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Journal of Indian Prosthodontic Society Jul 2024Synthetic inorganic materials are commonly used as reinforcing agents in polyetheretherketone (PEEK) composite, whereas natural organic plant-based reinforcing agents... (Comparative Study)
Comparative Study
Comparative evaluation on surface nanohardness, surface microhardness, surface roughness, and wettability of plant-based organic nanoparticle reinforced polyetheretherketone as an implant material - An in vitro study.
AIM
Synthetic inorganic materials are commonly used as reinforcing agents in polyetheretherketone (PEEK) composite, whereas natural organic plant-based reinforcing agents are negligible. Surface hardness, roughness, and wettability are indicative factors of osseointegration behavior to be used as an implant material. This study evaluated micro surface hardness (MSH), nano surface hardness (NSH), surface roughness (SR), and contact angle (CA) of PEEK-Azadirachta indica reinforced at 10 wt%, 20 wt%, and 30 wt%.
SETTINGS AND DESIGN
This was an in vitro study.
MATERIALS AND METHODS
Neem (A. indica) leaf nanoparticles were prepared and reinforced with PEEK powder at 10%, 20%, and 30% weight ratios by injection molding. Sixty specimens underwent the microhardness and CA testing using a digital microhardness tester, and CA goniometer, respectively, and later nanoindentation test to analyze the nanohardness and SR.
STATISTICAL ANALYSIS USED
A one-way ANOVA test with a 95% confidence interval for MSH and NSH, SR, and CA was performed on the samples. A post hoc Bonferroni test was conducted (α = 0.05) to compare the groups.
RESULTS
There was a significant increase in nanohardness (P = 0.000) with zero difference in microhardness (P = 0.514). The addition of 10 wt%, 20 wt%, and 30 wt% nanoparticles increased the SR value of the pure PEEK from 273.19 nm to 284.10 (3.99%), 296.91 (8.68%), and 287.54 (5.24%), respectively. In the analysis of the CA, CA 20% shows the lowest angle (63.69) with the highest for control specimens (82.39). There is an increase in the PEEK composite SR with a decrease in CA.
CONCLUSIONS
The addition of plant-derived nanoparticles into the PEEK matrix has a significant impact on the hardness and hydrophobicity enhancing cell growth and osteoblastic differentiation during osseointegration of dental implants.
Topics: Benzophenones; Polyethylene Glycols; Polymers; Ketones; Nanoparticles; Surface Properties; Wettability; Hardness; In Vitro Techniques; Dental Implants; Materials Testing; Plant Leaves
PubMed: 38946507
DOI: 10.4103/jips.jips_511_23 -
Journal of Indian Prosthodontic Society Jul 2024The aim is to determine thermal conduction by heat-activated polymethylmethacrylate (PMMA) infiltrated with 1 weight% Titanium Dioxide (TiO2) and 1 weight% Zirconium...
Effect of titanium dioxide and zirconium dioxide nanoparticle incorporation on the thermal conductivity of heat-activated polymethylmethacrylate denture base resins: An in vitro experimental study.
AIM
The aim is to determine thermal conduction by heat-activated polymethylmethacrylate (PMMA) infiltrated with 1 weight% Titanium Dioxide (TiO2) and 1 weight% Zirconium Dioxide (ZrO2) nanoparticles and to compare with that of conventional PMMA.
STUDY SETTING AND DESIGN
In vitro experimental study.
MATERIALS AND METHODS
Eighteen disc shaped specimens with a thickness of 5 mm and diameter of 50 mm, were fabricated and grouped according to the material used: Group B1 (resin infiltrated with 1 weight% TiO2), Group B2 (resin infiltrated with 1 weight% ZrO2), and Control Group B3 (heat-activated conventional PMMA resin). Disc-shaped specimens were analyzed for thermal conductivity using "modified guarded hot plate apparatus" in the thermal lab of the Indian Space Research Organisation.
STATISTICAL ANALYSIS USED
One-way ANOVA followed by Tukey's post hoc test was used to compare the arithmetic means of all three groups.
RESULTS
A statistically significant difference was noted among all three groups. Group B2 had the maximum thermal conductivity, followed by Group B1. Thermal conductivity was the least for Group B3. A post hoc comparison revealed that the difference was significant between Group B2 and Group B3.
