Development of a web-based care networking system to support visiting healthcare professionals in the community.

BACKGROUND: The role of visiting health services has been proven to be effective in promoting the health of older populations. Hence, developing a web system for nurses may help improve the quality of visiting health services for community-dwelling frail older adults. This study was conducted to develop a web application that reflects the needs of visiting nurses. METHODS: Visiting nurses of public health centers and community centers in South Korea participated in the design and evaluation process. Six nurses took part in the focus group interviews, and 21 visiting nurses and community center managers participated in the satisfaction evaluation. Focus group interviews were conducted to identify the needs of visiting nurses with respect to system function. Based on the findings, a web application that can support the effective delivery of home visiting services in the community was developed. An artificial intelligence (AI) algorithm was also developed to recommend health and welfare services according to each patient's health status. After development, a structured survey was conducted to evaluate user satisfaction with system features using Kano's model. RESULTS: The new system can be used with mobile devices to increase the mobility of visiting nurses. The system includes 13 features that support the management of patient data and enhance the efficiency of visiting services (e.g., map, navigation, scheduler, protocol archives, professional advice, and online case conferencing). The user satisfaction survey revealed that nurses showed high satisfaction with the system. Among all features, the nurses were most satisfied with the care plan, which included AI-based recommendations for community referral. CONCLUSIONS: The system developed from the study has attractive features for visiting nurses and supports their essential tasks. The system can help with effective case management for older adults requiring in-home care and reduce nurses' workload. It can also improve communication and networking between healthcare and long-term care institutions.

Capacitance Contribution of NIH/3T3 Cells Existing on and between Electrodes of an Impedance Biosensor.

In this study, an impedance biosensor capable of real-time monitoring of the growth and drug reactions using NIH/3T3 cells was fabricated through a semiconductor process. With the fabricated impedance biosensor, the cell growth and drug reaction states are monitored in real-time, showing the validness of the developed biosensor. By using the developed impedance biosensor, we have investigated the capacitance contribution of NIH/3T3 cells existing on electrodes and between electrodes. To compare the capacitance value contributions of the cells on and between electrodes, wide- and narrow-gap electrode patterns are manufactured with 3.7 and 0.3 mm electrode gap spacings, respectively. From the detailed analysis, the capacitance contributions of NIH/3T3 cells existing on electrodes are estimated around less than 20 percent compared to the cells existing between electrodes. In other words, a minimized electrode area with maximized electrode spacing is the promising impedance biosensor design guide for accurate cell capacitance measurements.

Effect of abutment shade, ceramic thickness, and coping type on the final shade of zirconia all-ceramic restorations: in vitro study of color masking ability.

PURPOSE: The aim of the study was to evaluate the effect of abutment shade, ceramic thickness, and coping type on the final shade of zirconia all-ceramic restorations. MATERIALS AND METHODS: Three different types of disk-shaped zirconia coping specimens (Lava, Cercon, Zirkonzahn: ø10 mm × 0.4 mm) were fabricated and veneered with IPS e.max Press Ceram (shade A2), for total thicknesses of 1 and 1.5 mm. A total of sixty zirconia restoration specimens were divided into six groups based on their coping types and thicknesses. The abutment specimens (ø10 mm × 7 mm) were prepared with gold alloy, base metal (nickel-chromium) alloy, and four different shades (A1, A2, A3, A4) of composite resins. The average L*, a*, b* values of the zirconia specimens on the six abutment specimens were measured with a dental colorimeter, and the statistical significance in the effects of three variables was analyzed by using repeated measures analysis of variance (α=.05).The average shade difference (ΔE) values of the zirconia specimens between the A2 composite resin abutment and other abutments were also evaluated. RESULTS: The effects of zirconia specimen thickness (P<.001), abutment shade (P<.001), and type of zirconia copings (P<.003) on the final shade of the zirconia restorations were significant. The average ΔE value of Lava specimens (1 mm) between the A2 composite resin and gold alloy abutments was higher (close to the acceptability threshold of 5.5 ΔE) than th ose between the A2 composite resin and other abutments. CONCLUSION: This in-vitro study demonstrated that abutment shade, ceramic thickness, and coping type affected the resulting shade of zirconia restorations.

Effect of cement washout on loosening of abutment screws and vice versa in screw- and cement- retained implant-supported dental prosthesis.

PURPOSE: The purpose of this study was to examine the abutment screw stability of screw- and cement-retained implant-supported dental prosthesis (SCP) after simulated cement washout as well as the stability of SCP cements after complete loosening of abutment screws. MATERIALS AND METHODS: Thirty-six titanium CAD/CAM-made implant prostheses were fabricated on two implants placed in the resin models. Each prosthesis is a two-unit SCP: one screw-retained and the other cemented. After evaluating the passive fit of each prosthesis, all implant prostheses were randomly divided into 3 groups: screwed and cemented SCP (Control), screwed and noncemented SCP (Group 1), unscrewed and cemented SCP (Group 2). Each prosthesis in Control and Group 1 was screwed and/or cemented, and the preloading reverse torque value (RTV) was evaluated. SCP in Group 2 was screwed and cemented, and then unscrewed (RTV=0) after the cement was set. After cyclic loading was applied, the postloading RTV was measured. RTV loss and decementation ratios were calculated for statistical analysis. RESULTS: There was no significant difference in RTV loss ratio between Control and Group 1 (P=.16). No decemented prosthesis was found among Control and Group 2. CONCLUSION: Within the limits of this in vitro study, the stabilities of SCP abutment screws and cement were not significantly changed after simulated cement washout or screw loosening.

