Effect of erbium, chromium-doped: yttrium, scandium, gallium, and garnet laser-assisted periodontal therapy using radial firing tip during early healing period: a randomized controlled split-mouth clinical trial.

BACKGROUND: This study aimed to demonstrate the efficacy of erbium, chromium-doped:yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser-assisted nonsurgical periodontal therapy in periodontitis patients during 8 weeks of healing. METHODS: A split-mouth, single-blinded, randomized controlled clinical trial was conducted on 12 patients diagnosed with stage III/IV periodontitis and had a minimum of two teeth with probing pocket depth (PPD) > 5 mm in at least two quadrants. Upon randomization, each quadrant was assigned for conventional scaling and root planing (SRP) procedure or laser-assisted therapy (SRP + laser) using radial firing tip (RFPT 5, Biolase). Clinical measurements and gingival crevicular fluid collection were performed for statistical analysis. RESULTS: In the initial statistical analysis on the whole subject teeth, modified gingival index (MGI) reduction was greater in test group at 1(P = 0.0153), 4 (P = 0.0318), and 8 weeks (P = 0.0047) compared to the control in the same period. PPD reduction at 4 weeks in test group was -1.67 ± 0.59 showing significant difference compared to the control (-1.37 ± 0.63, P = 0.0253). When teeth with mean PPD ≥5 mm were sorted, MGI decrease was significantly greater in test group at 1 (P=0.003) and 8 week (P=0.0102) follow-ups. PPD reduction was also significantly greater in test group at 4 week period (-1.98 ± 0.55 vs -1.58 ± 0.56, test vs control, P=0.0224). CONCLUSIONS: Er,Cr:YSGG-assisted periodontal therapy is beneficial in MGI and PPD reductions during early healing period.

Development of a greenhouse gas - air pollution interactions and synergies model for Korea (GAINS-Korea).

This study aimed to create Greenhouse Gas - Air Pollution Interactions and Synergies (GAINS)-Korea, an integrated model for evaluating climate and air quality policies in Korea, modeled after the international GAINS model. GAINS-Korea incorporates specific Korean data and enhances granularity for enabling local government-level analysis. The model includes source-receptor matrices used to simulate pollutant dispersion in Korea, generated through CAMx air quality modeling. GAINS-Korea's performance was evaluated by examining different scenarios for South Korea. The business as usual scenario projected emissions from 2010 to 2030, while the air quality scenario included policies to reduce air pollutants in line with air quality and greenhouse gas control plans. The maximum feasible reduction scenario incorporated more aggressive reduction technologies along with air quality measures. The developed model enabled the assessment of emission reduction effects by both greenhouse gas and air pollutant emission reduction policies across 17 local governments in Korea, including changes in PM2.5 (particulate matter less than 2.5 µm) concentration and associated benefits, such as reduced premature deaths. The model also provides a range of visualization tools for comparative analysis among different scenarios, making it a valuable resource for policy planning and evaluation, and supporting decision-making processes.

Investigation of Bone Regeneration Efficacy of New Bovine Bone Minerals in a Canine Mandibular Critical Defect Model.

This study aims to investigate the bone regeneration effect of bovine hydroxyapatite-processed biomaterials Bone-XB and S1-XB in a beagle mandibular defect model. A total of four saddle-type critical sizes (15 mm × 10 mm) bone defects are created in each dog: two defects in the left mandible and two defects in the right mandible. The defect control (DC) group is kept unfilled, and the other three defects are filled with three different biomaterials as follows: positive control Bio-Oss (Bio-Oss group), Bone-XB (XB group), and S1-XB (S1-XB group). Bone regeneration is evaluated by radiography, micro-computed tomography, and histological analysis. It is revealed that Bone-XB and S1-XB significantly increase newly formed bone, defect filling percentage, and bone healing score compared to the DC group, which is confirmed by bone microstructure augmentation (bone volume/total volume, trabecular number, and trabecular thickness). Interestingly, no significant differences are observed between the Bone-XB, S1-XB, and Bio-Oss groups. It is suggested that Bone-XB or S1-XB stimulates bone regeneration demonstrated by the increase in newly formed bone and bone microstructure, thereby improving bone defect filling, which is equivalent to the Bio-Oss. Therefore, bovine hydroxyapatite-processed Bone-XB or S1-XB can be considered effective biomaterials for correcting critical-size bone defects or fractures.

