Disordered Eating Behaviors Prevalent in T1D Individuals Using Insulin Pumps, claims study

A recent cross-sectional study uncovered a significant connection between disordered eating behaviors (DEB) and diabetes management among young individuals who use insulin pumps. The findings were published in the Diabetes Technology & Therapeutics Journal.

This study included 167 young individuals of age 13 to 21 years who were having with type 1 diabetes (T1D) and used insulin pumps. The outcome yielded crucial insights into the prevalence of disordered eating behaviors and their impact on diabetes outcomes. DEB is more common among those with T1D who were found to be associated with higher HbA1c levels which indicate the potential challenges in diabetes management.

This observational, cross-sectional investigation utilized data from medical records of patients and self-reported questionnaires. Of the participants, 42.5% exhibited DEB, with notable associations found. Female sex, higher BMI-Z-score, elevated HbA1c levels, and increased rates of pump discontinuation were positively linked to the presence of DEB.

Also, this study looked into the use of hybrid closed-loop (HCL) systems by comparing them to traditional insulin pumps. Among individuals without DEB, the HCL system users showed a higher BMI-Z-score and a tendency toward lower HbA1c levels. For those with DEB, HCL system use lowered HbA1c levels. The findings suggest a nuanced relationship between DEB, insulin delivery systems, and the overall diabetes management.

These outcome highlight the prevalence of DEB among young individuals managing T1D with insulin pumps. The association between DEB and higher HbA1c levels underscores the potential hurdles in glycemic control. The introduction of HCL systems into the analysis adds a layer of complexity by revealing differing impacts based on the presence or absence of DEB. This emphasize the importance of regular screening for DEB and associated risk factors to enhance diabetes management.

Reference:

Propper-Lewinsohn, T., Elran-Barak, R., Gillon-Keren, M., Yackobovitch-Gavan, M., Liberman, A., Phillip, M., & Shalitin, S. (2023). Disordered eating behaviors among adolescents and young adults with type 1 diabetes treated with insulin pumps and hybrid closed-loop systems. In Diabetes Technology & Therapeutics. Mary Ann Liebert Inc. https://doi.org/10.1089/dia.2023.0500

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New Town Kolkata Development Authority mulls setting up multi-speciality hospital

Kolkata: Responding to persistent calls from New Town residents for an affordable
multi-speciality hospital, the New Town Kolkata Development Authority (NKDA) is
considering a proposal to utilize a plot in Action Area I for this purpose.

This plot was initially designated for an urban community health centre (UCHC).
The proposed plan involves constructing an 8-10-storey multi-speciality
hospital, but it requires state government approval before proceeding.

Also Read:Manipal Hospitals expands footprints in East India, rebrands AMRI units

The NKDA has initiated steps to advance this plan and recently held
discussions with senior members from both the health and urban development
departments. The current site adjacent to the proposed hospital location houses
an urban primary health centre (UPHC) which is supposed to be a 30-bed
facility. The envisioned multi-speciality hospital would feature a
multi-storied building with a basement and ample car parking space.

“It has been our demand for a long time to have a
multi-speciality hospital in New Town. We had previously placed our demands in
front of NKDA officials and recently, we also held a meeting with the
authorities to discuss this matter,” Samir Gupta, secretary of New Town
citizens’ welfare fraternity told the Times of India. The architectural design phase is set to begin soon, with NKDA
coordinating closely with health department authorities to ensure the plan’s
feasibility and alignment with healthcare needs.

Residents of New Town have expressed that the rapidly growing population
requires the establishment of an affordable multi-speciality hospital.
Presently, the lack of such a facility forces many to seek urgent medical
services in Salt Lake or along EM Bypass, highlighting the pressing need for a
local, comprehensive healthcare centre, reports The Daily. “Even though a number of private hospitals are coming up, we have been
receiving feedback from several New Town residents that there was a lack of a
govt-run hospital in the township and the private hospitals that are coming up
were not multi-speciality hospitals. Keeping this in mind, we plan to develop a
multi-speciality hospital in the public sector,” said an NKDA official.

The proposed hospital aims to provide a wide range of medical services
under one roof, reducing the need for residents to travel long distances for
specialized treatments. NKDA’s commitment to this project reflects its
dedication to enhancing the quality of life for New Town residents by
addressing critical infrastructure needs. As the planning progresses, NKDA will continue to engage with
stakeholders and gather input to ensure the hospital meets the community’s
expectations and healthcare standards.