In vitro evaluation of resonance frequency analysis values to different implant contact ratio and stiffness of surrounding material.

PURPOSE: The present study was aimed to evaluate the influence of implant contact ratio and stiffness of implant-surrounding materials on the resonance frequency analysis (RFA) values. MATERIALS AND METHODS: Seventy resin blocks that had the different amounts (100, 50, 30, 15%) of resin-implant contact (RIC) were fabricated. Ten silicone putty blocks with 100% silicone-implant contact were also made. The implants with Ø5.0 mm × 13.0 mm were placed on eighty specimen blocks. The RFA value was measured on the transducer that was connected to each implant by Osstell Mentor. Kruskal-Wallis and Scheffe's tests (α=.05) were done for statistical analysis. RESULTS: The control resin group with 100% RIC had the highest RFA value of 83.9, which was significantly different only from the resin group with 15% RIC among the resin groups. The silicone putty group with 100% contact had the lowest RFA value of 36.6 and showed statistically significant differences from the resin groups. CONCLUSION: Within the limitations of this in vitro study, there was no significant difference in the RFA values among the resin groups with different RIC's except when the RIC difference was more than 85%. A significant increase in the RFA value was observed related to the increase in stiffness of material around implant.

Effect of loading time on the survival rate of anodic oxidized implants: prospective multicenter study.

PURPOSE: The purpose of this prospective study was to evaluate the effect of early loading on survival rate or clinical parameter of anodic oxidized implants during the 12-month postloading period. MATERIALS AND METHODS: Total 69 implants were placed in 42 patients. Anodic oxidized implants (GS II, Osstem Cor., Busan, Korea) placed on the posterior mandibles were divided into two groups, according to their prosthetic loading times: test group (2 to 6 weeks), and control group (3 to 4 months). The implant survival rates were determined during one-year postloading period and analyzed by Kaplan-Meier method. The radiographic peri-implant bone loss and periodontal parameters were also evaluated and statistically analyzed by unpaired t-test. RESULTS: Total 69 implants were placed in 42 patients. The cumulative postloading implant survival rates were 88.89% in test group, compared to 100% in control group (P<.05). Periimplant marginal bone loss (T: 0.27±0.54 mm, C: 0.40±0.55 mm) and periodontal parameters showed no significant difference between the groups (P>.05). CONCLUSION: Within the limitation of the present study, implant survival was affected by early loading on the anodic oxidized implants placed on posterior mandibles during one-year follow-up. Early implant loading did not influence peri-implant marginal bone loss, and periodontal parameters.

Simplified abutment tooth extrusion using a mini-implant.

This is the report of a patient with an anterior four-unit fixed partial denture in whom a screw was used to extrude a too-short abutment tooth. Due to the mini-implant, fewer teeth needed to be bonded, thereby keeping more teeth out of harm's way.

In vitro evaluation of reverse torque value of abutment screw and marginal opening in a screw- and cement-retained implant fixed partial denture design.

PURPOSE: The purpose of this study was to evaluate the clinical efficacy of implant prostheses retained by screws and cement (SCPs) by examining the reverse torque values (RTVs) of the abutment screws and the marginal openings of the implant prostheses. MATERIALS AND METHODS: Two implants (3.8 x 13 mm; Camlog Biotechnologies) were embedded in an acrylic resin block 5 mm apart. Eighteen copies of this resin specimen were fabricated and randomly divided into two groups. Two-unit implant prostheses with two different designs-purely cement-retained implant prostheses (group 1) and SCPs (group 2)-were made out of type IV gold alloy and placed on the implants. After tightening to about 30 Ncm, the preloading RTVs of the abutment screws were measured. After retightening the abutment screws or cementing the prostheses, followed by cyclic loading, the postloading RTVs of the abutment screws were examined. Also, the marginal openings of the prostheses in the two groups were measured under a stereomicroscope. These measurements were compared statistically. RESULTS: The postloading RTVs and their differences from the preloading RTVs of the abutment screws demonstrated no significant differences between groups (P > .05). Group 2 prostheses showed significantly smaller marginal openings than group 1 prostheses (P < .05). CONCLUSION: The forces generated when torquing the abutment screw of the SCP did not cause more loosening of the abutment screws than the purely cement-retained implant prosthesis. The SCP showed better marginal adaptation of the cement-retained part than the purely cement-retained implant prosthesis, possibly as a result of the screw-retained abutment seating the restoration. Within the limitations of this in vitro test, the SCP showed no significant difference in RTV of the abutment screw and a smaller marginal gap compared to a purely cement-retained implant prosthesis.