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Τρίτη 16 Αυγούστου 2022

Survival rates, patient satisfaction, and prosthetic complications of implant fixed complete dental prostheses: A 12‐month prospective study

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Abstract

Purpose

To determine the survival rate, incidence of prosthetic complications and patient satisfaction of implant fixed complete dental prostheses (IFCDPs) after a mean observation period of 1.4 years.

Materials and Methods

Twenty-eight (28) eligible participants were recruited according to specific inclusion and exclusion criteria. The definitive metal-acrylic resin IFCDPs consisted of titanium bars veneered with acrylic resin and acrylic denture teeth. Prosthodontic complications, divided into major and minor, were monitored. Parameters such as gender, jaw location, bruxism, and occlusal scheme were evaluated. Moreover, a questionnaire was administered throughout the study to assess patient satisfaction. Poisson regression as well as repeated measures ANOVA were used for statistical analysis.

Results

Fourteen (14) males and 14 females were enrolled and followed-up at 3, 6, and 12 months. All IFCDPs survived (100% survival rate). The most frequent minor complication was the loss of material used to close the screw access hole (20% out of total complications). The most frequent major complication was chipping of the acrylic denture teeth (77.14% out of total complications). Gender (P = 0.008) and bruxism (P = 0.030) were significant predictors for the total major complications (major wear and major chipping) while occlusal scheme was a significant predictor for major chipping events (P = 0.030).

Conclusions

While IFCDPs demonstrated high prosthetic survival rates, they also exhibited a high number of chipping events of the acrylic veneering material, especially in males, bruxers, and individuals with canine guidance occlusion. However, the occurrence of these prosthetic complications did not negatively affect patient satisfaction.

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Influence of geometric dimensions on early failures of adhesively retained composite resin core build‐ups

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Abstract

Objective

To determine the influence of the geometric dimensions of core build-ups on early core build-up failure, that is, loss before definitive prosthesis cementation.

Materials and Methods

Adhesive core build-ups of exclusively vital teeth in 114 participants were evaluated (n materials: 40 Rebilda DC, 38 Multicore Flow, 36 Clearfil DC Core; n teeth: 8 incisors, 54 premolars, 52 molars). Impressions of the abutment teeth were made (1) after removal of insufficient restorations/caries and (2) after core build-up and preparation for a fixed prosthesis. Digitized model surfaces of both situations were aligned (Geomagic Design X) and core build-up volume (V CBU), remaining hard tissue volume (V Abut), and size of the adhesive surface (A adh) were assessed. The derived measure d CBU = V CBU/A adh can be interpreted as mean arithmetic core build-up thickness. Associations between participant or core build-up design characteristics and the occurrence of early failures were statistically evaluated (SPSS v27, α = 0.05).

Results

A total of six (5.3%) core build-up failures were registered. Higher participant age, greater core build-up volume V CBU and greater arithmetic uniform thickness d CBU were associated with a greater incidence of failure in bivariate and univariate, however, not in multivariate statistics.

Conclusions

Core build-up volume and thickness were associated with early success or failure.

Clinical Significance

In the case of voluminous/thick core build-ups in relation to the adhesive surface, additional measures, such as the preparation of retentive elements to increase the bonding area, might be considered to reduce the risk of early core build-up failure.

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Stability of nasal symmetry following primary cleft lip and nasal repair: five years of follow-up

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Despite advances in cleft lip treatment, various levels of residual deformity remain after primary repair of cleft lip and palate. The aim of the current study was to compare the stability of short- and long-term postoperative nasal symmetry. This retrospective study included 100 consecutive non-syndromic patients with unilateral complete cleft lip who underwent primary cleft lip repair with follow-up of 5 years. Measurements taken from basal and frontal standard photograph views, obtained preoperatively (T1) and immediately (T2), 1 year (T3), and 5 years postoperative (T4), were analysed. (Source: International Journal of Oral and Maxillofacial Surgery)
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Evaluation of off‐label anti‐vascular endothelial growth factor and steroid implant medication uses in macular edema due to retinal vein occlusion

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Evaluation of off-label anti-vascular endothelial growth factor and steroid implant medication uses in macular edema due to retinal vein occlusion in Turkey

Retinal vein occlusion (RVO) is one of the most common causes of vision loss. Anti-vascular endothelial growth factor (anti-VEGF) drugs and corticosteroid implants are approved as the standard treatment options for RVO. In this study, we aimed to review the applications for off-label drug use for RVO to the Turkish Medicines and Medical Devices Agency in 2018. Majority of the drugs requested for off-label use were anti-VEGF agents, followed by a potent corticosteroid dexamethasone implant. No applications were made for bevacizumab since its use does not require official permission. In the beginning of the 2019, substantial regulations were imposed for the intravitreal drug use principles for RVO in Turkey. Administration of three consecutive doses of off-label bevacizumab have become mandatory before utilizing licensed drugs for RVO (ranibizumab, aflibercept and dexamethasone implant). This study reports off-label drug preferences and previous and current principles of drug use fo r RVO in Turkey.


