The aim of this trial was to investigate the diagnostic value of the basic erosive wear examination (BEWE) in clinical use, on dental photographs, and on dental casts over a two-year follow-up period (2013-2015). According to the main hypothesis for longitudinal monitoring of dental erosion, the BEWE is equally reproducible by the three assessment methods.The clinical assessment included intraoral photographic documentation, dental impressions, oral examination, and assessment of BEWE. Clinical assessment of BEWE was done by one blinded examiner, whereas assessment on photographs and dental casts was performed by three calibrated examiners and repeated after 14 days. The three assessment methods were analyzed separately by longitudinal agreement and inter- and intrarater reliability (intraclass correlation coefficient) alongside 95% confidence intervals (CIs).Comparing the longitudinal data of the years 2013-2015, clinical use and photographs showed no significant difference (p=0.0681-0.9963), whereas the statistical analysis showed a significant difference for dental casts by comparing data from 2013 vs 2014 (p=0.0266) as well as data from 2013 vs 2015 (p=0.0001). Statistical evaluation of overall BEWE showed an intrarater reliability of 0.79-0.91 for photographs and 0.60-0.87 for dental casts. The interrater reliability was 0.77 (95% CI=[0.69; 0.84]) for photographs and 0.63 (95% CI=[0.52; 0.72]) for dental casts.This investigation showed that in longitudinal clinical monitoring, the assessment of the BEWE on patients and dental photographs yielded comparable results. In addition, based on these findings, the assessment of the BEWE on dental casts showed moderate reproducibility. Therefore, dental casts may be better used for laboratory assessment techniques.
Abstract Background To assess long-term results of implants (XiVE/Frialit-2 Synchro) in a private periodontal practice according to survival and success rates (biological and technical complications) and to detect possible influencing factors, retrospectively. Methods Implant placement of at least one implant took place 10 years ±6 months before clinical and radiographic re-examination. Incidence of implant loss as main and incidence of mucositis/ peri-implantitis as secondary outcome were detected. Also, patient-related and implant-related influencing factors were determined by regression analyses. Results 100 patients (59.0% female) with 242 implants were included into analysis. Survival rate was 94.0% (XiVE: 97.7%; Frialit-2-Synchro: 66.7%). Mucositis was found in 77.6% of all patients, moderate/severe peri-implantitis in 16.3%. In logistic regression analyses statistically significant influencing factors for implant loss was implant type ( p < 0.001), for mucositis a wider implant diameter ( p = 0.0438) and a high modified Plaque Index ( p = 0.0253), for peri-implantits number of implants per patient ( p = 0.0075) and a wider implant diameter ( p = 0.0079). Technical complications were found in 47 implants (19.4%). Conclusions XiVE implants showed a high survival rate over a 10-year follow-up, on the other hand Frialit-2 Synchro implants had worse survival rates. Success rates regarding biological complications are in line with other implant systems.
Indirect comparisons (including network meta-analyses [NMAs]) allow us to compare benefits and risks of multiple interventions for the same clinical condition when head-to-head comparisons are not feasible.To provide guidance to the clinical community on better understanding indirect comparison methods to help them to interpret their results by applying two quality standards to published indirect comparisons of systemic biologics for moderate to severe psoriasis.A systematic literature review (SLR) of published indirect comparisons of biologics for the treatment of moderate to severe psoriasis in adults was conducted. Data extraction was performed using a predefined subset of NICE TSD7 (National Institute for Health and Care Excellence Technical Support Document 7) checklist questions and methods used to perform each analysis were descriptively compared. Methodological quality of the SLR underlying each indirect comparison was assessed using AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews version 2).Twenty-two NMAs and four adjusted indirect comparisons (AICs) were identified. Although there were some similarities, for example, application of Bayesian random-effects models, several important methodological aspects varied considerably across NMAs identified, for example, classes of drugs, number of treatments and studies included, reporting and handling of different doses, and reporting of both checks for and investigations of inconsistency. Methodological comparisons across AICs were limited by the small number. The quality of most underlying SLRs described, assessed as overall level of confidence in the results, was 'critically low'.Understanding that there are different methodologies employed to answer differing research questions is key to helping clinicians to interpret the indirect evidence currently available in psoriasis.
To identify risk factors for loss of molars during supportive periodontal therapy (SPT).A total of 136 subjects with 1015 molars at baseline were examined retrospectively. The association of risk factors with loss of molars was assessed using a multilevel Cox regression analysis. Furcation involvement (FI) was assessed clinically at start of periodontal therapy and assigned according to Hamp et al. (1975).Fifty molars were extracted during active periodontal therapy (APT) and 154 molars over the average SPT period of 13.2 ± 2.8 years. FI degree III (HR 4.68, p < 0.001), baseline bone loss (BL) > 60% (HR 3.74, p = 0.009), residual mean probing pocket depth (PPD, HR 1.43, p = 0.027), and endodontic treatment (HR 2.98, p < 0.001) were identified as relevant tooth-related factors for loss of molars during SPT. However, mean survival time for molars with FI III or BL > 60% were 11.8 and 14.4 years, respectively. Among the patient data, age (HR 1.57, p = 0.01), female gender (HR 1.99, p = 0.035), smoking (HR 1.97, p = 0.034), and diabetes mellitus (HR 5.25, p = 0.021) were significant predictors for loss of molars.Overall, periodontal therapy results in a good prognosis of molars. Degree III FI, progressive BL, endodontic treatment, residual PPD, age, female gender, smoking, and diabetes mellitus strongly influence the prognosis for molars after APT.
The antetorsional angle was determined in several patients as well as in an isolated femoral bone by means of computer tomography. A comparison with Rippsteins method shows good correlation, taking different definitions of the antetorsional angle into consideration. Due to a mathematical correction method, the CT determination method is independent of the positioning of the patient.