Incorporating Stud Attachments in the Bar Design for an Implant-Supported Overdenture.

Bone resorption following tooth loss might compromise retention, stability, and support of conventional removable prostheses, and for this reason, implant-supported overdentures are suggested as a viable alternative for completely edentulous patients. Bars, telescopic attachments, or stud attachments have been used to provide retention through a different mechanism of action based on specific design characteristics. The purpose of this report is to thoroughly describe the applied protocol for the fabrication of an implant overdenture supported by two bars incorporating stud attachments. A 67-year-old male patient presented to the Postgraduate Clinic of the National and Kapodistrian University in Athens seeking dental rehabilitation. The remaining teeth were characterized with poor prognosis, mainly due to their periodontal status. The proposed treatment plan included the placement of four implants in the maxilla and two implants in the mandible and the fabrication of implant-supported overdentures. The diagnostic stages revealed adequate prosthetic space that would enable the fabrication of a bar substructure for the maxillary overdenture. To combine the benefits of bars and stud attachments, two bars with four attachments were fabricated. Evaluation of the delivered prosthesis revealed adequate retention, support, and stability achieved with minimal palatal coverage. Patient's reported satisfaction and quality of life were increased. Recall appointments at one, six, and twelve months did not reveal any adverse effects or patient's complaints. According to the present case report, different types of attachments may be used after careful study of each case. More studies are needed to report on different aspects of the chosen treatment plan.

Temperature Changes during Implant Osteotomy Preparations in Human Cadaver Tibiae Comparing MIS® Straight Drills with Densah® Burs.

(1) Background: Several studies showed a sustained temperature of 47 °C or 50 °C for one minute resulted in vascular stasis and bone resorption with only limited bone regrowth over a 3-4-week healing period. The purpose of the present study was to evaluate the temperature changes (ΔΤ) that occur during the preparation of dental implant osteotomies using MIS® straight drills versus Densah® burs in a clockwise (cutting) drilling protocol. (2) Methods: Two hundred forty (240) osteotomies of two different systems' drills were prepared at 6 mm depth at 800, 1000, and 1200 revolutions per minute (RPM), in fresh, unembalmed tibiae, obtained by a female cadaver. ΔΤ was calculated by subtracting the baseline temperature on the tibial surface, from the maximum temperature-inside the osteotomy (ΔT = Tmax - Tbase). The variables were evaluated both for their individual and for their synergistic effect on ΔΤ with the use of one-, two-, three- and four-way interactions; (3) Results: An independent and a three-way interaction (drill design, drill width, and RPM) was found in all three RPM for the Densah® burs and at 1000 RPM for the MIS® straight drills. As Densah® burs diameter increased, ΔΤ decreased. The aforementioned pattern was seen only at 1000 RPM for the MIS® straight drills. The usage of drills 20 times more than the implant manufacturers' recommendation did not significantly affect the ΔΤ. A stereoscopic examination of the specimens confirmed the findings. (4) Conclusions: The independent and synergistic effect of drills' diameter, design and RPM had a significant effect on ΔΤ in human tibiae, which never exceeded the critical threshold of 47 °C.

Diverging trends of respiratory allergies and eczema in Greek schoolchildren: Six surveys during 1991-2018.

Background: The prevalence of childhood asthma, rhinoconjunctivitis, and eczema in the city of Patras, Greece, has been followed in four consecutive surveys since 1991. After a continuous rise in the prevalence of all three of these disorders, a plateau was reached for asthma between 2003 and 2008, whereas the prevalence of rhinoconjunctivitis and eczema continued to increase. Objective: To investigate these trends in the same population into the following decade. Methods: We repeated two methodologically identical cross-sectional parental questionnaire surveys in 2013 and 2018 among 8-9-year-old schoolchildren (N = 2554 and N = 2648, respectively). In 2018, spirometry and fractional exhaled nitric oxide (FeNO) measurements were also performed. Results: Current asthma (i.e., wheeze/asthma in the past 2 years) decreased from 6.9% in 2008 to 5.2% in 2013 and 4.3% in 2018 (p for trend < 0.001). The prevalence of lifetime ("ever had") rhinoconjunctivitis also declined (5.1% in 2008, 4.4% in 2013, 3.0% in 2018; p for trend < 0.001), whereas that of lifetime eczema increased (10.8%, 13.6%, and 16.1%, respectively; p for trend < 0.001). The relative risk of current asthma in children with ever-had rhinoconjundtivitis was 7.73 in 2008, 6.00 in 2013, and 6.69 in 2018, whereas the relative risk in those with ever-had eczema was 5.15, 2.80, and 2.22, respectively. Among children with asthma, those with rhinoconjunctivitis had lower forced expiratory volume in the first second of expiration and higher FeNO values than those with eczema. Conclusion: The prevalence of asthma and rhinoconjunctivitis declined during the past decade in Greek schoolchildren, whereas the prevalence of eczema continued to rise. Nevertheless, the relationship between rhinoconjunctivitis and asthma remained strong, whereas the association between eczema and asthma appears to have weakened.

Influence of different material substrates on the accuracy of 3 intraoral scanners: A single-blinded in vitro study.

