Three-year outcomes of Straumann Bone Level SLActive dental implants in daily dental practice: a prospective non-interventional study

OBJECTIVE The aim of this investigation was to evaluate the performance of Straumann Bone Level SLActive implants in various clinical situations in daily dental practice for up to 3 years. METHOD AND MATERIALS This was a prospective, multicenter, non-interventional study in which implants were placed within approved indications in any situation deemed suitable by the treating clinician. No implant placement or loading protocol was specified, and implants were placed according to the routine treatment protocols at each participating center. RESULTS In this analysis, data were available from 342 implants in 233 patients in three countries (USA, Canada, and Switzerland). One or two implants were placed in the majority of patients (70.8% and 19.3%, respectively), mostly in the maxilla (71.3%); almost half (47.7%) were placed in the esthetic zone. Implant placement after 4 to > 16 weeks of healing was preferred in Switzerland (92.0%), while 42.0% of implants were placed immediately in the USA and Canada. A flapless procedure was performed in 25.2% of cases in the USA and Canada, compared to 0.5% in Switzerland. Cumulative implant survival and success rates after 3 years were 97.5% and 93.5%, respectively. CONCLUSION Straumann Bone Level Implants can achieve favorable outcomes and high survival rates after 3 years in daily dental practice. The survival and success rates were comparable with those achieved in formal controlled clinical trials.

Microbiota at teeth and implants in partially edentulous patients. A 10-year retrospective study.

OBJECTIVE To determine the microbiota at implants and adjacent teeth 10 years after placement of implants with a sandblasted and acid-etched surface. MATERIAL AND METHODS Plaque samples obtained from the deepest sites of 504 implants and of 493 adjacent teeth were analyzed for certain bacterial species associated with periodontitis, for staphylococci, for aerobic gram-negative rods, and for yeasts using nucleic acid-based methods. RESULTS Species known to be associated with periodontitis were detectable at 6.2-78.4% of the implants. Significantly higher counts at implants in comparison with teeth were assessed for Tannerella forsythia, Parvimonas micra, Fusobacterium nucleatum/necrophorum, and Campylobacter rectus. Higher counts of periodontopathogenic species were detectable at implants of current smokers than at those of non-smokers. In addition, those species were found in higher quantities at implants of subjects with periodontitis. The prevalence of Prevotella intermedia, Treponema denticola, C. rectus, and moreover of Staphylococcus warneri might be associated with peri-implant inflammation. Selected staphylococcal species (not Staphylococcus aureus), aerobic gram-negative rods, and yeasts were frequently detected, but with the exception of S. warneri, they did not show any association with periodontal or peri-implant diseases. CONCLUSIONS Smoking and periodontal disease are risk factors for colonization of periodontopathic bacteria at implants. Those bacterial species may play a potential role in peri-implant inflammation. The role of S. warneri needs further validation.

Host-derived biomarkers at teeth and implants in partially edentulous patients. A 10-year retrospective study.

OBJECTIVES To assess a selection of host-derived biomarkers in peri-implant sulcus fluid (PISF) and gingival crevicular fluid (GCF) from adjacent teeth 10 years following implant placement. MATERIAL AND METHODS Peri-implant sulcus fluid and GCF samples obtained from the deepest sites of 504 implants and 493 adjacent teeth were analysed for levels of interleukin (IL)-1β, matrix metalloproteinase (MMP)-3, MMP-8, MMP-1, and MMP-1 bound to tissue inhibitor of MMP (TIMP)-1 (MMP-1/TIMP-1) by enzyme-linked immunosorbent assay (ELISA) technique. RESULTS Overall, MMP-8 was detected in 90% of the sites. In more than 50% of the sites, IL-1β was identified while in 30% of the sites MMP-1, MMP-1/TIMP-1 and MMP-3 were found over the detection level. Increased biomarkers levels from PISF and GCF were positively correlated (r = 0.375-0.702; P < 0.001). However, no qualitative and quantitative differences were found between PISF and GCF. The levels of MMP-1 were negatively correlated with those of MMP-1/TIMP-1 at implants (r = -0.644; P < 0.001). Median MMP-1 levels at implants were high (5.17 pg/site) in subjects with severe chronic periodontitis and low in patients with mild-to-moderate chronic periodontitis (0 pg/site; P = 0.026) or gingivitis (0 pg/site; P = 0.034). Levels of IL-1β were found to be different in GCF according to the periodontal conditions (P = 0.001) with the highest level found in mild-to-moderate periodontitis (6.2 pg/site). Clinical attachment levels at implants demonstrated an inverse correlation with MMP-1/TIMP-1 (r = -0.147; P = 0.001). CONCLUSIONS Increased levels of MMP-8 and IL-1β in PISF or GCF may be associated with inflammation around teeth and implants while lower levels of MMP-1/TIMP-1 may be an indicator of disease progression around implants.