Screening of Hydroxyapatite Biomaterials for Alveolar Augmentation Using a Rat Calvaria Critical-Size Defect Model: Bone Formation/Maturation and Biomaterials Resolution.

BACKGROUND: Natural (bovine-/equine-/porcine-derived) or synthetic hydroxyapatite (HA) biomaterials appear to be the preferred technologies among clinicians for bone augmentation procedures in preparation for implant dentistry. The aim of this study was to screen candidate HA biomaterials intended for alveolar ridge augmentation relative to their potential to support local bone formation/maturation and to assess biomaterial resorption using a routine critical-size rat calvaria defect model. METHODS: Eighty adult male Sprague Dawley outbred rats obtained from a approved-breeder, randomized into groups of ten, were used. The calvaria defects (ø8 mm) either received sham surgery (empty control), Bio-Oss (bovine HA/reference control), or candidate biomaterials including bovine HA (Cerabone, DirectOss, 403Z013), and bovine (403Z014) or synthetic HA/ß-TCP (Reprobone, Ceraball) constructs. An 8 wk healing interval was used to capture the biomaterials' resolution. RESULTS: All biomaterials displayed biocompatibility. Strict HA biomaterials showed limited, if any, signs of biodegradation/resorption, with the biomaterial area fraction ranging from 22% to 42%. Synthetic HA/ß-TCP constructs showed limited evidence of biodegradation/erosion (biomaterial area fraction ≈30%). Mean linear defect closure in the sham-surgery control approximated 40%. Mean linear defect closure for the Bio-Oss reference control approximated 18% compared with 15-35% for the candidate biomaterials without significant differences between the controls and candidate biomaterials. CONCLUSIONS: None of the candidate HA biomaterials supported local bone formation/maturation beyond the native regenerative potential of this rodent model, pointing to their limitations for regenerative procedures. Biocompatibility and biomaterial dimensional stability could suggest their potential utility as long-term defect fillers.

PM2.5 Forecast in Korea using the Long Short-Term Memory (LSTM) Model.

The National Institute of Environmental Research, under the Ministry of Environment of Korea, provides two-day forecasts, through AirKorea, of the concentration of particulate matter with diameters of ≤ 2.5 µm (PM2.5) in terms of four grades (low, moderate, high, and very high) over 19 districts nationwide. Particulate grades are subjectively designated by human forecasters based on forecast results from the Community Multiscale Air Quality (CMAQ) and artificial intelligence (AI) models in conjunction with weather patterns. This study evaluates forecasts from the long short-term memory (LSTM) algorithm relative to those from CMAQ-solely and AirKorea using observations from 2019. The skills of the one-day PM2.5 forecasts over the 19 districts were 39-70% for CMAQ, 72-79% for LSTM, and 73-80% for AirKorea; the AI forecasts showed comparable skills to the human forecasters at AirKorea. The one-day forecast skill levels of high and very high PM2.5 pollution grades are 31-98%, 31-74%, and 39-81% for the CMAQ-solely, the LSTM, and the AirKorea forecasts, respectively. Despite good skills for forecasting the high and very high events, CMAQ-solely forecasts also generate substantially higher false alarm rates (up to 86%) than the LSTM and AirKorea forecasts (up to 58%). Hence, applying only the LSTM model to the CMAQ forecasts can yield reasonable forecast skill levels comparable to the operational AirKorea forecasts that elaborately combine the CMAQ model, AI models, and human forecasters. The present results suggest that applications of appropriate AI models can greatly enhance PM2.5 forecast skills for Korea in a more objective way. Supplementary Information: The online version contains supplementary material available at 10.1007/s13143-022-00293-2.

A novel statistical-dynamical method for a seasonal forecast of particular matter in South Korea.

Societal concerns about air quality in East Asia are still growing despite country-level efforts to reduce air pollution emissions. In coping with this growing concern, the government and the public demand a longer­lead forecast of air quality to ensure sufficient response time until society prepares for countermeasures such as a temporary reduction of specific emission sources. Here we propose a novel method that produces skillful seasonal forecasting of wintertime (December to February) PM10 concentration over South Korea. The method is based on the idea that climate condition and air quality have co-variability in the seasonal time scales and that the state-of-art seasonal prediction model will benefit air quality forecasting. More specifically, a linear regression model is constructed to link observed winter PM10 concentration and climate variables where the predicted climate variables were furnished from NCEP CFSv2 forecast initialized during autumn. In this case, climate variables were selected as predictors of the model because they are not only physically related to air quality but also 'predictable' in CFS hindcast. Through analysis of retrospective forecasts of 20 winters for the period 2001-2020, we found this model shows statistically significant skill for the seasonal forecast of wintertime PM10 concentration.

