Implant Stability after Graftless Motor-Driven Crestal Sinus Elevation: A Cohort Study.

Graftless motor-driven crestal sinus elevation may be a preferable alternative to conventional methods due to the reduction of post-surgical complications and lower cost. This prospective cohort study evaluated the stability of implants installed using this technique. Twenty-nine Straumann BLT implants in 29 different patients were included in the sample. Average implant stability quotients (ISQ) were measured immediately after surgery (Mean 73.5 ± 9.2) and after a period of healing (Mean 77.1 ± 4.5) using resonance frequency analysis (RFA). There was a significant increase in implant stability after healing (p = .035). The healing duration did not significantly influence how implant stability increased (p =.373). The mean ISQ after healing was significantly higher than the clinically acceptable stability value of 65 ISQ (p <.001). Implant length and width were not significantly correlated with ISQ increase (p =.764 and p =.085, respectively). In addition, there were no significant differences in average ISQ values measured immediately post-surgery (at baseline) or after healing between implants with and without registered perforations during surgery (p =.118 and p =.366, respectively). The post-healing stability of four implants that did not achieve primary stability was not significantly less stable after the healing period than those that had achieved primary stability (p =.086). Moreover, the level of insertion torque significantly impacted implant stability immediately post-surgery (p < .001), but the ISQ values measured after healing were not significantly different based on the initial insertion torque values (p = .131). This study suggests that implants installed using graftless motor-driven crestal sinus elevation may achieve clinically acceptable stability as measured by RFA.

A resonance frequency analysis to investigate the impact of implant size on primary and secondary stability.

Objective: Recent years have seen a rise in the usage of dental implants to restore lost teeth. The stability of a dental implant is the main factor in determining its success. Implant stability is influenced by various factors. Several approaches have been employed clinically to evaluate stability at different time intervals. One non-invasive way to assess implant stability is by resonance frequency analysis. Utilizing the resonance frequency analysis method, this study seeks to understand how implant length and diameter affect primary and secondary stability. Methods: The current prospective study was conducted in the Prosthodontics Department of Institute of Dentistry, CMH Lahore Medical College. The duration of the study was six months. A total of 90 implants of sizes 4.5 x 8.5 mm and 4 x 10mm were placed. Resonance frequency measurements were recorded using Osstell™ AB device for primary stability at implant insertion and at 12 weeks for secondary stability. All the measurements were carried out by only one of the researchers to minimize inter-observer bias. Results: The average primary stability was 70.33±6.60, and the average secondary stability was 71.43±5.44. The data was stratified for age, gender, and implant site, and the mean primary and secondary stability of both sizes didn't show any statistically significant differences. Conclusion: Without forfeiting implant stability, both implant sizes (4 x 10mm and 4.5 x 8.5mm) can be used interchangeably, depending on available space and anatomical constraints.

Correlation Between Implant Stability Quotient and Percussion Sound Frequency.

OBJECTIVES: To determine the correlation between the primary implant stability quotient and the implant percussion sound frequency. MATERIALS AND METHODS: A total of 14 pigs' ribs were scanned using a dental cone beam computed tomography (CBCT) scanner to classify the bone specimens into three distinct bone density Hounsfield units (HU) value categories: D1 bone: >1250 HU; D2: 850-1250 HU; D3: <850 HU. Then, 96 implants were inserted: 32 implants in D1 bone, 32 implants in D2 bone, and 32 implants in D3 bone. The primary implant stability quotient (ISQ) was analyzed, and percussion sound was recorded using a wireless microphone connected and analyzed with frequency analysis software. RESULTS: Statistically significant positive correlations were found between the primary ISQ and the bone density HU value (r = 0.719; p < 0.001), and statistically significant positive correlations between the primary ISQ and the percussion sound frequency (r = 0.606; p < 0.001). Furthermore, significant differences in primary ISQ values and percussion sound frequency were found between D1 and D2 bone, as well as between D1 and D3 bone. However, no significant differences were found in primary ISQ values and percussion sound frequency between D2 and D3 bone. CONCLUSION: The primary ISQ value and the percussion sound frequency are positively correlated.

ISQ as a Diagnostic Tool in Implants Affected with Bone Loss: An In Vitro Experimental Study.

