The magnitude and progress of lean body mass,fat-free mass,and skeletal muscle mass loss following bariatric surgery: A systematic review and meta-analysis

Postbariatric loss of muscle tissue could negatively affect long-term health due to its role in various bodily processes, such as metabolism and functional capacity. This meta-analysis aimed to unravel time-dependent changes in the magnitude and progress of lean body mass (LBM), fat-free mass (FFM), and skeletal muscle mass (SMM) loss following bariatric surgery. A systematic literature search was conducted in Pubmed, Embase, and Web of Science. Fifty-nine studies assessed LBM (n = 37), FFM (n = 20), or SMM (n = 3) preoperatively and ≥1 time points postsurgery. Random-effects meta-analyses were performed to determine pooled loss per outcome parameter and follow-up time point. At 12-month postsurgery, pooled LBM loss was ?8.13 kg [95%CI ?9.01; ?7.26]. FFM loss and SMM loss were ?8.23 kg [95%CI ?10.74; ?5.73] and ?3.18 kg [95%CI ?5.64; ?0.71], respectively. About 55% of 12-month LBM loss occurred within 3-month postsurgery, followed by a more gradual decrease up to 12 months. Similar patterns were seen for FFM and SMM. In conclusion, >8 kg of LBM and FFM loss was observed within 1-year postsurgery. LBM, FFM, and SMM were predominantly lost within 3-month postsurgery, highlighting that interventions to mitigate such losses should be implemented perioperatively.     

Specialisation and specialist education in prosthetic dentistry in Europe

This presentation reports on the results of a meeting of prosthodontists from selected European countries. The aim of the meeting was to analyse and promote specialisation and specialist education in Prosthetic Dentistry in Europe. Representatives for Europe were selected from the European Prosthodontic Association (EPA) board, the Education and Research Committee of International College of Prosthodontists (ICP), countries with a legally recognised speciality, countries without a recognised speciality but organised training programmes and countries with neither of these situations. Data about specialisation and specialist training in Prosthodontics in Europe was scrutinised and discussed. The programmes for countries with specialist training had relatively similar content, mostly of three years duration. There was strong agreement that a recognised speciality raises the level of care within the discipline for both specialists and non-specialists. In several of the countries where a speciality had been introduced it had been initiated by pressure from public health planning authorities. The conclusions are that from a professional viewpoint an advancement of the speciality over Europe would develop the discipline, improve oral health planning and quality of patient care. A working group for harmonisation was recommended.     

Early trabecular bone healing around titanium implants: a histologic study in rabbits

BACKGROUND: A detailed insight into the early healing response of trabecular bone to unloaded titanium implants is lacking. METHODS: Cylindrical implants were inserted in the tibial epiphysis of rabbits and left to heal for 1 to 42 days. Samples were processed into paraffin or methylmethacrylate sections and histomorphometrically analyzed. RESULTS: A hematoma was observed after 1 and 3 days of implant placement. In addition, small fragments of bone trabeculae were detected around the implant as a result of the implant installment procedure. Soon, osteoclasts were observed resorbing these fragments, whereas osteoblasts incorporated them in strands of new bone, thereby making them difficult to distinguish from day 7 onward. At that time, osteoblasts were detected at the edges of the preexisting bone, actively depositing new bone, resulting in maximal osteoid deposition around the implant after 28 days (58%). After 7 days of healing, the presence of basic remodeling units in the surrounding bone was already maximal (P <0.05 versus t = 1 and 3 days). This remodeling activity, together with the new bone formation, provided a firm anchoring of the implant in the trabecular bone. CONCLUSIONS: This study evaluated the early cellular events in trabecular bone surrounding titanium implants. The insertion of an implant into bone initiates a series of biologic processes, including the formation of a hematoma, shattered bone fragments adjacent to the implantation site, intensive bone remodeling, and the formation of new bone, eventually leading to the osseointegration of the implant.     

