit tooth-supported FDPs with a minimum follow-up time of 6 months after prosthesis delivery. The criteria for the diagnosis of "possible" and "probable" sleep or awake bruxism were used. A matched group of nonbruxers was selected on the basis of similarities in four factors, patients' gender and age, number of prosthetic units of the FDPs, and follow-up time. The paired-samplesThe cohort group consisted of 62 noncantilevered FDPs in each group, followed up for a mean of 110.1 and 106.5 months (bruxers and nonbruxers, respectively). Tooth-supported FDPs in bruxers presented significantly higher failure rate than in nonbruxers (32.3% vs. 25.8%, respectively;Bruxism is suggested to increase technical and biological complications and FDP failure.

Objective To investigate how weight loss by different diets impacts postprandial levels of glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and glucagon. Methods In this single-centre, parallel group 2-year trial, 70 healthy postmenopausal obese women were randomised to the Paleolithic diet or a healthy control diet based on Nordic Nutrition Recommendations. Both diets were without calorie restriction. The primary outcome was the change in fat mass. Here, secondary analyses on GLP-1, GIP and glucagon measured during an OGTT are described. Results In the Paleolithic diet group, mean weight loss compared to baseline was 11% at 6 months and 10% at 24 months. In the control diet group, mean weight loss was 6% after 6 and 24 months (P = 0.0001 and P = 0.049 for the comparison between groups at 6 and 24 months respectively). Compared to baseline, the mean incremental area under the curve (iAUC) for GLP-1 increased by 34 and 45% after 6 and 24 months in the Paleolithic diet group and increased by 59% after 24 months in the control diet group. The mean iAUC for GIP increased only in the Paleolithic diet group. The area under the curve (AUC) for glucagon increased during the first 6 months in both groups. The fasting glucagon increase correlated with the β-hydroxybutyrate increase. Conclusions Weight loss caused an increase in postprandial GLP-1 levels and a further rise occurred during weight maintenance. Postprandial GIP levels increased only after the Paleolithic diet. Reduced postprandial glucagon suppression may be caused by a catabolic state.

In this paper, we describe and critically reflect on the possibilities and challenges of developing and implementing an empowerment-based school intervention regarding healthy food and physical activity (PA), involving participants from a Swedish multicultural area characterized by low socioeconomic status. The 2-year intervention was continually developed and implemented, as a result of cooperation and shared decision making among researchers and the participants. All 54 participants were seventh graders, and the intervention comprised health coaching, health promotion sessions and a Facebook group. We experienced that participants valued collaborating with peers, and that they took responsibility in codeveloping and implementing the intervention. Participants expressed feeling listened to, being treated with respect and taken seriously. However, we also experienced a number of barriers that challenged our initial intentions of aiding participation and ambition to support empowerment. Moreover, it was challenging to use structured group health coaching and to work with goal-setting in groups of participants with shared, and sometimes competing, goals, wishes and needs related to food and PA. Successful experiences from this intervention was the importance of acquiring a broad and deep understanding of the context and participants, being open to negotiating, as well as adjusting the intervention.