PURPOSE: To determine the relationship between bone loss that occurs during the peri-implantitis process and variations in implant stability using resonance frequency analysis (RFA) measurement methods. MATERIALS AND METHODS: Forty selftapping implants were placed in cow ribs, and study scenarios were established according to the affected implant side and bone loss depth (n = 10 implants per group): Case 1 = bone loss on one side (vestibular); Case 2 = bone loss on two opposite sides (buccal and lingual); Case 3 = bone loss on two adjacent sides (buccal and mesial); and Case 4 = foursided bone loss (circumferential). For each group of 10 implants, first a bone loss of 0 mm was evaluated, then 4-mm defects (simulating 1/3 of bone loss) were created and evaluated, and finally 8-mm defects (simulating 2/3 of bone loss) were created and evaluated. Osteotomy measurements were made with a periodontal probe. For each implant, RFA was measured by the same operator using the Beacon system (Osstell). RESULTS: The initial implant stability quotient (ISQ) values of the 40 implants exceeded 70, reflecting an average of 73 in the buccolingual (VL) and 74.8 in the mesiodistal (MD) directions. ISQ measurements in the 10 implants in which bone dehiscence was performed on the vestibular aspect reflected a decrease in ISQ values as bone loss increased. When generating bone loss in two opposite sides (buccal and lingual), a greater decrease in ISQ values was observed when 2/3 of the implant were affected. The average VL ISQ measurement was less than 70 when at sites with 2/3 of bone loss. CONCLUSIONS: When bone loss occurs on only one side of the implant, the ISQ values decrease, but the implant maintains good stability. The same occurs when two opposite sides of the implant are affected, as the unaffected side has the least decrease in ISQ value.

A Comprehensive Study on Implant Stability Quotient (ISQ) in View of Resonance Frequency and Spectrum Analysis.

PURPOSE: This experimental study investigated how well implant stability quotient (ISQ) represents resonance frequency. Benchtop experiments on standardized samples, mimicking a premolar section of a mandible, were conducted to correlate an ISQ value and a resonance frequency to synthetic bone density and an incremental insertion torque. A frequency spectrum analysis was performed to check the validity of the resonance frequency analysis (RFA). MATERIALS AND METHODS: Branemark Mk III implants with dimensions ∅4 Å~ 11.5 mm were placed in Sawbones test models of five different densities (40, 30, 40/20, 20, 15 PCF). An incremental insertion torque was recorded during implant placement. To perform stability measurements, the test models were clamped partially in a vise (unclamped volume 10 Å~ 20 Å~ 34 mm). A MultiPeg was attached onto the implants, and a Penguin RFA measured ISQ. Simultaneously, motion of the MultiPeg was monitored via a laser Doppler vibrometer and processed by a spectrum analyzer to obtain the resonance frequency. Tightness of the clamp was adjusted to vary the resonance frequency. A statistical analysis produced a linear correlation coefficient 𝑅 among the measured ISQ, resonance frequency, and incremental insertion torque. RESULTS: The resonance frequency had high correlation to the incremental insertion torque (𝑅 = 0.978), confirming the validity of using RFA for this study. Measured ISQ data were scattered and had low correlation to the resonance frequency (𝑅 = 0.214) as well as the incremental insertion torque (𝑅 = -0.386). The spectrum analysis revealed simultaneous presence of multiple resonance frequencies. CONCLUSIONS: For the designed benchtop tests, resonance frequency does indicate implant stability in view of Sawbones density and incremental insertion torque. ISQ measurements, however, do not correlate well to the resonance frequency, and may not reflect the stability when multiple resonance frequencies are present simultaneously.

The relationship between subjective difficulty in interoceptive processing and accuracy of heartbeat perception in autistic individuals.

Most autistic people experience difficulties in sensory processing, including interoceptive processing. For example, they often report subjective difficulties in the interoceptive processing of interoceptive input, such as difficulty in interpreting bodily signals, including hunger, thirst, and fatigue. However, whether these subjective interoceptive difficulties are from underlying problems in interoceptive accuracy remains unclear. This study investigated the relationship between subjective interoceptive difficulty and behavioral interoceptive accuracy in autistic adults and a control group. Subjective interoceptive accuracy was measured using an interoceptive sensitivity questionnaire, and behavioral interoceptive accuracy was measured using a heartbeat counting task. The results showed no significant relationship between subjective interoceptive difficulty and behavioral interoceptive accuracy in the autistic or control groups. This suggests that subjective interoceptive difficulty and behavioral interoceptive accuracy reflect different aspects of interoceptive processing. One possible interpretation is that autistic adults can identify individual local sensory inputs, such as heartbeats, however, they have difficulty integrating multiple inputs and recognizing internal body states such as hunger and fatigue.

A Comparative Assessment of Primary Implant Stability Using Osseodensification vs. Conventional Drilling Methods: A Systematic Review.