Effect of implant surface roughness and loading on peri-implant bone formation

BACKGROUND: Critical factors for the establishment of osseointegration are the implant surface microtopography and the local mechanical environment. The present study evaluated the bone response around a turned (T) and a roughened (R) implant for either an unloaded or a well-controlled loaded situation. METHODS: Bone chambers were installed in the tibia of 20 rabbits. In each of the chambers, two identical displacement-controlled loading experiments were performed: 30 microm for 400 cycles at 1 Hz, three times a week for 9 weeks versus 0-microm implant displacement. A linear mixed model and a logistic mixed model with alpha = 5% were set to study the significant effect of the surface texture on the peri-implant bone response in the unloaded (T-0 microm versus R-0 microm) and the loaded (T-30 microm versus R-30 microm) mode. RESULTS: Results indicated no microtopographic dependence of the bone response further away from the implant in unloaded and loaded conditions. For a load-free implant, osseointegration seemed to occur with a higher incidence at a roughened compared to a turned implant surface. In the presence of loading, the topographic dependency of the osteogenic activity at the interface was overruled by the loading-related bone response, revealing no significant differences in osseointegration incidence between T and R. CONCLUSION: A predominant effect of the interfacial mechanical environment over the implant surface characteristics on the differentiating cell population is suggested.     

Immediate functional loading of single-tooth TiO2 grit-blasted implant restoration. A controlled prospective study in a porcine model. Part II: Histology and histomorphometry

Background: Evidently, there is a fast‐moving shift from delayed to immediate implant loading. The hypothesis to be tested was that bone reactions adjacent to single TiO₂‐microthreaded implants exposed to immediate masticatory loading for 10 weeks after placement would modulate osseointegration. Materials and Methods: Cylindrical‐ and tapered‐designed implants (Astra Tech AB, Mölndal, Sweden) replaced first and third mandibular premolars respectively in 12 pigs. The animals were allocated into two groups based on soft and hard diet feeding. Each animal received, at random positions, four different masticatory loading conditions: implant with either (1) a cover screw only, (2) a healing abutment, (3) an implant with a crown without occlusal contact, or (4) an implant with a crown in contact with the antagonistic teeth. Results: Histomorphometry showed that there were no statistically significant differences in bone‐implant contact (BIC), bone mass inside/outside of the threads and soft tissue ingrowth ratio for all the implants at 10 weeks after placement irrespective of masticatory loading condition. Bone loss showed a trend of progressive increase for implants with a healing abutment toward implants with occlusal contact. Conclusions: The results of this study rejected the hypothesis and could be explained by the fact that grit‐blasted acid‐etched implants were already placed in dense bone.     

Prosthetic aspects and patient satisfaction with two-implant-retained mandibular overdentures: a 10-year randomized clinical study

PURPOSE: This study aimed to compare the prosthetic aspects and patient satisfaction with prosthetic care in two-implant-retained mandibular overdentures, whether implants were splinted with a bar or left with magnets or ball attachments. MATERIALS AND METHODS: Thirty-six completely edentulous patients had two Br?nemark implants placed in the mandibular canine area. A randomized procedure allocated patients into three groups of equal size, each with a different attachment system: bars, magnets, or balls. Prosthesis retention and mechanical as well as soft tissue complications were recorded in addition to patient satisfaction. A linear mixed model was fitted with attachment type and time as classification variables and adjusted by Turkey's multiple range test. RESULTS: Ball-retained overdentures showed at year 10 the greatest vertical retention force (1,327 g), followed by bars (1,067 g) and magnets (219 g). In the ball group, need for tightening of abutment screws was the most common mechanical complication; in the magnet and bar groups, respectively, the most common complications were wear and corrosion, and the need for clip activation. Prosthesis stability and chewing comfort for the overdenture were rated significantly lower for the magnet group compared to the ball and bar groups. Prosthesis stability of the maxillary denture was rated significantly lower in the bar group compared to ball and magnet groups. CONCLUSION: The ball group scored best in relation to retention of the overdenture, soft tissue complications, and patient satisfaction at year 10. The bar group scored lower for comfort and stability of the maxillary denture. Magnets offered patients the least comfort.