CONCLUSION
Nano ZrO2 addition in PMMA increased its thermal conductivity. There is evidence that it improves its mechanical properties as well. Hence, Nano ZrO2 addition in PMMA is highly recommended. Nano TiO2 addition in PMMA did not provide any significant advantage in terms of thermal conductivity, but its addition in PMMA is justified because of its mechanical and antimicrobial properties.
Topics: Titanium; Zirconium; Polymethyl Methacrylate; Thermal Conductivity; Nanoparticles; Hot Temperature; Denture Bases; Materials Testing; In Vitro Techniques
PubMed: 38946506
DOI: 10.4103/jips.jips_575_23 -
Journal of Indian Prosthodontic Society Jul 2024The aim of this study was to compare the marginal fit of prefabricated occlusal veneers with computer-aided design/computer-aided manufacturing (CAD-CAM)-milled zirconia... (Comparative Study)
Comparative Study
A comparative evaluation of marginal fit and microleakage of computer-aided design/computer-aided manufacturing-milled zirconia and prefabricated posterior occlusal veneers: An in vitrostudy.
AIMS
The aim of this study was to compare the marginal fit of prefabricated occlusal veneers with computer-aided design/computer-aided manufacturing (CAD-CAM)-milled zirconia occlusal veneers in the posterior teeth.
SETTINGS AND DESIGN
Forty extracted human maxillary premolars were divided into two groups of 20 each. Group 1 was prepared to receive prefabricated occlusal veneers, and Group 2 was prepared to receive CAD-CAM-milled zirconia occlusal veneers.
MATERIALS AND METHODS
Prefabricated samples (Edelweiss) were selected for Group 1, whereas for Group 2, the tooth preparations were scanned, and occlusal veneers were fabricated using Exocad designing software and milling machine. After luting, both the groups were submerged in dye, sectioned, and evaluated for marginal fit and microleakage under a stereomicroscope using the microscope imaging software and its measurement tool.
STATISTICAL ANALYSIS USED
Data collected were subjected to statistical analysis using SPSS 27.0. Intragroup and intergroup comparison was done using the Mann-Whitney U test. The Chi-square test was applied to check the depth of penetration of dye based on percentages.
RESULTS
The marginal gap of zirconia occlusal veneers fabricated with CAD-CAM is higher compared to that of prefabricated occlusal veneers. Similarly, the depth of penetration of dye is higher in CAD-CAM-milled zirconia occlusal veneers than prefabricated occlusal veneers.
CONCLUSION
The marginal fit of prefabricated occlusal veneer is better than the marginal fit of zirconia occlusal veneers fabricated with CAD-CAM. Similarly, it can also be concluded that the microleakage of prefabricated occlusal veneer is less compared to the CAD-CAM-milled zirconia occlusal veneers.
Topics: Dental Veneers; Zirconium; Computer-Aided Design; Humans; Dental Marginal Adaptation; Dental Leakage; Dental Prosthesis Design; In Vitro Techniques; Bicuspid
PubMed: 38946505
DOI: 10.4103/jips.jips_346_23 -
Journal of Indian Prosthodontic Society Jul 2024The present systematic review compares the stability, crestal bone levels and efficacy of osseodensification (OD) drilling techniques for dental implant placement to... (Comparative Study)
Comparative Study
AIM
The present systematic review compares the stability, crestal bone levels and efficacy of osseodensification (OD) drilling techniques for dental implant placement to traditional drilling methods.
SETTINGS AND DESIGN
The Cochrane online library, PubMed, Scopus, and other well-known online resources are used in the research. Using a systematic review design, the current study examines published qualitative studies with an emphasis on analysis.
MATERIALS AND METHODS
Using precise keywords, a thorough search of pertinent databases was carried out in accordance with PRISMA standards. Studies testing dental implant stability, crestal bone levels and clinical results using both OD and traditional procedures were covered by the inclusion criteria.
STATISTICAL ANALYSIS USED
The risk of bias and quality of included studies was assessed using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for randomized controlled trials.
RESULTS
A total of 170 patients and 334 implants from Egypt, India, and Brazil were included in eight papers that made up the systematic review. In several clinical situations, osseodensification outperformed standard drilling in terms of implant durability, bone development, and torque data. Statistical analysis presented the lowest risks, while blinded outcome assessment, allocation concealment, random sequence generation, incomplete outcome data and experimental technique revealed higher risks. Bias assessment found various risks across different components.
