Customized Root-Analogue Implants: A Review on Outcomes from Clinical Trials and Case Reports

(1) It is estimated that 10% of the world’s population will need a dental implant in their lifetime. Despite all the advances in the comprehension of dental implant designs, materials and techniques, traditional implants still have many limitations. Customized root-analogue implants are, therefore, gaining increased interest in dental rehabilitation and are expected to not only preserve more hard and soft tissues but also avoid a second surgery and improve patient overall satisfaction. In this sense, the aim of this review was to collect and analyse the clinical trials and case reports on customized root-analogue implants available in the literature; (2) This review was carried out according to the PRISMA Statement. An electronic database search was performed using five databases: PubMed, Google Scholar, Medline, Science Direct, and Scopus. The following keywords were used for gathering data: custom-made, dental implants, root-analogue, anatomical, customized and tooth-like; (3) 15 articles meeting the inclusion criteria—articles reporting clinical trials, case reports or animal studies and articles with root-analogue implants and articles with totally customized implant geometries—were selected for the qualitative synthesis. The design and manufacturing techniques, implant material and surface treatments were assessed and discussed; (4) The performance of some root-analogue implants with specific features (i.e., macro-retentions) was successful, with no signs of infection, periodontitis nor bleeding during the follow-up periods.     

Sophrology versus resistance training for treatment of women with fibromyalgia: A randomized controlled trial

IntroductionPhysical training has been recommended to improve overall well-being in patients with fibromyalgia. Body relaxation exercises also seem to have some beneficial effect, however there is no consensus regarding this modality.ObjectiveComparing the effectiveness of sophrology and resistance training in improving the pain of women with fibromyalgia.MethodA randomized controlled clinical trial with a blind evaluator. Sixty (60) women with a medical diagnosis of fibromyalgia were randomized and included in two groups: sophrology group (SG) who participated in a relaxation program based on sophrology (n = 30), and resistance group (RG) (n = 30) who participated in a resistance training program for biceps, pectoral, triceps, knee extensors, trapezius, knee flexors, hip abductors. Both groups were treated twice a week for 12 weeks and reevaluated every 4 weeks. The assessment instruments used were the Visual Analog Scale for Pain (VAS), the one-repetition maximum test (1 RM), the overall quality of life (SF-36), the 6-min walk test (6MWT), the Timed Up and Go test (TUG) and the Fibromyalgia Impact Questionnaire (FIQ).ResultsWe found that the RG presented statistically significant decreases in pain (VAS) during the evaluations (p < 0.05) and increased strength of the evaluated muscles (p < 0.05). A statistically significant decrease in pain (p < 0.05) was observed in the SG compared to T0, with no significant differences in muscle strength. Differences between groups were observed, with better indices only for 6MWT and functional capacity domain of the SF36 for the RG (p < 0.05).ConclusionNo differences in pain were found between the groups. Resistance training was more effective than sophrology in improving strength and functional capacity of women with fibromyalgia.     

Influence of Esophageal Motility on Esophageal Speech of Laryngectomized Patients

After laryngectomy for treatment of cancer of the larynx, the patient may have vocal rehabilitation by esophageal speech. Some patients fail to achieve the esophageal speech due to reasons involving surgery, radiotherapy, and psychological alterations. Our hypothesis is that the esophageal motility alterations consequent to laryngectomy may be involved in the failure to achieve esophageal speech. Using manometry with continuous perfusion, we studied the esophageal motility of 25 laryngectomized patients, 10 of them able to produce esophageal speech and 15 unable to produce esophageal speech, and 40 asymptomatic normal volunteers. The lower esophageal sphincter (LES) pressure was measured by the rapid pull-through method and the upper esophageal sphincter (UES) pressure by the station pull-through method. The contractions were measured at 5, 10, and 15 cm above the LES after the subjects performed 10 swallows with a 5-mL bolus of water. By comparing volunteers and laryngectomized patients, we found a lower UES pressure, lower amplitude of contractions, and increased percentage of simultaneous contractions in laryngectomized patients (p <0.05). There was no difference between patients able and unable to produce esophageal speech in LES and UES pressure, esophageal contraction duration and velocity, or in the percentage of failed and simultaneous contractions. The esophageal contraction amplitude was lower in patients who acquired esophageal speech than in patients who did not (p <0.05 at 10 cm from LES). We conclude that there are esophageal motility alterations in laryngectomized patients but only the decrease of esophageal contraction amplitude seems to be associated with the acquisition of esophageal speech.     