Osseodensification is a novel biomechanical bone preparation technique that has been established to replace conventional bone drilling and therefore will optimize the implant site. The purpose of this systematic review was to compare the implant stability obtained by osseodensification drilling to those associated with conventional drilling techniques. An electronic search was performed in the PubMed, Scopus, EMBASE, Cochrane Oral Health Group, and Dentistry and Oral Science Source databases searched through Elton B. Stephens Company (EBSCO) for potentially relevant publications in the English language from January 2013 to December 2022. Randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs), contrasting osseodensification drilling with conventional drilling, studies documenting implant stability quotient (ISQ), and studies reporting the immediate outcome and at least three months of follow-up after dental implant placement were included. Two independent investigators evaluated the quality of the reviewed studies to determine the risk of bias using the version 2 of Cochrane risk-of-bias (RoB) tool for RCTs (RoB 2) and RoB for NRSIs (ROBINS-I). Majority of the studies showed that bone density was significantly higher in the osseodensification group. The overall RoB for the NRSIs was reported to be low with respect to confounding, selection, classification, incomplete data, deviance from interventions, outcome evaluation, and selective reporting. The quality assessment of the RCT studies included in the review using the RoB 2 tool showed a high overall risk. The findings of the current review reveal that osseodensification drilling exhibited higher resonance frequency analysis (RFA) and ISQ values than conventional drilling protocols. Similarly, when osseodensification regions were contrasted with traditional drilling, bone density at the implant surface was augmented.

Influence of Implant Macro-Design, -Length, and -Diameter on Primary Implant Stability Depending on Different Bone Qualities Using Standard Drilling Protocols-An In Vitro Analysis.

(1) Background: Primary implant stability is vital for successful implant therapy. This study explores the influence of implant shape, length, and diameter on primary stability in different bone qualities. (2) Methods: Three implant systems (two parallel-walled and one tapered) with various lengths and diameters were inserted into polyurethane foam blocks of different densities (35, 25, 15, and 10 PCF) using standard drilling protocols. Primary stability was assessed through insertion torque (IT) and resonance frequency analysis (RFA). Optimal ranges were defined for IT (25 to 50 Ncm) and RFA (ISQ 60 to 80). A comparison of implant groups was conducted to determine adherence to the optimal ranges. (3) Results: Implant macro-design, -length, and -diameter and bone block density significantly influenced IT and RFA. Optimal IT was observed in 8/40 and 9/40 groups for the parallel-walled implants, while the tapered implant achieved optimal IT in 13/40 groups (within a 25-50 Ncm range). Implant diameter strongly impacted primary stability, with sufficient stability achieved in only one-third of cases despite the tapered implant's superiority. (4) Conclusions: The findings highlight the need to adapt the drilling protocol based on diverse bone qualities in clinical practice. Further investigations should explore the impact of these adapted protocols on implant outcomes.

Immediate implant placement with and without provisionalization: A comparison of a one-year longitudinal study.

Background/purpose: Immediate implant placement (IIP) with and without immediate provisionalization (Ipro) may yield satisfactory results in appropriate indications and treatment, especially in the esthetic zone. The aim of this study was to compare implant stability, marginal bone loss (MBL), survival rates, and patient satisfaction between IIP with Ipro and IIP without Ipro. Materials and methods: Seventy patients, each with a failed maxillary anterior tooth, were randomly assigned to IIP with Ipro (Group A: n = 35) or IIP without Ipro (Group B: n = 35). Implant stability quotient (ISQ) and standardized periapical radiographs were performed at surgery and at 3, 6, 9, and 12 months postoperatively to investigate implant stability and MBL, respectively. Survival was assessed 1 year after surgery. Patient satisfaction was evaluated with a visual analogue scale (VAS). Results: Primary ISQ and MBL were not significantly different between groups A and B immediately after surgery (P ＞ 0.05). Implant survival was 100% in both groups, and only one mechanical complication was observed. Patient satisfaction was good at definitive crown delivery and postoperatively 1-year in both groups. However, the immediate postoperative VAS score in Group A was significantly higher than that in Group B (P < 0.05). Conclusion: Group A revealed significantly higher secondary ISQ than Group B at postoperatively 3, 6, 9, and 12 months. There were no significant differences between groups A and B in terms of MBL and survival. Notably, patient satisfaction in Group A was significantly higher than in Group B immediately after surgery.

Implant stability and marginal bone level changes: A 2-year prospective pilot study.