CONCLUSION
The thorough examination of eight papers demonstrates that osseodensification is a technique with great promise in the field of dental implants. It exhibits superior torque values, bone development, and stability when compared to traditional drilling. The overall results highlight the potential of osseodensification to improve clinical outcomes and advance the science of dental implantology, even in the face of variances in bias concerns.
Topics: Humans; Dental Implants; Dental Implantation, Endosseous; Osseointegration
PubMed: 38946504
DOI: 10.4103/jips.jips_480_23 -
Journal of Indian Prosthodontic Society Jul 2024The aim of this umbrella review was to systematically review the systematic reviews on antagonist enamel wear opposing zirconia crowns compared to other ceramics and...
AIM
The aim of this umbrella review was to systematically review the systematic reviews on antagonist enamel wear opposing zirconia crowns compared to other ceramics and natural enamel.
SETTINGS AND DESIGN
This was an umbrella review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
MATERIALS AND METHODS
An electronic search of PubMed, Cochrane Central, EBSCOhost, and Google Scholar search engines for articles published from January 1, 2013, to January 1, 2023, was conducted using keywords "enamel wear," "zirconia," "feldspathic," "dental ceramics," and "Y-TZP" to identify systematic reviews on antagonist enamel wear opposing zirconia crowns compared to other ceramics and natural enamel.
STATISTICAL ANALYSIS USED
Qualitative analysis.
RESULTS
A total of 86 articles were obtained through electronic search, of which four articles were selected after abstract screening that met the inclusion criteria for evaluating antagonist enamel wear. As compared to feldspathic groups, zirconia had substantially less antagonist wear, while surface polishing exhibited less enamel wear than glazing. Because of the heterogeneity in study design, measurement methods, and outcome variables, a meta-analysis was not possible.
CONCLUSIONS
Over time, the opposing enamel wear caused by polished monolithic zirconia will be either equal to or less than that of natural enamel wear. Polished monolithic zirconia also maintains lower values of enamel wear compared to metal ceramics, feldspathic porcelains, and lithium disilicate.
Topics: Humans; Ceramics; Crowns; Dental Enamel; Tooth Wear; Zirconium
PubMed: 38946503
DOI: 10.4103/jips.jips_32_24 -
The Bone & Joint Journal Jul 2024In cases of severe periprosthetic joint infection (PJI) of the knee, salvage procedures such as knee arthrodesis (KA) or above-knee amputation (AKA) must be considered.... (Comparative Study)
Comparative Study
Above-knee amputation shows higher complication and mortality rates in line with lower functional outcome compared to knee arthrodesis in severe periprosthetic joint infection.
AIMS
In cases of severe periprosthetic joint infection (PJI) of the knee, salvage procedures such as knee arthrodesis (KA) or above-knee amputation (AKA) must be considered. As both treatments result in limitations in quality of life (QoL), we aimed to compare outcomes and factors influencing complication rates, mortality, and mobility.
METHODS
Patients with PJI of the knee and subsequent KA or AKA between June 2011 and May 2021 were included. Demographic data, comorbidities, and patient history were analyzed. Functional outcomes and QoL were prospectively assessed in both groups with additional treatment-specific scores after AKA. Outcomes, complications, and mortality were evaluated.
RESULTS
A total of 98 patients were included, 52 treated with arthrodesis and 47 with AKA. The mean number of revision surgeries between primary arthroplasty and arthrodesis or AKA was 7.85 (SD 5.39). Mean follow-up was 77.7 months (SD 30.9), with a minimum follow-up of two years. Complications requiring further revision surgery occurred in 11.5% of patients after arthrodesis and in 37.0% of AKA patients. Positive intraoperative tissue cultures obtained during AKA was significantly associated with the risk of further surgical revision. Two-year mortality rate of arthrodesis was significantly lower compared to AKA (3.8% vs 28.3%), with age as an independent risk factor in the AKA group. Functional outcomes and QoL were better after arthrodesis compared to AKA. Neuropathic pain was reported by 19 patients after AKA, and only 45.7% of patients were fitted or were intended to be fitted with a prosthesis. One-year infection-free survival after arthrodesis was 88.5%, compared to 78.5% after AKA.
