Long Live Marketization for Local Public Spaces: A Study of Scandinavian Managers’ Satisfaction with Private Provider Performance

Continued critiques, evidence and newer reform trends have increasingly contested the use of market-centered models–the competition prescription–for urban public space maintenance as well as other local services. This article adopts a contextualized contingency perspective on the competition prescription and questions the contested status of market-centered models in a survey-based study of the current use of and satisfaction with private providers for maintenance of parks/greenspaces and road/streets in Scandinavian local governments. The study finds widespread use of and satisfaction with private providers. However, satisfaction depends on national context and multiple contingencies. The study challenges the contested status of market-centered models, highlights that different models serve different strategic objectives, and directs attention to discussions of context and key contingencies that define how well market-centered models perform.

Fiber Reinforced Composite Space Maintainers Versus Band and Loop Space Maintainers – A Systematic Review

BACKGROUND Premature loss of primary teeth requires orthodontic intervention to prevent the occurrence of malocclusions in the future. The most preferred way to maintain this space is by using space maintainers. Band and loop maintainers are the most commonly used fixed space maintainers. Despite being the most effective, it has several disadvantages. Hence, the objective of this review was to compare the efficiency between fiber reinforced composite (FRC) space maintainer and the conventional band & loop space maintainer. METHODS A systematic review was performed. Electronic and hand search retrieved 260 records, 246 were screened. The intervention and outcomes were assessed in the study included for systematic review. RESULTS Seven studies were included in this systematic review. These studies compared the fiber reinforced composite and the conventional band & loop and provided results about their clinical efficacy and patient satisfaction. CONCLUSIONS Despite being one of the gold standard appliances for space maintenance, the conventional band and loop space maintainers have multiple disadvantages. The major disadvantages included failure of the appliance due to cement loss and bending of the wire. Out of the 7 articles included in this study, 6 of the articles concluded that the FRC space maintainers are as effective as the conventional band and loop. FRC space maintainers proved to be time effective, more aesthetic, has better patient acceptance and is easier to fabricate. Hence, fiber reinforced composite space maintainers can be used as a more aesthetic and effective alternative to the conventional band and loop space maintainers if proper technique and protocol is followed. KEY WORDS Space Maintainers, Band and Loop Space Maintainer, Fiber Reinforced Space Maintainer, Interceptive Orthodontics, Orthodontics

Management of Early Loss of first Permanent Molar in Adolescent

The first molar is the largest tooth in the oral cavity and bears the maximum occlusal load, and they influence the vertical distance of the maxilla and mandible, the occlusal height, and aesthetic proportions. Since they have the maximum root surface area, they are also considered the best source of anchorage for moving the teeth (Mostafa Rezaie el al 2018). The timing of first molar eruption makes these teeth vulnerable to dental caries. The loss of a permanent first molar in adolescent patient creates a need for early space maintenance and restorative of function. This paper describes a conservative, functional and cost-effective bridge as an interim restoration after the loss of permanent first molar in an early adolescent dentition (Rajashekhara el al 2012).

Guided Bone Regeneration- A Comprehensive Review

Successful implant treatment requires prosthetically driven placement of an implant, primary stability at placement, and careful living bone management. The resorptive changes of alveolar bone are an inevitable process following tooth loss, periodontal disease or trauma which causes bone defects. This results in various aesthetic and functional complications such as soft tissue recession, infection and inflammation. Various methods have been tried and advocated for augmenting these bone deficiencies. Guided Bone Regeneration (GBR) is a successful modality for bone augmentation with a wide range of indications and helps restore the alveolar ridge dimensions. It utilises the principle of Guided Tissue Regeneration (GTR) for space maintenance within a bony defect. Different types of barrier membranes are being utilised along with various bone grafts in GBR. Thorough knowledge regarding the biology of bone is required before the initiation of any bone augmentation procedure. A combination of Collagen Membrane (CM) and graft material was found successful for GBR. Hence, this review focuses on presentation of best available evidence for various aspects of GBR.