Also Read: Private Hospitals in Kolkata set to revise charges citing inflation

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Gas and propane stove-generated nitrogen dioxide linked to asthma, claims study

Gas and propane stove-generated nitrogen dioxide linked to asthma, claims study published in the Science Advances.

Gas stoves are used in approximately 50 million U.S. homes and millions more worldwide. Gas and propane combustion in stoves emits hazardous air pollutants, including nitrogen dioxide (NO2), benzene (C6H6), carbon monoxide (CO), formaldehyde (H2CO), and ultrafine particles. Nitrogen dioxide and benzene emissions are of particular concern, as typical gas stove use can elevate indoor concentrations of these pollutants above health benchmarks. Long-term exposure (averaged over a year) to NO2 has been linked to increased incidence and exacerbation of pediatric asthma, incidence and mortality from chronic obstructive pulmonary disease (COPD), and incidences of lung cancer, preterm birth, and diabetes mellitus. Given the abundance of gas and propane stoves and the dangers of additional NO2 exposure generally, quantifying the burden of NO2 exposures and health outcomes from gas and propane combustion by stoves is needed for assessing public safety.

Gas and propane stoves emit nitrogen dioxide (NO2) pollution indoors, but the exposures of different U.S. demographic groups are unknown. We estimate NO2 exposure and health consequences using emissions and concentration measurements from >100 homes, a room-specific indoor air quality model, epidemiological risk parameters, and statistical sampling of housing characteristics and occupant behavior. Gas and propane stoves increase long-term NO2 exposure 4.0 parts per billion volume on average across the United States, 75% of the World Health Organization’s exposure guideline. This increased exposure likely causes ~50,000 cases of current pediatric asthma from long-term NO2 exposure alone. Short-term NO2 exposure from typical gas stove use frequently exceeds both World Health Organization and U.S. Environmental Protection Agency benchmarks. People living in residences <800 ft2 in size incur four times more long-term NO2 exposure than people in residences >3000 ft2 in size; American Indian/Alaska Native and Black and Hispanic/Latino households incur 60 and 20% more NO2 exposure, respectively, than the national average.

Reference:

Yannai Kashtan et al. ,Nitrogen dioxide exposure, health outcomes, and associated demographic disparities due to gas and propane combustion by U.S. stoves.Sci. Adv.10,eadm8680(2024).DOI:10.1126/sciadv.adm8680

Keywords:

Gas, propane, stove-generated, nitrogen dioxide, asthma, study, Yannai Kashtan, Science Advances

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Sparsentan superior to irbesartan in focal segmental glomerulosclerosis patients, reveals DUPLEX trial

USA: A groundbreaking clinical trial, known as the DUPLEX trial, has unveiled promising results in treating Focal Segmental Glomerulosclerosis (FSGS), a rare and debilitating kidney disorder. The study compared the efficacy of two medications, Irbesartan (IRB) and Sparsentan (SPAR), in patients suffering from FSGS, offering valuable insights into managing this challenging condition.

The phase III DUPLEX trial showed that sparsentan (Filspari) led to more complete and partial remissions of focal segmental glomerulosclerosis than irbesartan (Avapro).

“For a 108-week double-blind treatment period, 18.5% of sparsentan-treated patients achieved complete remission of FSGS versus 7.5% of irbesartan-treated patients (relative risk [RR] 2.47),” Michelle N. Rheault, MD, of the University of Minnesota Medical School in Minneapolis, and colleagues reported at the National Kidney Foundation (NKF) Spring Clinical meeting.

Of the patients on sparsentan, 37.5% had partial remission compared with 22.6% of those on irbesartan (RR 1.60). At the 36-week interim analysis point, those taking sparsentan also had a significantly higher probability of achieving partial remission.

FSGS is a chronic kidney disease characterized by scarring in the kidney’s filtering units, leading to impaired kidney function and protein leakage into the urine. Currently, treatment options for FSGS are limited, emphasizing the urgency for novel therapeutic approaches.

The phase 3 DUPLEX trial evaluated the nephroprotective and antiproteinuric potential of the dual endothelin angiotensin receptor antagonist (DEARA) SPAR versus active control IRB in patients with FSGS. DUPLEX met its interim efficacy endpoint (EP); more patients achieved partial remission of proteinuria at 36 weeks with SPAR vs IRB. Still, after 108 wk, the greater antiproteinuric effect did not translate to a significant difference in eGFR slopes. Dr. Rheault and colleagues present additional results from the 2-y analysis.