Small-diameter titanium grade IV and titanium-zirconium implants in edentulous mandibles: five-year results from a double-blind, randomized controlled trial.

BACKGROUND The aim of this study was to compare the 5-year survival and success rates of 3.3 mm dental implants either made from titanium-zirconium (TiZr) alloy or from Grade IV titanium (Ti Grade IV) in mandibular implant-based removable overdentures. METHODS The core study had a follow-up period of 36 months and was designed as a randomized, controlled, double-blind, split-mouth multicenter clinical trial. Patients with edentulous mandibles received two Straumann Bone Level implants (diameter 3.3 mm, SLActive®), one of TiZr (test) and one of Ti Grade IV (control), in the interforaminal region. This follow-up study recruited patients from the core study and evaluated the plaque and sulcus bleeding indices, radiographic crestal bone level, as well as implant survival and success 60 months after implant placement. RESULTS Of the 91 patients who initially received implants, 75 completed the 36 month follow-up and 49 were available for the 60 month examination. Two patients were excluded so that a total of 47 patients with an average age of 72 ± 8 years were analysed. The characteristics and 36-month performance of the present study cohort did not differ from the non-included initial participants (p > 0.05). In the period since the 36-month follow-up examination, no implant was lost. The cumulative implant survival rate was 98.9 % for the TiZr group and 97.8 % for the Ti Grade IV group. Crestal bone level changes at 60 months were not different in the test and control group (TiZr -0.60 ± 0.69 mm and Ti Grade IV -0.61 ± 0.83 mm; p = 0.96). The cumulative implant success rate after 60 months was 95.8 and 92.6 % for TiZr and Ti Grade IV, respectively. CONCLUSIONS After 60 months, the positive outcomes of the 36 month results for TiZr and Ti Grade IV implants were confirmed, with no significant differences with regard to crestal bone level change, clinical parameters and survival or success rates. TiZr implants performed equally well compared to conventional Ti Grade IV 3.3 mm diameter-reduced implants for mandibular removable overdentures. TRIAL REGISTRATION Registered on www.clinicaltrials.gov: NCT01878331.

Preparing Aston Business School students for placement

Aston Business School (ABS) has offered four-year sandwich degrees (including a year long placement) for over 30 years, and ABS has often been ranked top for graduate employability. This report outlines the activities ABS uses to meet its ever increasing placement targets. ABS builds relationships in students’ thinking between theory and practice, and this has implications for their study, the placement period and beyond. Developing the links has certainly been a factor in the enhanced employabilility of ABS graduates, resulting in ABS having been ranked top for graduate employability for many years. The eight employability skills used as the basis for the placement preparation objectives originate from Smith at al’s (2002) work on employability. We were encouraged to find that these employability skills overlap with the benchmark of the ‘Profile summary for Business and Management’ outlined by Hawkridge (2005). In this case study we provide a rationale and then the objectives of the placement preparation period, followed by specific details of the preparation process. The evaluation highlights key achievements and areas for development, and the discussion is future-focused. Readers should note that the ABS Undergraduate curriculum is aimed at preparing students for employment but this case study focuses on the role of the Placements Team.