Statistical Seasonal Forecasting of Winter and Spring PM2.5 Concentrations Over the Korean Peninsula.

Concentrations of fine particulate matter smaller than 2.5 µm in diameter (PM2.5) over the Korean Peninsula experience year-to-year variations due to interannual variation in climate conditions. This study develops a multiple linear regression model based on slowly varying boundary conditions to predict winter and spring PM2.5 concentrations at 1-3-month lead times. Nation-wide observations of Korea, which began in 2015, is extended back to 2005 using the local Seoul government's observations, constructing a long-term dataset covering the 2005-2019 period. Using the forward selection stepwise regression approach, we identify sea surface temperature (SST), soil moisture, and 2-m air temperature as predictors for the model, while rejecting sea ice concentration and snow depth due to weak correlations with seasonal PM2.5 concentrations. For the wintertime (December-January-February, DJF), the model based on SSTs over the equatorial Atlantic and soil moisture over the eastern Europe along with the linear PM2.5 concentration trend generates a 3-month forecasts that shows a 0.69 correlation with observations. For the springtime (March-April-May, MAM), the accuracy of the model using SSTs over North Pacific and 2-m air temperature over East Asia increases to 0.75. Additionally, we find a linear relationship between the seasonal mean PM2.5 concentration and an extreme metric, i.e., seasonal number of high PM2.5 concentration days. Supplementary Information: The online version contains supplementary material available at 10.1007/s13143-022-00275-4.

A novel CMAQ-CNN hybrid model to forecast hourly surface-ozone concentrations 14 days in advance.

Issues regarding air quality and related health concerns have prompted this study, which develops an accurate and computationally fast, efficient hybrid modeling system that combines numerical modeling and machine learning for forecasting concentrations of surface ozone. Currently available numerical modeling systems for air quality predictions (e.g., CMAQ) can forecast 24 to 48 h in advance. In this study, we develop a modeling system based on a convolutional neural network (CNN) model that is not only fast but covers a temporal period of two weeks with a resolution as small as a single hour for 255 stations. The CNN model uses meteorology from the Weather Research and Forecasting model (processed by the Meteorology-Chemistry Interface Processor), forecasted air quality from the Community Multi-scale Air Quality Model (CMAQ), and previous 24-h concentrations of various measurable air quality parameters as inputs and predicts the following 14-day hourly surface ozone concentrations. The model achieves an average accuracy of 0.91 in terms of the index of agreement for the first day and 0.78 for the fourteenth day, while the average index of agreement for one day ahead prediction from the CMAQ is 0.77. Through this study, we intend to amalgamate the best features of numerical modeling (i.e., fine spatial resolution) and a deep neural network (i.e., computation speed and accuracy) to achieve more accurate spatio-temporal predictions of hourly ozone concentrations. Although the primary purpose of this study is the prediction of hourly ozone concentrations, the system can be extended to various other pollutants.

Lip Repositioning Surgery Using an Er,Cr:YSGG Laser: A Case Series.

Excessive gingival display (EGD) is a common esthetic concern. Lip repositioning surgery (LRS) was introduced as one of the treatment options to manage EGD. LRS can be used for skeletally and/or muscularly induced EGD. The present case series applied LRS using an Er,Cr:YSGG laser to treat 24 patients with minor vertical maxillary overgrowth or a hypermobile lip. At 6 months, the gingival display had decreased by 3.79 ± 1.59 mm (mean ± standard deviation), and the visible lip body when smiling had increased by 1.23 ± 0.74 mm. A questionnaire revealed that the level of satisfaction with the smile increased among the patients and that they had a positive attitude toward Er,Cr:YSGG laser-assisted LRS.

Comparative assessment of net CO2 exchange across an urbanization gradient in Korea based on eddy covariance measurements.

