Resonance Frequency Analysis Tool for Implant Stability

Resonance Frequency Analysis Tool for Implant Stability Dr. Vishwanath Pattar Dr. Anjana Bagewadi MDS â€Å" Resonance frequency analysis (RFA) – A diagnostic tool for implant stability † Dental implants have become a significant aspect of tooth replacement in prosthodontic treatment. High implant success rates of the order of 78-100 % have been published, with more than 15 years of observation time. Treatment success of dental implant mainly depends on the stability of the implant bone support. Implant stability is a mechanical phenomenon which is related to the local bone quality and quantity, type of implant, and placement technique used. The application of a simple, clinically applicable, non-invasive test to assess implant stability and osseointegration is considered highly desirable. Resonance frequency analysis (RFA) is one of such techniques which is most frequently used nowadays. Aim of this paper is to review the technique of Radio frequency analysis and use of it to check the implant stability. Key words: Resonance frequency analysis, Implant stability, Implant stability quotient(ISQ) Introduction : Dental implants have reported success rates of over 90 % over long periods of time. However failures still occur and seem to be unpredictable. One factor that is being increasingly considered in failure of dental implants is occlusal loading . It has been clinically demonstrated that implant stability plays a significant role in determining treatment outcome (Sennerby Meredith 1998, Esposito et al. 1998). Implant stability can be seen as a combination of: 1). Mechanical stability, which is the result of compressed bone holding the implant tightly in place.2). Biological stability, which is the result of new bone cells forming at the site of the implant and osseointegration. Initially implant stability was measured by Surgeon’s perception while placing the implant (Insertion and seating torque), percussion testing, reverse torque test and radiographs etc. But none of them proven to be effective in measuring the implant stability. Resonance Frequency Analysis (RFA) is a non-inv asive diagnostic tool for detecting the implant stability of dental implants during the healing stages and in subsequent routine follow-up care after treatment. Advantages of Rasonance frequency analysis 1) Optimal loading decisions : It makes it easier for dentists to decide when is the optimal time to load implants. At placement, stability can be difficult to quantify objec ­tively by merely relying on tactile perception. Torque measure ­ments are difficult to repeat once the implant has started to integrate and can therefore not provide a baseline for subse ­quent comparisons. The invasive torque method may even damage the healing if used for monitoring osseointegration 2)  Early warnings – preventing failure : Dentists sometimes encounter patients whose initial stability score is low. The reason could be that they have had to undergo a bone graft. In such higher-risk situations, most surgeons would avoid an early-loading protocol. Similarly, a significant decrease in stability indicates a potential problem and should be considered an early warning. The surgeon may prefer to unload the implant – or perhaps place additional implants – and then wait until stability increases. RFA system makes the treatment of high-risk patients easier and more predictable – allowing more of these patients to be treated and more of their treatments to be successful. 3)  Quality assurance : Because RFA system helps the dentist decide when to load and avoid failure in high-risk situations, it becomes a quality-assurance system for the clinic. Most patients intuitively understand the stability measures and how they govern when to load an implant and when to wait. This increases their sense of confidence, security and quality. 