A Comparison of Conventionally Versus Digitally Fabricated Denture Outcomes in a University Dental Clinic.
- 作者列表："Clark WA","Brazile B","Matthews D","Solares J","De Kok IJ
PURPOSE:The purpose of this retrospective, cross-sectional study is to evaluate if there is a difference in number of visits (including fabrication and postoperative) and remake rate when comparing conventionally fabricated and digitally fabricated complete dentures by dental students in a predoctoral student dental clinic. MATERIALS AND METHODS:This two-year retrospective cross-sectional study consisted of a chart review for patients receiving maxillary and/or mandibular complete dentures between 2017 and 2019 (n = 314) at the UNC Adams School of Dentistry predoctoral student clinic. No control group was determined for this study. Data were extracted for 242 conventional dentures and 39 digital dentures. Objective treatment outcomes were obtained for each included denture: the number of patient appointments from preliminary impressions to denture placement, the number of postoperative visits, any complications noted, and any need for remakes. Fisher's Exact Test and Cochran-Mantel-Haenszel analysis were completed with statistical significance set at p < 0.05. RESULTS:For the number of visits from preliminary impression to placement, 50% of conventionally fabricated dentures had 6 or more visits, while only 5% of digitally fabricated dentures had 6 or more visits. This difference for the number of patient visits was statistically significant (p < 0.05). Additionally, conventionally fabricated dentures required an average of 2-3 postoperative visits, whereas digitally fabricated dentures required 1-2 postoperative visits. This difference was also statistically significant (p < 0.05). For the number of dentures requiring remake, there was no statistical difference (p = 0.1904). CONCLUSIONS:When comparing conventionally fabricated and digitally fabricated dentures in the predoctoral clinic, the digitally fabricated dentures required fewer patient appointments from start to finish, and fewer postoperative appointments than conventionally fabricated dentures. Fewer visits may be an important consideration for patients, especially those with limited access to care.
目的: 这项回顾性、横断面研究的目的是评估在博士生前牙科诊所比较牙科学生传统制作和数字制作的全口义齿时，就诊次数 (包括制作和术后) 和重拍率是否存在差异。 材料和方法: 这项为期两年的回顾性横断面研究包括对2017年至2019年间在UNC Adams牙科学院博士研究生诊所接受上颌和/或下颌全口义齿的患者 (n = 314) 的图表回顾。本研究未确定对照组。提取了242种常规义齿和39种数字义齿的数据。获得了每种包含的义齿的客观治疗结果: 从初步印象到义齿放置的患者预约次数、术后就诊次数、注意到的任何并发症以及任何重新制作的需要。Fisher精确检验和Cochran-Mantel-Haenszel分析完成，统计学显著性设定为p <0.05。 结果: 对于从初步印象到放置的访问次数，50% 的常规制作的义齿有6次或更多次访问，而只有5% 的数字化制作的义齿有6次或更多次访问。患者就诊次数的这种差异具有统计学显著性 (p <0.05)。此外，常规制造的假牙平均需要2-3次术后访视，而数字制造的假牙需要1-2次术后访视。这种差异也具有统计学意义 (p <0.05)。对于需要重新制作的义齿数量，没有统计学差异 (p = 0.1904)。 结论: 当比较博士前诊所的传统制作和数字制作假牙时，与传统制作假牙相比，数字制作假牙从开始到结束需要更少的患者预约，术后预约更少。对于患者来说，更少的就诊可能是一个重要的考虑因素，尤其是那些获得护理的机会有限的患者。
METHODS::The ATP binding-cassette superfamily corresponds the mostly transmembrane transporters family found in humans. These proteins actively transport endogenous and exogenous substrates through biological membranes in body tissues, so they have an important role in the regulation of many physiological functions necessary for human homeostasis, as well as in response regulation to several pharmacological substrates. The development of multidrug resistance has become one of the main troubles in conventional chemotherapy in different illnesses including cancer, being the increased efflux of antineoplastic drugs the main reason for this multidrug resistance, with a key role of the ABC superfamily. Likely, the interindividual variability in the pharmacological response among patients is well known, and may be due to intrinsically factors of the disease, genetic and environmental ones. Thus, the understanding of this variability, especially the genetic variability associated with the efficacy and toxicity of drugs, can provide a safer and more effective pharmacological treatment, so ABC genes are considered as important regulators due to their relationship with the reduction in pharmacological response. In this review, updated information about transporters belonging to this superfamily was collected, the possible role of these transporters in cancer, the role of genetic variability in their genes, as well as some therapeutic tools that have been tried to raise against main transporters associated with chemoresistance in cancer.
METHODS:BACKGROUND:Cholinergic neurotransmission regulates neuroinflammation in Parkinson disease (PD). RESEARCH DESIGN AND METHODS:The authors conducted a delayed-start study of donepezil for cognitive decline in non-demented PD patients. The study consisted of a 96-week randomized placebo-controlled double-blind phase 1, followed by a 24-week donepezil extension phase 2. The primary outcome measure was a change in the Mini-Mental State Examination (MMSE) at week 120. RESULTS:A total of 98 patients were randomly allocated to the early-start (donepezil-to-donepezil) and delayed-start (placebo-to-donepezil) groups. Mean (SD) of the baseline MMSE was 27.6 (2.0) and 28.0 (2.1), respectively. MMSE change at week 120 was better in the early-start group than in the delayed-start group, but the difference was not significant. The MMSE declined in apolipoprotein ε4 carriers, but not in non-carriers, and the factor interaction (intervention × ε4 genotype) was highly significant (P < 0.001). Analyzed with the interaction, the difference was significant (group difference 1.95 [0.33 to 3.57], P = 0.018). The MMSE decline slope in phase 1 was significantly better in the early-start group than in the delayed-start group (P = 0.048). CONCLUSIONS:Cognitive function deteriorated in ε4 carriers, but not in non-carriers, and early-start donepezil may postpone cognitive decline in the former.
METHODS::Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.