The study included 371 patients (8-75 y) with primary or genetic FSGS, eGFR ≥30 mL/min/1.73 m2, and urine protein-to-creatinine ratio (UPCR) ≥1.5 g/g. They were randomized in a 1:1 ratio to SPAR or IRB (800 and 300 mg/d) for 108 wk.

EPs included complete remission of proteinuria (CR; UPCR <0.3 g/g), the proportion of patients reaching composite kidney EPs, and absolute change in eGFR from baseline to 4 weeks post cessation of study drug (wk 112). Safety (adverse events) was also evaluated.

The following were the key findings of the study:

· Over 108 wk, CR was achieved earlier and more frequently with SPAR vs IRB.

· Fewer patients reached the composite kidney EPs, and the absolute decline in eGFR from baseline was numerically lower with SPAR vs IRB.

· SPAR was generally well tolerated, with no clinically meaningful fluid retention.

· There were no instances of heart failure in either group.

The study showed that SPAR led to more frequent CR and demonstrated a consistent trend of lower absolute decline in eGFR and fewer patients reaching composite kidney EPs versus IRB after two years. The findings support a potential clinical benefit of SPAR for FSGS.

Reference:

Rheault M, et al “Sparsentan vs irbesartan in patients with focal segmental glomerulosclerosis (FSGS): results from the phase 3 DUPLEX trial” NKF 2024; Poster 406.

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Can brief intervention reduce alcohol intake among ICU survivors with history of hazardous alcohol use?

Recently published research paper compared the effectiveness of a brief intervention (BI) with usual care in reducing alcohol intake in intensive care unit (ICU) survivors with a history of hazardous alcohol use. The study was a randomized controlled trial where adult ICU patients with an Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score > 5 for women, or > 6 for men were randomized to either receive a BI or treatment as usual (TAU). The primary outcome was self-reported alcohol consumption during the preceding week at 6 and 12 months after randomization. Secondary outcomes were the change in AUDIT-C scores from baseline to 6 and 12 months, health-related quality of life, and mortality.

The results indicated that at 6 months, the median alcohol intake in the BI and TAU groups did not significantly differ. At 12 months, there was also no significant difference in alcohol intake between the two groups. Furthermore, the change in AUDIT-C scores from baseline to 6 and 12 months did not significantly differ between the BI and TAU groups. Additionally, the study found that both groups showed a considerable reduction in alcohol consumption, with some individuals becoming abstinent. There was no significant difference in mortality between the two groups. The trial was terminated early due to slow recruitment during the pandemic, resulting in an underpowered study to reject or confirm that a single BI early after critical illness is effective in reducing alcohol consumption compared to TAU.

The authors concluded that the study lacked the statistical power to confirm or reject the hypothesis that a BI early after ICU discharge is effective in reducing the amount of alcohol consumed compared to TAU. However, the results suggested that critical illness is a strong motivating factor for changing behavior, and supporting this motivation may reduce the negative health consequences of hazardous alcohol consumption in ICU survivors. Although the study had limitations such as early termination and high loss to follow-up rates, the findings highlighted the importance of further research to identify the optimal methods for reducing hazardous alcohol consumption in ICU survivors.

Key Points –

– The research paper conducted a randomized controlled trial comparing a brief intervention (BI) with usual care in reducing alcohol intake in intensive care unit (ICU) survivors with a history of hazardous alcohol use. Adult ICU patients with a high Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score were randomized to receive either a BI or treatment as usual (TAU).

– The study found that at 6 and 12 months, there was no significant difference in alcohol intake between the BI and TAU groups. Additionally, the change in AUDIT-C scores from baseline to 6 and 12 months did not significantly differ between the two groups. Both groups showed a considerable reduction in alcohol consumption, with some individuals becoming abstinent, and there was no significant difference in mortality.

– The authors concluded that the study lacked the statistical power to confirm or reject the hypothesis that a BI early after ICU discharge is effective in reducing alcohol consumption compared to TAU. However, they suggested that critical illness is a strong motivating factor for changing behavior, and supporting this motivation may reduce the negative health consequences of hazardous alcohol consumption in ICU survivors. The study had limitations such as early termination and high loss to follow-up rates, highlighting the importance of further research in this area.