4) Data can be transferable : All the stability records measured from start of the treatment and the follow –up records can be transefered from one clinician to other. It makes easy to the one clinician to communicate with other about the treatment modalities. Implant stability quotient (ISQ) ISQ (Implant Stability Quotient) is a measurement scale for use with the RFA (Resonance Frequency Analysis) method of determining implant stability. It’s a mapping of resonance frequencies (kHz), presented as a clinically useful scale of 1-100 ISQ. 1 is the least ISQ value and 100 is the highest ISQ value. ISQ is used RFA to measure stability because Supports making good decision about when to load Allows advantageous protocol choice on a patient-to-patient basis. Indicates situations in which it is best to unload Supports good communication and increased trust Provides better case documentation Instrument kit: Fig.1 Hand held probe Fig.2 MonitorFig.3 Main plug Fig.4 Data cable Fig.5 Testing device Fig.6 Smart-peg Technique : Resonance frequency analysis (RFA) uses a sophisticated technology with computer-based measurement of resonance frequency (RF), which is determined by two parameters: the degree of bone density on implant-bone interface area and the level of marginal alveolar bone around the transducer Osstell is representative of RFA-technique and was tested first in 1997The apparatus consists of an Osstell transducer and Osstell analyzer connected to a PC or independent. The transducer is L-shaped or bolts-like (smartpeg) and firmly screwed in order to be positioned on the implant and its superstructure (4–5 N/cm ²) and consists of 2 small voltage controlled transducers. High-energy pulse-type oscillations of a continuous sinusoidal pulse excite implant, in order to register the mechanical vibration between the implant interconnection zone and the bone. As soon as the apparatus is activated the first electric transducer applies excitation signal of increasing frequency from 5 to 15 kHz to implant. Other voltage-controlled element registers ultrasonic vibrations response, ie resonant frequency of the implant-bone interface area and transmits a created signal to the amplifier, which amplifies it and to the analyzer which reads, evaluates and compares it with the frequency of the original signal. The measured amplitude of resonance frequency is displayed numerically and graphically on the Osstell analyzer, and the maximum amplitude represents the stability of the implant, quantified through the ISQ units. The ISQ value reflects the rigidity of the system transducer- implant-bone and transducer calibration parameters. Measured on a scale from 0 ISQ (3500 Hz) to 100 ISQ units (8500 Hz), a higher ISQ value indicates a greater stability of the implant. After a while ISQ values rise because of osseointegration where implant–bone the connection becomes stronger. Fig. 7 Fig.8 Fig.9 ISQ values: >60 – >70 Immediate loading can be done This graph illustrates the progress of implant stability over time, expressed in ISQ terms. The converging green curves show the two most likely scenarios: implant stability eventually sets at around 70 ISQ. A high initial ISQ value tends to decrease, as mechanical stability is supplanted by osseointegration. And a low initial value tends to increase, as osseointegration sets in. The scenario to watch out for is illustrated by the red curve. Here, osseointegration is not progressing as planned, and loading such an implant may result in a failed treatment†¦ High initial stability (ISQ values of 70 and above) tends not to increase over time despitethe fact that the initial high mechanical stability decreases and is replaced by increased biological stability. Lower initial stability normally increases with time because the lower  mechanical stability is increased by the bone remodeling process (osseointegration). Values of ISQ 55 or lower should be taken as a warning sign and act ions to improve the stability should be considered (larger implant diameter, longer healing time, etc.)* *(Implant stability measurements using Resonance Frequency Analysis. Biological and biomechanical aspects and clinical implications. Periodontology 2000, 2008. Sennerby Meredith) References: Chang WA et al. A newly designed resonance frequency analysis device for dental implant stability detection ; Dent Mater J. 2007 Sep;26(5):665-71 Rajiv KG et al . Resonance frequency analysis ; Indian Journal of Dental Research, 22(4), 2011

