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To describe the 5 years' trajectories in functionality and pain of patients with hip or knee osteoarthritis and arthroplasty and analyze the association of these with long-term patients survival. Patients with oA receiving total hip or knee arthroplasty were recruited and completed two sets of standardized questionnaires for functionality and pain 6, 12, and 60 months postoperatively. Multivariate mixed models were conducted to assess trajectories over time and the resulting improvement per month during the last time period was included in a landmark-model to estimate adjusted hazard ratios for mortality. In total 809 patients with joint replacement were included (mean age 65.0 years, 62.2% female), 407 patients died (median follow-up 18.4 years). Both instruments of functionality and pain showed extensive improvement during the first 6 months. Baseline and change in functionality (both p < 0.001) and pain (p = 0.02) during the first 6 months were associated with mortality. Better values in functionality corresponded with improved survival whereas the association with the pain scores was inverse. In patients with hip and knee OA, an explicit improvement in function is seen within the first 6 months after arthroplasty. In addition, especially the functionality scores at baseline as well as their improvement showed an association with long-term patient survival. Osteoarthritis (OA) is a very common musculoskeletal disorder. Prevalence of OA is increasing with age and OA leads to functional disability and pain in the joints 1,2. Arthroplasty is an established treatment in symptomatic patients in order to restore functionality, relief pain, and increase overall quality of life. It prevents disability and also enables a renewed physically active lifestyle, which is an important component of health 3. Overall, patients with OA seem to have no increased all-cause mortality compared to the general population, also previous studies revealed inconsistent results 4. A recent meta-analysis which investigated the association of symptomatic or radiological OA and all-cause mortality came to the conclusion that so far no reliable evidence exists for an association of OA with general and all-cause mortality 5. We came to a similar conclusion when analyzing the 20 years' mortality after the first hip or knee joint replacement in our study population 6. However, as impaired function and chronic pain associated with OA may result in disability as well as in decreased physical activity, these patients may also have long-term consequences on a variety of health-related endpoints, and

Objectives To three-dimensionally evaluate deviations of full-arch intraoral (IO) scans from reference desktop scans in terms of translations and rotations of individual teeth and different types of (mal)occlusion. Materials and methods Three resin model pairs reflecting different tooth (mal)positions were mounted in the phantom head of a dental simulation unit and scanned by three dentists and three non-graduate investigators using a confocal laser IO scanner (Trios 3®). The tooth-crown surfaces of the IO scans and reference scans were superimposed by means of best-fit alignment. A novel method comprising the measurement of individual tooth positions was used to determine the deviations of each tooth in the six degrees of freedom, i.e., in terms of 3D translation and rotation. Deviations between IO and reference scans, among tooth-(mal)position models, and between dentists and non-graduate investigators were analyzed using linear mixed-effects models. Results The overall translational deviations of individual teeth on the IO scans were 76, 32, and 58 µm in the lingual, mesial, and intrusive directions, respectively, resulting in a total displacement of 114 µm. Corresponding rotational deviations were 0.58° buccal tipping, 0.04° mesial tipping, and 0.14° distorotation leading to a combined rotation of 0.78°. These deviations were the smallest for the dental arches with anterior crowding, followed by those with spacing and those with good alignment (p < 0.05). Results were independent of the operator’s level of education. Conclusions Compared to reference desktop scans, individual teeth on full-arch IO scans showed high trueness with total translational and rotational deviations < 115 µm and < 0.80°, respectively. Clinical relevance Available confocal laser IO scanners appear sufficiently accurate for diagnostic and therapeutic orthodontic applications. Results indicate that full-arch IO scanning can be delegated to non-graduate dental staff members.

Objectives Previous studies have shown that aligners have limited ability to control root movements. The purpose of this study was to investigate which modification geometry and foil thickness are optimal for generating the force-moment (F/M) systems required for palatal root torque of maxillary central incisors. Materials and methods Tooth 11 was separated from a maxillary acrylic model and connected to a movement unit via a 3D F/M sensor. Different modification geometries (crescent, capsular, double-spherical) with different depths were digitally implemented in the labio-cervical region of tooth 11 to induce an increased contact force. We evaluated the F/M systems exerted by aligners with thicknesses of 0.4–1.0 mm. F/M measurements were taken with tooth 11 in the neutral position and during palatal displacement of tooth 11 (simulating its initial clinical movement). Results The mechanical requirements of palatal root torque are a palatally directed force (− Fy) and a palatal root torquing moment (− Mx). These requirements were reliably achieved with modification depths > 0.5 mm. The modification depth and foil thickness had a significant influence on − Fy magnitudes (linear mixed-effect models, p < 0.01). With the 0.75-mm aligners combined with 1.5-mm deep modifications, the palatal root torque range (palTR) started after an initial palatal crown displacement of 0.09, 0.12, and 0.12 mm for the capsular, crescent, and double-spherical modification geometries, respectively. Conclusions A relatively early start of the palatal torque range (after a 0.1-mm palatal crown displacement) and appropriate − Fy magnitudes were achieved with 0.75-mm-thick aligners containing 1.5-mm deep capsular or crescent pressure regions. Subsequent clinical trials are required to confirm the clinical effects of these modifications. Clinical relevance In vitro testing indicated that modified aligners are capable of generating the F/M components required for palatal root torque of upper central incisors.

Background Passive mandibular advancement with functional appliances is commonly used to treat juvenile patients with mandibular retrognathism. Objective The aim of this study was to investigate whether active repetitive training of the mandible into an anterior position would result in a shift of the habitual mandibular position (HMP). Methods Twenty adult healthy subjects were randomly assigned to one of two groups: a training group receiving six supervised functional training sessions of 10 min each and a control group without training. Bonded lateral biteplates disengaged occlusion among both groups throughout the 15‐day experiment. Customised registration‐training appliances consisted of a maxillary component with an anterior plane and a mandibular component with an attached metal sphere. Training sessions consisted of repeated mouth‐opening/closing cycles (frequency: 30/min) to hit an anteriorly positioned hemispherical target notch with this metal sphere. The HMP was registered at defined times during the experiment. Results The HMP in the training group showed a statistically significant anterior shift of 1.6 mm (interquartile range [IQR]: 1.2 mm), compared with a significant posterior shift of −0.8 mm (IQR: 2.8 mm) in the control group (p < .05). Although the anterior shift among the training group showed a partial relapse 4 days after the first training block, it then advanced slightly in the 4‐day interval after the second training block, which might indicate neuroplasticity of the masticatory motor system. Conclusions Motor learning by repetitive training of the mandible into an anterior position might help to improve the results of functional appliance therapy among patients with mandibular retrognathism.