Learning with other health professions in the United Kingdom MPharm degree:Multidisciplinary and placement education

This paper reviews the approach to multidisciplinary and placement education in UK schools of pharmacy. The methodology involved triangulation of course documentation, staff interviews and a final year student survey. Staff members were supportive of multidisciplinary learning. The advantages were development of a wider appreciation of the students? future professional role and better understanding of the roles of other professional groups. The barriers were logistics (student numbers; multiple sites; different timetables), the achievement of balanced numbers between disciplines and engagement of students from all participating disciplines. Placement education was offered by all schools, predominantly in hospital settings. Key problems were funding and the lack of staff resources. Currently, multidisciplinary learning within the UK for pharmacy students is inadequate and is coupled with relatively low levels of placement education. In order for things to change, there should be a review of funding and support from government and the private sector employers.

Do work placements improve final year academic performance or do high-calibre students choose to do work placements?

This study investigates whether the completion of an optional sandwich work placement enhances student performance in final year examinations. Using Propensity Score Matching, our analysis departs from the literature by controlling for self-selection. Previous studies may have overestimated the impact of sandwich work placements on performance because it might be the case that high-calibre students choose to go on placement. Our results, utilising a large student data set, indicate that self-selection is present, but the effects of a placement on student performance still have an impact. This robust finding is found to be of a remarkably similar magnitude across two UK universities.

Profiling The Campus Recruiter At A Four-Year Hospitality Program

Profiling the Campus Recruiter At a Four-Year Hospitality Program, is a written profile, supported by anecdotal rather than stridently empirical evidence, by Al lzzolo, Assistant Professor, College of Hotel Administration, University of Nevada, Las Vegas. “Each year major chain corporations as well as single unit companies interview hospitality students throughout the country. A study conducted at the University of Nevada, Las Vegas, was designed to profile the hospitality industry campus recruiter and to provide meaningful data to college students who would be interviewing with these recruiters,” the author initially proffers. “Recruiting at the four-year hospitality program, by its nature, is not a science, nor is it highly quantifiable. The interviewing and selection processes are highly subjective and vary from company to company,” says Izzolo to preface his essay. “Data were collected via a questionnaire specifically designed to answer questions about the recruiters and/or the companies that sent interviewers to the placement office of the university's hospitality program,” our author says to explain the process used to gather information for the piece. Findings of the study indicate that the typical recruiter is male, college educated – but not necessarily in a Hospitality’ curriculum – and almost 80 percent of respondents said they had the authority to hire management trainees. Few campuses are visited by hospitality industry recruitment staff as evidenced by Izzolo’s observations/data. Table 3 analyzes the desirable traits a recruiter deems appropriate for the potential employee candidate. Personal appearance, work experience, grade point average, and verbal communication rank high on the list of distinguishable attributes. The most striking finding in this portion of the study is that a student’s GPA is virtually ignored. “Recruiting for the hospitality industry appears to be very subjective,” Izzolo says. “Recruiters are basing decisions to hire not on knowledge levels as determined by an academic grade point average but rather on criteria much less definitive, such as verbal skills and personal appearance,” our author opines. In closing, Izzolo concedes this is not a definitive study, but is merely a launching pad to a more comprehensive investigation on the recruitment subject.