The Result of Sin Essay -- Literary Analysis, The Scarlet Letter.

Sin is the â€Å"wrongful conduct of a moral code selected by either society or the transgressor.† Sin is one of the main themes in Nathaniel Hawthorne's The Scarlet Letter. The Puritan society that Hester Prynne resides in does not accept people who deny to follow the moral code of the town. Throughout the novel three main characters are involved with the act of sin, Hester Prynne, Arthur Dimmesdale and Roger Chillingworth. Adultery by definition is voluntary having sexual intercourse between a married person and someone other than his or her lawful spouse. It is part of the ten commandments and a law that the Puritan village frowns upon. During the Puritan time period, crimes for adultery ended in execution. However Hester is only forced into wearing the scarlet letter due to the unknown information of who her husband and her lover were. Through adultery Hester Prynne and her daughter are forced to reside to the outskirts of town and be neglected by the rest of society. Hester is forced to wear the scarlet letter embroidered to her chest. This is to symbolize the adultery she has committed. "It [has] the effect of a spell, taking her out of the ordinary relations with humanity and enclosing her in a sphere by herself " (Hawthorne 49). This spell, the scarlet letter is "so fantastically embroidered and illuminated upon her bosom" (Hawthorne 49). The scarlet letter is what separates Hester from the rest of society because it symbolizes her sin. To make up for her sin Hester â€Å"bestowed all her superfluous means in charity, on wretches less miserable than herself†. (Hawthorne 76) However, although Hester tries her best to contribute to the less fortunate than even herself citizens continue to â€Å"[insult] the hand that [feeds] them†... ...t that out of the three characters Roger Chillingworth has the darkest conscience. This is apparent considering he feels no remorse or guilt from the people he is hurting. It is obvious that Roger does not think of the impact of his actions and does things for self gratification. There are many moral lessons demonstrated in the novel The Scarlet Letter. Hawthorne is able to get the point across that it is better to confess your sins rather than hide them. It may ruin ones reputation, or destroy a career, but it is better for yourself than to live in guilt forever. This is proven significantly through Hester Prynne at the end of the novel. Hester is able to overcome her sin and learn from her mistakes. She is discovered to be a woman who helps others and eventually regains the respect of the town. She is eventually is finally accepted by herself, society, and God.

