A panel of experts convened by the American Dental Association Council on Scientific Affairs presents an evidence-based clinical practice guideline on nonsurgical treatment of patients with chronic ...periodontitis by means of scaling and root planing (SRP) with or without adjuncts.
The authors developed this clinical practice guideline according to the American Dental Association's evidence-based guideline development methodology. This guideline is founded on a systematic review of the evidence that included 72 research articles providing clinical attachment level data on trials of at least 6 months' duration and published in English through July 2014. The strength of each recommendation (strong, in favor, weak, expert opinion for, expert opinion against, and against) is based on an assessment of the level of certainty in the evidence for the treatment's benefit in combination with an assessment of the balance between the magnitude of the benefit and the potential for adverse effects.
For patients with chronic periodontitis, SRP showed a moderate benefit, and the benefits were judged to outweigh potential adverse effects. The authors voted in favor of SRP as the initial nonsurgical treatment for chronic periodontitis. Although systemic subantimicrobial-dose doxycycline and systemic antimicrobials showed similar magnitudes of benefits as adjunctive therapies to SRP, they were recommended at different strengths (in favor for systemic subantimicrobial-dose doxycycline and weak for systemic antimicrobials) because of the higher potential for adverse effects with higher doses of antimicrobials. The strengths of 2 other recommendations are weak: chlorhexidine chips and photodynamic therapy with a diode laser. Recommendations for the other local antimicrobials (doxycycline hyclate gel and minocycline microspheres) were expert opinion for. Recommendations for the nonsurgical use of other lasers as SRP adjuncts were limited to expert opinion against because there was uncertainty regarding their clinical benefits and benefit-to-adverse effects balance. Note that expert opinion for does not imply endorsement but instead signifies that evidence is lacking and the level of certainty in the evidence is low.
Aim
To answer the following PICOS questions: in patients with periodontitis, which is the efficacy of adjunctive systemic antimicrobials, in comparison with subgingival debridement plus a placebo, in ...terms of probing pocket depth (PPD) reduction, in randomized clinical trials with at least 6 months of follow‐up?
Material and Methods
A systematic search was conducted: 34 articles (28 studies) were included. Data on clinical outcome variables changes were pooled and analysed using weighted mean differences (WMDs), 95% confidence intervals (CI) and prediction intervals (PIs), in case of significant heterogeneity.
Results
For PPD, statistically significant benefits (p < .001) were observed in short‐term studies (WMD = 0.448, 95% CI 0.324; 0.573, PI −0.10 to 0.99) and long‐term studies (WMD = 0.485, 95% CI 0.322; 0.648, PI −0.11 to 1.08). Additionally, statistically significant benefits were also found for clinical attachment level, bleeding on probing, pocket closure and frequency of residual pockets. The best outcomes were observed for the combination of amoxicillin plus metronidazole, followed by metronidazole alone and azithromycin. Adverse events were more frequently reported in groups using systemic antimicrobials.
Conclusions
The adjunctive use of systemic antimicrobials in periodontal therapy results in statistically significant benefits in clinical outcomes, with more frequent adverse events in test groups using systemic antimicrobials.
Abstract To obtain spray resistance directly, a prismatic planing hull test was conducted in a towing tank in static water. The characteristic angles of the standing line and leading edge line of the ...spray zone were obtained through the fixed flight test of the whole prismatic planing hull. The prismatic planing hull was divided into front and rear parts along the standing line, and then the fixed flight state test of the split planing hull was carried out, and the spray resistance was directly measured by the front planing hull. The results show that the percentage of splash resistance in the total resistance is from 15.83 % to 30.10 % under the condition of high-speed planing; Split planing hull model test is an effective method for direct measurement of spray resistance.
Conduct a systematic review and meta-analysis on nonsurgical treatment of patients with chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts.
A panel of experts ...convened by the American Dental Association Council on Scientific Affairs conducted a search of PubMed (MEDLINE) and Embase for randomized controlled trials of SRP with or without the use of adjuncts with clinical attachment level (CAL) outcomes in trials at least 6 months in duration and published in English through July 2014. The authors assessed individual study bias by using the Cochrane Risk of Bias Tool and conducted meta-analyses to obtain the summary effect estimates and their precision and to assess heterogeneity. The authors used funnel plots and Egger tests to assess publication bias when there were more than 10 studies. The authors used a modified version of the US Preventive Services Task Force methods to assess the overall level of certainty in the evidence.