Utilizing Traditional Cognitive Measures of Academic Preparation to Predict First-Year Science, Technology, Engineering, and Mathematics (STEM) Majors' Success in Math and Science Courses

For the past several years, U.S. colleges and universities have faced increased pressure to improve retention and graduation rates. At the same time, educational institutions have placed a greater emphasis on the importance of enrolling more students in STEM (science, technology, engineering and mathematics) programs and producing more STEM graduates. The resulting problem faced by educators involves finding new ways to support the success of STEM majors, regardless of their pre-college academic preparation. The purpose of my research study involved utilizing first-year STEM majors’ math SAT scores, unweighted high school GPA, math placement test scores, and the highest level of math taken in high school to develop models for predicting those who were likely to pass their first math and science courses. In doing so, the study aimed to provide a strategy to address the challenge of improving the passing rates of those first-year students attempting STEM-related courses. The study sample included 1018 first-year STEM majors who had entered the same large, public, urban, Hispanic-serving, research university in the Southeastern U.S. between 2010 and 2012. The research design involved the use of hierarchical logistic regression to determine the significance of utilizing the four independent variables to develop models for predicting success in math and science. The resulting data indicated that the overall model of predictors (which included all four predictor variables) was statistically significant for predicting those students who passed their first math course and for predicting those students who passed their first science course. Individually, all four predictor variables were found to be statistically significant for predicting those who had passed math, with the unweighted high school GPA and the highest math taken in high school accounting for the largest amount of unique variance. Those two variables also improved the regression model’s percentage of correctly predicting that dependent variable. The only variable that was found to be statistically significant for predicting those who had passed science was the students’ unweighted high school GPA. Overall, the results of my study have been offered as my contribution to the literature on predicting first-year student success, especially within the STEM disciplines.

Clinical placement before or after simulated learning environments? A naturalistic study of clinical skills acquisition among early-stage paramedicine students

BACKGROUND: There is conflicting evidence surrounding the merit of clinical placements (CPs) for early-stage health-profession students. Some contend that early-stage CPs facilitate contextualization of a subsequently learned theory. Others argue that training in simulated-learning experiences (SLEs) should occur before CP to ensure that students possess at least basic competency. We sought to investigate both claims. METHODS: First-year paramedicine students (n = 85) undertook 3 days of CP and SLEs as part of course requirements. Students undertook CP either before or after participation in SLEs creating 2 groups (Clin → Sim/Sim → Clin). Clinical skills acquisition was measured via direct scenario-based clinical assessments with expert observers conducted at 4 intervals during the semester. Perceptions of difficulty of CP and SLE were measured via the National Aeronautics and Space Administration Task Load Index. RESULTS: Students' clinical assessment scores in both groups improved significantly from beginning to end of semester (P < 0.001). However, at semester's end, clinical assessment scores for the Sim → Clin group were statistically significantly greater than those of the Clin → Sim group (P = 0.021). Both groups found SLEs more demanding than CP (P < 0.001). However, compared with the Sim → Clin group, the Clin → Sim group rated SLE as substantially more time-demanding than CP (P = 0.003). CONCLUSIONS: Differences in temporal demand suggest that the Clin → Sim students had fewer opportunities to practice clinical skills during CP than the Sim → Clin students due to a more limited scope of practice. The Sim → Clin students contextualized SLE within subsequent CP resulting in greater improvement in clinical competency by semester's end in comparison with the Clin → Sim students who were forced to contextualize skills retrospectively.

Exploring first-year academic achievement through structural equation modelling

The purpose of this research was to develop and test a multicausal model of the individual characteristics associated with academic success in first-year Australian university students. This model comprised the constructs of: previous academic performance, achievement motivation, self-regulatory learning strategies, and personality traits, with end-of-semester grades the dependent variable of interest. The study involved the distribution of a questionnaire, which assessed motivation, self-regulatory learning strategies and personality traits, to 1193 students at the start of their first year at university. Students' academic records were accessed at the end of their first year of study to ascertain their first and second semester grades. This study established that previous high academic performance, use of self-regulatory learning strategies, and being introverted and agreeable, were indicators of academic success in the first semester of university study. Achievement motivation and the personality trait of conscientiousness were indirectly related to first semester grades, through the influence they had on the students' use of self-regulatory learning strategies. First semester grades were predictive of second semester grades. This research provides valuable information for both educators and students about the factors intrinsic to the individual that are associated with successful performance in the first year at university.