Objectives To measure and compare the size of the cement gap of wax and polymer copings and final glass-ceramic crowns, produced from conventional and digital workflows, one additive and one subtractive. Methods Thirty wax copings were made by conventional manual layering technique and modeling wax on stone models with spacer varnish simulating a cement spacer. The wax copings were embedded and press-cast in lithium disilicate glass ceramic. Thirty wax copings were produced by milling from a wax blank, i.e. subtractive manufacturing, and thirty polymer burn-out copings were produced by stereolithography, i.e. additive manufacturing. These copings were embedded and press-cast in lithium disilicate glass ceramic in the same manner as the conventional group. The fit of the wax/polymer copings and subsequent crowns was checked using an impression replica method. Mean values for cement gap for marginal, axial, and occlusal areas were calculated and differences were analyzed using Student’s t-test. Results There were significant differences in mean values for accuracy/production tolerance among different manufacturing techniques for both production stages: wax and polymer copings and final pressed glass-ceramic crowns. In general, crowns produced from a digital additive workflow showed smaller mean cement gaps than crowns produced from a conventional workflow or a digital subtractive workflow. Additive polymer copings showed significantly smaller cement gaps than milled wax copings (p ≤ .001) and conventional wax copings (p ≤ .001) in the axial area. In the occlusal area, both additive polymer copings and conventional wax copings showed significantly smaller cement gaps than milled wax copings (p = .002 and p ≤ .001 respectively). Crowns produced from conventional manual build-up wax copings showed significantly larger mean cement gaps than crowns produced from milled wax and additively manufactured polymer copings in the marginal and axial areas (p ≤ .001). Among the crowns with smaller cement gaps, crowns produced from additively manufactured polymer copings showed significantly smaller mean cement gaps than crowns produced from milled wax in the marginal and axial areas (p ≤ .001). In the occlusal areas, the differences in mean cement gaps were only statistically significant between crowns produced from conventional manual build-up wax copings and crowns produced from milled wax where the latter ones showed smaller mean cement gaps (p = .025). Significance The present study suggests that an additive manufacturing technique produces smaller mean cement gaps in glass-ceramic crowns than a conventional or subtractive manufacturing technique.

The second most common biological complication in fixed prosthodontics is loss of pulp vitality, which may lead to restoration loss. While reasons for loss of pulp vitality are unclear, 2 potential contributing factors, duration of the interim restoration and operator experience, have not been fully investigated.The purpose of this retrospective study was to investigate whether the duration of the interim restoration or the experience of the dentist was correlated with loss of pulp vitality.Fixed prosthetic restorations placed between 2005 and 2012 were retrospectively analyzed. Abutment teeth supporting single-unti or multiunit restorations were evaluated regarding loss of pulp vitality. The Mann-Whitney U test and simple logistic regression were used, with α=.05 for the subsequent multiple logistic regression. The experience of dental professionals was defined by the number of treatments performed and coupled with failure rate by using an analysis of variance.One hundred seventy-four dentists made 15 879 restorations, of which 1136 failed during the observation period, a failure rate of 7.2%. Two hundred fifty restorations were randomly selected from the failed restorations, and a corresponding 250 restorations were randomly selected from nonfailed restorations for the control group. Increased duration with interim replacement was linked to a higher risk of loss of pulp vitality (P.001). Failure rate in the dentist group varied from 0% to 100%. No significant differences in failure rate were found among dentists who did few restorations and those who performed larger numbers of restorations.The results of the present study suggest that operator experience does not affect failure rate. However, extended time with an interim restoration was a contributing factor to the loss of pulp vitality.

Purpose To systematically evaluate and compare the clinical performance of lithium disilicate (LDS)- and zirconium dioxide (ZrO2)-based ceramic monolithic crowns in the posterior dentition. Materials and methods Treatment was administered by two experienced general dental practitioners in two public dental health care clinics. Forty-four patients received 60 crowns randomized to be either LDS or ZrO2 and cemented with resin cement. Evaluations were performed after 3 years using California Dental Association criteria. Results The mean follow-up time was 40 months (range: 31 to 50). No crown fractured during the observation time, and no chip-off fractures occurred. The success rate for ZrO2 was 80%, and the survival rate was 93.3%. For LDS, the success rate was 89.7%, and the survival rate was 100%. Survival after 3 years for all crowns together was 96.6%, and success was 84.7%. There was no significant difference between the two materials. Conclusion Crowns made of monolithic translucent ZrO2 and LDS show equal and promising clinical results from a short-term perspective. There seems to be a difference between how patients and professionals rate crowns concerning esthetics (color and shape), with patients rating the restorations more favorably.