The panel included 72 articles on the effectiveness of SRP with or without the following: systemic antimicrobials, a systemic host modulator (subantimicrobial-dose doxycycline), locally delivered antimicrobials (chlorhexidine chips, doxycycline hyclate gel, and minocycline microspheres), and a variety of nonsurgical lasers (photodynamic therapy with a diode laser, a diode laser, neodymium:yttrium-aluminum-garnet lasers, and erbium lasers).
With a moderate level of certainty, the panel found approximately a 0.5-millimeter average improvement in CAL with SRP. Combinations of SRP with assorted adjuncts resulted in a range of average CAL improvements between 0.2 and 0.6 mm over SRP alone. The panel judged the following 4 adjunctive therapies as beneficial with a moderate level of certainty: systemic subantimicrobial-dose doxycycline, systemic antimicrobials, chlorhexidine chips, and photodynamic therapy with a diode laser. There was a low level of certainty in the benefits of the other included adjunctive therapies. The panel provides clinical recommendations in the associated clinical practice guideline.
Aim
To answer the following PICOS question: in adult patients with periodontitis, which is the efficacy of adjunctive locally delivered antimicrobials, in comparison with subgingival debridement ...alone or plus a placebo, in terms of probing pocket depth (PPD) reduction, in randomized clinical trials with at least 6 months of follow‐up.
Material and methods
A systematic search was conducted: 59 papers, reporting 50 different studies, were included. Data on clinical outcome variables changes were pooled and analysed using weighted mean differences (WMDs) and 95% confidence intervals (CI), and prediction intervals (PI), in case of significant heterogeneity.
Results
Statistically significant differences were observed, in 6‐ to 9‐month studies, for PPD (WMD = 0.365, 95% CI 0.262; 0.468, PI −0.29; 1.01) and clinical attachment level (CAL) (WMD = 0.263, 95% CI 0.123; 0.403, PI −0.43; 0.96). For long‐term studies, significant differences were observed for PPD (WMD = 0.190, 95% CI 0.059; 0.321), but not for CAL. For adverse events, no differences were observed. Results were affected by study design (split‐mouth versus parallel studies) and assessment (full‐ or partial‐mouth), as well as by the formulation tested.
Conclusions
The use adjunctive locally delivered antimicrobials in periodontitis therapy results in statistically significant benefits in clinical outcomes, without relevant side effects.
The hydrodynamic characteristics of a waterjet-propelled amphibious craft traveling in displacement and planing modes are studied via full-scale experiments and numerical simulations in three ways. ...First, variations of pitch, resistance, and vertical rise for speeds from 2 to 18 knots are investigated. As speed is incrementally increased, pitch and resistance increase geometrically before maximizing in the transition region. In this region, the computations underpredict pitch, yet resistance matches the steady-state thrust measurements well. Second, maneuverability in displacement mode at 4 knots is investigated with a zigzag maneuver. Time variations of heading, pitch, yaw rate, roll, and roll rate predicted by computational fluid dynamics (CFD) for the zigzag maneuver are in good agreement with the experimental results. Third, the dynamic transition from displacement to planing mode is investigated by abruptly increasing the thrust beyond the craft's peak resistance. Beyond the resistance maximum, the vehicle experiences a sharp increase in speed and drop in pitch angle. Experiment and simulation conclude similarly with an abrupt cut to propulsion, resulting in a quick deceleration, which is overcome by its own wake. Simulated kinematics of the deceleration are remarkably accurate, suggesting valid computations of the transient drag, wake generation, and vehicle response to waves.
•Experiments and CFD were performed for the Gibbs Quadski amphibious craft in calm water.•Studies include resistance, transition to planing and a zigzag maneuver.•The vehicle shows the typical behavior of a planing craft, transitioning for Fr~1.•The study shows that CFD is capable of predicting the transition from displacement to planing.•CFD also matches well the general trends for the acceleration/stop and zigzag maneuvers.