BACKGROUND: It is important to quantify changes in CO2 sources and sinks with land use and land cover change. In the last several decades, carbon sources and sinks in East Asia have been altered by intensive land cover changes due to rapid economic growth and related urbanization. To understand impact of urbanization on carbon cycle in the monsoon Asia, we analyze net CO2 exchanges for various land cover types across an urbanization gradient in Korea covering high-rise high-density residential, suburban, cropland, and subtropical forest areas. RESULTS: Our analysis demonstrates that the urban residential and suburban areas are constant CO2 sources throughout the year (2.75 and 1.02 kg C m-2 year-1 at the urban and suburban sites), and the net CO2 emission indicate impacts of urban vegetation that responds to the seasonal progression of the monsoon. However, the total random uncertainties of measurement are much larger in the urban and suburban areas than at the nonurban sites, which can make it challenging to obtain accurate urban flux measurements. The cropland and forest sites are strong carbon sinks because of a double-cropping system and favorable climate conditions during the study period, respectively (- 0.73 and - 0.60 kg C m-2 year-1 at the cropland and forest sites, respectively). The urban area of high population density (15,000 persons km-2) shows a relatively weak CO2 emission rate per capita (0.7 t CO2 year-1 person-1), especially in winter because of a district heating system and smaller traffic volume. The suburban area shows larger net CO2 emissions per capita (4.9 t CO2 year-1 person-1) because of a high traffic volume, despite a smaller building fraction and population density (770 persons km-2). CONCLUSIONS: We show that in situ flux observation is challenging because of its larger random uncertainty and this larger uncertainty should be carefully considered in urban studies. Our findings indicate the important role of urban vegetation in the carbon balance and its interaction with the monsoon activity in East Asia. Urban planning in the monsoon Asia must consider interaction on change in the monsoon activity and urban structure and function for sustainable city in a changing climate.

Sinus augmentation using rhBMP-2/ACS in a mini-pig model: Influence of an adjunctive ceramic bone biomaterial.

BACKGROUND: Recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier (rhBMP-2/ACS) has been shown to support significant bone formation when used to augment the maxillary sinus for implant dentistry. Nevertheless, bone biomaterials have been suggested to extend rhBMP-2/ACS with limited support of the merits of such approaches. OBJECTIVES: To evaluate local bone formation/dental implant osseointegration following implantation of rhBMP-2/ACS combined with a ceramic bone biomaterial using a mini-pig sinus augmentation model. METHODS: Twelve adult Göttingen mini-pigs received rhBMP-2/ACS (rhBMP-2 adjusted to 0.43 mg/cc) alone or combined with an off-the-shelf biphasic ceramic (15%/85% HA/ß-TCP) biomaterial at 3:1, 1:1 and 1:3 ratios randomized to contra-lateral maxillary sinus sites yielding rhBMP-2/ACS fractions of 100%, 75%, 50% and 25%, respectively. A 4-cc implant volume was used for all sites. Two threaded dental implants (ø4.0 × 11.5 mm) were placed at each site. The animals were euthanized at 8 weeks for histologic analysis. RESULTS: Surgical execution and healing were generally uneventful, infraorbital local swelling was observed in all animals until suture removal. rhBMP-2/ACS combined with the ceramic biomaterial did not significantly enhance local bone formation (range 9.0 ± 1.5 to 9.7 ± 2.1 mm) compared with rhBMP-2/ACS alone (8.6 ± 1.1 mm; p > 0.05). Variations in rhBMP-2/ACS to ceramic matrix ratios yielding rhBMP-2 doses approximating 0.4, 0.9, 1.3 and 1.7 mg/sinus did not appreciably influence bone formation/osseointegration. CONCLUSIONS: Whereas rhBMP-2/ACS supports significant bone formation/osseointegration in the mini-pig sinus augmentation model and thus appears an effective alternative for sinus augmentation procedures, adding a ceramic biomaterial to rhBMP-2/ACS does not produce meaningful biological advantages.

Screening of candidate biomaterials for alveolar augmentation using a critical-size rat calvaria defect model.