Purpose To assess the clinical outcomes of maxillary overdentures supported by dental implants by conducting a literature review. Materials and methods An electronic search was undertaken in March 2019. Eligibility criteria included publications reporting cases of implant-supported maxillary overdentures with follow-up information. Results A total of 131 publications were included (1,478 overdentures supported by 6,681 implants). The mean number of attachments per overdenture was 3.8 ± 1.2 (range: 1 to 9), and a bar-clip system was used in about half of the cases. The prostheses were followed up for a mean of 47.9 ± 32.8 (range 1: to 240) months. A total of 401 implants (6.0%) failed in 219 patients (14.8%), and 55 prostheses (3.7%) failed at a mean of 40.2 ± 53.2 (6 to 240) months after placement. Most of the failures happened within the first year after placement for both implants (52.1%) and prostheses (41.8%). Patients with fewer implants per prosthesis presented higher prosthesis failure rates than patients with more implants per prosthesis. The cumulative survival rate for dental implants after 19 years was 70.4%, and for implant-supported maxillary overdentures was 79.8%. Presence of palatal coverage and/or metallic structure/reinforcement does not seem to have an influence on failure rate. Of the most commonly used attachment systems, the ball/O-ring and the Ceka were the ones with the highest rates of patients having at least one implant failure. Conclusion Most of the prosthesis failures were due to loss of implants, and the first year was the most critical period for failures. The number of dental implants placed per patient seemed to have an impact on the occurrence of overdenture failure.

Objective The aim of this review was to investigate the evidence correlating the emergence profile (EP) and emergence angle (EA), peri-implant tissue height, implant neck design, abutment and/or prosthesis material, retention and connection types with risk of peri-implant mucositis and peri-implantitis. Methods Seven focus questions were identified, and seven electronic search queries were conducted in PubMed. Human studies reporting on bleeding on probing, probing depth or case definitions of peri-implant mucositis and peri-implantitis were included. Results Emerging evidence with bone-level implants suggests a link between EA combined with convex EP and peri-implantitis. Depth of the peri-implant sulcus of ≥3 mm is shown to be reducing the effectiveness of treatment of established peri-implant mucositis. Modification of the prosthesis contour is shown to be an effective supplement of the anti-infective treatment of peri-implant mucositis. Limited evidence points to no difference with regard to the risk for peri-implant mucositis between tissue- and bone-level implants, as well as the material of the abutment or the prosthesis. Limited evidence suggests the use or not of prosthetic abutments in external connections and does not change the risk for peri-implantitis. Literature with regard to prosthesis retention type and risk for peri-implantitis is inconclusive. Conclusions Limited evidence indicates the involvement of EA, EP, sulcus depth and restricted accessibility to oral hygiene in the manifestation and/or management of peri-implant mucositis/peri-implantitis. Conclusions are limited by the lack of consensus definitions and validated outcomes measures, as well as diverse methodological approaches. Purpose-designed studies are required to clarify current observations.

The aim of this study was to compare the clinical outcomes of implant-supported overdentures (ODs) with either bar-clip or ball attachments. The implant, prosthesis failure, and technical complications were the outcomes analyzed in this retrospective clinical study conducted in a specialty clinic. Seventy-five patients with 242 implants supported by 76 ODs (36 maxillary, 40 mandibular) were included in the study and followed up for 88.8 ± 82.9 months (mean ± standard deviation). Bar-clip and ball attachments were used in 78.9% and 21.1% of the cases, respectively. Forty-three implant failures (17.8%) in 17 prostheses (17/76; 22.4%) were observed in this study. The average period of implant failure was 43.3 ± 41.0 months, and most of them were maxillary turned implants. The bar-clip system demonstrated more complications in the attachment parts compared to the ball attachment system. Poor retention of the prosthesis was similar between the two systems. Loss of implants resulted in the failure of 10 ODs in this study. ODs opposed by natural dentition or fixed prostheses presented with more complications. The Cox proportional hazards model did not show a significant effect on prosthesis failure for any of the factors. These findings indicated that patients with ODs need constant maintenance follow-ups to address the technical complications and perform prosthodontic maintenance regardless of the attachment system used.