The condition of the cutting tool is one of the most important factors as it directly affects the technological and economic efficiencies of the woodworking process. The large variety of raw ...materials of wood combined with possible impurities and inclusion of solids puts high demands on planing machines. One of the methods to modify their operational properties is to apply antiwear coating on their working surfaces using vacuum deposition methods, such as physical vapor deposition (PVD). The use of such coatings reduces the adhesion of planing products to the surface of industrial planer knives, reduces the friction between the cutting tool and the workpiece, and limits the penetration of heat into the tool, thereby contributing to extending its effective working life. This study examines the impact of PVD-based CrCN/CrN coating on the operational durability and intensity of wear of planer knives operating in production conditions compared to unmodified knives (typically used in the wood processing industry for pine wood planing). For the unmodified and CrCN/CrN-coated planing blades (before and after processing), detailed analyses were carried out. These analyses included determining the rounding radius and profile along the blade (worn edge displacement), calculating surface texture parameters of the rake face of planer knives, and carrying out visual microscopic analysis of its condition. The results of the experiments indicated an increase in durability of up to 142% for the CrCN/CrN-coated tools. It was also found that the use of PVD-based modified industrial planer knives turned out to be more beneficial in each analyzed area of analysis.
Sheet metal parts with high-quality surface have wide applications in many manufacturing procedures. However, polishing these parts are challenging due to occurrence of deformations at contact area ...between the polishing tool and part. This stems from the thinness of these parts, making them susceptible to deformations, compared to thick solid parts. To address the above challenge, this study proposes a new robotic polishing path planing method that accounts for such deformations. The proposed method starts by estimating the contact area between the tool head, and the free-form surface of the sheet metal part is estimated using Hertz theory and differential geometry. Next, it uses a polynomial equation—that is derived from FEM-based contact analysis of the part—to calculate the true tool-part contact area under deformations. Then, it combines the contact-area information with a new constant speed robot path planing technique to ensure high-quality robot polishing. Numerical studies on several sample geometries verify the effectiveness of the method.
Objective
Nutraceutical agents have been demonstrated as adjuncts for the treatment of several inflammatory diseases. The present study analyzed and compared new nutraceutical agent as an adjunct to ...Scaling and root planing (SRP) versus SRP alone for the treatment of periodontitis.
Materials and methods
Sixty-six patients with moderate periodontitis were enrolled. Through a randomized design, the patients were randomly assigned to SRP + nutraceutical agent (test group) or SRP alone (control group). Patients were regularly examined the clinical, inflammatory mediators and visual analogue scale (VAS) changes over a 6-month period. Clinical attachment level (CAL) was the primary outcome variable chosen. Gingival crevicular fluid (GCF) inflammatory mediator change and the impact of treatment on VAS were evaluated through a linear regression model.
Results
Both treatments demonstrated an improvement in periodontal parameters compared with baseline. After 6 months of treatment, compared with the control group, the test group determined a significant probing depth (PD) (
p
= 0.003) and bleeding on probing (BOP) reduction (
p
< 0.001), while CAL gain was significantly obtained at 30 and 60 days after treatment (
p
< 0.05). In the test group, the level of inflammatory mediators was significantly reduced compared with the control group (
p
< 0.05). The linear regression analysis demonstrated that the nutraceutical agent exerted, in the test group, a significant influence on VAS at 6, 12, 24, and 48 h after treatment (
p
< 0.05).
Conclusions
Nutraceutical agent resulted in a more significant reduction in clinical, inflammatory mediators and short-term pain compared with SRP alone.
Clinical relevance
Nutraceutical agent, when combined with SRP, was demonstrated to be effective in reducing periodontal parameters and controlling the levels of inflammatory mediators and pain in patients with periodontitis.
The mechanics of underwater supercavitating projectiles are currently being extensively researched. The disadvantage of such projectiles is their movement instability. There is a proposal to use ...stern planing plates to stabilize projectile’s movement. However, the hydrodynamic characteristics of planing plates are known only for low subsonic speeds. This article describes a load study on a planing plate at subsonic, transonic and supersonic speeds with detached and attached shock waves. The obtained calculation results of normal forces satisfactorily agree with the known theoretical solutions and experimental data and can be used to calculate the motion stabilization of supercavitating underwater projectiles with planing stern plates.
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