Reference –

Nissilä, E., Hynninen, M., Jalkanen, V. et al. The effectiveness of a brief intervention for intensive care unit patients with hazardous alcohol use: a randomized controlled trial. Crit Care 28, 145 (2024). https://doi.org/10.1186/s13054-024-04925-z

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Oral lasofoxifene effective for vaginal atrophy in postmenopausal women, finds study

A recent study published in the journal of Menopause revealed promising results for the treatment of moderate to severe vaginal atrophy in postmenopausal women using oral lasofoxifene. This research was conducted by Risa Kagan and team which included two phase 3, randomized, controlled trials that demonstrated the efficacy of lasofoxifene in reducing the symptoms associated with genitourinary syndrome of menopause (GSM).

The studies assessed whether lasofoxifene could improve the most bothersome symptoms (MBS) of GSM along with evaluating changes in vaginal pH and the percentages of vaginal parabasal and superficial cells. A total of 889 postmenopausal women with an average age of approximately 60 years participated in the trials. They were randomly assigned to receive either a daily dose of 0.25 mg or 0.5 mg of lasofoxifene or a placebo, over a 12-week period.

The participants who were receiving lasofoxifene showed significant improvements in all coprimary endpoints when compared to the placebo group. Also, the MBS decreased markedly with lasofoxifene 0.25 mg/d and 0.5 mg/d (least square mean difference from placebo: −0.4 and −0.5, respectively). Vaginal pH levels also dropped (−0.65, −0.58 for the lower dose and −0.57, −0.67 for the higher dose) which indicated a healthier vaginal environment. There was a notable increase in superficial cells and a reduction in parabasal cells which highlights the improvements in vaginal tissue health.

The benefits of lasofoxifene became apparent as early as week two of the treatment. The adverse effects were mostly mild to moderate, with hot flushes being the most frequently reported side effect (13%-23% for lasofoxifene versus 9%-11% for placebo). Also, serious adverse events were rare and no deaths were reported during course of this study.

The outcomes of this study concluded that lasofoxifene at both dosages provided significant and clinically meaningful improvements in the symptoms and signs of vaginal atrophy in postmenopausal women. The favorable safety profile of the drug further supports its potential as an effective treatment for GSM.

These findings offer new hope for postmenopausal women with vaginal atrophy which is a common yet often underreported condition that can significantly impact quality of life. The dual benefits of lasofoxifene in improving vaginal health and its manageable side effect profile make it a promising option for those seeking relief from GSM symptoms.

Reference:

Kagan, R., Simon, J. A., Goldstein, S. R., Komm, B. S., Jenkins, S. N., & Portman, D. J. (2024). Oral lasofoxifene’s effects on moderate to severe vaginal atrophy in postmenopausal women: two phase 3, randomized, controlled trials. In Menopause. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/gme.0000000000002355

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FENO-guided asthma treatment during pregnancy fails to improve infant developmental outcomes suggests study

FENO-guided asthma treatment during pregnancy fails to improve infant developmental outcomes suggests a study published in the European Journal of Pediatrics.

Asthma during pregnancy is associated with a range of adverse perinatal outcomes. It is also linked to increased rates of neurodevelopmental conditions in the offspring. We aimed to assess whether fractional exhaled nitric oxide (FENO)-based asthma management during pregnancy improves child developmental and behavioural outcomes compared to usual care. The Breathing for Life Trial was a randomised controlled trial that compared FENO-based asthma management during pregnancy to usual care. Participants were invited to the developmental follow-up, the Breathing for Life Trial – Infant Development study, which followed up infants at 6 weeks, 6 months and 12 months. The primary outcomes were measured in infants at 12 months using the Bayley-III: Cognitive, Language and Motor composite scores. Secondary outcomes included Bayley-III social-emotional and adaptive behaviour scores, autism likelihood and sensory and temperament outcomes. The exposure of interest was the randomised intervention group. Two hundred and twenty-two infants and their 217 participating mothers were recruited to the follow-up; 107 mothers were in the intervention group and 113 were in the control group. There was no evidence of an intervention effect for the primary outcomes: Bayley-III cognitive (mean = 108.9 control, 108.5 intervention, p = 0.93), language (mean = 95.9 control, 95.6 intervention, p = 0.87) and motor composite scores (mean = 97.2 control, 97.9 intervention, p = 0.25). Mean scores for secondary outcomes were also similar among infants born to control and FENO group mothers, with few results reaching p < 0.05. In this sample, FENO-guided asthma treatment during pregnancy did not improve infant developmental outcomes in the first year of life.

