Esthetic and Clinical Performance of Implant-Supported All-Ceramic Crowns Made with Prefabricated or CAD/CAM Zirconia Abutments: A Randomized, Multicenter Clinical Trial

2016 ◽  
Vol 96 (2) ◽  
pp. 163-170 ◽  
Author(s):  
J.G. Wittneben ◽  
J. Gavric ◽  
U.C. Belser ◽  
M.M. Bornstein ◽  
T. Joda ◽  
...  

Patients’ esthetic expectations are increasing, and the options of the prosthetic pathways are currently evolving. The objective of this randomized multicenter clinical trial was to assess and compare the esthetic outcome and clinical performance of anterior maxillary all-ceramic implant crowns (ICs) based either on prefabricated zirconia abutments veneered with pressed ceramics or on CAD/CAM zirconia abutments veneered with hand buildup technique. The null hypothesis was that there is no statistically significant difference between the 2 groups. Forty implants were inserted in sites 14 to 24 (FDI) in 40 patients in 2 centers, the Universities of Bern and Geneva, Switzerland. After final impression, 20 patients were randomized into group A, restored with a 1-piece screw-retained single crown made of a prefabricated zirconia abutment with pressed ceramic as the veneering material using the cut-back technique, or group B using an individualized CAD/CAM zirconia abutment (CARES abutment; Institut Straumann AG) with a hand buildup technique. At baseline, 6 mo, and 1 y clinical, esthetic and radiographic parameters were assessed. Group A exhibited 1 dropout patient and 1 failure, resulting in a survival rate of 94.7% after 1 y, in comparison to 100% for group B. No other complications occurred. Clinical parameters presented stable and healthy peri-implant soft tissues. Overall, no or only minimal crestal bone changes were observed with a mean DIB (distance from the implant shoulder to the first bone-to-implant contact) of −0.15 mm (group A) and 0.12 mm (group B) at 1 y. There were no significant differences at baseline, 6 mo, and 1 y for DIB values between the 2 groups. Pink esthetic score (PES) and white esthetic score (WES) values at all 3 examinations indicated stability over time for both groups and pleasing esthetic outcomes. Both implant-supported prosthetic pathways represent a valuable treatment option for the restoration of single ICs in the anterior maxilla ( ClinicalTrials.gov NCT02905838).

Author(s):  
Aqeel Ahmed ◽  
Muhammad Ibrar ◽  
Aatik Arsh ◽  
Sonia Wali ◽  
Shoukat Hayat ◽  
...  

Abstract Objective: To determine the effectiveness of Mulligan mobilisation versus Cyriax approach in the management of patients with subacute lateral epicondylitis. Methods: The clinical trial was conducted at the District Headquarter Hospital, Bahawalnagar, Pakistan, from September to December 2018, and comprised lateral epicondylitis patients having symptoms for >2 weeks. The diagnosis was confirmed on the basis of physical tests and musculoskeletal ultrasound. The subjects were randomly allocated to two equal groups A and B. Group A received deep transverse friction and Mill’s manipulation according to Cyriax approach, while group B received Mulligan mobilisation with movement techniques. Patient-related tennis elbow evaluation index was used to collect data which was analysed using SPSS 20. Results: Of the 60 patients, there were 30(50%) in each of the two groups. The overall mean age was 35.27±7.30 years, and 38(63.3%) participants were male.  After 4 weeks of treatment sessions, both groups showed significant improvements (p<0.05) in pain and functional disability scores. Group A showed significantly more improvement (p<0.05) in pain subscale scores compared to group B, while group B showed significant improvement (p<0.05) in functional disability subscale scores compared to group A. There was no significant difference (p>0.05) between the groups on total the patient-related tennis elbow evaluation index score. Conclusion: Both Mulligan mobilisation with movement and Cyriax approach decreased pain and improved functional status in lateral epicondylitis patients. Key Words: Elbow, Lateral epicondylitis, Massage, Mobilisation, Physiotherapy. Continuous..,