Background/purpose: Implant stability is crucial for successful osseointegration. Marginal bone level is considered an important indicator of long-term implant success and stability. The purposes of this study were to investigate 1) the effect of age, gender, bone density, implant length, and implant diameter on insertion torque (IT), primary implant stability quotient (ISQ), and secondary ISQ, 2) the impact of age, gender, bone density, implant length, implant diameter, IT, and ISQ on marginal bone loss (MBL). Materials and methods: Ninety patients who needed implant therapy were enrolled and overall 156 implants were installed to support single crowns. IT and ISQ were recorded for all implants during surgery and ISQ measurements were performed at follow-up visits. Age, gender, bone density, implant length and diameter were also registered. Radiographic evaluation of MBL was performed postoperative immediate (baseline), 3, 6, 9, 12, 18, and 24 months using digital periapical radiographs. Results: Age had little effect on IT and primary ISQ (P > 0.05). Generally, males had higher IT and primary ISQ, but no significant differences between genders were detected. Bone density showed significant effects on IT and primary ISQ. Correlation analysis revealed high positive correlations between IT/bone density and primary ISQ/implant diameter. Significant impacts of bone density and IT on MBL were found. Conclusion: Implant diameter had a more profound impact than length on IT/primary ISQ. Bone density played a considerable role in IT/primary ISQ determination. Bone density and IT had more impacts than primary ISQ on MBL.

Comparison of Implant Stability Between Conventional Drilling and Piezosurgical Implant Bed Preparation Techniques.

This prospective study compared the stability of implants placed using piezoelectric surgery (piezo group) and those placed using conventional rotary drills (bur group) during the first 90 days postoperatively. Teeth in the posterior maxillary regions of 21 patients were randomly assigned to 2 groups. The implant stability quotient (ISQ) was measured at days 0, 7, 14, 21, 28, 42, 56, and 90 postoperatively. Twenty-eight of 29 implants were successfully integrated at day 90 (1 implant in the test group was lost). Although both groups showed a significant overall increase in implant stability with time (P < .0001) and a high final mean ISQ value, no statistically significant difference in stability was seen between the groups. The bur group showed greater variance in ISQ values than the piezo group did (P < .001) at all time points. Long-term studies with larger samples are needed to investigate the bone response to the use of piezoelectric surgery for implant preparation.

Influence of Multiple Sterilization on Performance of Titanium Pegs When Measuring Implant Stability With Resonance Frequency Analyses.

This in vitro study was conducted to investigate the repeatability of the implant stability quotients (ISQ) measured with multipegs after numerous sterilizations and to detect the exact time when the readings start to deviate. Multipegs were sterilized with 3 different methods (autoclaved, autoclaved + ultrasonic cleaner, chemical disinfection + autoclaved) and grouped according to the method applied. All specimens were put into the autoclave with sealed packages every time they were sterilized. Each specimen was sterilized 50 times according to the technique described in its group after an ISQ measurement was performed. Results of the 2-way analysis of variance showed that neither the sterilization method nor the cycles, nor their interaction, were statistically significant. A multipeg may be reused multiple times after sterilization procedures and may be more cost-effective than a disposable smartpeg for checking implant stability after confirming these results in further investigations.

Intervenções interdependentes de enfermagem como indicadores sensíveis de qualidade - cuidados em ventilação mecânica não invasiva / Interdependent nursing interventions as sensitive indicators of quality - care in non-invasive mechanical ventilation

