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  • 1
    ISSN: 1399-3038
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Differences have been suggested to occur in the composition of intestinal microflora from allergic and non-allergic children. In this study we used a semi-quantitative enzyme-linked immunosorbent assay (ELISA) for the measurement of Clostridium difficile-specific immunoglobulin G (IgG) (CDIgG). CDIgG was excellent in differentiating between adults with or without Cl. difficile colitis (absorbance levels, positive vs. negative controls: geometric mean (GM) 0.301, 95% CI: 0.289–0.314 vs. GM 0.167, 95% CI: 0.155–0.181; mean difference 1.8-fold, 95% CI: 1.65–1.95; p 〈 0.0001). We used this technique to investigate whether there are any differences between atopic wheezy infants and non-atopic non-wheezy controls. In a prospective cohort study (n = 390) 10 patients were identified at 1 year of age (atopic, history of recurrent wheeze) and matched (gender, month of birth, exposure to Der p 1, Fel d 1 and Can f 1) with a control group of infants (non-atopic, no history of wheeze). The patients had significantly higher Cl. difficile-specific IgG absorbance levels (GM 0.298, 95% CI: 0.249–0.358) compared with controls (GM 0.235, 95% CI: 0.201–0.274; mean difference 1.27-fold, 95% CI: 1.07–1.50; p = 0.01). These results suggest that there may be differences in the composition of intestinal microflora between allergic and non-allergic infants at 1 year of age, with allergic children having higher Cl. difficile IgG antibody levels.
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  • 2
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: In order for clinicians to effectively manage their practices, they need to know how much time they spent in carrying out procedures. The provision of two-implant overdentures for edentulous patients is becoming more prevalent as increasing evidence demonstrates their great benefit to patients. The aim of this study was to measure the number of visits and the time required during the surgical phase (from pre-op examination to preliminary impressions) of mandibular two-implant overdenture treatment. Thirty edentulous patients were assigned to receive two root-form implants in the mandible between the mental foramen, as part of a randomized controlled clinical trial. All visits and time spent by the oral surgeon, the surgical assistant and the prosthodontist were measured individually. The mean number of scheduled visits with the oral surgeon was four, and the mean time taken was 104 min. The mean time taken by the surgical assistant was 122 min. On average, the prosthodontist was required for two visits, with a total mean time of 36 min. In addition to the scheduled visits, 14 patients solicited additional appointments (unscheduled visits) for various problems (e.g. loose healing cap). The average time taken for unscheduled visits was 32 min. Combining scheduled and unscheduled visits, the mean total time taken by the oral surgeon was 109 min. The surgical assistant was needed for a mean total of 125 min, and the prosthodontist spent, on average, 46 min in this phase of treatment. Results from this study will assist clinicians in establishing the total time and number of visits needed for the surgical phase of two-implant mandibular overdenture treatment.
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  • 3
    ISSN: 1600-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract – Implant overdentures and conventional prostheses have been compared in several trials using a variety of functional and oral health-related quality of life (OHQOL) outcomes. In this paper, we describe the impact of implant overdentures on general and OHQOL in seniors.Objectives: To compare the oral health-related and general quality of life of seniors (aged 65–75 years) who received either mandibular implant overdentures or conventional dentures.Methods: Sixty edentulous patients were recruited. Thirty received mandibular overdentures retained by two implants (IOD) and a conventional maxillary denture, the other 30 subjects received new maxillary and mandibular conventional complete dentures (CD). All completed the 20-item version of the Oral Health Impact Profile (OHIP-20) before treatment, then at two and 6 months after delivery of the dentures. The SF-36 general health questionnaire was completed at baseline and 6 months only.Results: Pretreatment and 6-month data from 55 subjects were analyzed. Those who received the IODs had significantly better OHIP-20 total scores at 6 months. Results for IOD subjects were also superior in the functional limitation, physical pain, physical disability and psychological disability subscales. While no significant between group difference was found on the SF-36 health survey, significant pre–post-treatment differences within the IOD group were detected for the role emotional, vitality and the social function scales.Conclusions: Mandibular overdentures retained by two implants provide elderly patients with better OHQOL. General health-related quality of life improved in the implant group.
