Flapless dental implant surgery : a retrospective study of 1,241 consecutive implants

Purpose: The purpose of this study was to identify retrospectively the predictors of implant survival when the flapless protocol was used in two private dental practices. Materials and Methods: The collected data were initially computer searched to identify the patients; later, a hand search of patient records was carried out to identify all flapless implants consecutively inserted over the last 10 years. The demographic information gathered on statistical predictors included age, sex, periodontal and peri-implantitis status, smoking, details of implants inserted, implant locations, placement time after extraction, use of simultaneous guided hard and soft tissue regeneration procedures, loading protocols, type of prosthesis, and treatment outcomes (implant survival and complications). Excluded were any implants that required flaps or simultaneous guided hard and soft tissue regeneration procedures, and implants narrower than 3.25 mm. Results: A total of 1,241 implants had been placed in 472 patients. Life table analysis indicated cumulative 5-year and 10-year implant survival rates of 97.9% and 96.5%, respectively. Most of the failed implants occurred in the posterior maxilla (54%) in type 4 bone (74.0%), and 55.0% of failed implants had been placed in smokers. Conclusion: Flapless dental implant surgery can yield an implant survival rate comparable to that reported in other studies using traditional flap techniques.

Compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia

Occupational exposures of healthcare workers tend to occur because of inconsistent compliance with standard precautions. Also, incidence of occupational exposure is underreported among operating room personnel. The purpose of this project was to develop national estimates for compliance with standard precautions and occupational exposure reporting practices among operating room nurses in Australia. Data was obtained utilizing a 96-item self-report survey. The Standard Precautions and Occupational Exposure Reporting survey was distributed anonymously to 500 members of the Australian College of Operating Room Nurses. The Health Belief Model was the theoretical framework used to guide the analysis of data. Data was analysed to examine relationships between specific constructs of the Health Belief Model to identify factors that might influence the operating room nurse to undertake particular health behaviours to comply with standard precautions and occupational exposure reporting. Results of the study revealed compliance rates of 55.6% with double gloving, 59.1% with announcing sharps transfers, 71.9% with using a hands-free sharps pass technique, 81.9% with no needle recapping and 92.0% with adequate eye protection. Although 31.6% of respondents indicated receiving an occupational exposure in the past 12 months, only 82.6% of them reported their exposures. The results of this study provide national estimates of compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia. These estimates can now be used as support for the development and implementation of measures to improve practices in order to reduce occupational exposures and, ultimately, disease transmission rates among this high-risk group.

Influences on compliance with standard precautions among operating room nurses

Background Occupational exposures of health care workers occur because of inconsistent compliance with standard precautions. The purpose of this study was to develop national estimates of compliance with standard precautions and occupational exposure reporting among operating room nurses (specifically, scrub nurses) in Australia and to assess variables that influence compliance. Methods A descriptive correlation design was used to investigate relationships between variables and compliance, using a theoretical framework, the Health Belief Model, to give meaning to the variables. Data collection was done through mail-out surveys to members of the Australian College of Operating Room Nurses. Results This article reports the results of compliance with the following 2 specific self-protective behaviors: double-gloving and wearing adequate eye protection. Mean compliance rates were 55.6% with always double-gloving during surgical procedures and 92% with always wearing adequate eye protection. In addition, the variable that had the most influence on compliance was the perception of barriers to compliance, specifically, that adhering to standard precautions interfered with duties. Conclusion These results have implications for the development of multifaceted perioperative infection control programs, including strategies for prevention, education, and policy development, to improve practices aimed at reducing occupational exposures among this high-risk group.

'In the Room' and 'School Chemistry Class'

Two poems in journal Axon. 2013 Issue 4.

Improving dental and medical students’ psychological health using a self-development coaching program : a pilot study

Introduction: Dental and medical students worldwide, including in Saudi Arabia, have been reported to have a high incidence of poor psychological health, such as depression, stress, anxiety, and lowlife satisfaction. Self-development coaching programs have become an increasingly popular way to improve individuals’ lives. However, few studies have evaluated the psychological effects of such programs among dental and medical students. Moreover, no studies have been conducted on self-development coaching programs in Saudi Arabia. Aims: The aim of this study was to assess the feasibility of a larger study via a pilot study and to acquire preliminary findings about the effectiveness of a self-development coaching program on psychological health among dental and medical students in Saudi Arabia. Methods: A pre-post interventional study design was used to test a self-development coaching program (How to be an Ultra-Super Student) with a sample of medical students (n=17) at Umm Al-Qura University at Saudi Arabia. The outcome measures were students’ psychological distress (depression, anxiety, and stress), life satisfaction, self-efficacy, the coach, and coaching program characteristics. Results: The study showed that there was a significant improvement in depression (p=0.04), self-efficacy (p=0.02), and satisfaction with life (p=0.04), which supported the feasibility of a large study in the future. Conclusions: The study’s findings encourage the implementation of a randomized, controlled trial study with a larger sample to further test the effectiveness of using self-development coaching programs with medical and dental students in Saudi Arabia to improve their psychological health.