Abstract

What is Known and Objective

Retinal vein occlusion (RVO) is one of the most common causes of vision loss. Anti-vascular endothelial growth factor (anti-VEGF) drugs, ranibizumab and aflibercept, and corticosteroid implants are approved treatment options for RVO-related macular edema (ME) in Turkey. To the best of our knowledge, there is no data regarding the off-label use of these drugs for RVO in English literature. We aimed to evaluate the clinical and demographic characteristics of off-label drug use applications in Turkey for RVO.

Methods

Applications made to the Turkish Medicines and Medical Devices Agency between January 1 and December 31, 2018, for the use of off-label drugs (ranibizumab, aflibercept, dexamethasone implant) for the diagnosis of RVO from hospitals across Turkey were retrospectively analysed. Data of the applications, such as demographic characteristics, previous treatment regimens, reasons for applications, applicant hospitals and their regions, were recorded.

Results

There were 291 approved applications for RVO. The mean age of the patients was 64.88 ± 10.78 years, 48.8% were male, and 51.2% were female. Of these applications, 44.7% were for aflibercept, 35.7% for ranibizumab and 19.6% for dexamethasone implant. No application was made for bevacizumab since it could be used without needing for an application. The most common reasons for applications were due to dose limitations, failure to complete loading doses, and glaucoma, respectively. In terms of the distribution of the applicant hospitals, public university hospitals ranked first with 72.5%, training and research hospitals ranked second with 14.7% and foundation university hospitals ranked third with 13.1% rates.

What is New and Conclusion

The practice of drug use in RVO in Turkey has changed as of the beginning of 2019. Stepwise therapy has been accepted by the drug regulatory agency Turkish Medicines and Medical Devices Agency. Utilization of licensed drugs, aflibercept, ranibizumab and dexamethasone has been allowed only after administration of 3 doses of intravitreal bevacizumab. After 3 doses of bevacizumab, the physician may continue either with bevacizumab again or a dexamethasone implant. If there is a reason such as the presence of glaucoma, the physician may skip dexamethasone and switch to aflibercept and ranibizumab, but in this case, dexamethasone cannot be administered to the patient for life. The evaluation of the off-label treatments of RVO, which is one of the most frequently followed diseases in retina clinics, not only contributes to the literature but also provides information regarding the most frequently applied treatments and the physicians' off-label drug preferences for RVO.

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Periodontal ligament fibroblasts-derived exosomes induced by PGE2 inhibit human periodontal ligament stem cells osteogenic differentiation via activating miR-34c-5p/SATB2/ERK

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Publication date: Available online 15 August 2022

Source: Experimental Cell Research

Author(s): Chen Lin, Yingying Yang, Yingxue Wang, Heng Jing, Xinyi Bai, Zheng Hong, Chunxiang Zhang, Hui Gao, Linkun Zhang

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Translational Significance of CDKN2A/B Homozygous Deletion in IDH-Mutant Astrocytoma

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Abstract
Isocitrate dehydrogenase (IDH) 1 or 2 mutations confer a favorable prognosis compared to IDH-wildtype in astrocytoma, frequently denoting a lower grade malignancy. However, recent molecular profiling has identified specific aggressive tumor subgroups with clear clinical prognostic implications that are independent of histologic grading. The homozygous deletion of CDKN2A/B is the strongest implicated independent indicator of poor prognosis within IDH-mutant astrocytoma, and the identification of this alteration in these lower histologic grade tumors transforms their biology toward an aggressive grade 4 phenotype clinically. CDKN2A/B homozygous deletion is now sufficient to define a grade 4 tumor in IDH-mutant astrocytomas regardless of histologic appearance, yet there are currently no effective molecularly informed targeted therapies for these tumors. The biologic impact of CDKN2A/B homozygous deletion in IDH-mutant tumors and the optimal treatmen t strategy for this molecular subgroup remains insufficiently explored. Here we review the current understanding of the translational significance of homozygous deletion of CDKN2A/B gene expression in IDH-mutant astrocytoma and associated diagnostic and therapeutic implications.
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