Does immediate loading affect clinical and patient-centered outcomes of mandibular 2-unsplinted-implant overdenture? : a 2-year within-case analysis

Objective To provide 2-year clinical- and patient-oriented data with regard to mandibular overdenture assisted by 2 immediately loaded unsplinted implants. Material and methods In this pre-post design, Phase-I clinical trial, 18 edentate individuals (62.4 ± 7.7 years) received a new set of complete denture. Then, following standard procedures, 3 threaded implants (OsseoSpeed TX™, Dentsply Implants, Mölndal, Sweden) were placed in the mandible in each patient, and locator abutments (Zest Anchors LLC, Escondido, U.S.A.) were inserted on the right and left side implants. The midline implant served as a control for within-patient comparison. The immediate loading was conducted within 24 h of surgery. Data were collected at baseline (T0), 12 (T1) and 24 (T2) months after immediate loading. The clinical outcomes included implant survival rate, crestal bone level changes and implant stability. These criteria were assessed through clinical and radiographic examinations as well as resonance frequency analysis. Patient-centered outcomes included patient satisfaction and oral health-related quality of life measured using validated questionnaires. Brunner-Langer approach was used for statistical analysis. Results Implant survival rate for immediate loaded implants was 91.7% at 2-year follow-up. None of the unloaded implants failed. There was no statistically significant difference at baseline and follow-ups with regard to clinical outcomes between loaded and unloaded implants. Patient satisfaction and quality of life improved (p < 0.0001) from baseline to 2-year follow-up. Conclusion Immediate loading protocol did not negatively affect clinical outcomes, satisfaction and quality of life of patients wearing 2-unsplinted-implant mandibular overdenture for 2 years. This conclusion requires confirmation by randomized control trials. Clinical significance statement Mandibular overdenture assisted by two immediately-loaded unsplinted implants is successful treatment based on 2-year clinical and patient-based outcomes.

Strategic Voting in Proportional Systems: The Case of Finland. IHS Political Science Series No. 138, September 2014

Voters try to avoid wasting their votes even in PR systems. In this paper we make a case that this type of strategic voting can be observed and predicted even in PR systems. Contrary to the literature we do not see weak institutional incentive structures as indicative of a hopeless endeavor for studying strategic voting. The crucial question for strategic voting is how institutional incentives constrain an individual’s decision-making process. Based on expected utility maximization we put forward a micro-logic of an individual’s expectation formation process driven by institutional and dispositional incentives. All well-known institutional incentives to vote strategically that get channelled through the district magnitude are moderated by dispositional factors in order to become relevant for voting decisions. Employing data from Finland – because of its electoral system a particularly hard testing ground - we find considerable evidence for observable implications of our theory.

Numerical and experimental investigation of structural stiffness influence on ratcheting convection cell in granular soils under cyclic loading

Lateral cyclic loaded structures in granular soils can lead to an accumulation of irreversible strains by changing their mechanical response (densification) and forming a closed convective cell in the upper layer of the bedding. In the present thesis the convective cell dimension, formation and grain migration inside this closed volume have been studied and presented in relation to structural stiffness and different loads. This relation was experimentally investigated by applying a cyclic lateral force to a scaled flexible vertical element embedded in dry granular soil. The model was monitored with a camera in order to derive the displacement field by means of the PIV technique. Modelling large soil deformation turns out to be difficult, using mesh-based methods. Consequently, a mesh-free approach (DEM) was chosen in order to investigate the granular flow with the aim of extracting interesting micromechanical information. In both the numerical and experimental analyses the effect of different loading magnitudes and different dimensions of the vertical element were considered. The main results regarded the different development, shape and dimensions of the convection cell and the surface settlements. Moreover, the Discrete Element Method has proven to give satisfactory results in the modelling of large deformation phenomena such as the ratcheting convective cell.

