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Reports on digitally fabricated complete dentures are increasing. However, comprehensive evidence-based research on their cost-efficiency and patient-reported outcome measures (PROMs) is lacking.

The purpose of this systematic review was to compare the cost-effectiveness and PROMs between digitally and conventionally fabricated complete dentures.

Material and methods

An electronic search of publications from 2011 to mid-2023 was established using PubMed/Medline, EBSCOhost, and Google Scholar. Retrospective, prospective, randomized controlled, and randomized crossover clinical studies on at least 10 participants were included. A total of 540 articles were identified and assessed at the title, abstract, and full article level, resulting in the inclusion of 14 articles. Data on cost, number of visits, patient satisfaction, and oral health-related quality of life were examined and reported.

Results

The systematic review included 572 digitally fabricated complete dentures and 939 conventionally fabricated complete dentures inserted in 1300 patients. Digitally fabricated complete dentures require less clinical time with a lower total cost, despite higher material costs compared with the conventional fabrication technique. Digitally and conventionally fabricated complete dentures were found to have significant effects on mastication efficiency, comfort, retention, stability, ease of cleaning, phonetics, and overall patient satisfaction, as well as social disability, functional limitation, psychological discomfort, physical pain, and handicap.

Digitally fabricated complete dentures are more cost-effective than conventionally fabricated dentures. There are various impacts of conventionally and digitally fabricated complete dentures on PROMs, and they are not better than one another.

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Reference:

Digitally versus conventionally fabricated complete dentures: A systematic review on cost-efficiency analysis and patient-reported outcome measures (PROMs)

In Meei Tew, Suet Yeo Soo, Edmond Ho Nang Pow. Published:November 23, 2023DOI:https://doi.org/10.1016/j.prosdent.2023.10.028

Keywords:

Both, digital, conventional, fabrication, complete, dentures, yield, comparable, clinical outcome, In Meei Tew, Suet Yeo Soo, Edmond Ho Nang Pow,Journal of Prosthetic Dentistry

A travoprost intraocular implant may effectively lower intraocular pressure (IOP) over the course of 36 months after a single administration, according to new findings, substantially diminishing the necessity of topical IOP-lowering medications and helping to lessen problems with adherence and side effects.

These findings on the implant’s sustained-release drug delivery system were the results of a phase 2 trial conducted to look at the long-term safety and the effectiveness of travoprost intraocular implant. The investigators noted prior to their research that IOP is the only known modifiable risk factor for glaucoma, with many studies pointing to the essential role of IOP lowering in the practice of decreasing glaucoma development.

The overall goal of the investigators was to find a way to reduce treatment burden for patients and to improve adherence to IOP-lowering treatments, and this particular system was assessed in this analysis. The research into this implant for IOP was authored by Tomas Navratil, from the Glaukos Corporation in Aliso Viejo, California.

“The objective of the current study was to report on the 3 year safety of the implant, and percentage of patients who reduced or maintained their topical IOP-lowering medication burden relative to pre-study medications,” Navratil and colleagues wrote.

The team sought to examine the safety and efficacy of 2 travoprost intraocular implants that each used different elution rates compared to timolol eye drops (Timolol Maleate Ophthalmic Solution, USP, 0.5%) for those with OAG or OHT who were already on 0–3 topical medications that were IOP-lowering.

Individuals who had been diagnosed with open-angle glaucoma or with ocular hypertension were assigned to be placed into 1 of 3 groups:

A fast-eluting implant (FE implant, n = 51) and twice-daily (BID) placebo eye drops

A slow-eluting implant (SE implant, n = 54) and BID placebo eye drops

A sham surgical procedure with BID timolol 0.5% (n = 49)

IOP measurements were done at several different intervals up to 36 months. The investigators looked at efficacy by assessing the mean change from the 8:00 AM unmedicated baseline IOP throughout the total study period.

The research team also looked into the percentage of subjects using the same or fewer topical IOP-lowering treatments as they had at screening. They evaluated safety data by monitoring the reported adverse events and using different ophthalmic parameters.

The intraocular implant was shown to have strong efficacy in its reduction of IOP, with the investigators finding major decreases in subjects’ need for topical medications designed for IOP-lowering. This decrease lasted for a duration of up to 36 months following a single administration.

“These results suggest that the travoprost intraocular implant may represent a meaningful addition to the interventional glaucoma armamentarium, demonstrating safe and well-tolerated IOP lowering for up to 36 months after a single administration and addressing the key shortcomings of topical IOP-lowering medications defined by low adherence and adverse impact on ocular surface health,” they wrote.

Refrence:

Berdahl, J.P., Sarkisian, S.R., Ang, R.E. et al. Efficacy and Safety of the Travoprost Intraocular Implant in Reducing Topical IOP-Lowering Medication Burden in Patients with Open-Angle Glaucoma or Ocular Hypertension. Drugs (2023). https://doi.org/10.1007/s40265-023-01973-7.

Keywords:

Single, administration, travoprost, intraocular, implant, may, effectively, lower, IOP, over, course, 3 years, Berdahl, J.P., Sarkisian, S.R., Ang, R.E, Drugs

Water is vital for the living, especially humans. Water makes up most
of your body and is essential for many everyday critical bodily functions,
including regulating your body temperature, aiding your brain function,
eliminating waste, and carrying nutrients and oxygen across your body.

