OBJECTIVE: To evaluate the influence of abutment geometry on papillary fill in the esthetic zone in a delayed crown protocol.MATERIALS AND METHODS: Twenty-six subjects received two non-adjacent endosseous implants in the esthetic zone. Functional temporary crowns were installed 17-19 weeks later, using conventional (control) and curved (experimental) abutments. The abutments were randomized in each patient independently. Final crowns were cemented after 2 months (T0). Standard intraoral photographs and radiographs were made to evaluate papillary fill after 12 months (T12). The interproximal papilla fill was measured by means of the papilla index score (PIS) and related to the maximum bone level between the implant and the adjacent root as well as the peri-implant marginal bone level at T12, both measured radiographically.RESULTS: No statistically significant difference between the experimental and the control group could be demonstrated (P = 0.25). Ordinal regression analysis showed a positive correlation between the maximum bone level and papilla fill (P < 0.01) and a negative correlation between the peri-implant marginal bone level and papilla fill (P < 0.05).CONCLUSION: A concave abutment does not exhibit a better fill of the papilla compared with a straight abutment in single-tooth implant placement using a delayed protocol in the esthetic zone after 12 months of function.
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Objective: To examine spoken language outcomes in children undergoing bilateral cochlear implantation compared with matched peers undergoing unilateral implantation. Design: Case-control, frequency-matched, retrospective cross-sectional multicenter study. Setting: Two Belgian and 3 Dutch cochlear implantation centers. Participants: Twenty-five children with 1 cochlear implant matched with 25 children with 2 cochlear implants selected from a retrospective sample of 288 children who underwent cochlear implantation before 5 years of age. Intervention: Cochlear implantation. Main Outcome Measures: Performance on measures of spoken language comprehension and expression (Reynell Developmental Language Scales and Schlichting Expressive Language Test). Results: On the receptive language tests (mean difference [95% CI], 9.4 [0.3-18.6]) and expressive language tests (15.7 [5.9-25.4] and 9.7 [1.5-17.9]), children undergoing bilateral implantation performed significantly better than those undergoing unilateral implantation. Because the 2 groups were matched with great care on 10 auditory, child, and environmental factors, the difference in performance can be mainly attributed to the bilateral implantation. A shorter interval between both implantations was related to higher standard scores. Children undergoing 2 simultaneous cochlear implantations performed better on the expressive Word Development Test than did children undergoing 2 sequential cochlear implantations. Conclusions: The use of bilateral cochlear implants is associated with better spoken language learning. The interval between the first and second implantation correlates negatively with language scores. On expressive language development, we find an advantage for simultaneous compared with sequential implantation.
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Practical experience and research reveal generic spoken language benefits after cochlear implantation. However, systematic research on specific language domains and error analyses are required to probe sub-skills. Moreover, the effect of predictive factors on distinct language domains is unknown. In this study, outcomes of 70 school-aged children with cochlear implants were compared with hearing peers. Approximately half of the children with cochlear implants achieved age-adequate language levels. Results did not reveal systematic strong or weak language domains. Error analyses showed difficulties with morphological and syntactic rules and inefficient narrative skills. Children without additional disabilities who received early intervention were raised with one spoken language, and used a second cochlear implant or contralateral hearing aid were more likely to present good language skills.
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Nowadays, there is particular attention towards the additive manufacturing of medical devices and instruments. This is because of the unique capability of 3D printing technologies for designing and fabricating complex products like bone implants that can be highly customized for individual patients. NiTi shape memory alloys have gained significant attention in various medical applications due to their exceptional superelastic and shape memory properties, allowing them to recover their original shape after deformation. The integration of additive manufacturing technology has revolutionized the design possibilities for NiTi alloys, enabling the fabrication of intricately designed medical devices with precise geometries and tailored functionalities. The AM-SMART project is focused on exploring the suitability of NiTi architected structures for bone implants fabricated using laser powder bed fusion (LPBF) technology. This is because of the lower stiffness of NiTi alloys compared to Ti alloys, closely aligning with the stiffness of bone. Additionally, their unique functional performance enables them to dissipate energy and recover the original shape, presenting another advantage that makes them well-suited for bone implants. In this investigation, various NiTi-based architected structures will be developed, featuring diverse cellular designs, and their long-term thermo-mechanical performance will be thoroughly evaluated. The findings of this study underscore the significant potential of these structures for application as bone implants, showcasing their adaptability for use also beyond the medical sector.