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  • 4
    ISSN: 1399-3054
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology
    Notes: The effects of high α-linolenate content on lipid peroxidation, oxidative stress and loss of plant growth potential during ageing of potato (Solanum tuberosum L.) seed-tubers was examined. Endoplasmic reticulum (FAD3) and plastidal (FAD7) 18:2 fatty acid desaturases were upregulated in potato (cv. Desiree), resulting in a 2-fold average increase in mol percentage 18:3 in the total lipid fraction across all transgenic clones. In double-transformed (FAD3+7) tubers, high α-linolenate phenotype effected accelerated ageing, resulting in growth responses characteristic of older seed-tubers. Although respiration rates of wild-type (WT) and FAD3+7 tubers were equal at 7 months of storage, rates had increased by 23% and 50% in WT and FAD3+7 tubers, respectively, by 19 months of storage. Electrolyte leakage of tissue from 19-month-old FAD3+7 tubers was significantly greater than that from WT tubers of the same age, indicating that the high α-linolenate phenotype was detrimental to membrane integrity during long-term storage. On average, indices of lipid peroxidation (malondialdehyde, ethane, C-6 aldehydes) were higher in older FAD3+7 tubers, relative to WT tubers. Activities of glucose-6-phosphate dehydrogenase, peroxidase, glutathione reductase, ascorbate peroxidase and monodehydroascorbate reductase increased in tubers with advancing age and were higher, on average, in FAD3+7 tubers. Dehydroascorbate reductase activity decreased with age, with no difference between transgenic and WT lines. Collectively, these results indicate that FAD3+7 tubers underwent a higher degree of oxidative stress during ageing. The age-induced increase in respiration of FAD3+7 tubers was at least partly a response to fuel increased free radical scavenging through the ascorbate-glutathione antioxidant pathway. By affecting the susceptibility of lipids to peroxidation, the degree of fatty acid unsaturation influenced the development of oxidative stress and the overall rate at which growth potential was lost from seed-tubers during ageing. Thus, oxidative stress plays an integral role in modulating the ageing process to affect growth potential from potato seed-tubers.
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  • 5
    ISSN: 1600-065X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 6
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary: ITI® dental implants are available with two bone-anchoring surfaces, a titanium plasma-sprayed (TPS) surface, and a recently introduced sandblasted and acid-etched (SLA) surface. Cell culture and animal tests demonstrate that the SLA surface stimulates bone cell differentiation and protein production, has large amounts of bone-to-implant contact, and results in large removal torque values in functional testing of the bone contact. As a result of these studies, a prospective human clinical trial was initiated to determine whether the 4.1 mm diameter SLA ITI® solid screw implants could be predictably and safely restored as early as six weeks after implant placement surgery. The protocol restricted the use of the reduced healing time to a) healthy patients with sufficient bone volume to surround the implant, and b) those patients who had good bone quality (classes I-III) at the implant recipient site. Patients with poorer bone quality (class IV) did not have restorations until 12 weeks after implant placement. The clinical trial is an ongoing multicenter trial, with six centers in four countries, and with follow-up over five years. The primary outcome variable was abutment placement with a 35 Ncm force, with no countertorque and no pain or rotation of the implant. A secondary outcome was implant success, as defined by no mobility, no persistent pain or infection, and no peri-implant radiolucency. To date, 110 patients with 326 implants have completed the one-year post-loading recall visit, while 47 patients with 138 implants have completed the two-year recall. Three implants were lost prior to abutment connection. Prosthetic restoration was commenced after shortened healing times on 307 implants. The success rate for these implants, as judged by abutment placement, was 99.3% (with an average healing time of 49 days). Life table analyses demonstrated an implant success rate of 99.1%, both for 329 implants at one year and for 138 implants at two years. In the 24-month period after restoration, no implant losses were reported for the 138 implants. These results demonstrate that, under defined conditions, solid screw ITI® implants with an SLA endosseous surface can be restored after approximately six weeks of healing with a high predictability of success, defined by abutment placement at 35 Ncm without countertorque, and with subsequent implant success rates of greater than 99% two years after restoration.
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  • 7
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Although maxillary implant overdentures are used in oral rehabilitation, different designs have not been compared previously in clinical trials. This crossover trial was designed to measure differences in patient satisfaction with maxillary long-bar implant overdentures with and without palatal coverage opposed by a fixed mandibular implant-supported prosthesis. Data were also gathered on new conventional dentures and on maxillary conventional dentures opposed by mandibular fixed prostheses. Sixteen participants were selected from a population wearing conventional dentures. Fifteen received new upper and lower dentures (1 drop-out). Four implants were placed in the maxilla and mandible (2 drop-outs). A mandibular fixed prosthesis was inserted in 13 participants, who were then divided into 2 groups. One group (n=7) received long-bar overdentures with palate, then long-bar overdentures without palate. The other group (n=6) received the same treatments in the reverse order. Mastication tests and psychometric evaluations using Visual Analog Scales and Categorical Scales were performed throughout the study. General satisfaction was very high with both maxillary implant-supported prostheses, as were ratings of almost all psychosocial and functional variables. There were no significant differences between treatments, suggesting that patients are equally satisfied with long-bar overdentures with and without palate when these are opposed by mandibular fixed prostheses. However, the ratings given to the maxillary implant prostheses were not significantly higher than for new conventional maxillary prostheses. This suggests that maxillary implant prostheses should not be considered as a general treatment of choice in patients with good bony support for maxillary conventional prostheses.