2021 ◽  
Vol 10 (4) ◽  
pp. 3296-3299
Author(s):  
Waqar M. Naqvi

To compare the effect of Land based exercises and Pool based exercises for shoulder strength to reduce shoulder pain in competitive swimmers using Shoulder Pain Disability Index (SPADI) score, Hand-Held dynamometer (HHD), Randomized Clinical trial.29 competitive swimmers with age group between 8 to 18 years were evaluated for shoulder pain using Shoulder Pain Disability Index Score [SPADI] and shoulder strength was evaluated using Hand Held Dynamometer [HHD] before and after the study. Then all the subjects were divided into 2 groups, for Group A Pool based exercises were given and for Group B Land based exercises were given. Statistically there is significant difference in values of outcome measures after the study in both groups but there is more significant difference in Group A than Group B. Pool based exercises showed more significant effect on shoulder pain than land based exercises in swimmer’s shoulder.


2019 ◽  
Vol 13 (01) ◽  
pp. 029-035 ◽  
Author(s):  
Debopriya Chatterjee ◽  
Anjali Kapoor ◽  
Sharmistha Vijay ◽  
Geetika Sobti ◽  
Dheeraj Kara ◽  
...  

Abstract Objective Periodontitis initiation and progression are a result of host immune inflammatory response to oral pathogens. Several pharmacological agents are being delivered locally, to improve periodontal health. Hence, the present randomized placebo controlled clinical trial is designed to check the clinical and antimicrobial efficacy of locally delivered 1.2% rosuvastatin (RSV) in intrabony defects (IBD) in periodontitis patients. Materials and Methods One-hundred patients were randomly allotted into two treatment groups: group A received 1. 2% RSV gel, scaling and root debridement and group B received placebo gel, scaling and root debridement. Clinical parameters, including modified sulcus bleeding index (mSBI), probing depth (PD), clinical attachment level (CAL), and plaque index (PI), were recorded at baseline before phase 1 and after 6 months. Radiographic assessment of IBD was done by cone beam computed tomography at baseline and after 6 months. Anaerobic colony count was done at baseline and after 180 days. Results On intragroup comparison, there is a significant improvement in periodontal parameters in both the groups. On intergroup comparison, there is significant gain in CAL in group A than group B (p = 0.04). There is significant decrease in PD in group A, compared to group B. There is significant bone fill in group A (p = 0.034), compared to group B. With respect to mSBI, PI, and anaerobic colony count, there is no significant difference between the two groups after 6 months. No adverse effect was noticed in any subjects. Conclusion The author concludes that 1.2% RSV gel when delivered locally into IBD improved periodontal clinical parameters such as PD and CAL and showed significant bone fill.


2021 ◽  
Vol 23 (05) ◽  
pp. 421-432
Author(s):  
Dr. Mohammad Kheiri Mahmod ◽  
◽  
Dr. Bashar Naser Hussein ◽  
Dr. Ammar Hamid Hanoosh ◽  
◽  
...  

Background: The physiological consequences of post-operative pain including Stress response to surgery, Respiratory complications, cardiovascular complications, Thromboembolic complications, Gastrointestinal complications, Musculoskeletal complications and Psychological complications, all of which could delay or impair postoperative recovery and increase the economic cost of surgery as a result of the longer period of hospitalization. Inadequate post-operative pain control may also lead to the development of chronic pain after surgery .Aim of This study: is to evaluate the preemptive analgesic effect of intravenous ketamine in laparoscopic cholecystectomy. Patients and Methods: double blinded randomized clinical trial conducted at Al-Yarmouk teaching hospital, over a period of one year from March 2013 to March 2014 on a total of 120 adult patients scheduled for elective laparoscopic cholecystectomy, Patients were divided in to three groups of 40 patients each, the study drug administered intravenously during induction. Groups A and B received ketamine in a dose of 1 and 0.5 mg/kg, respectively, whereas group C received isotonic saline. The degree of pain at rest and deep breathing postoperatively were estimated using VAS, time of first analgesic dose, total opioid consumption, nausea, vomiting and hallucination were recorded for 24 h postoperatively. Results: postoperative pain scores were significantly low in group A when compared with the other groups at most times in the first 24 hours. Highest pain score was in group C at 0 h. Postoperative analgesic consumption was minimum in group A then group B and highest in group C. There was little significant difference in the pain scores between groups B and C. Group A had a significantly higher blood MAP than group B at 0, 0.5 and 1 h. 7.5% incidence of hallucinations were in group A. Conclusion: According to this study we conclude that preemptive ketamine in a dose of 1 mg/kg has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. A low dose of 0.5 mg/kg had little significant in preemptive analgesic effect and in reducing analgesic requirement.