Reference:

Whalen, Olivia M., et al. “Effect of Fractional Exhaled Nitric Oxide (FENO)-based Asthma Management During Pregnancy Versus Usual Care On Infant Development, Temperament, Sensory Function and Autism Signs.” European Journal of Pediatrics, 2024.

Keywords:

FENO-guided, asthma, treatment, pregnancy fails, improve, infant, developmental, outcomes, study, European Journal of Pediatrics, Whalen, Olivia M.

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Andexanet Alfa Reduces Hematoma Expansion in Intracerebral Hemorrhage Patients Receiving Factor Xa Inhibitors: NEJM

Researchers have investigated the efficacy and safety of andexanet alfa, a reversal agent for factor Xa inhibitors, in patients with acute intracerebral hemorrhage. Hematoma expansion is a significant concern in these patients, particularly those on anticoagulant therapy. Patients with acute intracerebral hemorrhage who are receiving factor Xa inhibitors are at risk of hematoma expansion, which can lead to worse outcomes. Andexanet alfa has been proposed as a reversal agent for factor Xa inhibitors, but its efficacy and safety in this population have not been well studied.

This study was published in The New England Journal Of Medicine by Stuart J. and colleagues. In this randomized controlled trial, patients with acute intracerebral hemorrhage within 15 hours of taking factor Xa inhibitors were assigned to receive either andexanet or usual care. The primary endpoint was hemostatic efficacy, defined by limited hematoma volume expansion, improvement in neurologic deficit, and no receipt of rescue therapy between 3 and 12 hours after treatment initiation. Safety endpoints included thrombotic events and death.

The key findings of the study were as follows:

  • A total of 530 patients with acute intracerebral hemorrhage and recent use of factor Xa inhibitors were enrolled in the study, with 263 assigned to receive andexanet and 267 to receive usual care.

  • Hemostatic efficacy, defined by limited hematoma volume expansion, was achieved in 67.0% of patients receiving andexanet alfa, compared to 53.1% of patients receiving usual care.

  • No significant differences were observed between the groups in terms of functional outcomes or mortality within 30 days.

  • Thrombotic events occurred in 10.3% of patients receiving andexanet and 5.6% receiving usual care, with ischemic stroke occurring in 6.5% and 1.5% of patients, respectively.

The study demonstrates that andexanet alfa improves control of hematoma expansion in patients with intracerebral hemorrhage who are receiving factor Xa inhibitors. However, its use is associated with an increased risk of thrombotic events, including ischemic stroke.

Andexanet alfa shows promise in reducing hematoma expansion in patients with intracerebral hemorrhage on factor Xa inhibitors, but its use must be carefully balanced with the risk of thrombotic events. Further research is needed to optimize its safety and efficacy profile in this population.

Reference:

Connolly, S. J., Sharma, M., Cohen, A. T., Demchuk, A. M., Członkowska, A., Lindgren, A. G., Molina, C. A., Bereczki, D., Toni, D., Seiffge, D. J., Tanne, D., Sandset, E. C., Tsivgoulis, G., Christensen, H., Beyer-Westendorf, J., Coutinho, J. M., Crowther, M., Verhamme, P., Amarenco, P., … Shoamanesh, A. (2024). Andexanet for factor xa inhibitor–associated acute intracerebral hemorrhage. The New England Journal of Medicine, 390(19), 1745–1755. https://doi.org/10.1056/nejmoa2313040

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Methotrexate safe in Dermatomyositis Patients, may not increase risk of interstitial lung disease: JAMA

A recent cohort study published in the Journal of American Medical Association provided reassuring findings for dermatomyositis (DM) patients regarding the safety of methotrexate (MTX) usage. DM is a condition characterized by muscle weakness and skin rash, often presents with interstitial lung disease (ILD) as a complication by affecting about 23% of DM patients in North America.

The study was conducted within the NIH-sponsored All of Us Research Program to investigate the link between MTX use and ILD development in DM patients. Despite MTX being a first-line treatment for DM, the concerns over its potential pulmonary toxicity have made clinicians to hesitate its use in this patient group.

This research analyzed data from a total of 315 DM patients, of whom 163 met the inclusion criteria. Among them, 58 patients received MTX, while the other 105 did not. The study found that 17% of MTX-exposed patients and 16% of MTX-unexposed patients developed ILD, showing no significant difference in ILD risk associated with MTX use.