Every
person needs to consume a certain amount of water to ensure the smooth and
efficient functioning of the body. However, an alarming number of Indians are
constantly dehydrated, which affects their health.

When your water intake is lower than your body needs, it affects your
brain, kidneys, digestive and urinary systems and most importantly, your blood.

When you do not drink enough water, your blood will be more concentrated,
affecting your sugar levels and overall health. And if you have diabetes, the
concentrated blood will report a higher amount of glucose per deciliter of
blood when measured.

Now let us see how dehydration affects your blood sugar levels:

Mild Dehydration causes a quick but minor increase in
your blood sugar levels. However, even this spike negatively affects your
overall diabetes health.

Sudden Dehydration causes a significant spike in your blood
sugar levels that instantly affects your ketone levels, causing an increase in
diabetes.

Severe Dehydration causes a gradual increase in your blood
sugar levels, escalating your ketone levels and may lead to diabetic
ketoacidosis.

Unfortunately, not many of you know that sipping coffee and having
beverages does not add to your overall water intake, even though it may seem
so, as the caffeine content in coffee is known to increase insulin resistance.

At the same time, beverages are loaded with chemicals that also affect insulin
resistance. On the contrary, unsweetened traditional beverages are a great way
to stay hydrated. However, nothing beats the good-old hydrating option – water.

As a healthcare practitioner, I come across many patients with
ill-formed water-drinking habits. So, I recommend they inculcate certain
must-dos in their daily routines and learn to rehydrate themselves.

Set Water Routine

According to Ayurveda, drinking a glass of warm water upon waking up
and before sleeping aids digestion and sleep while keeping you active during
the day.

Energize Your Water

As some of you feel water is too bland, make your water more
interesting; add sliced lemon, fruit pieces and herbs to infuse it with flavor
and minerals.

Schedule Hydration Breaks

Just as you take tea or bathroom breaks, you must schedule hydration
breaks to drink some water mindfully for a few minutes.

Carry a Reusable Bottle

Keeping a reusable and measurable water bottle with you throughout the
day is a visual reminder to drink water and helps track your water intake.

Think Beyond Water

Water hydrates; however, many other drinks hydrate equally well.
Alternating milk, coconut water, and tea to increase fluid intake is a good
idea.

Include Water-Rich Food

It is effortless to include greens, vegetables, and fruits high in
water in your diet through salads and smoothies to keep you hydrated.

So, the real crux is that adequate water intake is essential to good
health. So, talk to your doctor to understand how much water you should drink.
Once you know this, prioritize water to improve your blood sugar levels and
overall health.

Retrospective studies have suggested clofazimine as an alternative to rifampicin in MAC-PD treatment. Sanne M.H. Zweijpfenning, Radboudumc Center for Infectious Diseases, HB Nijmegen, The Netherlands, and colleagues sought to determine if a treatment regimen consisting of clofazimine-ethambutol-macrolide non-inferior to the standard treatment regimen (rifampicin-ethambutol-macrolide) in the treatment of M.avium complex pulmonary disease in a single centre non-blinded clinical trial.

The study, published in the CHEST journal, revealed that the clofazimine-ethambutol-macrolide regimen showed similar results to the standard rifampicin-ethambutol-macrolide regimen and should be considered in the MAC-PD treatment. In both the arms, the frequency of adverse events was similar but their nature was different.

Adult patients with MAC-PD were randomly assigned in a ratio of 1:1 to receive clofazimine (n=21) or rifampicin (n=19) as an adjunct to an ethambutol-macrolide backbone. The study’s primary outcome was sputum culture conversion following six months of treatment.

The study led to the following findings:

• After six months of treatment, both arms showed similar percentages of sputum culture conversion based on intention-to-treat analysis: 58% for rifampicin; and 62% for clofazimine.
• Study discontinuation, mainly due to adverse events, was equal in both arms (26% versus 33%).
• Based on an on-treatment analysis sputum culture conversion after 6 months of treatment was 79% in both groups.
• In the clofazimine arm, diarrhoea was more prevalent (76% versus 37%), while arthralgia was more frequent in the rifampicin arm (37% versus 5%).
• No difference in the frequency of QTc prolongation was seen between both groups.

“A clofazimine-ethambutol-macrolide regimen is noninferior to the standard rifampicin-ethambutol-macrolide regimen and should be considered in the treatment of M.avium complex pulmonary disease,” the researchers wrote.

“Possible drug-drug interactions and individual patient characteristics should be taken into consideration when choosing an antibiotic regimen for MAC-PD,” they concluded.

Reference:

Zweijpfenning, S. M., Aarnoutse, R., Boeree, M. J., Magis-Escurra, C., Stemkens, R., Geurts, B., Van Ingen, J., & Hoefsloot, W. (2023). Clofazimine is a safe and effective alternative for rifampicin in Mycobacterium avium complex pulmonary disease treatment – outcomes of a randomized trial. CHEST. https://doi.org/10.1016/j.chest.2023.11.038