2015 ◽  
Vol 09 (04) ◽  
pp. 462-469 ◽  
Author(s):  
M. Manju ◽  
P. Prathyusha ◽  
Elizabeth Joseph ◽  
Rupali Borkar Kaul ◽  
Srinivas L. Shanthraj ◽  
...  

ABSTRACT Objective: The aim of this study was to evaluate and compare the effect of tongue scraping, tongue brushing, and saturated saline on salivary MS levels. Materials and Methods: A single-blinded, randomized, parallel group clinical trial was conducted in children aged 9–12 years. Total sample of 45 subjects were randomly assigned to three groups, that is, Group A, Group B, and Group C comprised of 15 each. Group A, Group B, and Group C were asked to do tongue scraping, tongue brushing and saturated saline rinsing twice daily, respectively for 21 days. Saliva samples, collected from the subjects on the baseline, 7th day and 21st day, were inoculated on mitis salivarius bacitracin agar and incubated at 37°C for 48 h. The mean streptococcal colony forming counts were enumerated. The data were subjected to statistical analysis using Wilcoxon signed rank sum test for intragroup comparisons and Mann–Whitney U-test for intergroup comparisons. Results: Intragroup comparisons showed statistically significant reduction in MS levels (P < 0.01). However, the intergroup comparisons showed no statistically significant difference (P > 0.05). Conclusion: The oral hygiene measures evaluated proved equal efficacy in reducing the colony counts. Hence, there is a need to emphasize the importance of incorporating supplementary oral hygiene measures in daily oral care.


2016 ◽  
Vol 9 (2) ◽  
pp. 256 ◽  
Author(s):  
Hamidollah Afrasiabian ◽  
Mohammad Hadi Imanieh ◽  
Mohammad Ali Nejati ◽  
Alireza Salehi

<p><em>H. pylori</em><strong> </strong>infection is one of the most common infections in the world so that the aim of this study was to evaluate the antimicrobial <em>P. Atlantica Kurdica</em> gum in the eradication of <em>H. pylori</em>. This study is a randomized clinical trial; Patients with positive Urea Breath Test and symptoms of dyspepsia were entered. Patients were randomly divided into four groups. Group A: three drugs including 500 mg of Amoxicillin twice a day (bd), Clarithromycin 500 mg bd and Omeprazole 20 mg (bd) and Group B: Group A drugs plus the capsule containing 1 g of powdered <em>P. Atlantica Kurdica </em>gum (bd). In Group C: the capsule containing 1 g of powdered <em>P. Atlantica Kurdica</em> gum (bd) and Group D: this group took placebo-containing capsule (bd) for 14 days respectively. Dyspeptic symptoms before and after healing period and the UBT results two days before the start of treatment and 30 days after the completion were compared in 4 groups. Patients were not statistically significant difference from each other in the four groups regarding the demographic situation. Moreover, <em>H. pylori</em> eradication rate was 19/24 in Group A, 18/24 in Group B, 10/23 in Group C and 2/24 in Group D. Relieving symptoms of dyspepsia in Groups B and C were significantly higher than in Group D (P=0.025 and p=0.006 respectively). <em>P. Atlantica Kurdica</em> significantly led to the treatment of dyspepsia symptoms and <em>H. pylori</em> eradication.</p>


2022 ◽  
Vol 12 (6) ◽  
pp. 6-11
Author(s):  
Vinayaka A.M. ◽  
Gayathri G.V. ◽  
Triveni M.G.