CONCLUSION
Above-knee amputation in PJI results in high complication and mortality rates and poorer functional outcome compared to arthrodesis. Mortality rates after AKA depend on patient age and mobility, with most patients not able to be fitted with a prosthesis. Therefore, arthrodesis should be preferred whenever possible if salvage procedures are indicated.
Topics: Humans; Arthrodesis; Male; Female; Amputation, Surgical; Aged; Prosthesis-Related Infections; Reoperation; Middle Aged; Quality of Life; Postoperative Complications; Arthroplasty, Replacement, Knee; Knee Prosthesis; Aged, 80 and over; Treatment Outcome; Retrospective Studies; Prospective Studies
PubMed: 38946307
DOI: 10.1302/0301-620X.106B7.BJJ-2023-0978.R2 -
Arthroplasty (London, England) Jul 2024Mid-flexion instability has been identified as a cause for dissatisfaction following total knee arthroplasty (TKA). Robotic-assisted surgery using the Mako robot only...
PURPOSE
Mid-flexion instability has been identified as a cause for dissatisfaction following total knee arthroplasty (TKA). Robotic-assisted surgery using the Mako robot only allows for assessment of stability at 10° and 90°. This study aimed to investigate any evidence of mid-flexion instability in Mako-assisted TKA.
METHODS
Data from 72 TKA in 59 patients from 2018 to 2022 were collected. All patients underwent an RA (Mako, Stryker, Fort Lauderdale, FL, USA), single-radius design, cruciate-retaining TKA. Intraoperatively, medial, and lateral pressures were measured at 10°, 45° and 90° of flexion using a pressure sensor (Verasense, OrthoSensor, 59 Inc., Dania Beach, FL, USA). The knee was considered balanced if the difference in pressures between compartments was less than 15 pounds-force (lbf).
RESULTS
There was no significant difference between the pressures measured in the medial compartment at 10°, 45° and 90° of flexion (P = 0.696). A statistically significant difference was found between the pressures measured in the lateral compartment at 10°, 45° and 90° of flexion, with the 10° value being significantly higher (P < 0.001), but this did not exceed the threshold of 15 lbf. None of the patients had a pressure difference of more than 15 lbf when pressures at 45° were compared to that at 10° and 90°, medially or laterally.
CONCLUSION
This study showed no evidence of mid-flexion instability in Mako-assisted TKA, using a single radius, cruciate-retaining prosthesis whilst maintaining the joint height.
LEVEL OF EVIDENCE
Level III retrospective cohort study.
PubMed: 38946011
DOI: 10.1186/s42836-024-00253-3 -
The Bone & Joint Journal Jul 2024Proximal humeral fractures are the third most common fracture among the elderly. Complications associated with fixation include screw perforation, varus collapse, and... (Meta-Analysis)
Meta-Analysis Comparative Study
AIMS
Proximal humeral fractures are the third most common fracture among the elderly. Complications associated with fixation include screw perforation, varus collapse, and avascular necrosis of the humeral head. To address these challenges, various augmentation techniques to increase medial column support have been developed. There are currently no recent studies that definitively establish the superiority of augmented fixation over non-augmented implants in the surgical treatment of proximal humeral fractures. The aim of this systematic review and meta-analysis was to compare the outcomes of patients who underwent locking-plate fixation with cement augmentation or bone-graft augmentation versus those who underwent locking-plate fixation without augmentation for proximal humeral fractures.
METHODS
The search was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Articles involving patients with complex proximal humeral fractures treated using open reduction with locking-plate fixation, with or without augmentation, were considered. A meta-analysis of comparative studies comparing locking-plate fixation with cement augmentation or with bone-graft augmentation versus locking-plate fixation without augmentation was performed.
RESULTS
A total of 19 studies were included in the qualitative synthesis, and six comparative studies were included in the meta-analysis. Overall, 120 patients received locking-plate fixation with bone-graft augmentation, 179 patients received locking-plate fixation with cement augmentation, and 336 patients received locking-plate fixation without augmentation. No statistically relevant differences between the augmented and non-augmented cohorts were found in terms of the Disabilities of the Arm, Shoulder and Hand questionnaire score and Constant-Murley Score. The cement-augmented group had a significantly lower rate of complications compared to the non-augmented group.