Background Recently we provided evidence for a leptin-independent homeostatic regulation, the gravitostat, of body weight in rodents. The aim of the present translational proof of concept study was to test the gravitostat hypothesis in humans. Methods We conducted a randomized controlled single center trial (ClinicalTrial.gov number, NCT03672903), to evaluate the efficacy of artificially increased weight loading on body weight in subjects with mild obesity (BMI 30–35 kg/m2). Subjects were either treated with a heavy (=high load; 11% of body weight) or light (=low load; 1% of body weight) weight vest for eight hours per day for three weeks. The primary outcome was change in body weight. Secondary outcomes included change in body fat mass and fat-free mass as measured using bioelectrical impedance analysis. Findings In total 72 participants underwent randomization and 69 (36 high load and 33 low load) completed the study for the primary outcome. High load treatment resulted in a more pronounced relative body weight loss compared to low load treatment (mean difference -1.37%, 95% confidence interval (CI), -1.96 to -0.79; p = 1.5 × 10−5). High load treatment reduced fat mass (-4.04%, 95% CI, -6,53 to -1.55; p = 1.9 × 10−3) but not fat free mass (0.43%, 95% CI, -1.47 to 2.34; p = 0.65) compared to low load treatment. Interpretation Increased weight loading reduces body weight and fat mass in obese subjects in a similar way as previously shown in obese rodents. These findings demonstrate that there is weight loading dependent homeostatic regulation of body weight, the gravitostat, also in humans. Funding Funded by Jane and Dan Olsson (JADO) Foundation, the Torsten Soderberg Foundation, The Knut and Alice Wallenberg's Foundation and the Novo Nordisk Foundation.

BACKGROUND: The oral rehabilitation with fixed restorations supported by the combination of teeth and dental implants has been advocated in some cases. PURPOSE: To assess the clinical outcomes of these prostheses. Fixed restorations supported by the combination of teeth and dental implants. MATERIALS AND METHODS: This retrospective study included all patients treated with combined tooth-implant-supported fixed dental prostheses (FDPs) at one specialist clinic. Abutment/prosthesis failure and technical complications were the outcomes analyzed. RESULTS: A total of 85 patients with 96 prostheses were included, with a mean follow-up of 10.5 years. Twenty prostheses failed. The estimated cumulative survival rate was 90.7%, 84.8%, 69.9%, and 66.2% at 5, 10, 15, and 20 years, respectively. The failure of tooth and/or implant abutments in key positions affected the survival of the prostheses. There were seven reasons for prostheses failure, with the loss of abutments exerting a significant influence. Bruxism was possibly associated with failures. Prostheses with cantilevers did not show a statistically significant higher failure rate. No group had a general higher prevalence of technical complications in comparison to the other groups. CONCLUSIONS: Although combined tooth-implant-supported FDPs are an alternative treatment option, this study has found that across 20 years of service nearly 35% the prostheses may fail.