To clinically evaluate & compare the efficacy of 4% Mangosteen Gel and 1% chlorhexidine digluconate gel in managing patients with chronic gingivitis. Materials and Methods: A total of 50 patients with an age group of 20-45 years diagnosed with generalized plaque-induced gingivitis were selected for this clinical trial once attaining their informed consent. A thorough case history was chronicled comprising plaque index (P.I.), gingival index (G.I.) and Sulcus bleeding index (SBI) at baseline; then full-mouth scaling and polishing (SAP) was performed by a solitary attuned examiner. Patients were then randomly assigned into two groups using a computer-generated random numbering sequence system. Patients in group A received 4% Mangosteen Gel, and group B received 1% chlorhexidine digluconate gel for home application. The post-treatment follow-up examination for P.I., G.I. and SBI changes were assessed after 14 days and 21 days and compared with baseline data. Results: In both the groups, the mean plaque index, gingival index and sulcus bleeding index scores were significantly decreased after the 14th and 21st day compared to baseline scores. There was no significant difference between the groups, but only in group B, there was a substantial difference in SBI scores observed on day 21. Conclusion: 4% Mangosteen Gel and 1% chlorhexidine digluconate gel were clinically effective when used as an adjunct to SAP in managing patients with gingivitis. Hence, 4% Mangosteen Gel can be considered an alternative to 1% chlorhexidine digluconate gel without any side effects in managing generalized plaque-induced gingivitis.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245329
Author(s):  
Min Seung Kang ◽  
Jonghoon Shin ◽  
Jeong Min Kwon ◽  
Jin Huh ◽  
Ji Eun Lee

Purpose To quantitatively evaluate the effects of 0.05% cyclosporine A (CsA) on lipid layer thickness (LLT) and meibomian glands after cataract surgery using the LipiView® ocular surface interferometer. Methods This study was a prospective randomized double-masked clinical trial conducted by Pusan National University Yangsan Hospital between April 04, 2019, and November 31, 2019. Sixty-two participants were recruited, and 12 of them were not enrolled because they had undergone previous treatments for ocular surface diseases. The participants were adult patients with cataract, exhibiting normal lid position; they did not present any other ocular disease and did not meet the exclusion criteria of the clinical trial. Fifty subjects were enrolled in the study. The randomized subjects received treatment with 0.05% CsA (group A) or 0.5% carboxymethyl cellulose (CMC) (group B) over the 3 months following the cataract surgery. Subjective and objective assessments were performed at preoperative and postoperative visits. Ocular Surface Disease Index (OSDI), tear breakup time (TBUT), and Schirmer’s I test were performed by the same surgeon, and LLT and meiboscore were determined using the LipiView® interferometer. Results Fifty subjects subjects enrolled consisted of men (50%) and women (50%), with a mean (SD) age of 65.94 (10.35) years. Four subjects in group A and five in group B were excluded from the analysis as they were lost to follow-up within 1 month after cataract surgery. Thus, the study comprised 41 eyes of 41 subjects; 21 subjects were treated with CsA and 20 subjects with CMC. Comparing the clinical measurements between groups A and B taken at the last visit, while controlling the effects of the preoperative values, TBUT and LLT showed significant differences (p = 0.035 and p = 0.047, respectively, by ANCOVA). The TBUT between the subjects using CsA and those using CMC after cataract surgery showed a significant difference during follow up (p = 0.003 by repeated measures ANOVA). In the multivariate analysis, preoperative LLT and the use of CsA were found to be independent parameters for postoperative LLT (R2 = 0.303; p = 0.008 and p = 0.045, respectively), whereas the follow-up duration exhibited a positive correlation with the difference between the preoperative and postoperative values of LLT in the group treated with CsA (R2 = 0.738 and p < 0.001). Conclusion Treatment with 0.05% CsA following cataract surgery is effective in improving TBUT and LLT in comparison with 0.5% CMC. A higher preoperative value of LLT and the postoperative use of CsA could be significant determinants of a higher postoperative LLT value. Trial registration ISRCTN registry with ISRCTN 10173448.


