How does the COVID-19 pandemic affect the personal lives and care realities of people with a schizophrenia spectrum disorder? A qualitative interview study.

BACKGROUND: The COVID-19 pandemic constitutes one of the greatest recent public crises. This study explored its influence on the lives and care realities of people with a schizophrenia spectrum disorder (SSD). METHODS: Between October 2020 and April 2021, semi-structured in-depth interviews were conducted with 30 volunteers with SSDs receiving inpatient or outpatient treatment in Vienna (Austria). Interviews were audio-recorded, transcribed verbatim and analysed thematically. RESULTS: Three main themes were identified. First, 'Pandemic life is deprived, lonely and surreal - though certain aspects can be perceived as positive'. Second, 'Bio-psycho-social support systems were struck at their core by the pandemic and were left severely compromised'. Last, 'There is a complex interplay between one's prior experience of psychosis and the experience of the COVID-19 pandemic'. The pandemic situation affected interviewees in various ways. For many, it led to a drastic reduction in day-to-day and social activities and contributed to an atmosphere of strangeness and threat. Bio-psycho-social support providers frequently suspended their services and offered alternatives were not always helpful. Participants indicated that whilst having an SSD might render them vulnerable to the pandemic situation, prior experience with psychotic crises can also provide knowledge, skills and self-confidence which enable better coping. Some interviewees also perceived aspects of the pandemic situation as helpful for recovering from psychosis. CONCLUSION: Healthcare providers must acknowledge the perspectives and needs of people with SSDs in present and future public health crises to ensure proper clinical support.

Immediate occlusal vs nonocclusal loading of implants: A randomized prospective clinical pilot study and patient centered outcome after 36 months.

BACKGROUND: Immediate provisionalization reduces chair time and improves patient comfort. PURPOSE: To analyze immediate functional loading vs nonfunctional loading with restorations in the posterior mandible for marginal bone defects, implant success/survival, and patient satisfaction. MATERIALS AND METHODS: A randomized controlled clinical trial was designed to assess these parameters based on 20 adult patients who underwent implant surgery, followed by immediate delivery of screw-retained or cemented single or splinted restorations in full occlusal contact or in infraocclusion (test and control group). A questionnaire with visual analog scales was used to assess patient satisfaction. RESULTS: Following 36-month data were evaluable for 9 patients (21 implants) in the study group (immediate functional loading) and for 10 patients (31 implants) in the control group (immediate nonfunctional loading). One implant in the control group was lost, hence the overall implant survival and success rate was 98.2%. Marginal bone defects were consistent with previous studies and comparable in both groups. Periotest values did not significantly change from baseline and the 12-month follow-up (Friedmann test). Patient satisfaction was high and did not involve any significant intergroup differences (Mann-Whitney U-test). CONCLUSIONS: Both types of immediate provisional restorations are viable in selected patients. Larger randomized controlled trials are needed to establish immediate functional loading as a standard treatment for partially edentulous jaws.

Does Timing of Implant Placement Affect Implant Therapy Outcome in the Aesthetic Zone? A Clinical, Radiological, Aesthetic, and Patient-Based Evaluation.

PURPOSE: To compare five different implant treatment protocols in the anterior maxilla, including immediate, early, and delayed implant placement, as well as implant placement in conjunction with simultaneous guided bone regeneration and implant placement 3 months following horizontal autologous bone block grafting. MATERIAL AND METHODS: Aesthetic indices used included the Pink Esthetic Score (PES), Papilla Index (PI), Subjective Esthetic Score (SES), and White Esthetic Score (WES). Subjective evaluation of implant aesthetics was performed using a visual analogue scale (VAS). The VAS consisted of a 10 cm-long line representing the degree of discontent (0%) or satisfaction (100%). RESULTS: A total of 153 implants in 153 patients (80 women, 73 men) were evaluated after a mean follow-up of 4.5 ± 2.9 years. Mean peri-implant bone loss was 1.6 ± 0.9 mm and not affected by treatment protocol, time after implant placement, or crown length. Papilla presence, by contrast, differed significantly between the protocols: Papilla formation was more pronounced following delayed and immediate implant placement. No statistical significance was found among treatment modalities with regard to PES, SES, or WES. Longer crowns were associated with lower PES and PI ratings and correlated with greater midfacial recession. SES was also influenced by time after implant placement and keratinized mucosa. Patient satisfaction differed significantly among treatment protocols, favoring immediate implant placement. Agreement between objective and subjective aesthetic ratings was low. CONCLUSION: The present study suggests that comparable clinical, radiological, and aesthetic results can be achieved with all treatment protocols. Gingival recession, however, seems to occur in the long term irrespective of the technique used.

Immediate Occlusal versus Non-Occlusal Loading of Implants: A Randomized Clinical Pilot Study.

BACKGROUND: Immediate occlusal and non-occlusal loading protocols have been discussed and, despite varying success rates, are considered viable in selected cases. Preoperative implant planning and intraoperative transfer are essential to the success of implant-supported reconstructions in partially or completely edentulous jaws. PURPOSE: This study was performed to compare clinical outcomes of immediate occlusal versus non-occlusal loading of posterior implants. MATERIALS AND METHODS: Of 19 patients with 52 screw-type implants replacing mandibular molars or premolars, nine patients with 21 implants were randomized to a study group that received immediate restorations with occlusal loading, whereas 10 patients with 31 implants were randomized to a control group that received provisional restorations without occlusal loading. Occlusal loading was defined as full loading in maximum intercuspidation. Single-tooth or splinted multiunit restorations were incorporated by screw retention or cementation. Marginal bone defects (MBD), implant survival, and implant success were evaluated 12 months after insertion. RESULTS: Both groups revealed similar MBD levels consistent with previous reports. No implants were lost (overall survival: 100%) or found to fail (overall success: 100%). No significant intergroup differences were noted for any of the evaluated parameters. CONCLUSIONS: Immediate restorations in partially edentulous mandibles demonstrated successful clinical and radiographic 12-month results. Larger long-term prospective studies are needed to confirm the final evidence and predictability of immediate functional loading as a standard treatment concept for partially edentulous jaws.