CONCLUSION
While locking-plate fixation with cement augmentation appears to produce a lower complication rate compared to locking-plate fixation alone, functional outcomes seem comparable between augmented and non-augmented techniques.
Topics: Humans; Bone Plates; Shoulder Fractures; Fracture Fixation, Internal; Bone Cements; Bone Transplantation; Treatment Outcome
PubMed: 38945543
DOI: 10.1302/0301-620X.106B7.BJJ-2023-1113.R1 -
The Bone & Joint Journal Jul 2024Robotic arm-assisted surgery offers accurate and reproducible guidance in component positioning and assessment of soft-tissue tensioning during knee arthroplasty, but... (Comparative Study)
Comparative Study
AIMS
Robotic arm-assisted surgery offers accurate and reproducible guidance in component positioning and assessment of soft-tissue tensioning during knee arthroplasty, but the feasibility and early outcomes when using this technology for revision surgery remain unknown. The objective of this study was to compare the outcomes of robotic arm-assisted revision of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA) versus primary robotic arm-assisted TKA at short-term follow-up.
METHODS
This prospective study included 16 patients undergoing robotic arm-assisted revision of UKA to TKA versus 35 matched patients receiving robotic arm-assisted primary TKA. In all study patients, the following data were recorded: operating time, polyethylene liner size, change in haemoglobin concentration (g/dl), length of inpatient stay, postoperative complications, and hip-knee-ankle (HKA) alignment. All procedures were performed using the principles of functional alignment. At most recent follow-up, range of motion (ROM), Forgotten Joint Score (FJS), and Oxford Knee Score (OKS) were collected. Mean follow-up time was 21 months (6 to 36).
RESULTS
There were no differences between the two treatment groups with regard to mean change in haemoglobin concentration (p = 0.477), length of stay (LOS, p = 0.172), mean polyethylene thickness (p = 0.065), or postoperative complication rates (p = 0.295). At the most recent follow-up, the primary robotic arm-assisted TKA group had a statistically significantly improved OKS compared with the revision UKA to TKA group (44.6 (SD 2.7) vs 42.3 (SD 2.5); p = 0.004) but there was no difference in the overall ROM (p = 0.056) or FJS between the two treatment groups (86.1 (SD 9.6) vs 84.1 (4.9); p = 0.439).
CONCLUSION
Robotic arm-assisted revision of UKA to TKA was associated with comparable intraoperative blood loss, early postoperative rehabilitation, functional outcomes, and complications to primary robotic TKA at short-term follow-up. Robotic arm-assisted surgery offers a safe and reproducible technique for revising failed UKA to TKA.
Topics: Humans; Arthroplasty, Replacement, Knee; Male; Female; Prospective Studies; Robotic Surgical Procedures; Aged; Middle Aged; Reoperation; Treatment Outcome; Range of Motion, Articular; Follow-Up Studies; Length of Stay; Postoperative Complications; Knee Prosthesis; Aged, 80 and over; Osteoarthritis, Knee
PubMed: 38945538
DOI: 10.1302/0301-620X.106B7.BJJ-2023-0943.R2 -
Mymensingh Medical Journal : MMJ Jul 2024Abdominal aortic aneurysm remains mostly asymptomatic. It is usually detected incidentally with imaging studies. Here we present a 55 years old hypertensive, non smoker,...
Abdominal aortic aneurysm remains mostly asymptomatic. It is usually detected incidentally with imaging studies. Here we present a 55 years old hypertensive, non smoker, non diabetic, male patient who was diagnosed as a case of infrarenal abdominal aortic aneurysm. He was treated by endovascular means using endograft without laparatomy. Endografts were deployed through bilateral femoral artery cut down technique under general anesthesia. Completion angiogram following this endovascular aneurysm repair (EVAR) technique revealed good technical success with no endoleak. This hybrid procedure was performed in a cathlab having surgical instruments in hand. Three years after the procedure, patient is doing well.
Topics: Humans; Aortic Aneurysm, Abdominal; Male; Endovascular Procedures; Middle Aged; Bangladesh; Blood Vessel Prosthesis Implantation; Endovascular Aneurysm Repair
PubMed: 38944744
DOI: No ID Found