Objectives
To systematically examine the evidence guiding the use of implant therapy relative to glycemic control for patients with diabetes and to consider the potential for both implant therapy to support diabetes management and hyperglycemia to compromise implant integration.
Material and Methods
A systematic approach was used to identify and review clinical investigations directly assessing implant survival or failure for patients with diabetes. A MEDLINE (PubMED) database search identified potential articles for inclusion using the search strategy: (dental implants OR oral implants) AND (diabetes OR diabetic). Inclusion in this review required longitudinal assessments including at least 10 patients, with included articles assessed relative to documentation of glycemic status for patients.
Results
The initial search identified 129 publications, reduced to 16 for inclusion. Reported implant failures rates for diabetic patients ranged from 0–14.3%. The identification and reporting of glycemic control was insufficient or lacking in 13 of the 16 studies with 11 of these enrolling only patients deemed as having acceptable glycemic control, limiting interpretation of findings relative to glycemic control. Three of the 16 studies having interpretable information on glycemic control failed to demonstrate a significant relationship between glycemic control and implant failure, with failure rates ranging from 0–2.9%.
Conclusions
Clinical evidence is lacking for the association of glycemic control with implant failure while support is emerging for implant therapy in diabetes patients with appropriate accommodations for delays in implant integration based on glycemic control. The role for implants to improve oral function in diabetes management and the effects of hyperglycemia on implant integration remains to be determined.
This randomized study from a single institution demonstrates that closed management of the abdomen may be a more rational approach after operative treatment of SSP and questions the recent enthusiasm for the open alternative, which has been based on observational studies.
Implant stabilization was similar for the conventional SLA and chemically modified SLA implants in type 2 diabetic patients with relatively poor glycemic control. Furthermore, this study demonstrated clinically successful implant placement even in poorly controlled diabetic patients.
This report is the third in a series of articles on the dental school work environment commissioned by the American Dental Education Association's Commission on Change and Innovation in Dental Education. The report is based on the most extensive research to date on faculty satisfaction in the dental school environment. The purpose of the study was to assess faculty perceptions and recommendations related to work environment, sources of job satisfaction and dissatisfaction, and professional development needs. More broadly, the study intends to provide insight into the "change readiness" of dental schools to move forward with curricular improvements and innovations. Findings are based on 1,748 responses from forty-nine U.S. dental schools obtained during the time frame of February to April 2007. The total number of respondents constituted 17 percent of all U.S. dental school faculty. The average response rate per school was thirty-six (21 percent). To elucidate the data in terms of issues related to the quality of faculty work-life based on demographics, the authors compared perceptions of various aspects of the work culture in academic dentistry among faculty with different academic ranks and academic degrees and by other variables such as age and gender, tenure versus non-tenure appointments, and full-versus part-time status. Quantitative and qualitative analyses show that the majority of faculty members described themselves as very satisfied to satisfied with their dental school overall and with their department as a place to work. Tenured associate professors expressed the greatest level of dissatisfaction. Opportunities for and support of professional development emerged as an area requiring substantially more attention from dental schools. The authors of the study suggest that dental school leaders use these findings to assess their individual dental school's work environment and to plan changes as needed.
O trabalho faz um cotejo entre o reforço escolar no Brasil e as explicações em Portugal, como parte do sistema educativo sombra, que se desenvolve como forma de combater o fracasso escolar e melhorar a competitividade dos alunos em processos seletivos, como o acesso à educação superior. A pesquisa exploratória do lado do Brasil se fez numa escola pública e numa particular do Distrito Federal, enquanto em Portugal se realizou nos estabelecimentos públicos de uma cidade média. Dentre os principais resultados se destacam os gastos significativos dos pais, que introduzem novas desigualdades educacionais, de origem socioeconômica. As dificuldades com a aprendizagem de matemática e ciências correlatas e a frequência e período das aulas de reforço são maiores no Brasil. Ambos os países necessitam de políticas públicas mais efetivas para aumentar a democratização educacional e do ensino médio em particular.
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