This multicenter prospective clinical trial investigated immediately provisionalized, anodized, conical connection, tapered implants with platform shifting in maxillary anterior and premolar sites.
Materials and methods
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.
Results
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.
Conclusions
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.
Clinical relevance
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.
Growing recognition of the inadequacy of traditional methods of providing informed consent, especially for individuals vulnerable to impaired decisional capacity, has spurred recent interest in how to assess and improve components of consent-related decision making. In this preliminary study, we aimed to compare different methods of interactive questioning during presentation of research consent information among patients with schizophrenia. Patients were randomized to receive either standard administration (SA) of a consent form or one of two interactive questioning methods: Corrective Feedback (CF), in which the correct answer was provided following the participant's response, or Errorless Learning (EL), in which correct answers were provided just prior to the question. The MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) was used to measure understanding, appreciation, reasoning, and expression of a choice following presentation of the consent form. There was no significant effect of condition (SA vs. EL vs. CF) on any of the components of decisional capacity. Understanding scores measured during the consent process were higher than those measured afterward, but the two scores were highly correlated. Thus, the results of this randomized study suggest that interactive questioning neither helped nor harmed understanding, appreciation, or reasoning among patients with schizophrenia. Other considerations, however, may favor use of such methods in the consenting process. 相似文献
Unimpaired cognition is an important feature of successful aging. Differences in cognitive performance among healthy older adults may be related to differences in brain structure. The authors reviewed the literature to examine the relationship between brain-structure size and cognitive performance in older adults. Eighty-three percent of studies found at least one positive relationship between these factors; however, findings were variable. Positive relationships emerged most consistently between the hippocampal formation and global cognition and memory and between frontal measures and executive function. Additional longitudinal study is needed to further evaluate structure-cognition relationships in older adulthood and across the adult lifespan. 相似文献
Introduction. Neurodevelopmental processes of adolescence, when superimposed on a vulnerable brain, may produce additive effects reflecting the subthreshold psychotic symptoms, cognitive, and functional deterioration that are the hallmark of the early stages of schizophrenia. Methods. As part of a longitudinal study, we investigated Continuous Performance Task, Identical Pairs Version (CPT-IP) performance in a sample of 301 participants (at risk for psychosis: 109; first episode–FE: 90; and controls: 102). Performance across groups was compared using d' of fast and slow, spatial and verbal conditions over two time points. Age effects were investigated using a regression model. Results. Across all four CPT-IP conditions FE patients performed significantly worse than controls while AR individuals significantly differed from healthy subjects in the verbal condition. Age-related performance associations across groups significantly differed in the slow verbal condition because the FE sample did not show a significant association with increasing age like the AR and NC samples. CPT performance was stable over time. Conclusions. Sustained attention in the putative prodrome of psychosis is not only impaired but associated with age. Research focusing on cognitive and neurobiological age-related changes can help to address fundamental questions about the nature of the disorder, including whether the underlying pathophysiology of early psychosis is static or deteriorating. 相似文献
The study investigated the validity of the response format of the Oral Health Impact Profile 49 (OHIP-49). The OHIP-49 was completed by 145 consecutive prosthodontic patients. For each OHIP item, subjects completed the standard ordinal response format (with responses given as never, hardly ever, occasionally, often, or very often, and scored from 0 to 4, respectively). Subjects also separately reported the absolute frequency of impacts for each item (numerical response format) in a personal interview. Response codes for the standard ordinal response format (0-4) and for the numerical response format were summed to give two separate OHIP summary scores. The reliability and validity of the scores generated from each response format were compared using the numerical response format as the standard. Score reliability was high and almost identical for both response formats. Score validity was also satisfactory with a high correlation of scores between response methods. There was also a moderate correlation of scores from both response methods with a single global rating of perceived oral health. These data support the validity of the standard ordinal response format of the OHIP and suggest the use of the numerical response format in order to help capture impacts on oral health when they are infrequent. 相似文献
Clinical Oral Investigations - This open, single-cohort, multicenter, prospective study investigated the efficacy of immediately provisionalized tapered conical connection implant for single-tooth... 相似文献
The body can’t control massive bleeding without treatment. Different hemostatic agents have been prepared recently, but most of them are ineffective in severe bleeding and expensive or cause safety concerns. In this study, in order to achieve fast control of bleeding, we synthesized and characterized fast-swelling porous superabsorbent hydrogel (FSPSH) and investigated its use as a hemostatic agent. The FSPSH was prepared by grafting acrylic acid and acrylamide onto starch through free-radical polymerization in aqueous solution. The FSPSH was characterized by Fourier transform infrared, X-ray diffraction, field emission scanning electron microscope, and thermogravimetric analysis. Then, temporal swelling behavior and coagulation time experiments were used to predict the in vivo behavior of the FSPSH. The hemocompatibility of synthesized FSPSH was evaluated by hemolysis test and blood cells function. In vivo study using femoral artery injury in rat demonstrated the FSPSH’s ability to aid in rapid hemostasis. Furthermore, monitoring the rat on first and seventh day after femoral artery injury also showed no harmful effect. This study indicates that FSPSH adsorbs fluid and swells, thus forms a physical barrier to blood loss. FSPSH, moreover, as hemostat is simple to use, lightweight, stable, and harmless. 相似文献
Many neuroimaging studies interpret the commonly reported findings of age-related increases in frontal response and/or increased bilateral activation as suggestive of compensatory neural recruitment. However, it is often unclear whether differences are due to compensation or reflective of other cognitive or physiological processes. This study aimed to determine whether there are compensatory age-related changes in brain systems supporting successful associative encoding while taking into account potentially confounding factors including age-related differences in task performance, atrophy, and resting perfusion. Brain response during encoding of face-name pairs was measured using functional magnetic resonance imaging in 10 older and nine young adults and was correlated with memory performance. During successful encoding, older adults demonstrated increased frontal and decreased occipital activity as well as greater bilateral involvement relative to the young. Findings remained significant after controlling for age-related cortical atrophy and hypoperfusion. Among the older adults, greater response was associated with better memory performance. Cognitive aging may involve recruitment of compensatory mechanisms to improve performance or prevent impairment. Results extend previous findings by suggesting that age-related alterations in activation cannot be attributed to the commonly observed findings of poorer task performance, reduced resting perfusion, or cortical atrophy among older adults. 相似文献