ObjectivesThromboembolic events are the major factor affecting the prognosis of patients with chronic kidney disease (CKD). Haemostatic alterations are possible causes of these complications, but their roles remain poorly characterised. In the prospective observational study, we investigated the entire coagulation process in patients with CKD to elucidate the mechanisms of their high thromboembolic risk.MethodsA total of 95 patients with CKD and 20 healthy controls who met the inclusion criteria were consecutively recruited from September 2015 to March 2016. The platelet count, platelet aggregation, von Willebrand factor antigen (vWF:Ag), vWF ristocetin cofactor activity (vWF:RCo), fibrinogen, factor V (FV), FVII, FVIII, antithrombin III, protein C, protein S, D-dimer, standard coagulation tests and thromboelastography were measured in patients with CKD and controls. Associations between the estimated glomerular filtration rate (eGFR) and haemostatic biomarkers were tested using multivariable linear regression.ResultsThe adjusted and unadjusted levels of vWF:Ag, vWF:RCo, fibrinogen, FVII, FVIII and D-dimer were significantly higher in patients with CKD than that in the healthy controls, and were elevated with CKD progression. However, after adjustment for baseline differences, platelet aggregation and thromboelastography parameters showed no significant differences between patients with CKD and healthy controls. In the correlation analysis, vWF:Ag, vWF:RCo and FVIII were inversely associated with eGFR (r=−0.359, p<0.001; r=−0.391, p<0.001; r=−0.327, p<0.001, respectively). During the 1-year of follow-up, one cardiovascular event occurred in patients with CKD 5 stage, whereas no thromboembolic event occurred in the CKD 3 and 4 and control groups.ConclusionsPatients with CKD are characterised by endothelial dysfunction and increased coagulation, especially FVIII activity. The abnormal haemostatic profiles may contribute to the elevated risk of thrombotic events but further longer-term study with large samples is still required to more precisely determine the relationship between the elevation of procoagulant factors and clinical outcomes.

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Immediate implant placement and provisionalization (IIPP) in the extraction socket is an attractive treatment modality that facilitates immediate tooth replacement and reduces treatment time, cost and surgical trauma as compared to delayed approaches

Objectives To compare the three‐dimensional changes in quantity and morphology following clinical adjustment of a posterior single implant crown between chairside digital workflow (test) and hybrid digital workflow (control). Materials and Methods A total of 33 participants were included for single‐tooth replacement with screw‐retained crowns in posterior sites of either the maxillary or mandible. A total of 17 participants were carried to a chairside digital workflow, receiving monolithic lithium disilicate (LS2)‐crowns (test), while the remaining 16 participants were fitted with CAD/CAM‐fabricated zirconia superstructures and hand‐layered ceramic veneering crowns (control). As each crown underwent intraoral scanning (3Shape TRIOS Color, 3Shape), 3D digital models were rendered. These scans were taken both before and after try‐in. Clinical adjustment dimensional changes were measured by superimposing the optical scans of models within a reverse software (Geomagic Control 2014). Adjustment counts and amounts (from vertical dimension) between two workflows were assessed and compared. Time consumption was recorded for efficiency analysis. Results All patients were successfully treated in both groups. The median maximum vertical adjustment (taking both occlusal and interproximal surfaces into consideration) was 237 μm ± 112 in the test group and 485 μm ± 195 in the control group (p < .0001), respectively. The median adjustment count was 2.00 ± 1.09 in test group and 3.00 ± 1.05 in control group (p = .001), respectively. The total active working time/ total time for two workflows was 92.3/113.7 min for the test group and 146.3/676.3 min for the control group, respectively. Conclusion The test group showed fewer adjustments and apparent precision on the occlusal surface compared with the control group with only a fifth of the consumption of a hybrid workflow.

Background Soft tissue dynamics in the esthetic zone are gaining increasing attention in recent years. Emerging intraoral scanning technology allows easier capture of soft tissue contours. Purpose To quantitatively assess the time‐dependent contour alterations of labial soft tissue following single immediate implants and immediate provisionalization (IIPP) in maxillary incisors via intraoral scanning. Materials and Methods This was a prospective cohort study. Thirty eligible consecutive patients were included and received immediate replacement of a failure maxillary single incisor. A screw‐retained immediate restoration was delivered for each patient. Subsequently, the anterior maxillary region was scanned by an intraoral scanning system at four time points: preoperation (baseline, BL), 3 months (3 m), 6 months (6 m), and 12 months (12 m). The Standard Tessellation Language files were exported to a dedicated software and superimposed for visual analysis. At 3, 6, and 12 months, the mid‐facial mucosa level (ML) was assessed, and the precise three‐dimensional (3D) configuration of the altered volume was calculated and reconstructed for visual analysis. Furthermore, quantitative analysis of the reconstructed morphology was performed using the following parameters: mean change in thickness (△d), mesio‐distal width (w), coronal‐apical height (h), and horizontal and vertical position of the thickest point represented by coordinates (x, z). Result Twenty‐seven of thirty enrolled patients were finally available for analysis at the 1‐year follow‐up. In general, the frontal view of the reconstructed volume exhibited a crescent shape. The mid‐facial ML change at 3, 6, and 12 months was −0.05 ± 0.36 mm, −0.03 ± 0.32 mm, and −0.24 ± 0.37 mm, respectively (P = .012). The mean change in thickness at 3 months (△d3m), 6 months (△d6m), and 12 months (△d12m) was 0.50 ± 0.19 mm, 0.59 ± 0.21 mm, and 0.62 ± 0.22 mm, respectively (P <.001). At 12 months, nine patients had a △d less than 0.5 mm. The mean △d3 m/△d12 m and △d6 m/△d12 m was 0.81 ± 0.17 and 0.96 ± 0.13. The w, h, x, and z results showed no significant differences during the 1‐year observation (P = .126, P = .324, P = .635, P = .263). At 12 months, w, h, x, and z were 11.57 ± 1.77 mm, 6.46 ± 2.01 mm, 0.03 ± 1.43 mm, and 2.16 ± 0.65 mm, respectively. Conclusion During the 1‐year observation following single IIPP treatment in maxillary incisors, the labial soft tissue contour showed a continuous alteration resulting in a mean change in thickness of 0.62 mm that occurred mainly in the first 3 months and tended to be relatively stable after 6 months, while the crescent‐like shape, width, height, and thickest point position of the alteration volume remained stable after 3 months. No advanced mid‐facial recession was observed.