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Statement of problem: Computer-engineered complete dentures (CECDs) have significant potential as shown by recent reports of outcomes and specific applications. An understanding of complications and quality assessment factors associated with CECDs from compiled data is lacking in published reports.
Material and methods: Electronic searches of publications in English from January 1984 to September 2016 were performed in MEDLINE and Cochrane databases, with the results enriched by manual searches and citation mining to address 2 population intervention comparison outcome (PICO) questions: what are the clinical complications associated with CECDs, and what are the quality assessments with CECDs?
Conclusions: Patient dissatisfaction, inadequate retention, and inadequate esthetics were the most common complications with CECDs. The addition of a trial placement option for CECDs could result in a better clinical outcome, reducing the incidence of other complications related to occlusal vertical dimension, centric relationship, tooth arrangement, and esthetics, improving patient satisfaction, and reducing remakes. The difficulty in reading the digital preview for an objective assessment before fabrication is a unique but not a common, complication for CECDs.
Background: Computer-aided dental implant placement seems to be useful for placing implants by using a flapless approach. However, evidence supporting such applications is scarce. The aim of this study is to evaluate the accuracy of and complications that arise from the use of selective laser sintering surgical guides for flapless dental implant placement and immediate definitive prosthesis installation.
Methods: Sixty implants and 12 prostheses were installed in 12 patients (four males and eight females; age range: 41 to 71 years). Lateral (coronal and apical) and angular deviations between virtually planned and placed implants were measured. The patients were followed up for 30 months, and surgical and prosthetic complications were documented.
Conclusions: The mean lateral deviation was 2 mm. The complication rate was 34.4%. Hence, computer-aided dental implant surgery still requires improvement and should be considered as in the developmental stage.
This systematic review evaluated the implant survival rate, changes in marginal bone level, and complications associated with guided surgery for the treatment of fully edentulous patients followed up for longer than 1 year. A comprehensive literature search was conducted in MEDLINE/PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) to retrieve studies published up until July 2014 that met predefined eligibility criteria. Thirteen studies were included. In studies on the guided surgery technique, a survival rate of 97.2% and a mean marginal bone loss of 1.45 mm were found during 1-4 years of follow-up. However, associated complications, such as implant loss, prosthesis or surgical guide fractures, and low primary stability, were often found, and there is a learning curve to achieve treatment success. Further longitudinal comparative studies should improve the technique and its success rate.
Background: In the last decade several stereolithographic guided surgery systems were introduced to the market. In this context, scientific information regarding accuracy of implant placement and surgical and prosthodontical complications is highly relevant as it provides evidence to implement this surgical technique in a clinical setting.
Material and methods: PubMed database was searched using the following keywords: "three dimensional imaging,""image based surgery,""flapless guided surgery,""customized drill guides,""computer assisted surgery,""surgical template," and "stereolithography." Only papers in English were selected. Additional references found through reading of selected papers completed the list.
Results: In total 31 papers were selected. Ten reported deviations between the preoperative implant planning and the postoperative implant locations. One in vitro study reported a mean apical deviation of 1.0 mm, three ex vivo studies a mean apical deviation ranging between 0.6 and 1.2 mm. In six in vivo studies an apical deviation between 0.95 and 4.5 mm was found. Six papers reported on complications mounting to 42% of the cases when stereolithographic guided surgery was combined with immediate loading.
Conclusion: Substantial deviations in three-dimensional directions are found between virtual planning and actually obtained implant position. This finding and additionally reported postsurgical complications leads to the conclusion that care should be taken whenever applying this technique on a routine basis.
Background: Computer-assisted navigation (CAN) and robotic-assisted (RA) knee arthroplasty procedures carry unique risks of tracking pin-related complications. This systematic review aimed to quantitatively assess the incidence, timing, treatment, and clinical outcomes of all tracking pin-related complications following CAN and RA knee arthroplasty.
Methods: A systematic review was performed using PubMed, Cochrane Central and Scopus databases. All clinical studies that documented pin-related complications associated with the use of CAN or RA for total or partial knee arthroplasty were included. Descriptive statistics were analyzed when data were available.
Conclusion: Pin-related complications following CAN and RA knee arthroplasty are relatively uncommon. While pin loosening, superficial infections and fractures have been most commonly documented, other complications such as vascular injury, myositis ossificans, and osteomyelitis can also occur. The potential for pin-related complications should be considered by arthroplasty surgeons, especially during early stages of adoption. Further studies investigating patient risk factors for pin-related complications are warranted.
Background: Data on the clinical impact of computer navigation (CN) and robotic assistance (RA) in total knee arthroplasty (TKA) are mixed. This study aims to describe modern utilization trends in CN-TKA, RA-TKA, and traditionally-instrumented (TD) TKA and to assess for differences in postoperative complications and opioid consumption by procedure type.
Methods: A national database was queried to identify primary, elective TKA patients from 2015 to 2020. Trends in procedural utilization rates were assessed. Differences in 90-day postoperative complications and inpatient opioid consumption were assessed. Multivariate regression analyses were performed to account for potential confounders.
Conclusion: From 2015 to 2020, there was a relative 13.7% and 601.2% increase in CN-TKAs and RA-TKAs, respectively. This trend was associated with reductions in hospitalization duration, postoperative complications, and opioid consumption. These data support the safety of RA-TKA and CN-TKA compared to TD-TKA. Further investigation into the specific indications for these technology-assisted TKAs is warranted.
The mouse is a standard piece of computer equipment. Computer users use the mouse almost three times as much as the keyboard. As exposure rates are high, improving upper extremity posture while using a computer mouse is very important. Because most people using a mouse in a workplace setting must use the computer keyboard at the same time, using a mouse regularly involves stationary positions, and small and repetitive movements of the same small muscles over and over again for prolonged periods of time. These factors can lead to discomfort, pain, and Workplace Musculoskeletal Disorders (WMSDs).
It is important that all elements of the computer (keyboard, mouse, monitor), the workstation (desk, chair, footrest), and work practices (posture, pace, work breaks) are considered in order to minimize these risks. Please see the various OSH Answers documents under Office Ergonomics for more information.
First, using a mouse requires a person to make small, exact movements with their hand, fingers, and thumb. By positioning, travelling, scrolling, and clicking the mouse again and again, the same small muscles can become tired and overworked. This overuse can cause:
The second reason using a computer mouse can be hazardous is that the placement of the mouse can make it awkward to reach. Many computer workstations have limited space; since the keyboard is already directly in front of the person using the computer, most times the mouse is placed around the upper right (or left) hand corner of the keyboard and toward the back of the desk (Figure 2).
When the mouse is in this position (Figure 2), it is out of 'easy reach': it is beyond the safe distance range for comfortable hand movements. In order to use the mouse, the person has to lean forward, reaching outwards and forwards (Figure 3) and remain there unsupported for as long as they are using the mouse.
Maintaining this position for the workday can cause soreness and fatigue by putting an extra load on the muscles in the upper back (trapezius muscle) and shoulder (deltoid muscle). Repeated use of the mouse, therefore, can cause aches and pains in the shoulder and neck area. Lower back pain, while not directly caused by the mouse, can also be a problem if the computer user has poor posture and leans forward when they sit.
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