Purpose To evaluate the influence of the framework designs on the stress distribution within tooth-supported partially veneered fixed dental prostheses (FDPs) made of translucent zirconia under simulated loads using a three-dimensional finite element analysis (3D-FEA). Material and methods For a linear 3D-FEA, simplified 3D solid models of prepared abutment teeth (first premolar and first molar) with different 3-unit FDPs were created. The models with different FDP designs-monolithic zirconia (control); semi-monolithic zirconia with 0.3 mm veneer thickness (SM0.3); semi-monolithic zirconia with 0.5 mm veneer thickness (SM0.5); semi-monolithic zirconia with 0.5 mm veneer thickness supported with cap design (SMC), and semi-monolithic zirconia with 0.5 mm veneer thickness supported with wave design (SMW)-were analyzed using 3D-FEA. The elastic properties of the components (bone, dentine, cement, translucent zirconia, and veneering porcelain) were obtained from the published data for FEA. Simulated static loading forces (300 N) were applied at 10° oblique direction over six points in the occlusal surfaces of the FDPs. Maximum principal stress, shear stress, and safety factor were calculated and analyzed among the different models. Results Semi-monolithic with cap design showed the smallest maximum principal stress levels in the veneering porcelain compared to all other models (SM0.3, SM0.5, SMW). The SM0.3 had lower maximum principal stress levels in the veneering porcelain compared to SM0.5. Regarding stresses in the zirconia framework, all models had comparable results in maximum principal tensile stresses, except SMW had a lower value. Maximum principal stress levels were located in the veneer component of SM0.3, SM0.5, and SMW, whereas, such levels were observed in the cervical areas of the zirconia frameworks of SMC and control. The SM0.3 had the highest maximum shear stress levels at the zirconia-veneer interface, while SMW had the lowest shear values. The 3D-FEA models with different FDP designs showed different minimum safety factor levels. Conclusions Framework and veneer designs play a significant role in the stress distribution of the partially veneered zirconia FDPs under loading. The FDPs with zirconia frameworks with cap design minimize the maximum principal tensile stress in the veneering porcelain. The FDPs with 0.3-mm-veneering porcelain show low maximum principal tensile stress in the veneering porcelain, but highest maximum shear stress at the zirconia-veneer interface. The FDPs with wave design of zirconia frameworks minimize the maximum shear stress considerably.

OBJECTIVE: To assess the outcomes of implant-supported full-arch fixed dental prostheses (ISFAFDPs) and the supporting implants. MATERIAL AND METHODS: This retrospective study included patients treated with ISFAFDPs at one specialist clinic. Implant/prosthesis failure and complications were the outcomes analyzed. Survival analysis methods were used. RESULTS: A total of 709 patients with 869 ISFAFDPs (4,797 implants) were included, with a mean ± SD follow-up of 10.7 ± 7.2 years. A total of 353 implants and 62 prostheses failed. Estimated cumulative survival rates were as follows: 93.3% (95% CI 91.3, 95.3) after 10 years and 87.1% (95% CI 83.4, 90.8) after 20 years. Implants installed in bruxers, smokers, and maxilla had a lower survival than implants installed in non-bruxers, non-smokers, and mandible, respectively. A total of 415 ISFAFDPs (47.8%) presented technical complications, of which 67 (7.7%) presented only occurrences of loss/fracture of implant access hole sealing. Bruxism was a factor to exert a higher risk of screw loosening (HR 3.302; also in younger patients), screw fracture (HR 4.956), ceramic chipping/fracture (HR 5.685), and loss/fracture of acrylic teeth (HR 2.125; this last complication with higher risk also in men, in maxillae, and when the opposing jaw presented natural dentition or fixed prostheses). Patients with bruxism had a statistically significant higher risk of prosthesis failure than non-bruxers (HR 3.276). CONCLUSIONS: ISFAFDPs presented good long-term prognosis. Failure of several supporting implants was the main reason for failure. The results of the present study strongly suggest that bruxism is an important contributor to implant and prosthesis failure, as well as to an increased prevalence of technical complications in ISFAFDPs.

Developing healthy eating behaviours is important to assist children in maintaining good health and decrease the risk of chronic health conditions. Recent nutrition promotion efforts in Australian primary schools have mainly focused on canteen guideline compliance and obesity prevention interventions. The aim of this study was to investigate the primary school food environment, specifically, allocated lunch eating duration and the governance of children's lunch breaks. Parents (n = 402) and teachers (n = 123) were asked via an online survey, about school allocated lunch eating duration and its adequacy. Respondents were asked about the supervision, monitoring and feedback of children's lunches, as well as how they felt about these practices. Parents (n = 308) and teachers (n = 102) also responded to the open-ended question “What could be done to improve the school food environment at your school?“. Ten minutes was the allocated lunch eating duration reported by most parents and teachers and 54% of those parents and 30% of those teachers rated this as inadequate. Increasing the allocated lunch eating duration was frequently cited as a way to improve the school food environment. A similar proportion of parents and teachers agreed with teachers monitoring food intake, not providing feedback on food brought to school, and that parents should decide what children eat. More parents (44%) than teachers (23%) believed that teachers should eat their own lunch with the children. These findings provide an insight into the primary school lunch environment and the views of two key stakeholder groups. School food policies should consider these findings in future revisions, particularly with regards to eating times.