Diminished Retention of Food in the Proximal Stomach Correlates with Increased Acidic Reflux in Patients with Gastroesophageal Reflux Disease and Dyspeptic Symptoms

This work aimed at evaluating the intragastric distribution of food in patients with GERD and dyspepsia and its relationship to acidic reflux episodes. Gastric emptying and food retention in the proximal stomach were evaluated by scintigraphy in 12 healthy subjects and 19 patients with GERD and dyspepsia after a liquid test meal. Patients also underwent 24-hr esophageal pH monitoring, which included a 2-hr postprandial period following a similar test meal. Total gastric emptying was similar in patients and controls, whereas proximal gastric retention (AUCprox/AUCtot) was significantly decreased in patients (mean +/- SD: 0.48 +/- 0.07 vs. 0.56 +/- 0.06; P = 0.02). Within the GERD-dyspepsia group, a significant negative correlation was found between proximal gastric retention and the number of acidic reflux episodes. We concluded that abnormally decreased retention of gastric contents in the proximal stomach after a liquid meal may contribute to the pathogenesis of acidic reflux episodes in patients with GERD and dyspepsia.     

Impulsiveness in chronic hepatitis C patients

Objective

The objective was to investigate impulsiveness among chronic hepatitis C (CHC) patients and its association with sociodemographic, clinical and psychopathological factors.

Method

Ninety-one CHC individuals were enrolled in a cross-sectional study at a Brazilian public university-based outpatient’s service for infectious diseases. They were assessed using the Barrat Impulsiveness Scale, Brief Fatigue Inventory, Beck Depression Inventory and Hamilton Anxiety Scale. Structured psychiatric interview was performed according to the Mini International Neuropsychiatric Interview. Multivariate analysis was performed according to linear stepwise forward regression.

Results

The total score of impulsiveness according to BIS in studied population was 64.6±9.8. The scores for the nonplanning, cognitive–attentional and motor domains were 23.8±5, 19.4±2.9 and 21.4±5, respectively. Impulsiveness was associated with lower educational level, current interferon-α (IFN) use, attention-deficit/hyperactivity disorder, alcohol use disorder, mixed anxiety and depressive disorder, specific phobia, bipolar spectrum disorders and anxiety symptoms. During IFN treatment, impulsiveness was also associated with suicide risk.

Conclusion

Impulsiveness was frequent in CHC patients and was associated with several psychopathological alterations. Impulsiveness management should be considered when attending CHC patients.     

Apical transportation associated with ProTaper? Universal F1, F2 and F3 instruments in curved canals prepared by undergraduate students

Objective

This study evaluated apical transportation associated with ProTaper^® Universal Fl, F2 and F3 rotary files in curved canais prepared by undergraduate students.

Material and Methods

Twenty mesial roots of mandibular molars with curvatures ranging between 25° and 35° were selected. Mesiobuccal canals were instrumented by twenty students with the ProTaper^® system (Dentsply-Maillefer, Ballaigues, Switzerland) according to the manufacturer''s instructions. Pre-fiaring was performed with Sl and SX files. A #15 K-file was inserted into the root canal up to the working length (WL), and an initial digital radiograph was taken in a buccolingual direction (baseline). Afterwards, the S1, S2, F1, F2, and F3 files were employed up to the WL. Other radiographies were taken in the same orientation of the baseline after the use of the Fl, F2, and F3 files, with each file inserted into the root canal. The radiographic images were overlapped, and the Image J software was used to measure the distance between the rotary files'' ends and the #15 K-file''s end, characterizing the apical transportation. Data were analyzed by Repeated Measure ANOVA and by the SNK post hoc test (P<0.05).

Results

It was verified that file size affected apical transportation significantly (P<0.001). The F3 file showed higher apical transportation than Fl and F2, while between these last files there was no difference.

Conclusion

The undergraduate students produced lower apical transportation in curved canals when they did not use the F3 rotary file.     

Masticatory muscle function three years after surgical correction of class III dentofacial deformity

Individuals with dentofacial deformities have masticatory muscle changes. The objective of the present study was to determine the effect of interdisciplinary treatment in patients with dentofacial deformities regarding electromyographic activity (EMG) of masticatory muscles three years after surgical correction. Thirteen patients with class III dentofacial deformities were studied, considered as group P1 (before surgery) and group P3 (3 years to 3 years and 8 months after surgery). Fifteen individuals with no changes in facial morphology or dental occlusion were studied as controls. The participants underwent EMG examination of the temporal and masseter muscles during mastication and biting. Evaluation of the amplitude interval of EMG activity revealed a difference between P1 and P3 and no difference between P3 and the control group. In contrast, evaluation of root mean square revealed that, in general, P3 values were higher only when compared with P1 and differed from the control group. There was an improvement in the EMG activity of the masticatory muscles, mainly observed in the masseter muscle, with values close to those of the control group in one of the analyses.