Durante os estágios, para aquisição de competências enquanto enfermeira especialista em Enfermagem Médico-cirúrgica, na vertente do doente crítico, o planeamento dos cuidados de enfermagem à pessoa em situação crítica, consubstanciado numa metodologia científica inerente ao processo de enfermagem, permitiu sustentar o processo de tomada de decisão e a implementação das intervenções, incorporando na prática os conhecimentos teóricos baseados em evidência científica. Após a identificação das necessidades, prescrevem-se intervenções de enfermagem de forma a detetar precocemente complicações e problemas potenciais e resolver ou minorar problemas reais identificados, mediante um paradigma de atuação preciso, concreto eficiente e em tempo útil, por exemplo, na "apropriada implementação de medidas de suporte avançado de vida" e na "gestão adequada de protocolos terapêuticos complexos" (OE, 2017). O enfermeiro possui formação humana, técnica e científica adequada para a prestação de cuidados em todo o contexto, particularmente em situação de elevada complexidade que lhe permita atuar de forma interdependente. Neste domínio, as competências específicas do enfermeiro especialista em Enfermagem Medico Cirúrgica na vertente da pessoa em situação critica, estão regulamentadas e publicadas em Diário da República a 16 de julho de 2018, pelo regulamento 429/2018, pa.19359. Para a OE (2015) a melhoria contínua dos cuidados implica a qualidade dos cuidados. A avaliação da qualidade dos cuidados de enfermagem pretende determinar o cumprimento das orientações estabelecidas pelos enfermeiros e a utilização dessa análise para tomar decisões acerca das mudanças que devem ser implementadas nos cuidados. No ano de 2001, a OE devido à necessidade de criar sistemas de qualidade para a profissão, definiu os "Padrões de Qualidade dos Cuidados de Enfermagem", sendo um referencial que regula e orienta o exercício profissional. Nos padrões de qualidade foram definidos seis enunciados descritivos de qualidade do exercício profissional dos enfermeiros ­ satisfação dos clientes, promoção da saúde, prevenção de complicações, bem-estar e autocuidado, readaptação funcional e organização dos cuidados de enfermagem, que pretendem ser um instrumento que clarifica o papel do enfermeiro junto das pessoas, dos demais profissionais e dos políticos (OE, 2001). No domínio da melhoria contínua da qualidade, das competências comuns do enfermeiro especialista, o enfermeiro deve "desenvolver práticas de qualidade, gerindo e colaborando em programas de melhorias contínua.". Os projetos de melhoria contínua da qualidade dos cuidados de enfermagem envolvem o planeamento e implementação de ações, visando a melhoria de forma a oferecer cuidados de enfermagem que atendam as expetativas da pessoa. As Intervenções Interdependentes de Enfermagem (IIE) e os constrangimentos na Ventilação Mecânica não Invasiva (VMNI) ao doente crítico, são essenciais para a segurança dos cuidados e qualidade em saúde. Sendo assim, são legalmente reconhecidas ao enfermeiro dois tipos de intervenções: autónomas e interdependentes, segundo (OE/REPE, 2015). As intervenções interdependentes referem-se a uma atuação de complementaridade funcional relativamente aos demais profissionais de saúde, intervenções essas realizadas pelos enfermeiros de acordo com as respetivas qualificações profissionais, em conjunto com outros técnicos, para atingir um objetivo comum, e são decorrentes de planos de ação previamente definidos pelas equipas multidisciplinares onde estão integrados as prescrições ou orientações previamente formalizadas. No que concerne à tomada de decisão do enfermeiro, também o REPE, é perentório em afirmar, que os cuidados de enfermagem se caracterizam pela presença e estabelecimento de uma relação de ajuda com o utente (abordagem sistémica e sistemática), cuja interação é objetivamente documentada, em processo de enfermagem, mediante a aplicação de metodologia científica (OE, 2015). O objetivo, da presente investigação, é identificar as IIE ao doente crítico com VMNI, que pela sua consistência executória, se assumem, como Indicadores de processo Sensíveis de Qualidade (IPSQ) aos cuidados, e a sua relação com as variáveis sociodemográficas e profissionais. Os indicadores que aqui se colocam em estudo, são os de processo, porque a literatura atual (Migote, 2022) menciona que através da análise de indicadores de estrutura e processo, se pode aceder à monitorização aprofundada dos resultados de saúde, razão que torna pertinente a relação em estudo. Na metodologia, foi desenvolvido um estudo exploratório, quantitativo descritivo, a partir da análise às respostas a um questionário elaborado com base em pesquisa bibliográfica com evidencia científica para o efeito, numa amostra de 76 enfermeiros, de urgência e medicina intensiva, maioritariamente, do sexo feminino (82,9%), com idades entre 36 e 45 anos (51,3%). As IIE ao doente crítico com VMNI, que pela sua consistência executória, se assumem, como ISQ aos cuidados, são: "doente é monitorizado segundo as recomendações" e "(...) é informado e pedida a sua colaboração" e os constrangimentos mais sentidos foram: "presença de secreções excessivas (...)", "a ocorrência de PCR é contraindicação" e "o nível de consciência do doente influencia o sucesso (...)". Foram verificadas relações estatisticamente significativas entre: a IIE "recurso à sedação" e o tempo de serviço, e o constrangimento "nível de consciência" e as varáveis: formação específica e tempo de serviço. Reafirma-se a importância de um protocolo de atuação na VMNI, para uniformização de cuidados.