PURPOSE: To compare the accuracy of three commercially available intraoral scanners when imaging various dental material substrates. MATERIALS AND METHODS: A maxillary dentate typodont model with 11 different dental material substrates was prepared and scanned using three intraoral scanners (TRIOS 3, 3Shape; CS 3600, Carestream; and Emerald S, Planmeca). The model was further scanned with a laboratory scanner (7series, Dental Wings) for reference. Files were exported in standard tessellation language format and inserted into a metrology 3D mesh software (CloudCompare). RESULTS: In terms of influence of different substrates on IOS trueness, a significant effect on the performance of TRIOS 3 and Emerald S was revealed. Concerning the accuracy of different intraoral scanners when scanning more translucent and reflective materials, pairwise comparisons revealed significant differences among scanners. In terms of complete-arch trueness and precision, pairwise comparisons revealed that TRIOS 3 had significantly higher trueness and precision compared to CS3600 and Emerald S. The complete-arch trueness and precision of CS3600 and Emerald S did not differ significantly. CONCLUSIONS: Dental material substrates influenced the accuracy of all three tested scanners. The full metal crown exhibited significantly lower trueness compared to other substrates across all three scanners. For the high-translucency substrate group, TRIOS 3 exhibited significantly higher trueness compared to CS 3600. Polished and unpolished class II amalgam restorations of similar dimensions did not exhibit significant differences in trueness regardless of intraoral scanner. In terms of complete-arch accuracy, TRIOS 3 had significantly higher trueness and precision compared to CS 3600 and Emerald S. All three scanners exhibited complete-arch average accuracy below 100 µm.

Neonatal Sepsis Due to Bacillus subtilis.

Bacillus subtilis is a gram-positive bacillus, commonly found in the environment (also as an endospore) and in the human gut (in a carrier-state), being considered as a bacterium of minimal virulence. We present a rare case of late-onset neonatal sepsis with multiple positive blood cultures and isolation of B. subtilis as the causative pathogen.

Changing trends in the prevalence of childhood asthma over 40 years in Greece.

BACKGROUND: A series of repeated questionnaire surveys among 8- to 9-year-old school children in the city of Patras, Greece, demonstrated a continuous rise in the prevalence of wheeze/asthma from 1978 to 2003, with a plateau between 2003 and 2008. We further investigated wheeze/asthma trends within the same environment over the last decade. METHODS: Two follow-up surveys were conducted in 2013 (N = 2554) and 2018 (N = 2648). Physician-diagnosed wheeze and asthma were analyzed in relation to their occurrence (recent-onset: within the last 2 years; noncurrent: before 2 years; persistent: both prior and within the last 2 years). In 2018, spirometry was also performed in participants reporting symptoms and in a sample of healthy controls. RESULTS: The prevalence of current wheeze/asthma declined from 6.9% in 2008% to 5.2% in 2013% and 4.3% in 2018. The persistent and noncurrent wheeze/asthma groups followed this overall trend (P-for-trend <0.001), while the prevalence of recent-onset wheeze/asthma remained unchanged (P-for-trend >0.05). Persistent and noncurrent wheezers were also more frequently diagnosed with asthma, in contrast to those with recent-onset wheeze. The FEV1 z-score was less than -1 in 32.1% of children with recent-onset and in 22.4% of those with persistent wheeze/asthma; both rates were higher than those of the Noncurrent wheeze/asthma group (7.1%; p < .05) and of healthy controls (3.5%; p < .001). CONCLUSIONS: The prevalence of childhood wheeze/asthma has declined significantly during the last decade in Greece. The reversing trend may in part be attributed to changing asthma perceptions among physicians and/or parents, especially in the case of younger children with troublesome respiratory symptoms.

Ralstonia Mannitolilytica, an Unusual Pathogen in the Neonatal Intensive Care Unit: A Case of Neonatal Sepsis and Literature Review.

BACKGROUND: Premature infants are considered high-risk subgroup for neonatal sepsis due to yet defective immune system, interventions practised and synergy of factors favoring multiple resistance of Gram-positive and Gram-negative pathogens to antimicrobial agents. CASE PRESENTATION: We present a case of late-onset neonatal sepsis in a premature infant caused by an uncommon pathogen; a premature infant of extremely low birth weight had in his 4th week of life severe clinical deterioration with lethargy, fever, pallor, mottling, abdominal distention, tachycardia, and worsening respiratory impairment. Full septic screen was performed, broad-spectrum antibiotic therapy was initiated and supportive care per needs was provided. Blood cultures (endotracheal tube tip cultures) isolated meropenem- and gentamicin-resistant strain of rare pathogen Ralstonia mannitolilytica. Ralstonia spp. are aerobic, Gram-negative, lactose non-fermenting, oxidaseand catalase-positive bacilli, thriving in water and soil. Ralstonia spp. are identified only sporadically as causative agents of neonatal sepsis; to our knowledge, this is the second report of neonatal sepsis due to R. mannitolilytica in the literature so far. Our patient was eventually treated (per sensitivity pattern) with intravenous ciprofloxacin and recovered well from the infection. CONCLUSION: We intend to raise awareness among neonatologists with regard to early detection of unusual pathogens, the emergence of antibiotic resistance patterns, and the obligation for adherence to infection control policies.