Our group reported that three diabetic retinopathy (DR) phenotypes: A, characterized by low microaneurysm turnover (MAT < 6) and normal central retinal thickness (CRT); B, low MAT (<6) and increased CRT, and C, high MAT (≥6), present different risks for development of macular edema (DME) and proliferative retinopathy (PDR). To test these findings, 212 persons with type 2 diabetes (T2D) and mild nonproliferative retinopathy (NPDR), one eye per person, were followed for five years with annual visits. Of these, 172 completed the follow-up or developed an outcome: PDR or DME (considering both clinically significant macular edema (CSME) and center-involved macular edema (CIME)). Twenty-seven eyes (16%) developed either CSME (14), CIME (10), or PDR (4), with one eye developing both CSME and PDR. Phenotype A showed no association with development of vision-threatening complications. Seven eyes with phenotype B and three with phenotype C developed CIME. Phenotype C showed higher risk for CSME development, with 17.41 odds ratio (p = 0.010), compared with phenotypes A + B. All eyes that developed PDR were classified as phenotype C. Levels of HbA1c and triglycerides were increased in phenotype C (p < 0.001 and p = 0.018, respectively). In conclusion, phenotype C identifies eyes at higher risk for development of CSME and PDR, whereas phenotype A identifies eyes at very low risk for vision-threatening complications.
This study evaluated the biocompatibility of a new silicone-based sealer (GuttaFlow Bioseal) in rat subcutaneous tissue and compared the results with those for GuttaFlow2 and AH Plus. Each of 16 Wistar rats received four subcutaneous tissue implants, namely, GuttaFlow Bioseal, GuttaFlow2, AH Plus, and one empty polyethylene tube. Eight rats were euthanized at day 8 and the remaining eight at day 30. Histological sections were stained with haematoxylin and eosin and analysed with a light microscope. Scores were established for inflammatory reaction, macrophage infiltrate, thickness of the fibrous capsule, and vascular changes. Differences between groups were assessed by using the Friedman test with Bonferroni correction. Histological analysis showed that GuttaFlow Bioseal had the lowest inflammatory reaction of all tested sealers at day 8. At day 30, the silicone-based sealers had similar inflammation profiles, but inflammation scores were nonsignificantly higher for AH Plus than for the negative control. The inflammatory reaction decreased from day 8 to day 30 in all sealers. GuttaFlow Bioseal had the most macrophage infiltrate. Under the present experimental conditions, GuttaFlow Bioseal induced limited inflammatory reactions at days 8 and 30, and initial inflammatory reactions to GuttaFlow2 and AH Plus subsided within 30 days. All tested sealers exhibited satisfactory biocompatibility at day 30 after subcutaneous implantation.
Aim The aim of this study was to compare clinical and radiographic outcomes of dental implants with different neck characteristics. Methods A protocol‐oriented search aimed at the question: “In patients subjected to tooth replacement with screw‐type dental implants does the modification of the implant neck macro‐ or microgeometry contribute to the improvement of survival rates and maintenance of the peri‐implant marginal bone levels?” Primary outcomes were survival and marginal bone level (MBL) changes evaluated on randomized controlled trials with >10 participants and follow‐up >1 year. Risk of bias was evaluated using the Cochrane Collaboration's tool. The review follows the PRISMA statement. Results Forty‐three studies compared: (a) One‐ versus two‐piece implants (N = 7); (b) Two‐piece implants with different neck characteristics (machined and rough collars, microthreads, LASER microtexturing) (N = 21); (c) Two‐piece implants with macrogeometry modifications (tapering, back‐tapering, and scalloping) (N = 6). One‐ and two‐piece implants showed similar survival (RR = 0.45, 95% CI: [0.12, 1.66], p = 0.23) and MBL changes (WMD = 0.09 mm, 95% CI: [−0.27, 0.45], p = 0.64) at 1‐year post‐loading. Machined collar implants have higher risk of early failure than rough collar implants (RR = 3.96, 95% CI: [1.12, 13.93], p = 0.03) and 0.43 mm higher bone resorption (95% CI: [0.0, 0.86], p = 0.05). Microthreads (WMD = 0.07 mm, 95% CI: [−0.01, 0.15], p = 0.10) and LASER microtexturing (WMD = 0.15 mm, 95% CI: [−0.35, 0.65], p = 0.56) do not reduce bone resorption. Scalloped implants have 1.26 mm higher resorption (95% CI: [0.72, 2.00], p < 0.001). Conclusions One‐ and two‐piece implants have similar survival and MBL changes. Rough collar implants have lower MBL changes than machined collar implants. Additional modifications to rough collars are irrelevant.
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