During internships, in order to acquire skills as a specialist nurse in Medical-surgical Nursing, in terms of critically ill patients, the planning of nursing care for people in critical situations, embodied in a scientific methodology inherent in the nursing process, allowed sustaining the decision-making process and the implementation of interventions, incorporating theoretical knowledge based on scientific evidence into practice. After identifying needs, nursing interventions are prescribed in order to detect complications and potential problems early and solve or alleviate real problems identified, through a precise, concrete, efficient and timely paradigm of action, for example, in the "appropriate implementation of advanced life support measures" and in the "adequate management of complex therapeutic protocols" (OE, 2017). Nurses have adequate human, technical and scientific training to provide care in any context, particularly in highly complex situations that allow them to act interdependently. In this domain, the specific competences of the specialist nurse in Medical-Surgical Nursing in terms of the person in a critical situation, are regulated and published in Diário da República on July 16, 2018, by regulation 429/2018, pa.19359. For OE (2015) the continuous improvement of care implies quality of care. The assessment of the quality of nursing care aims to determine compliance with the guidelines established by nurses and the use of this analysis to make decisions about the changes that must be implemented in care. In 2001, the OE, due to the need to create quality systems for the profession, defined the "Nursing Care Quality Standards", being a reference that regulates and guides professional practice. In the quality standards, six descriptive statements of the quality of nurses' professional practice were defined - client satisfaction, health promotion, prevention of complications, well-being and self-care, functional readaptation and organization of nursing care, which are intended to be a instrument that clarifies the nurse's role with people, other professionals and politicians (OE, 2001). In the field of continuous quality improvement, one of the common skills of specialist nurses, nurses must "develop quality practices, managing and collaborating in continuous improvement programs.". Continuous improvement projects in the quality of nursing care involve the planning and implementation of actions, aimed at improving in order to offer nursing care that meets the person's expectations. Continuous quality improvement results from the intention to promote change to obtain higher standards (OE, 2019). Interdependent Nursing Interventions (IIE) and constraints on Non-Invasive Mechanical Ventilation (NIMV) for critically ill patients are essential for safe care and quality in health. Therefore, two types of interventions are legally recognized for nurses: autonomous and interdependent, according to (OE/REPE, 2015). The interdependent interventions refer to a performance of functional complementarity in relation to the other health professionals, interventions carried out by the nurses according to the respective professional qualifications, together with other technicians, to reach a common objective, and are resulting from action plans previously defined by the multidisciplinary teams which include the previously formalized prescriptions or guidelines. With regard to the nurse's decision-making, REPE is also peremptory in stating that nursing care is characterized by the presence and establishment of a helping relationship with the user (systemic and systematic approach), whose interaction is objectively documented, in the nursing process, through the application of scientific methodology (OE, 2015). The aim of this investigation is to identify the IIE for critically ill patients with NIMV, which, due to their enforceable consistency, are assumed to be Quality Sensitive Process Indicators (IPSQ) for care, and their relationship with sociodemographic and professional variables. The indicators that are studied here are those of process, because the current literature (Migote, 2022) mentions that through the analysis of structure and process indicators, it is possible to access the in-depth monitoring of health outcomes, reason that makes the relationship under study relevant. In terms of methodology, an exploratory, quantitative and descriptive study was carried out, based on the analysis of responses to a questionnaire prepared on the basis of bibliographical research with scientific evidence for the purpose, in a sample of 76 nurses, in emergency and intensive medicine, mostly male and female. female (82.9%), aged between 36 and 45 years (51.3%). The IIE for critically ill patients with NIMV, which, due to their enforceable consistency, are assumed, as ISQ for care, are: "patient is monitored according to recommendations" and "(...) is informed and asked for their collaboration" and the constraints more senses were: "presence of excessive secretions (...)", "the occurrence of CA is a contraindication" and "the patient's level of consciousness influences success (...)". Statistically significant relationships were verified between: the SII "use of sedation" and length of service, and the embarrassment "level of consciousness" and the variables: specific training and length of ser- vice. The importance of an action protocol in NIMV is reaffirmed, in order to standardize care.

Cylindrical Implant Versus Tapered Implant: A Comparative Study.

AIMS AND OBJECTIVES: The aim of this study is to compare the efficacy of tapered implants with cylindrical implants by evaluating the implant stability using the Osstell implant stability quotient (ISQ) instrument (W&H Dental India PVT Ltd., Bangalore, India) postoperative pain using the visual analog scale (VAS) score, and the peri-implant health using implant mobility scale. MATERIALS AND METHODS: This study included 30 patients who were partially edentulous with single or bilateral missing teeth and received 30 tapered implants on the one side and 30 cylindrical implants on the other side. Implant stability, postoperative pain, and peri-implant health were evaluated. RESULTS: In the evaluation of 30 tapered implants and 30 cylindrical implants, the implant stability quotient (ISQ) value for the tapered implants was higher when compared to that of cylindrical implants, and the group that received tapered implants had the least pain and good peri-implant health than the group that received cylindrical implants. CONCLUSION: On the basis of our clinical findings, it can be concluded that tapered implants provide greater primary stability than cylindrical implants. With the popularity of loading protocols in implant dentistry, the implant surgeon can increase predictability and success by selecting a tapered implant.

The Construction and Evaluation of a Multi-Task Convolutional Neural Network for a Cone-Beam Computed-Tomography-Based Assessment of Implant Stability.