Ankylosed Primary Molar in a Japanese Child with Hypophosphatasia

Hypophosphatasia (HPP) is a rare genetic disorder; affected patients may experience early exfoliation of primary teeth, especially anterior teeth. However, there have been few reports regarding longitudinal follow-up for primary teeth, especially posterior teeth, until their replacement with permanent teeth. Here, we describe a patient with HPP who underwent follow-up from 1 to 9 years of age. A 14-month-old boy was referred to our hospital with the chief complaint of early loss of primary anterior teeth. He was diagnosed with odonto-type HPP by his pediatrician, due to low serum alkaline phosphatase concentration and early exfoliation of primary teeth with bone hypomineralization. The patient experienced exfoliation of three additional primary anterior teeth by 4 years and 1 month of age. Partial dentures were applied for space maintenance; there were no problems regarding subsequent replacement with permanent teeth in the anterior region. However, the primary mandibular right first molar appeared to be submerged when the patient was 8 years and 3 months of age; the severity of submergence was greater when the patient was 9 years of age. The affected primary molar was considered to be ankylosed; it was extracted when the patient was 9 years and 4 months of age. Histopathological analysis of the tooth revealed disturbed cementum formation, which is a typical characteristic of teeth in patients with HPP. On the basis of these findings, we hypothesize that the disturbed cementum formation could lead to susceptibility to early exfoliation of anterior teeth, as well as occurrence of ankylosis involving posterior teeth.

A Retrospective Study Assessing the Frequency of Patient’s Requiring TPA/LSA During Orthodontic Therapy- An Institutional Study

TPA, also known as Transpalatal Arch is used as an adjunctive equipment during orthodontic therapy to regulate anchorage in the vertical, transverse and sagittal (antero-posterior) dimensions. TPA have many uses such as space maintenance, retention and molar anchorage after rapid maxillary expansion. TPAs have eminent versatility, appearing as a stand-alone appliance or as an accessory appliance to fixed appliances. Hence the aim of this study is to assess the number of patients who required TPA/LSA during an orthodontic therapy. Retrospective cross sectional study was carried out and the case records of patients requiring TPA/LSA was collected by reviewing patient records and analyzing the data of patients between June 2019- April 2020. The collected data was subjected to Chi-square test for statistical analysis and correlation using the SPSS software. The findings of this study showed female predilection with a percentage of 53% and males with a percentage of 47%. It also revealed that the prevalence of patients requiring TPA during an orthodontic therapy was 32% and LSA was 26%. This study shows that 32.24% of the patients required TPA and 25.75% of the patients also required LSA during an orthodontic treatment and this was found to be statistically significant.

A biodegradable gelatin-based nanostructured sponge with space maintenance to enhance long-term osteogenesis in maxillary sinus augmentation

The search for bone substitutes that are biodegradable, ensure space maintenance, and have osteogenic predictability, is ongoing in the field of sinus augmentation. We thus compared the bone regeneration potential of nanostructured sponges (NS-Sponge) with that of collagen-stabilized inorganic bovine bones (BO-Collagen), gelatin sponges (Gelatin), and blood clots (Cont) in sinus augmentation of rabbits. NS-Sponge was prepared by thermally induced phase separation with porogen leaching techniques. All the materials were non-hemolytic and cytocompatible. The porous and nanofibrous NS-Sponge showed better dimensional stability to support cell growth and osteogenic differentiation. In vivo, the sinus membrane collapsed in Cont and Gelatin, while BO-Collagen and NS-Sponge maintained the elevated height as assessed by come-beam computed tomography. Limited bone regeneration was observed in Cont and Gelatin. In the entire implanted area, histological analysis revealed a higher percentage of new bone area at 4 weeks of BO-Collagen treatment; however, a significantly greater increase in new bone area was observed after 12 weeks of NS-Sponge treatment. The 12-week remnant NS-Sponge material was significantly lower than the 4-week remnant material. Overall, NS-Sponge may be highly recommended for sinus augmentation, as it exhibits numerous advantages, including excellent operability, clear imaging characteristics, space maintenance, biodegradability, and superior osteogenic potential.