PURPOSE To investigate the load-bearing capacity and failure mode of monolithic zirconia fixed dental prostheses (FDPs) fabricated with different connector designs and embrasure shaping methods. MATERIALS AND METHODS Seventy four-unit zirconia FDPs (with two premolar pontics) were fabricated and divided into seven groups (n = 10) according to the different connector designs gained by using different embrasure shaping methods. The groups were as follows: monolithic FDPs fabricated with sharp embrasures, monolithic FDPs fabricated with blunt embrasures, monolithic FDPs fabricated with blunt embrasures and no occlusal embrasures, two groups of monolithic FDPs fabricated with blunt embrasures and interproximal separations made with diamond discs at the soft stage and at the fully sintered stage, and monolithic FDPs fabricated with blunt embrasures and interproximal separation accentuated by localized porcelain build-up. A final group was used as a control group, where fully veneered traditional zirconia FDPs were fabricated with default milling settings. The FDPs were artificially aged and loaded to fracture. Load to fracture and failure modes were analyzed by one-way ANOVA, Tukey's post hoc test, and Fisher exact test (α = 0.05). RESULTS The FDPs fabricated with interproximal porcelain separation showed significantly the highest load to fracture (1038 N ± 82) of all groups (p < 0.001), with no significant difference compared to the FDPs with no occlusal embrasures (934 N ± 175; p ˃ 0.29). The FDPs fabricated with blunt embrasures showed significantly higher load to fracture (873 N ± 115) compared to the FDPs in the control group (689 N ± 75) and the FDPs with sharp embrasures (417 N ± 87; p < 0.001). There were no significant differences between the FDPs with sharp embrasures (417 N ± 87) and the FDPs with interproximal disc separations (467 N ± 94; p ˃ 0.23). Failure mode of the FDPs fabricated with sharp embrasures and interproximal disc separations differed significantly compared to the FDPs in the other groups (p < 0.001). CONCLUSIONS Sharp embrasures and interproximal separations made with diamond discs significantly decrease the load-bearing capacity of monolithic zirconia FDPs compared to FDPs made with blunt embrasures. Blunt embrasures in combination with localized porcelain build-up produce FDPs with high load-bearing capacity in relation to loads that might be expected under clinical use.

The aim of this study is to explore conditioning factors influencing learning opportunities in food-related education taught from a perspective of sustainable development. Over the course of the ei...

Aim: Self-assessment ability is a crucial skill for any professional. Training self-assessment leads to improved capabilities and should be performed continuously during the dental education. Usin ...

Nutritional epidemiology is an inherently complex and multifaceted research area. Dietary intake is a complex exposure and is challenging to describe and assess, and links between diet, health, and disease are difficult to ascertain. Consequently, adequate reporting is necessary to facilitate comprehension, interpretation, and generalizability of results and conclusions. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement is an international and collaborative initiative aiming to enhance the quality of reporting of observational studies. We previously presented a checklist of 24 reporting recommendations for the field of nutritional epidemiology, called "the STROBE-nut." The STROBE-nut is an extension of the general STROBE statement, intended to complement the STROBE recommendations to improve and standardize the reporting in nutritional epidemiology. The aim of the present article is to explain the rationale for, and elaborate on, the STROBE-nut recommendations to enhance the clarity and to facilitate the understanding of the guidelines. Examples from the published literature are used as illustrations, and references are provided for further reading. Funding Agencies|Forte grantt hrough the Swedish Network in Epidemiology and Nutrition (NEON) [2013-0022]; Research Foundation-Flanders (FWO) [G0D4815N]; Schlumberger Foundation; Medical Research Council [MR/L02019X/1]

OBJECTIVE: Abdominal fat accumulation after menopause is associated with low-grade inflammation and increased risk of metabolic disorders. Effective long-term lifestyle treatment is therefore neede ...