Objectives: Assessing implant stability is integral to dental implant therapy. This study aimed to construct a multi-task cascade convolution neural network to evaluate implant stability using cone-beam computed tomography (CBCT). Methods: A dataset of 779 implant coronal section images was obtained from CBCT scans, and matching clinical information was used for the training and test datasets. We developed a multi-task cascade network based on CBCT to assess implant stability. We used the MobilenetV2-DeeplabV3+ semantic segmentation network, combined with an image processing algorithm in conjunction with prior knowledge, to generate the volume of interest (VOI) that was eventually used for the ResNet-50 classification of implant stability. The performance of the multitask cascade network was evaluated in a test set by comparing the implant stability quotient (ISQ), measured using an Osstell device. Results: The cascade network established in this study showed good prediction performance for implant stability classification. The binary, ternary, and quaternary ISQ classification test set accuracies were 96.13%, 95.33%, and 92.90%, with mean precisions of 96.20%, 95.33%, and 93.71%, respectively. In addition, this cascade network evaluated each implant's stability in only 3.76 s, indicating high efficiency. Conclusions: To our knowledge, this is the first study to present a CBCT-based deep learning approach CBCT to assess implant stability. The multi-task cascade network accomplishes a series of tasks related to implant denture segmentation, VOI extraction, and implant stability classification, and has good concordance with the ISQ.

Evaluation of Correlation between Vitamin D Levels and Implant Stability in Indian Population: A Prospective Study in Bangalore.

Purpose: Dental implants have become a definitive method for the esthetic and functional rehabilitation of both partially and completely edentulous arch. There is a significant role of vitamin D in bone metabolism and there are only few human studies that evaluate the effect of vitamin D deficiency on stability of dental implants. The study thus aims to evaluate the correlation of vitamin D deficiency and implant stability in delayed endosseous implant. Methods: The study included 20 subjects of either gender in the age group of 20-50 years, who required implant placement for rehabilitation of partially edentulous condition. Vitamin D status was evaluated for all subjects preoperatively. Implant stability was checked postoperatively at three months and six months using Electronic Technology Resonance Frequency Analysis. Results: The study found that for every 1 ng/ml increase in Vitamin D levels, the implant stability Quotient value (ISQ) significantly increased by 0.48 at 3 months and 0.62 units at 6 months, which was statistically significant at P = 0.01 and P = 0.002, respectively. Statistical analysis was done using Student Paired t test, Pearson Correlation test and Simple Linear regression analysis. Conclusion: Albeit the smaller sample size, the results of the study showed the positive influence of vitamin D on stability of implant. The study thus emphasizes on the significance of screening the vitamin D status of subjects prior to implant placement.

Ridge augmentation using autologous concentrated growth factors enriched bone graft matrix versus guided bone regeneration using native collagen membrane in horizontally deficient maxilla: A randomized clinical trial.

BACKGROUND: Facial resorption of maxillary alveolar ridges is a challenging situation for implant rehabilitation, which mandates a preparatory surgery of bone augmentation. Guided bone regeneration using a 1:1 mixture of autogenous particulate and anorganic bovine bone mineral (ABBM) showed reliable outcomes in treating horizontally deficient ridges. METHODS: Twenty-eight patients were randomly assigned into two groups; in the control group, the 1:1 mixture of particulate autogenous bone and ABBM was covered with native collagen membrane, while in the study group, it was mixed with autologous fibrin glue (AFG) to make a sticky bone that was covered by concentrated growth factor (CGF) membrane. For each proposed implant site, the average bone width gain was calculated preoperatively, immediately after augmentation and after 6 months. Implants were placed after 6 months and the implant stability quotient (ISQ) was measured after insertion and after 6 more months. RESULTS: The graft consolidation period went uneventful in both groups; however, two cases in the sticky bone group showed total resorption of the graft upon re-entry. The mean horizontal bone width after 6 months was 9 mm ± 0.71 in the guided bone regeneration (GBR) group which was higher than 7.9 mm ± 0.92 for the sticky bone group. The mean primary stability was higher in the GBR group; 67.19 ± 2.23 compared to 66.7 ± 3.22 for the sticky bone group, while the mean secondary stability was higher in the sticky bone group; 72 ± 2.15 compared to 71.7 ± 2.27 for the GBR group. Results of Shapiro-Wilk's for bone width data and model residuals were both statistically not significant (p > 0.05). CONCLUSION: Comparing CGF membrane versus native collagen membrane as barriers for GBR showed no statistically significant difference regarding bone gain. However, from a clinical point of view, CGF membrane is not a predictable barrier for guided bone regeneration.

Intra- and inter-operator concordance of the resonance frequency analysis. A cross-sectional and prospective clinical study.

