Occlusal equilibration and muscle activity in fixed versus removable mandibular implant supported overdenture.

OBJECTIVES: Single denture rehabilitated patients have negative appraisals regarding oral function, mostly associated by stability and retention issues regarding mandibular prosthetics. Therefore, this study assessed patients' occlusal equilibration, muscle activity, and oral health-related quality of life (OHRQoL) receiving milled removable or fixed mandibular implant retained prostheses. MATERIALS AND METHODS: Twenty-two edentulous mandibular ridges patients were randomly distributed into two groups based on the definitive prosthesis received. Group I: Removable mandibular implant-supported overdenture, Group II: Implant retained fixed prosthesis. Occlusal equilibration was evaluated utilizing Occlusense, muscle activity via Electromyograph (EMG) at delivery, after one, and three months. The OHRQoL was evaluated by Oral Health Impact Profile questionnaire (OHIP-19) before delivery and after follow-ups. Data were collected, tabulated, and analyzed, utilizing independent t-test and One-way ANOVA followed Tukey`s post-hoc test. Significance level set at P ≤ 0.05. RESULTS: Groups I &II showed significant improvement in occlusal equilibration, muscle activity and OHRQoL. Group II demonstrated significantly higher improvement than group I in occlusal equilibration associated with muscle activity after 1 month, and in functional limitations domain in OHRQoL questionnaire after 3 months. CONCLUSION: Implant retained mandibular prosthesis showed improvement in occlusal equilibration, muscle activity, and OHRQoL regardless of prosthesis type employed. Fixed implant-supported prosthesis revealed better outcomes than removable mandibular implant-supported overdenture concerning occlusal equilibration, muscle activity, and OHRQoL regarding functional limitations. CLINICAL RELEVANCE: Implant retained mandibular prosthesis is one of best treatment options for single mandibular completely edentulous patients, as dental implants improved occlusal equilibration, muscle activity, and OHRQoL.

Anthracyclines and the risk of arrhythmias: A systematic review and meta-analysis.

BACKGROUND: There have been controversial findings from recent studies regarding anthracyclines use and the subsequent risk of arrhythmias. This study aimed to evaluate the existing evidence of the risk of arrhythmias in patients treated with anthracyclines. METHODS: PubMed, Scopus, and Web of Science databases were searched up to April 2022 using keywords such as "anthracycline" and "arrhythmia." Dichotomous data were presented as relative risk (RR) and confidence interval (CI), while continuous data were presented as mean difference (MD) and CI. Revman software version 5.4 was used for the analysis. RESULTS: Thirteen studies were included with a total of 26891 subjects. Pooled analysis showed that anthracyclines therapy was significantly associated with a higher risk of arrhythmia (RR: 1.58; 95% CI: 1.41-1.76; P < .00001), ST segment and T wave abnormalities (RR: 1.73, 95% CI: 1.18-2.55, P = .005), conduction abnormalities and AV block (RR = 1.86, 95% CI = 1.06-3.25, P = .03), and tachycardia (RR: 1.736, 95% CI: 1.11-2.69, P = .02). Further analyses of the associations between anthracyclines and atrial flutter (RR = 1.30, 95% CI = 0.29-5.89, P = .74), atrial ectopic beats (RR: 1.27, 95% CI: 0.78-2.05, P = .34), and ventricular ectopic beats (RR: 0.93, 95% CI: 0.53-1.65, P = .81) showed no statistically significant results. Higher doses of anthracycline were associated with a higher risk of arrhythmias (RR: 1.49; 95% CI: 1.08-2.05; P = .02) compared to the lower doses (RR: 1.36; 95% CI: 1.00-1.85; P = .05). Newer generations of Anthracycline maintained the arrhythmogenic properties of previous generations, such as Doxorubicin. CONCLUSION: Anthracyclines therapy was significantly associated with an increased risk of arrhythmias. Accordingly, Patients treated with anthracyclines should be screened for ECG abnormalities and these drugs should be avoided in patients susceptible to arrhythmia. The potential benefit of the administration of prophylactic anti-fibrotic and anti-arrhythmic drugs should also be explored.