2021 ◽  
Author(s):  
Heidar Safarpour ◽  
Mohammad Hadi Imanieh ◽  
naser honar ◽  
sajad hekmati ◽  
Naeimehossadat Asmarian

Abstract BackgroundThis study aimed to compare different regimens of Polyethylene Glycol (PEG, single dose vs. divided dose) in the treatment of functional constipation among children aged 4-15 years.Materials and MethodsThis double-blind randomized clinical trial was conducted on the children (4-15 years old) with functional constipation who were visited in an outpatient pediatric clinic affiliated to Shiraz University of Medical Sciences between February and July 2021. Among the120 eligible patients, 80 ones who met the inclusion criteria were recruited. The patients were divided into two parallel groups; the children who received single-dose PEG (group A) and those who received PEG in divided doses (group B). The study was performed during 12 weeks and follow-up visits were scheduled at 1, 3, 6, and 12 weeks after enrollment. The outcomes were measured using the Bristol Stool Form Scale (BSFS).ResultsThe study was performed on 78 cases including 45 boys (57.7%) and 33 girls (42.3%) with the mean age of 5.52±1.79 years. After 12 weeks, a significant difference was observed between groups A and B regarding the mean of BSFS (4.94±0.52 vs. 4.50±0.88, p=0.008). However, no significant difference was observed between the two groups regarding the number of defecation times during the study. The detected complications included mild abdominal pain in eight children in group A (5.3%), fecal incontinency in six children in group B (3.8%), and painful defecation in six children in group B (3.8%).ConclusionThis study confirmed that the administration of the single dose (0.4 g/kg) of PEG early in the morning was more effective, well tolerated, and accompanied by fewer complications compared to the divided dose.


2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Maryam Panhwar ◽  
Shazia Perveen Rajpur ◽  
Eisha Abrar ◽  
Mansour Alqutub ◽  
Tariq Abduljabbar

Objectives: The purpose of the present study was to compare the topical application of chlorohexidine (CHX) and Metronidazole (MTZ) gels, individually and in combination in patients with gingivitis for up to 12 weeks follow-up. Methods: The clinical trial was conducted at Liaquat University of Medical Health Sciences (LUMHS) Jamshoro and Hyderabad, Institute of Dentistry from 1st March 2019 to 1st March 2020. Patients were selected based on inclusion criteria. Out of 125 screened patients, ninety-nine patients agreed to participate in the study. At the beginning of study all patients were assessed for gingival inflammation by using gingival index (GI) (Loe and silness, 1963). Scaling root planning (SRP) was performed in all patients. Subjects were randomly selected in three groups (n=33 each). In Group-A CHX gel was applied, Group-B Metronidazole gel was applied and the combination of two was applied to patients of Group-C. Patient follow up was done and gingival parameters were assessed at baseline, fourth week and twelve weeks. Apart from the clinical evaluation, a subjective evaluation was also undertaken. Significance level of 0.05 and a desired study power of at least 80% was estimated. Analysis of Variance (ANOVA) test for comparison was used within groups. Results: A significant improvement in gingival scores was noted in all groups from baseline. At 4 weeks CHX (1.25±0.21) MTZ (1.81±0.38) CHX+MTZ (1.29±0.34) compared to baseline CHX (2.77±0.24) MTZ (2.84±0.54) CHX+MTZ (2.74±0.31) demonstrated substantial improvement (p<0.001). However, gingival scores showed inclination at 12 weeks CHX (1.18±0.41) MTZ (1.21±0.48) CHX+MTZ (1.11±0.14) with no significant difference to week 4 (p>0.001). Conclusion: Local MTZ gel and MTZ+CHX gel showed effectiveness similar to CHX gel application adjunct to scaling and root planning in the treatment of gingivitis. doi: https://doi.org/10.12669/pjms.37.5.4236 How to cite this:Panhwar M, Rajpar SP, Abrar E, Alqutub M, Abduljabbar T. Effectiveness of Chlorhexidine and Metronidazole Gels in the management of gingivitis. A clinical trial. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4236 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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