Kakutani’s “Word Police” Essay

In Michiko Kakutani’s essay, â€Å"The Word Police,† the author uses examples, illustrations and definitions to support the claim that our language is on the brink of absurdity because we hide our true identities and inequalities with euphemisms. In regard to euphemisms, Kakutani states that they â€Å"tend to distract attention from the real problems of prejudice and injustice in society† (423). Although the essay is persuasive and supported well, the author falls short of persuading her unbiased audience because of repetitive and tedious criticisms of the politically correct movements. Her argument lacks absolution in her failure to provide her audience with an alternative solution. Kakutani opens with the claim the political correctness is prevalent in society today. For support she uses several examples of icons that are being redeveloped to appease the growing demand for P.C. These include Little Miss Coppertone, who will soon have a male equivalent, and Superman, who will come in four new flavors. In using these familiar, mainstream products, Kakutani sways the audience in her direction while consolidating her claim. She also makes us aware of her aversion to politically correct movements with the use of her sarcasm in renovating the words â€Å"Miss† and â€Å"Superman.† The author then discusses a more considerable issue, that of the controversy over our language. â€Å"Political correctness† defined by Kakutani as â€Å"a vision of a more just, inclusive society in which racism, sexism and prejudice of all sorts have been erased,† (421) has good intent, but the methods used by politically correct activists to achieve their goals are too extreme. This, in turn, will just lead to the â€Å"scorn of conservative opponents and the mockery of cartoonists and late-night television hosts† (421). To validate her claim, Kakutani uses the example of a woman changing â€Å"testimony† to â€Å"ovarimony† at a Modern Language Association. This illustration supports her claim and persuades the audience to agree that the techniques used by P.C. radicals are excessive. To further her claim, she also adds a list of commonly used words and phrases, such as â€Å"charley horse† and â€Å"lazy susan† that, in a  politically correct language, would never be acceptable and debates the necessity and feasibility of changing them. The author also believes that the trendy surge of P.C. dictionaries becoming available to us is forming a new way of speaking and writing. The majority of Kakutani’s backing for this is Rosalie Maggio’s book The Bias-Free Word Finder, a Dictionary of Nondiscriminatory Language. Maggio offers over 5,000 prejudice words and phrases to avoid, as well as techniques on how to make one’s speaking and writing less offensive. In order to support her argument that politically correct language is on the verge being ridiculous, she farcically reconstructs several popular phrases with the use of Maggio’s â€Å"dictionary.† Leonardo DiVinci’s â€Å"Mona Lisa† becomes his â€Å"acme of perfection,† while â€Å"king of the jungle† becomes â€Å"monarch of the jungle.† The extreme illustration is an excellent technique for convincing her audience, but her narrow breadth of sources causes the reader to doubt whether or not she has any other support. Kakutani then inquires as to who will accept and live by these P.C. rules. Her use of satire as a persuasion technique is very efficient when she states that Maggio’s book will most likely never become a staple in the average classroom, or be â€Å"adopted by the average man (sorry, individual)† (421). She then argues that these â€Å"P.C. dictionaries† only create confusion among there own supporters with there self-contradictions. More proof for Kakutani’s claim is an example from Language, Gender, and Professional Writing, by Francine Wattman Frank and Paula A. Treichler of the Modern Language Association. In the book, Frank and Treichler state that using â€Å"he† or â€Å"she† is an â€Å"appropriate construction for talking about an individual (like a jockey, say) who belongs to a profession that’s predominantly male† (422). Kakutani points out that later in the book, the authors contradict themselves by stating, â€Å"using masculine pronouns rhetorically can underscore ongoing male dominance in those fields, implying the need for change† (422). This example regains the trust of Kakutani’s readers. The citation accomplishes its goal in influencing the audience to agree with her claim and causes the reader to wonder what good the  politically correct activists are doing if they cannot even agree with their selves. With the readers trust regained and the su pport of Kakutani’s belief, the author proceeds into her most persuasive argument. Kakutani discusses Maggio’s suggestion to substitute politically incorrect words and phrases with symbols in order to draw attention to the fact that those words and phrases are improper. Rebutting this idea, Kkautani proclaims that Maggio’s philosophy offers no real solution to remove bigotry from our country. In actuality, Maggio’s suggestions focus only on the surface of the word or phrase being corrected and not it’s content. Kakutani supports her claim with the example of when Mark Twain’s classic, The Adventures of Huckleberry Finn, was under consideration for being eliminated from school curriculums because it was labeled racist due to the fact that it included the word â€Å"nigger.† By using such a well-known incident, Kakutani again convinces the reader to agree with her claim, in part because of the common ground that the incident creates. The support succeeds in persuading and building communion with the reader since most well edu cated individuals have read The Adventures of Huckleberry Finn and are aware that the book has no racist purpose. Kakutani then argues that the politically correct actions taken to correct our language are in reality distorting the meanings of the words being attacked. Using the pamphlet, â€Å"Dictionary of Cautionary Words and Phrases† as an example, Kakutani lists non-prejudicial words that are labeled discriminatory. She relates her claim to words used to describe the Vietnam War and Watergate by the government. Using two incidents that are associated negatively to the reader, the author succeeds in convincing her audience. Kakutani next repeats her allegation that the replacing of politically correct words by symbols or other words is not a solution to end problems, instead it will â€Å"make it easier to shrug off the seriousness of their situation† (423). Once again, Kakutani retreats to an example from Maggio’s book to probe her claim. Concluding, Kakutani states that the actions taken by the politically correct activists are being â€Å"purchased at the cost of freedom of expression and freedom of speech† (424). She ends her argument  with an illustration of how the Gettysburg Address would sound if it had been written in a politically correct manner. Overall, Kakutani loses the readers attention towards the end of her debate. She convinces the unbiased audience that the politically correct movements are flawed, but fails to full persuade them to agree with her view that they are ineffective. The use of so many examples from the same source entices the reader to ponder the legitimacy of her arguments. One book is not enough ground to convince a sophisticated, intelligent reader. Moreover, Kakutani’s neglect to suggest an alternative solution to the one offered by the politically correct advocates makes her essay seem unfinished, and casts a negative shadow over Kakutani’s entire debate.

