Accuracy of flapless surgery using an autonomous robotic system in full-arch immediate implant restoration: A case series.

OBJECTIVES: This observational study aimed to evaluate the accuracy of robotic computer-assisted implant surgery (r-CAIS) for full-arch immediate restoration and to analyse possible factors contributing to deviations. METHODS: Three edentulous patients (five arches) underwent r-CAIS. Osteotomies were performed using an autonomous robot under the surgeon's supervision, and implant placement was performed in a freehand or robotic manner. Prefabricated provisional prostheses were delivered immediately after surgery. Postoperative cone beam computed tomography scans were performed to assess the deviations between the planned and placed implants. Statistics were compared with deviations of s-CAIS outlined in a meta-analysis. RESULTS: A sum of 28 implants were used. The mean global coronal and apical deviations measured 0.91 ± 0.43 mm and 1.01 ± 0.45 mm, respectively, and the mean angular deviation measured 1.21 ± 1.24 º. The r-CAIS showed significantly better precision than the s-CAIS in full-arch cases (P < 0.001). The implants inserted using the robotic arm exhibited fewer deviations than those placed in the freehand manner. Eighty percent of prefabricated provisional prostheses were successfully delivered. CONCLUSIONS: Within the limitations of the present study, our data suggest that autonomous r-CAIS is a feasible approach for simultaneous immediate restoration in edentulous patients, showing better accuracy than s-CAIS. Further large-scale studies are necessary to verify the advantages and disadvantages of this novel technique and to explore possible factors that influence its accuracy. CLINICAL SIGNIFICANCE: Autonomous r-CAIS can provide clinically acceptable implant placement accuracy in edentulous patients, significantly surpassing s-CAIS. This level of accuracy may represent a viable therapeutic approach for simultaneous immediate full-arch restoration.

The Mediating Role of Psychological Capital in the Relationship Between Occupational Stress and Fatigue: A Cross-Sectional Study Among 1,104 Chinese Physicians.

Purpose: This study aimed to explore the association of occupational stress with fatigue and to examine the mediating role of psychological capital (PsyCap) among Chinese physicians. Materials and Methods: A cross-sectional study was conducted in Liaoning province, China, in 2018. Using a multistage stratified sampling method, a total of 1,500 physicians participated and 1,104 (73.6%) physicians responded effectively. The study used a self-administered questionnaire consisting of the 14-item Fatigue Scale (FS-14), the Effort-reward Imbalance questionnaire (ERI), the Psychological Capital Questionnaire (PCQ) and items about demographic and working characteristics. Hierarchical multiple regression analyses were performed to explore the association of occupational stress, PsyCap, and fatigue among physicians. Asymptotic and resampling strategies were used to examine the mediating effect. Results: The incidence of fatigue among Chinese physicians was 83.70%. The average level of fatigue was 7.96 ± 3.95 (mean ± SD). Occupational stress and PsyCap were significantly associated with fatigue. PsyCap significantly mediated the association of ERR (a × b = 0.106, bias-corrected and accelerated 95% confidence interval [BCa 95% CI]: 0.078, 0.138) and overcommitment (a × b = 0.068, BCa 95% CI: 0.044, 0.092) with fatigue. Two important components of PsyCap, self-efficacy and resilience, play more important roles in the mediating effect. Conclusions: The level of fatigue among Chinese physicians was high, which should be taken seriously by management. PsyCap could mediate the association between occupational stress and fatigue. The intervention strategies and measures to relieve fatigue could be focused on physicians' positive PsyCap improvement.

Associations of occupational stress, workplace violence, and organizational support on chronic fatigue syndrome among nurses.

AIMS: Chronic fatigue syndrome is an agnogenic disease worldwide. Nurses are at a high risk of chronic fatigue syndrome. However, no research has been done to examine the associations of workplace violence, organizational support, and occupational stress with chronic fatigue syndrome among Chinese nurses. This study aimed to examine effects of these factors on chronic fatigue syndrome in this occupational group. DESIGN: Cross-sectional. All participants voluntarily completed a questionnaire survey. METHODS: The study was conducted in Liaoning province from December 2017-January 2018. Self-administered questionnaires were distributed to 1,200 nurses, including Effort-Reward-Imbalance, Workplace Violence Scale, Survey of Perceived Organizational Support, together with age, gender, marital status, education levels, physical activities, job rank, monthly income, and weekly working hours. Complete responses were obtained from 1,080 (90%) participants. Chronic fatigue syndrome was diagnosed by doctors according to the Centers for Disease Control and Prevention criteria. Multivariable logistic regression was performed to examine these independent risk factors. RESULTS: The prevalence of chronic fatigue syndrome was 6.76%. The results of logistic regression analysis showed that nurses who experienced serious higher levels of overcommitment, workplace violence and less organizational support were more likely to be classified as chronic fatigue syndrome. CONCLUSION: There was a high prevalence of chronic fatigue syndrome. Lower workplace violence, more organizational support and lower overcommitment could be effective resources for reducing chronic fatigue syndrome. IMPACT: Workplace violence, organizational support, and occupational stress were related to chronic fatigue syndrome, which helped to explain why Chinese nurses suffered higher prevalence of chronic fatigue syndrome. Overcommitment explained chronic fatigue syndrome better than Effort/Reward Ratio, so intrinsic stress played a more critical role than extrinsic stress in chronic fatigue syndrome. Chinese nurses suffered serious sleep disorders and impairment of concentration and memory. These symptoms might also attribute to serious occupational stress, unsafe and unsupportive working environment. Creating a safe and supportive working environment, relieving intrinsic occupational stress should be considered as an institutional strategy to early prevent chronic fatigue syndrome.