OBJECTIVE: Resonance frequency analysis (RFA) provides an evaluation of implant stability over time. This analysis is a non-invasive, precise, and objective method. Several studies compare the RFA system with other devices. However, few investigations analyze repeatability and reproducibility between different operators. The aim of this study was to evaluate the intra- and inter-operator concordance of the Osstell® ISQ. MATERIAL AND METHODS: RFA measurements were performed with Osstell® ISQ in a total of 37 implants placed in 21 patients. At the time of implant placement, 6 measurements per implant were taken by three different experienced operators. Three measurements were carried out consecutively and three by removing and placing the SmartPeg-Osstell® to assess intra-operator and inter-operator agreement. RESULTS: Intra-operator concordance according to the intraclass correlation coefficient (ICC) showed high concordance. The ICC values were higher than 0.9 (p < 0.0001) for consecutive measures and alternative measures, being almost perfect of Landis & Koch classification. For inter-operator concordance The ICC was 0.709 (p < 0.0001) and 0.670 (p < 0.0001) for consecutive and alternative measures, respectively, both estimates being in the substantial category. In torque and ISQ values, no statistically significant differences were observed when operators and measurements were compared. CONCLUSIONS: Osstell® ISQ system was stable both in intra-operator and inter-operator measurements. This device has excellent repeatability and reproducibility, demonstrating reliability to measure the stability of dental implants. CLINICAL RELEVANCE: Resonance frequency analysis (RFA) is a non-invasive, objective, and reliable diagnostic method to determine the ideal moment to load the implant, as well as to predict possible failures.

Validation of an implant stability measurement device using the percussion response: a clinical research study.

BACKGROUND: Several devices have been developed to measure implant-bone stability as an indicator of successful implant treatment; these include Osstell®, which measures the implant stability quotient (ISQ), and the more recent AnyCheck®, which relies on percussion for the implant stability test (IST). These devices make it possible to measure implant stability. However, no studies have compared the performance of AnyCheck® and Osstell® (i.e., IST and ISQ values) in clinical practice. Therefore, this study aimed to determine the correlation between primary and secondary implant stability using the Osstell® and AnyCheck® devices. METHODS: Ten patients (7 women; age [mean ± standard deviation]: 49.1 ± 13.3 years) with partially edentulous jaws who received a total of 15 implants were included. IST (AnyCheck®) and ISQ (Osstell®) values were measured immediately after implantation and at 1, 2, 3, 4, and 6 weeks post-implantation. Each measurement was performed three times, and the average value was used as the result. The correlation between measurements obtained using the two devices was determined using Spearman's rank correlation coefficient. RESULTS: The IST values ranged from 79.1 ± 2.87 to 82.4 ± 2.65. The ISQ values ranged from 76.0 ± 2.8 to 80.2 ± 2.35. Spearman's rank correlation coefficient was r = 0.64 immediately after implantation, r = 0.29 at 1 week, r = 0.68 at 2 weeks, r = 0.53 at 3 weeks, r = 0.68 at 4 weeks, and r = 0.56 at 6 weeks. A positive correlation was found in all cases, except at week 1 when the correlation was weak; the IST and ISQ values decreased the most during the first postoperative week and increased during the second week. The IST values were also slightly higher at all measurement points. CONCLUSION: The ability to assess implant stability without removing the abutment during healing is essential for determining the timing of loading without the risk of bone resorption. The results of this study suggest that AnyCheck® is useful for determining primary and secondary implant stability.

The effect of an information brochure on patients undergoing cardiac catheterization on their anxiety, knowledge and fear: A randomized controlled study.

Introduction: Patients who undergo coronary angiography experience a rather stressful situation. They need information about this invasive procedure which most of the times find either from the internet, their referring physicians, acquaintances or friends with past experience of an invasive procedure. Aim: The aim of the study was on the one hand to test the potential beneficial effects of an information brochure on undergoing a cardiac catheterization for the first time and on the other hand to highlight the importance of informing patients before coronary angiography and its beneficial effects on both reducing their fear and anxiety. Methods: Patients were randomly assigned to an experimental group receiving the brochure at least 1 day before the cardiac catheterization (N = 44), or to a control group not receiving the brochure (N = 44). The SFQ, ISQ and STAI tools were distributed to both groups. Results: All experimental subjects in the intervention group read the brochure. The intervention group had significantly lower scores on both short-term and overall fear compared to the control group. However, the fear of the long-term consequences of cardiac catheterization was similar in both groups. Women had higher fear of the short-term consequences of catheterization than men. The control group experienced a mean satisfaction score of 10.9 points (SD= 2.5 points) while the intervention group had a score of 11.1 points respectively (SD= 2.3 points). In addition, 95, 5% of the control group and 88, 6% of the intervention group patients considered that the provision of information could have been improved. In terms of stress, patients with co-morbidities scored 7.39 points higher, meaning they experienced more symptoms of permanent anxiety, compared to patients who did not have an underlying disease. In addition, the more the patients were satisfied with the information provided, the fewer the symptoms of transient anxiety they experienced. Conclusions: Providing information in the form of a brochure regarding cardiac catheterization before the procedure, is of great importance and constitutes an efficient intervention.