OBJECTIVE: To screen candidate biomaterials intended for alveolar augmentation relative to their potential to enhance local bone formation using a routine critical-size (ø8-mm) rat calvaria defect model. METHODS: One hundred and forty male Sprague Dawley outbred rats, age 11-12 weeks, weight 325-375 g, obtained from USDA approved breeder, randomised into 14 groups of 10 animals, each received one of the following treatments: sham-surgery (empty control), Bio-Oss (bovine HA/reference control), or candidate biomaterials including bovine HA, synthetic HA/ß-TCP and calcium phosphate constructs, mineralised/demineralised human bone preparations, a ß-TCP/calcium sulphate and an HA/calcium sulphate putty. A 4-week healing interval was chosen to discern local bone formation using incandescent and polarised light microscopy. Statistical analysis used one-way ANOVA followed by Bonferroni for pairwise comparisons. RESULTS: Candidate biomaterials all displayed biocompatibility. They exhibited limited, if any, appreciable bioerosion or biodegradation. No statistically significant differences in mean linear defect closure were observed among experimental groups, sham-surgery displaying the highest score (48.1 ± 24.3%). Sham-surgery also showed a significantly greater bone area fraction than all other groups (19.8 ± 13.9%, p < .001). The HA/calcium sulphate putty showed a significantly greater residual biomaterial area fraction than all other groups (61.1 ± 8.5%, p < .01). CONCLUSION: Within the limitations of this animal model, although biocompatible, none of the tested biomaterials enhanced local bone formation beyond the innate regenerative potential of this craniotomy defect.

Comparison of partially-absorbable lightweight mesh with heavyweight mesh for inguinal hernia repair: multicenter randomized study.

PURPOSE: Prosthetic mesh is widely used for inguinal hernia repair; however, pain and stiffness can develop. This study was a prospective, multicenter, single-blind, randomized trial to assess postoperative pain and quality of life according to mesh type after inguinal hernia repair. METHODS: Forty-seven patients who underwent Lichtenstein repair for unilateral inguinal hernia with prosthetic mesh were enrolled and randomly allocated to the partially-absorbable lightweight mesh (LW group, n = 24) or heavyweight mesh group (HW group, n = 23). Data were collected using a visual analogue scale (VAS), Carolinas Comfort Scale (CCS), and Activities Assessment Scale (AAS) at screening and postoperative day 1, 7, 90, and 120; foreign body sensation, sense of stiffness, and sense of pull during activity were also evaluated. RESULTS: There were no significant differences in patients' demographics and clinical characteristics between groups. The VAS at day 90 was significantly lower in the LW group (0.46 ± 0.78 vs. 0.96 ± 0.82, P = 0.027). The CCS and AAS were significantly lower in the LW group at day 1 (51.33 ± 20.29 vs. 64.65 ± 22.64, P = 0.047 and 39.83 ± 9.88 vs. 46.43 ± 7.82, P = 0.015, respectively). Foreign body sensation was significantly lower in the LW group at day 120 (4.2% vs. 30.4 %, P = 0.023), as was sense of stiffness (P = 0.023). The sense of pull during activity was lower in the LW group at day 90 and 120 (P = 0.012 and P = 0.022, respectively). There was no recurrence or serious complication during follow-up. CONCLUSION: Partially-absorbable lightweight prosthetic mesh can be used for inguinal hernia repair safely and improve functional outcomes and quality of life after surgery.

Sinus augmentation using a mini-pig model: Effect of ceramic and allogeneic bone biomaterials.

BACKGROUND: Present clinical practice broadly relies on off-the-shelf allogeneic, xenogeneic or synthetic bone biomaterials in support of sinus augmentation. Also, recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier (rhBMP-2/ACS) has been shown to support clinically relevant bone formation when used to augment the maxillary sinus. OBJECTIVES: To evaluate local bone formation/dental implant osseointegration following implantation of two particulate bone biomaterials using the mini-pig sinus augmentation model. METHODS: Nine adult Göttingen mini-pigs were used for evaluation of a biphasic ceramic (15%/85% HA/ß-TCP) and an allogeneic mineralized bone biomaterial. Treatments randomized to contralateral sinus sites included sham-surgery (control) and biomaterials. Two threaded dental implants (ø4.0 × 11.5 mm) were placed at each sinus site. The animals were euthanized at 8 weeks for histologic analysis. RESULTS: Execution of the surgical protocol and healing was unremarkable. Limited infraorbital swelling was observed until suture removal. The biphasic ceramic and allogeneic bone biomaterials produced significantly increased bone formation (5.2 ± 1.9 mm and 4.9 ± 1.6 mm vs. 2.6 ± 0.5 mm, p < 0.05) and osseointegration (18.0 ± 6.0% and 25.1 ± 18.2% vs. 10.1 ± 8.0%, p < 0.05) over the sham-surgery control. No significant differences were observed between biomaterials. CONCLUSIONS: Implantation of biphasic ceramic or allogeneic bone biomaterials enhances bone formation in the mini-pig maxillary sinus, however, dental implant bone support is incomplete resulting in overall limited osseointegration.

Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet Laser Effectively Ablates Single-Species Biofilms on Titanium Disks Without Detectable Surface Damage.

BACKGROUND: Increasing evidence implicates biofilms, consisting of species such as Porphyromonas gingivalis (Pg), in the etiology of peri-implantitis. Multiple approaches to ablate biofilms on failing implants have been proposed and include use of lasers, most recently the erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser. The purpose of this study is to establish an in vitro single-species biofilm model on implant surfaces and determine power settings of the Er,Cr:YSGG laser that remove biofilm without causing physical damage to disks. METHODS: Single-species biofilms consisting of Pg strain 381 were grown on titanium disks, including: 1) sandblasted, large-grit, acid-etched (SLA); 2) calcium phosphate nano-coated (CaP); 3) anodized; or 4) machined surfaces. Power settings from 0 to 1.5 W using an Er,Cr:YSGG laser equipped with radial firing tip were used. Biofilm formation/removal was quantitated using confocal and scanning electron microscopy. Surface changes in temperature, microroughness, and water contact angle were analyzed. RESULTS: Results show confluent Pg biofilm coating all disk surfaces. The laser removed biofilms from all surfaces, with CaP and SLA surfaces requiring power setting of 1.0 to 1.5 W for ablation of bacteria coating the disks. Within this power range, and with water spray, there were no changes in surface temperature, surface roughness, or contact angle on any surfaces tested. CONCLUSION: The Er,Cr:YSGG laser with radial firing tip and water spray was able to effectively ablate ≥95% of biofilm on all types of tested titanium surfaces, using clinically relevant power settings, without causing measurable physical changes to surfaces.

Evaluating the predictability of PM10 grades in Seoul, Korea using a neural network model based on synoptic patterns.

As of November 2014, the Korean Ministry of Environment (KME) has been forecasting the concentration of particulate matter with diameters ≤ 10 µm (PM10) classified into four grades: low (PM10 ≤ 30 µg m-3), moderate (30 < PM10 ≤ 80 µg m-3), high (80 < PM10 ≤ 150 µg m-3), and very high (PM10 > 150 µg m-3). The KME operational center generates PM10 forecasts using statistical and chemistry-transport models, but the overall performance and the hit rate for the four PM10 grades has not previously been evaluated. To provide a statistical reference for the current air quality forecasting system, we have developed a neural network model based on the synoptic patterns of several meteorological fields such as geopotential height, air temperature, relative humidity, and wind. Hindcast of the four PM10 grades in Seoul, Korea was performed for the cold seasons (October-March) of 2001-2014 when the high and very high PM10 grades are frequently observed. Because synoptic patterns of the meteorological fields are distinctive for each PM10 grade, these fields were adopted and quantified as predictors in the form of cosine similarities to train the neural network model. Using these predictors in conjunction with the PM10 concentration in Seoul from the day before prediction as an additional predictor, an overall hit rate of 69% was achieved; the hit rates for the low, moderate, high, and very high PM10 grades were 33%, 83%, 45%, and 33%, respectively. Our findings also suggest that the synoptic patterns of meteorological variables are reliable predictors for the identification of the favorable conditions for each PM10 grade, as well as for the transboundary transport of PM10 from China. This evaluation of PM10 predictability can be reliably used as a statistical reference and further, complement to the current air quality forecasting system.

First-Order Mathematical Correlation Between Damping and Resonance Frequency Evaluating the Bone-Implant Interface.

PURPOSE: Various advanced technologies have been designed to estimate dental implant stability, including insertion torque, implant damping using the Periotest, and resonance frequency analysis expressed in implant stability quotient units. This study aimed to establish the relationship between the estimates for these three techniques. MATERIALS AND METHODS: Bovine cortical bone blocks were trimmed to square shapes of precisely controlled thickness and density. Thereafter, 4-mm-diameter × 10-mm-long implants were placed in the bone blocks using 30-, 45-, and 60-Ncm insertion torques. Implant damping and resonance frequency analysis were conducted at four angles for each implant. Spearman correlation coefficients were calculated to examine the relationship between insertion torque, resonance frequency analysis, and implant damping measured values. RESULTS: Resonance frequency analysis and implant damping estimates exhibited a strong inverse correlation (r = -0.98, P < .001). A linear equation was formulated: Periotest value = 15.54 + (-0.26 × implant stability quotient). Implant damping and resonance frequency estimates revealed a weak correlation with insertion torque (P < .05). CONCLUSION: This study mathematically defined a linear correlation between implant damping and resonance frequency estimates, thereby providing a guide for clinicians when deciding the loading time for dental implants using the implant damping or resonance frequency estimates.