Compression Loading Induced Cellular Stress Response of Intervertebral Disc Cells in Organ Culture

Introduction: Mechanical stress is often associated to interverterbal disc (IVD) degeneration and the effect of mechanical loading on IVD has been studied and reviewed.1,2 Previously, expression of heat shock proteins, HSP70 and HSP27 has been found in pathological discs.3 However, there is no direct evidence on whether IVD cells respond to the mechanical loading by expression of HSPs. The objective of this study is to investigate the stress response of IVD cells during compressive loading in an organ culture. Materials and Methods: Fresh adult bovine caudal discs were cultured with compressive loading applied at physiological range. Effect of loading type (static and dynamic) and repeated loading (2 hours per day for 2 days) were studied. Nucleus pulposus (NP) and annulus fibrosus (AF) of the IVD were retrieved at different time points: right after loading and right after resting. Positive control discs were heat shocked (43°C). Cell activity was assessed and expression of stress response genes (HSP70 and HSF1) and matrix remodeling genes (ACAN, COL2, COL1, ADAMTS4, MMP3 and MMP13) were studied. Results: Cell activity was maintained in all groups. Both NP and AF expressed high level of HSP70 in heat shock groups, confirming their expression in response to stress. In NP, expression of HSP70 was up-regulated after static loading and dynamic loading with higher fold change was observed after static loading. During repeated loading, HSP70 appeared to be upregulated right after loading and decreased after resting. Such trend was not observed in AF and HSF1 levels. Expressions of matrix remodeling genes did not change significantly with loading except ADAMTS4 decreased in AF during static loading. Conclusion: This study demonstrated that NP cells upregulate expression of HSP70 in response to loading induced stress without changing cell activity and matrix remodeling significantly. Acknowledgments: This project was funded by AO Spine (AOSPN) (grant number: SRN_2011_14) and a fellowship exchange award by AO Spine Scientific Research Network (SRN).

Does immediate loading affect clinical and patient-centered outcomes of mandibular 2-unsplinted-implant overdenture? : a 2-year within-case analysis

Objective To provide 2-year clinical- and patient-oriented data with regard to mandibular overdenture assisted by 2 immediately loaded unsplinted implants. Material and methods In this pre-post design, Phase-I clinical trial, 18 edentate individuals (62.4 ± 7.7 years) received a new set of complete denture. Then, following standard procedures, 3 threaded implants (OsseoSpeed TX™, Dentsply Implants, Mölndal, Sweden) were placed in the mandible in each patient, and locator abutments (Zest Anchors LLC, Escondido, U.S.A.) were inserted on the right and left side implants. The midline implant served as a control for within-patient comparison. The immediate loading was conducted within 24 h of surgery. Data were collected at baseline (T0), 12 (T1) and 24 (T2) months after immediate loading. The clinical outcomes included implant survival rate, crestal bone level changes and implant stability. These criteria were assessed through clinical and radiographic examinations as well as resonance frequency analysis. Patient-centered outcomes included patient satisfaction and oral health-related quality of life measured using validated questionnaires. Brunner-Langer approach was used for statistical analysis. Results Implant survival rate for immediate loaded implants was 91.7% at 2-year follow-up. None of the unloaded implants failed. There was no statistically significant difference at baseline and follow-ups with regard to clinical outcomes between loaded and unloaded implants. Patient satisfaction and quality of life improved (p < 0.0001) from baseline to 2-year follow-up. Conclusion Immediate loading protocol did not negatively affect clinical outcomes, satisfaction and quality of life of patients wearing 2-unsplinted-implant mandibular overdenture for 2 years. This conclusion requires confirmation by randomized control trials. Clinical significance statement Mandibular overdenture assisted by two immediately-loaded unsplinted implants is successful treatment based on 2-year clinical and patient-based outcomes.

Loading functions for assessment of water pollution from nonpoint sources /

Item 431-I-12

Investigation of proportional counters /

"LADC 148"

Democracy or anarchy? : A study of proportional representation /

Mode of access: Internet.

Refinement of finite element analysis of automobile structures under crash loading. Volume I. Summary final report.

National Highway Traffic Safety Administration, Washington, D.C.

Transformation of Nine-Accelerometer-Package (NAP) data for replicating headpart kinematics and dynamic loading. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Recreational boat safe loading : operator study /

Contract no. DOT-CG-40672-A.

Refinement of finite element analysis of automobile structures under crash loading. Volume II. Final technical report.

National Highway Traffic Safety Administration, Washington, D.C.

Effects of hours of service regularity of schedules, and cargo loading on truck and bus driver fatigue. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Isolation of flaws by use of thermal differentials on a tire under mild loading conditions. Preliminary memorandum.

National Highway Traffic Safety Administration, Washington, D.C.