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  • 8
    ISSN: 1600-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract – Several researchers have suggested that patients' preferences for a particular form of treatment should be taken into account in clinical trials. Preferences may influence the outcome of treatment, especially in trials when patients cannot be blinded to the type of treatment received and the outcome is based on patients' evaluations of therapy. Participants in this study were 136 edentulous patients who took part in a randomised controlled clinical trial comparing two types of treatments for edentulism: conventional dentures and implant-supported prostheses. Prior to receiving treatment, subjects were required to complete a questionnaire regarding their satisfaction with their present prostheses. In addition, they were asked to indicate which treatment they would prefer if given a choice. The objective of this study was to determine whether there are important differences among study participants between patients who have a treatment preference and those who do not. The effects of satisfaction with pre-treatment prostheses, age, gender and level of education on preferences were examined. Level of satisfaction with the original dentures and level of education were significant predictors of preference. Compared to subjects who rated their satisfaction with their current condition as ‘low’, the odds ratios associated with having a preference for implant treatment were 0.31 (95% CI: 0.09 to 0.96) for subjects who rated their prostheses in the ‘medium’ range and 0.11 (95% CI: 0.03 to 0.41) for those who rated in the ‘high’ range. In addition, subjects with high levels of education were significantly less likely to have a preference for either conventional or implant treatments (OR=0.18, 95% CI: 0.02 to 0.77 and OR=0.20, 95% CI: 0.05 to 0.76, respectively) compared to those with low education. Neither age nor gender was a significant predictor of preference. We suggest that study designs which incorporate patients' preferences must take into account possible differences between preference groups that might confound the relationship between preference and the outcome of interest.
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  • 9
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Dental implants provide patients with restorative options for the edentulous maxilla. Both fixed and removable prostheses can be attached to the edentulous maxilla, but the efficacy of different designs has not been determined. In this two-session within-subject crossover trial we compared maxillary implant retained fixed prostheses with removable implant overdentures opposed by mandibular implant-supported overdentures. Sixteen patients, who had previously received mandibular implants, entered the study and received four to six maxillary implants. After dropouts as a consequence of a lack of osseointegration and general health problems, 13 remained. Of these, five received the removable prosthesis first and eight the fixed prosthesis. After 2 months, the prostheses were exchanged and the second was also worn for 2 months. Psychometric measurements of general satisfaction with the prostheses as well as comfort, ability to speak, stability, esthetics, ease of cleaning and occlusion were obtained once each prosthesis had been worn for 2 months. Chewing ability was assessed for seven types of food. Removable long-bar overdentures received significantly higher ratings of general satisfaction than fixed prostheses (P = 0.003). Patients also rated their ability to speak and ease of cleaning significantly better with the removable overdentures. Nine patients chose to keep the removable prosthesis and four preferred to keep the fixed prosthesis. The results suggest that maxillary removable overdentures on multiple implants may provide patients with better function than fixed prostheses.Heydecke G, Boudrias P, Awad MA, de Albuquerque Jr RF, Lund JP, Feine JS. Within subject comparisons of maxillary fixed and removable implant prostheses: Patient satisfaction and choice of prosthesis.
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  • 10
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Prostaglandin E2 (PGE2) and transforming growth factor-beta1 (TGF-β1) production are increased in cultures of osteoblasts grown on rough surfaces and prostaglandins are involved in osteoblast response to surface roughness. In the present study, we examined the effect of inhibiting cyclooxygenase on this response. MG63 osteoblast-like cells were cultured on cpTi disks with Ra values of 0.60 μm (PT), 3.97 μm (SLA), and 5.21 μm (TPS) in the presence or absence of 10−7 M indomethacin. Treatment was begun on days 1, 2, 3, or 4 after seeding, and all cultures were harvested on day 5. Indomethacin decreased PGE2 release by the cells to less than 50% of basal levels when the cells were cultured on plastic. Cell number decreased with increasing surface roughness and indomethacin treatment abrogated the surface roughness effect over time. Alkaline phosphatase specific activity (ALP) increased with surface roughness; after one day with indomethacin, ALP was decreased on smooth surfaces, but increased on rough surfaces. Over time, ALP decreased on all surfaces examined and remained greater than plastic only in cultures on TPS. Indomethacin also caused a time-dependent decrease in osteocalcin production on rough surfaces, eventually abrogating the increases due to surface roughness, but had no effect on osteocalcin production on smooth surfaces. TGF-β1 levels in the cell layer and media were sensitive to surface roughness; on rougher surfaces, TGF-β1 shifted from the media to the matrix. Indomethacin reduced TGF-β1 levels over time, but the surface roughness effect was still evident at 4 days. This indicates that prostaglandin production mediates the effects of surface roughness, since indomethacin causes a time-dependent abrogation of the response, but has no effect on proliferation, osteocalcin release, or TGF-β1 levels on smooth surfaces. Indomethacin’s effect was not immediate, suggesting that clinical protocols could be designed that would reduce inflammation without preventing osteoblastic differentiation. The effect of indomethacin was not complete, since TGF-β1 and ALP remained elevated on rough surfaces, suggesting that pathways or factors other than prostanoids are involved. TGF-β1 is preferentially stored in the matrix, acting on the cells through autocrine signaling, and may contribute to ALP even in the presence of indomethacin. These results demonstrate the importance of local factors in the autocrine regulation of osteogenesis and the potential for factors released in response to surface morphology to act in a paracrine manner.
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