The findings contrast with previous studies in populations with rheumatoid arthritis (RA) where MTX has been linked with pneumonitis and pulmonary fibrosis. In the DM group, MTX did not pose a significant risk of ILD development. Also, similar results were observed when analyzing the association between ILD and mycophenolate mofetil/mycophenolic acid (MMF/MPA) which is another commonly used medication for DM.

Rituximab use was also noted in relationship with MTX in this study cohort by possibly indicating established use of these medications together or prescribing patterns based on DM subtype. MTX was negatively associated with malignant neoplasms that suggests potential prescribing patterns or indicates its lower tumorigenicity in this context.

Despite the limitations which include reliance on electronic health records and sample size constraints, these findings offer valuable insights into the safety profile of MTX in DM patients. The outcomes suggest that MTX may not significantly increase the risk of ILD in this population by challenging the previous concerns.

Further prospective studies are imperative to validate the findings of this study and explore potential factors that could influence the observed associations. Overall, this study provides reassuring evidence regarding the use of MTX as a treatment option for DM patients by offering hope for enhanced management strategies in this condition.

Source:

Shah, J. T., Richardson, W. M., Mittal, L., Castillo, R., Mazori, D. R., Caplan, A. S., & Femia, A. N. (2024). Methotrexate Use and Risk of Interstitial Lung Disease in Dermatomyositis. In JAMA Dermatology. American Medical Association (AMA). https://doi.org/10.1001/jamadermatol.2024.0785

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Innovations in Dentistry: Monolithic zirconia fixed partial dentures with flexible connectors solve abutment teeth

Japan: In the ever-evolving landscape of dental care, a breakthrough has emerged to address a persistent challenge faced by patients and practitioners: nonparallel abutment teeth. Traditional fixed partial dentures (FPDs) often struggle to accommodate such irregularities, compromising aesthetics, durability, and functionality. However, a pioneering solution leveraging monolithic zirconia coupled with flexible connectors is poised to revolutionize restorative dentistry.

A viable treatment option for patients with nonparallel abutment teeth is a monolithic zirconia fixed partial denture (MZFPD) with both rigid and nonrigid connectors, the study published in the Journal of Prosthetic Dentistry has shown.

Recognizing the limitations of conventional approaches, dental professionals have embraced the integration of monolithic zirconia in FPD fabrication. Renowned for its exceptional strength, durability, and biocompatibility, monolithic zirconia offers unparalleled stability and aesthetics, making it an ideal choice for restorations. However, adapting these restorations to accommodate nonparallel abutment teeth has remained a formidable challenge—until now.

The clinical report by Yu Takaesu, Fukuoka Dental College, Fukuoka, Japan, and colleagues, describes the fabrication of a monolithic zirconia fixed partial denture using nonrigid and rigid connectors to overcome nonparallel abutment teeth.

A precise key and keyway in the ceramic material was designed with digital technology, improving biocompatibility, reducing material costs, and using esthetically superior nonmetallic materials.

Monolithic zirconia (MZ) fixed partial dentures (FPDs) have gained popularity for posterior prostheses because of their low cost, rapid production, high mechanical strength, excellent biocompatibility, and excellent short-term survival rates.

In patients with 1 or 2 missing teeth between nonparallel abutment teeth, prosthodontic treatment options may include implant-supported crowns or FPDs with a nonrigid connector, typically fabricated from metal by the lost-wax technique. However, ceramic crowns have been preferred over metal-ceramic crowns, and the development of computer-aided manufacturing (CAD-CAM) technology and computer-aided design has led to prostheses within the clinically acceptable marginal discrepancy range similar to those fabricated by the traditional lost-wax technique.

“Our clinical report presents treatment using a cantilever MZFPD with rigid and nonrigid connectors to overcome nonparallel abutment teeth,” the researchers wrote. “This MZFPD has adapted to teeth abutment at a clinically acceptable level and has been successful for 3.5 years.”

Digital technology facilitated reduced material costs, precise design, enhanced esthetics, and improved biocompatibility through monolithic zirconia use. However, long-term outcomes or potential complications associated with using nonrigid and rigid connectors in MZFPDs are to be studied in the future.

Reference:

Takaesu, Y., Isshi, K., Toguchi, T., & Matsuura, T. (2024). Providing a monolithic zirconia fixed partial denture with rigid and nonrigid connectors to overcome nonparallel abutment teeth. The Journal of Prosthetic Dentistry. https://doi.org/10.1016/j.prosdent.2024.03.043

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