Background The aim of this study was to investigate the micromorphological differences among three commercially available titanium abutments on Straumann implants. Furthermore, the possible impact of functional loading on the micromorphology and potential complications was investigated with the use of in vitro testing. Material and methods Three groups of Titanium abutments (A: Straumann Variobase n = 5, B: EBI best Duo n = 5, and C: Implant Direct n = 5) were torqued on Straumann RN implants, as according to each of the manufacturer's instructions. The implant–abutment units were scanned with Micro-CT. Three units of each group were directly sliced in the microtome and photographed under different magnifications (10×–500×) through a Scanning Electron Microscope. Six units (two from each group) were restored with cement-retained crowns, subjected to 2000,000 load cycles with loads between 30 and 300 N at 2 Hz, examined through Micro-CT and finally sliced and photographed as described above. The micromorphology of each unit was studied, and the total length of tight contact (

BACKGROUND Long-term success of implant-supported restorations can be affected by the accuracy of the prosthodontic workflow which may differ between conventional and digital techniques. PURPOSE The purpose was to compare the fit of two-implant-supported restorations, fabricated using conventional and digital workflows and to assess the influence of distance and angulation between the implants on the passive fit of the prosthesis. The SR test was selected to evaluate the fit of two-implant-supported zirconia restorations. MATERIALS AND METHODS Forty-eight zirconia two-implant-supported restorations were fabricated according to conventional (group C, n = 24) and digital (group D, n = 24) workflows. The SR parameter was calculated as a difference of rotation angles of each screw in passive and nonpassive situations. SR values between groups C and D were compared by performing measurements intraorally, on master and control casts. RESULTS SR intraorally in group C (16.25 ± 15.52°) was higher than it was in group D (13.85 ± 10.78°), but the difference was not statistically significant (P = .557). While measuring SR on the master cast, group C SR (6.04 ± 7.43°) had lower values than group D (13.12 ± 13.86°) (P = .0039). No statistically significant correlations were found between SR measurements and inter-implant distance or angulation. Restorations with inter-implant angle higher than 10° differed significantly from those with less than 10° angulation. CONCLUSIONS Digital restorations had a better fit on the control cast, which was used as a reference in this study. Angulation of more than 10° between the implants could negatively affect the passive fit of the digitally fabricated restorations intraorally.

(1) Background: This paper aimed to compare the cleanliness of clinically well-documented implant systems with implants providing very similar designs. The hypothesis was that three well-established implant systems from Dentsply Implants, Straumann, and Nobel Biocare were not only produced with a higher level of surface cleanliness but also provided significantly more comprehensive published clinical documentation than their correspondent look-alike implants from Cumdente, Bioconcept, and Biodenta, which show similar geometry and surface structure. (2) Methods: Implants were analyzed using SEM imaging and energy-dispersive X-ray spectroscopy to determine the elemental composition of potential impurities. A search for clinical trials was carried out in the PubMed database and by reaching out to the corresponding manufacturer. (3) Results: In comparison to their corresponding look-alikes, all implants of the original manufacturers showed&mdash, within the scope of this analysis&mdash, a surface free of foreign materials and reliable clinical documentation, while the SEM analysis revealed significant impurities on all look-alike implants such as organic residues and unintended metal particles of iron or aluminum. Other than case reports, the look-alike implant manufacturers provided no reports of clinical documentation. (4) Conclusions: In contrast to the original implants of market-leading manufacturers, the analyzed look-alike implants showed significant impurities, underlining the need for periodic reviews of sterile packaged medical devices and their clinical documentation.