Persistent Bleeding Following a Stapled Hemorrhoidopexy.

A stapled hemorrhoidopexy (SH) is widely used for treatment of patients with grades III and IV hemorrhoids. The SH is easy to perform, is associated with less pain and allows early return to normal activities. However, complications, whether severe or not, have been reported. Here, we present the case of a female patient with persistent bleeding after a SH. The bleeding was caused by the formation of granulation tissue at the stapler line, diagnosed with sigmoidoscopy, and successfully treated via transanal excision (TAE) under spinal anesthesia. The biopsy showed inflammatory granulation tissue. After the TAE, her symptom was completely gone.

Effect of Platform Shift/Switch on Crestal Bone Levels and Mucosal Profile Following Flapless Surgery and Crestal/Subcrestal Implant Placement.

BACKGROUND: Crestal remodeling/bone loss appears a common sequel to dental implant placement. Several hypotheses and clinical strategies have been advanced to explain and avert crestal remodeling; however, causative mechanisms remain unclear and the efficacy of clinical protocol uncertain. OBJECTIVE: The objective of the present study was to provide a histologic record of crestal versus subcrestal implant placement on crestal remodeling and mucosal profile comparing platform shift/switch and standard abutments following flapless implant surgery using a dog model. METHODS: Four dental implants each were placed into the left and right edentulated posterior mandibles in five adult male hound-Labrador mongrel dogs using a flapless approach including crestal versus subcrestal placement and using platform shift versus standard abutments. Block biopsies were collected for histological/histometric analysis following an 8-week healing interval. RESULTS: Both crestal and subcrestal implant installation resulted in significant crestal remodeling and bone loss, in particular at buccal sites, without significant differences between platform shift/switch and standard abutments. Implants installed subcrestally exhibited a significantly taller mucosal profile over crestal-level implants without significant differences between platform shift/switch and standard abutments; the epithelial attachment at all times arrested on the abutment surface. CONCLUSIONS: Comparing platform shift/switch versus standard abutments using a minimally invasive flapless approach including crestal or subcrestal implant placement, the platform shift/switch abutments offer no selective advantage over standard abutments.

Effect of Platform Shift on Crestal Bone Levels and Mucosal Profile Following Flap Surgery and Subcrestal Implant Placement in Presence/Absence of Gap Defects.

BACKGROUND: Physiologic remodeling resulting in crestal bone loss appears a common corollary to dental implant surgery. Several hypotheses and clinical strategies have been advanced to explain and avert crestal remodeling; however, causative mechanisms remain unclear and the efficacy of clinical protocols uncertain. PURPOSE: The objective of the present study was to provide a histologic account of crestal bone levels and mucosal profile at implant sites receiving platform shift/switch and standard abutments following conventional flap surgery and subcrestal implant placement in presence or absence of crestal gap defects using a dog model. MATERIALS AND METHODS: Four dental implants were placed into the left/right edentulated posterior mandible in five adult male Hound Labrador mongrel dogs using flap surgery including subcrestal placement with/without a 1 × 5 mm (width × depth) gap defect, and using platform shift/switch and standard abutments. Block biopsies were collected for histological/histometric analysis following an 8-week healing interval. RESULTS: No significant differences in crestal resorption were observed among experimental groups; crestal resorption being significantly more advanced at buccal than at lingual sites (p < .001). Similarly, crestal bone-implant contact was not significantly different among groups; crestal bone-implant contact being consistently below the implant platform at buccal sites (p < .01). Moreover, the peri-implant mucosal profile was not statistically different among groups, the mucosal height being significantly greater at buccal than at lingual sites (p < .001). Also, no significant differences among groups were observed for the apical extension of the epithelial attachment, the epithelial attachment being arrested more than 2 mm above the implant platform at both platform shift/switch and standard abutments. CONCLUSIONS: Using a clinical strategy including flap surgery and subcrestal implant placement, implant technology comparing platform shift/switch with standard abutments, surgical approach, and abutment selection seems to have a limited impact on crestal remodeling, associated bone loss, and mucosal profile.