| 3. |
- Esposito, Marco, 1965, et al.
(författare)
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MACHINED VERSUS CAST ABUTMENTS FOR DENTAL IMPLANTS: A 1-YEAR WITHIN-PATIENT MULTICENTRE RANDOMIZED CONTROLLED TRIAL ASSESSING MARGINAL SEAL CAPACITY AND OUTCOMES
- 2021
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Ingår i: Clinical Trials in Dentistry. - 2784-9015. ; 3:2, s. 19-31
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE To compare clinical outcomes of machined titanium abutments (machined group) versus cast cobalt-chrome abutments (cast group) and to evaluate in vitro their implant fit. MATERIALS AND METHODS This study comprised two parts. In the in vitro part, the im-plant–abutment fit of 5 cast abutments and 5 machined abutments screwed on with a torque of 30 Ncm was qualitatively and quantitatively evaluated using micro-computed tomography (µ-CT) and AgNO3 to reveal connection gaps. In the clinical part, 31 partially edentulous subjects received two single non-adjacent implant-supported crowns at three centres. At impression taking, three and a half months after implant placement, implants were randomized to receive a machined or cast abutment according to a wi-thin-patient study design. Unfortunately, four patients dropped out and one patient lost one implant before randomization, so only 26 patients had their implants randomized. Outcome measures were: prosthesis and implant failures, any complications, and radiographic peri-implant marginal bone level changes. Patients were followed up to 1 year after loading. RESULTS The fit of the implant–abutment connection was assessed in vitro using µ-CT scans. No gaps were revealed at any of the machined or cast abutments tested. In the clinical part, after randomization, three patients dropped out, no implant failed, but one crown on a cast abutment was replaced. The between-group difference in prosthesis failure was not statistically different (McNemar chi-square test P = 1.0; difference in proportions = 0.039). One complication occurred in each group, the difference not being statistically different (McNemar test P = 1.000; difference in proportions = 0; 95% CI 0.06 to 15.99). Both groups presented statistically significant peri-implant marginal bone loss from implant placement to 1 year after loading, respectively-0.76 ± 1.01 mm for machined and-0.69 ± 0.82 mm for cast abutments, with no statistically significant differences between the two groups (mean difference 0.07 mm; 95% CI-0.54 to 0.67; P = 0.828). Both groups gradually lost marginal peri-implant bone from loading to 1 year after loading but this was not significantly different, respectively-0.06 ± 0.56 mm for machined and-0.10 ± 0.29 mm for cast abutments, with no statistically significant differences between the two groups (P = 0.739; mean difference 0.07 mm; 95% CI-0.12 to 0.16; P = 0.739). CONCLUSIONS Our clinical data suggests that implant prognosis up to 1 year after loading is not affected by using machined or cast abutments. In support of these findings, in vitro analysis proved that both types of abutments allow a tight fit with no gaps. The-refore, for the time being dentists should feel free to choose whichever type they prefer. However, these preliminary results need to be confirmed by larger trials with at least 10 years of follow-up.
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| 4. |
- Lobon-Iglesias, M. J., et al.
(författare)
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Diffuse intrinsic pontine gliomas (DIPG) at recurrence : is there a window to test new therapies in some patients?
- 2018
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Ingår i: Journal of Neuro-Oncology. - : SPRINGER. - 0167-594X .- 1573-7373. ; 137:1, s. 111-118
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Tidskriftsartikel (refereegranskat)abstract
- Children with diffuse intrinsic pontine glioma (DIPG) need new and more efficient treatments. They can be developed at relapse or at diagnosis, but therefore they must be combined with radiotherapy. Survival of children after recurrence and its predictors were studied to inform the possibility to design early phase clinical trials for DIPG at this stage. Among 142 DIPG patients treated between 1998 and 2014, 114 had biopsy-proven DIPG with histone H3 status available for 83. We defined as long survivors' patients who survived more than 3 months after relapse which corresponds to the minimal life expectancy requested for phase I/II trials. Factors influencing post-relapse survival were accordingly compared between short and long-term survivors after relapse. Fifty-seven percent of patients were considered long survivors and 70% of them had a Lansky Play Scale (LPS) above 50% at relapse. Patients who became steroids-independent after initial treatment for at least 2 months had better survival after relapse (3.7 versus 2.6 months, p = 0.001). LPS above 50% at relapse was correlated with better survival after relapse (3.8 versus 1.8 months, p < 0.001). Patients with H3.1 mutation survived longer after relapse (4.9 versus 2.7 months, p = 0.007). Patients who received a second radiotherapy at the time of relapse had an improved survival (7.5 versus 4 months, p = 0.001). In the two-way ANOVA analysis, steroid-independence and LPS predicted survival best and the type of histone H3 (H3.1 or H3.3) mutated did not improve prediction. Survival of many DIPG patients after relapse over 3 months would make possible to propose specific trials for this condition. Steroid-independence, H3 mutation status and LPS should be considered to predict eligibility.
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