An evaluation of clinical procedures used in dental implant treatment in posterior maxilla using flapless technique

This study was a measure forward in cultivating the scientific basis for an approach to examine clinical procedure in Flapless dental implant surgery. The thesis is based on: the systematic review, retrospective study of flapless implants, and in vivo study on the osseo-integration in osteoporotic rats. Dr Doan investigated "clinical procedures used in dental implant treatment in posterior maxilla using flapless technique". The work has yielded significant contributions to the area of implant flapless surgery and its effects on osteoporotic patients having implants in the posterior maxilla.

Court finds negligent dental treatment not an intentional act intended to cause harm : Dean v Phung

NSW Supreme Court decision - claim resulting from alleged damaging dental treatment of healthy teeth - failure of plaintiff to prove dishonest and fraudulent behaviour - assessment of damages.

Experimental and numerical analysis of the relationship between indoor and outdoor airborne particles in an operating room

This work investigated the impact of the HVAC filtration system and indoor particle sources on the relationship between indoor and outdoor airborne particle size and concentrations in an operating room. Filters with efficiency between 65% and 99.97% were used in the investigation and indoor and outdoor particle size and concentrations were measured. A balance mass model was used for the simulation of the impact of the surgical team, deposition rate, HVAC exhaust and air change rates on indoor particle concentration. The experimental results showed that high efficiency filters would not be expected to decrease the risk associated with indoor particles larger than approximately 1 µm in size because normal filters are relatively efficient for these large particles. A good fraction of outdoor particles were removed by deposition on the HVAC system surfaces and this deposition increased with particle size. For particles of 0.3-0.5 µm in diameter, particle reduction was about 23%, while for particles >10 µm the loss was about 78%. The modelling results showed that depending on the type of filter used, the surgical team generated between 93-99% of total particles, while the outdoor air contributed only 1-6%.

Survival of rat functional dental pulp cells in vascularized tissue engineering chambers

Regenerative endodontics aims to preserve, repair or regenerate the dental pulp tissue. Dental pulp stem cells, have a potential use in dental tissue generation. However, specific requirements to drive the dental tissue generation are still obscured. We established an in vivo model for studying the survival of dental pulp cells (DPC) and their potential to generate dental pulp tissue. DPC were mixed with collagen scaffold with or without slow release bone morphogenic protein 4 (BMP-4) and fibroblast growth factor 2 (FGF2). The cell suspension was transplanted into a vascularized tissue engineering chamber in the rat groin. Tissue constructs were harvested after 2, 4, 6, and 8 weeks and processed for histomorphological and immunohistochemical analysis. After 2 weeks newly formed tissue with new blood vessel formation were observed inside the chamber. DPC were found around dentin, particularly around the vascular pedicle and also close to the gelatin microspheres. Cell survival, was confirmed up to 8 weeks after transplantation. Dentin Sialophosphoprotein (DSPP) positive matrix production was detected in the chamber, indicating functionality of dental pulp progenitor cells. This study demonstrates the potential of our tissue engineering model to study rat dental pulp cells and their behavior in dental pulp regeneration, for future development of an alternative treatment using these techniques.

Molecular aspects of tissue engineering in the dental field

Tissue engineering is a multidisciplinary field with the potential to replace tissues lost as a result of trauma, cancer surgery, or organ dysfunction. The successful production, integration, and maintenance of any tissue-engineered product are a result of numerous molecular interactions inside and outside the cell. We consider the essential elements for successful tissue engineering to be a matrix scaffold, space, cells, and vasculature, each of which has a significant and distinct molecular underpinning (Fig. 1). Our approach capitalizes on these elements. Originally developed in the rat, our chamber model (Fig. 2) involves the placement of an arteriovenous loop (the vascular supply) in a polycarbonate chamber (protected space) with the addition of cells and an extracellular matrix such as Matrigel or endogenous fibrin (34, 153, 246, 247). This model has also been extended to the rabbit and pig (J. Dolderer, M. Findlay, W. Morrison, manuscript in preparation), and has been modified for the mouse to grow adipose tissue and islet cells (33, 114, 122) (Fig. 3)...

Harnessing the influence of reactive edges and defects of graphene substrates for achieving complete cycle of room-temperature molecular sensing

Molecular doping and detection are at the forefront of graphene research, a topic of great interest in physical and materials science. Molecules adsorb strongly on graphene, leading to a change in electrical conductivity at room temperature. However, a common impediment for practical applications reported by all studies to date is the excessively slow rate of desorption of important reactive gases such as ammonia and nitrogen dioxide. Annealing at high temperatures, or exposure to strong ultraviolet light under vacuum, is employed to facilitate desorption of these gases. In this article, the molecules adsorbed on graphene nanoflakes and on chemically derived graphene-nanomesh flakes are displaced rapidly at room temperature in air by the use of gaseous polar molecules such as water and ethanol. The mechanism for desorption is proposed to arise from the electrostatic forces exerted by the polar molecules, which decouples the overlap between substrate defect states, molecule states, and graphene states near the Fermi level. Using chemiresistors prepared from water-based dispersions of single-layer graphene on mesoporous alumina membranes, the study further shows that the edges of the graphene flakes (showing p-type responses to NO2 and NH3) and the edges of graphene nanomesh structures (showing n-type responses to NO2 and NH3) have enhanced sensitivity. The measured responses towards gases are comparable to or better than those which have been obtained using devices that are more sophisticated. The higher sensitivity and rapid regeneration of the sensor at room temperature provides a clear advancement towards practical molecule detection using graphene-based materials.

Inactivation of a 25.5 µm Enterococcus faecalis biofilm by a room-temperature, battery-operated, handheld air plasma jet

Effective biofilm inactivation using a handheld, mobile plasma jet powered by a 12 V dc battery and operated in open air without any external gas supply is reported. This cold, room-temperature plasma is produced in self-repetitive nanosecond discharges with current pulses of ~100 ns duration, current peak amplitude of ~6 mA and repetition rate of ~20 kHz. It is shown that the reactive plasma species penetrate to the bottom layer of a 25.5 µm-thick Enterococcus faecalis biofilm and produce a strong bactericidal effect. This is the thickest reported biofilm inactivated using room-temperature air plasmas.

Room-temperature photoluminescence from nitrogenated carbon nanotips grown by plasma-enhanced hot filament chemical vapor deposition

Nitrogenated carbon nanotips with a low atomic concentration of nitrogen have been synthesized by using a custom-designed plasma-enhanced hot-filament plasma chemical vapor deposition system. The properties (including morphology, structure, composition, photoluminescence, etc.) of the synthesized nitrogenated carbon nanotips are investigated using advanced characterization tools. The room-temperature photoluminescence measurements show that the nitrogenated carbon nanotips can generate two distinct broad emissions located at ∼405 and ∼507 nm, respectively. Through the detailed analysis, it is shown that these two emission bands are attributed to the transition between the lone pair valence and bands, which are related to the sp3 and sp2 C-N bonds, respectively. These results are highly relevant to advanced applications of nitrogenated carbon nanotips in light emitting optoelectronic devices.

Room-temperature, atmospheric plasma needle reduces adenovirus gene expression in HEK 293A host cells

Room-temperature, atmospheric-pressure plasma needle treatment is used to effectively minimize the adenovirus (AdV) infectivity as quantified by the dramatic reduction of its gene expression in HEK 293A primary human embryonic kidney cells studied by green fluorescent protein imaging. The AdV titer is reduced by two orders of magnitude within only 8 min of the plasma exposure. This effect is due to longer lifetimes and higher interaction efficacy of the plasma-generated reactive species in confined space exposed to the plasma rather than thermal effects commonly utilized in pathogen inactivation. This generic approach is promising for the next-generation anti-viral treatments and imunotherapies.

Gold nanoresistors with near-constant resistivity in the cryogenic-to-room temperature range

Using a multiple plasma deposition-annealing (MDA) technique, we have fabricated an Au nanoisland-based thin film nanoresistor with a very low temperature coefficient of electrical resistivity in a cryogenic-to-room temperature range of 10 to 300 K. The nanoislanded gold film was deposited on a SiO2/Si wafer (500 nm SiO2 thickness) between two 300 nm thick Au electrodes which were separated by 100 m. A sophisticated selection of the thickness of the nanoislanded gold film, the annealing temperature, as well as the number of deposition/annealing cycles resulted in the fabrication of a nanoresistor with a temperature coefficient of electrical resistivity of 2.1 × 10-3 K-1 and the resistivity deviation not exceeding 2% in a cryogenic-to-room temperature range. We have found that the constant resistivity regime of the nanoisland-based thin film nanoresistor corresponds to a minimized nanoisland activation energy (approximately 0.3 meV). This energy can be minimized by reducing the nearest neighbor distance and increasing the size of the Au nanoislands in the optimized nanoresistor structure. It is shown that the constant resistivity nanoresistor operates in the regime where the thermally activated electron tunneling is compensated by the negative temperature dependence of the metallic-type conductivity of nanoislands. Our results are relevant to the development of commercially viable methods of nanoresistor production for various nanoelectronics-based devices. The proposed MDA technique also provides the opportunity to fabricate large arrays of metallic nanoparticles with controllable size, shapes and inter-nanoparticle gaps.