Some Thoughts on Dashes

Some Thoughts on Dashes Some Thoughts on Dashes Some Thoughts on Dashes By Maeve Maddox A reader wonders about the use of dashes to replace colons: More and more I see dashes (of various sorts) used to do the work you say that the colon should do: introduce a word, phrase, clause, list, or quotation after a complete sentence. Is either acceptable? I can’t find an example of a dash used to introduce a quotation, but its use in place of a colon to introduce a word, phrase, clause, or list is common: â€Å"Nonetheless,† he added, â€Å"just having these recordings is not going to be sufficient† to make any definitive conclusions about the cause of the crash- a process that could take weeks, if not months.† Now students’ needs are anticipated by a small army of service professionals- mental health counselors, student-life deans and the like. Coming at the end of a sentence in this way, the use of a dash is not as jarring to me as its increasingly popular use to replace commas or parentheses within a sentence: The study’s authors hypothesized that material gains made through early agricultural success- a proxy for wealth- gave smaller groups of related men the reproductive upper hand for generations. Boko Haram has widened its efforts from capturing foreigners- who can be ransomed off for big bucks- to targeting mass numbers of young women and children who can  be put to other uses. Commas or parentheses would do just fine in each example. The choice to replace commas or parentheses with a dash should be made with a clear understanding of the effect desired. Explanatory information meant for readers who may need help with a concept can go in parenthesis: The study’s authors hypothesized that material gains made through early agricultural success (a proxy for wealth) gave smaller groups of related men the reproductive upper hand for generations. Information relevant to the sentence, but of secondary importance can go between commas: Boko Haram has widened its efforts from capturing foreigners, who can be ransomed off for big bucks, to targeting mass numbers of young women and children who can  be put to other uses. Dashes are appropriate when the purpose is to startle the reader with an unexpected interruption that provides a peripheral thought: His chisel was one of the weapons used- not that he could help that, poor fellow- and no doubt you will want to ask him questions. The dash is an attention-getting punctuation mark that can be used to change the tone of a sentence. Dashes are like the unexpected chords in The Surprise Symphony: they jerk the reader into wakefulness. They are most effective when not overused. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Punctuation category, check our popular posts, or choose a related post below:Addressing A Letter to Two People50 Idioms About Arms, Hands, and FingersEach vs. Both

Free Essays on Vision, Language, And Experience

Vision, Language, and Experience Throughout Shelley’s Frankenstein there is constant tension between the visual and verbal. At one moment the reader can sympathize with the creature and at another the reader can relate with Victor’s anger. The visual portrayal of the creature does have an effect, but not nearly as much as the language. The sympathy changes throughout the volumes particularly do to the narratives of the characters. When Victor speaks it seems believable that the creature is a horrible thing, but when the creature speaks the perspective completely changes. But, there is still a problem because a conclusion cannot be addressed. Though language has an overwhelming effect, there is still a huge communication barrier between the characters in the novel and the reader’s understanding of them. Through this barrier, Shelley conveys a powerful message: people can only truly understand each other when put through the same experience. In the novel, Victor and Walton are the only two characters that really connect and it is because they share somewhat of the same experience. Both of them are excessively ambitious and both attempt, as Victor is successful, to defy the limitations of man. Walton writes in his letter to his sister: â€Å"I have no friend Margaret: there will be none to participate my joy† (8). Walton truly desires a friend for companionship and company. He desires a being that can understand him and see his greatness. He finds some of these qualities in Victor. Though Frankenstein is not his ideal friend, he completes Walton by advising him in the right direction. Walton reciprocates this in Victor as well. Walton is the only human to hear his story, which, in a deeper sense, means that he allows Victor to live on. Victor says, â€Å"But when you speak of new ties, and fresh affections, think you that any can replace those who are gone?† (180). Here Victor tells Walton that it is not conceivabl... Free Essays on Vision, Language, And Experience Free Essays on Vision, Language, And Experience Vision, Language, and Experience Throughout Shelley’s Frankenstein there is constant tension between the visual and verbal. At one moment the reader can sympathize with the creature and at another the reader can relate with Victor’s anger. The visual portrayal of the creature does have an effect, but not nearly as much as the language. The sympathy changes throughout the volumes particularly do to the narratives of the characters. When Victor speaks it seems believable that the creature is a horrible thing, but when the creature speaks the perspective completely changes. But, there is still a problem because a conclusion cannot be addressed. Though language has an overwhelming effect, there is still a huge communication barrier between the characters in the novel and the reader’s understanding of them. Through this barrier, Shelley conveys a powerful message: people can only truly understand each other when put through the same experience. In the novel, Victor and Walton are the only two characters that really connect and it is because they share somewhat of the same experience. Both of them are excessively ambitious and both attempt, as Victor is successful, to defy the limitations of man. Walton writes in his letter to his sister: â€Å"I have no friend Margaret: there will be none to participate my joy† (8). Walton truly desires a friend for companionship and company. He desires a being that can understand him and see his greatness. He finds some of these qualities in Victor. Though Frankenstein is not his ideal friend, he completes Walton by advising him in the right direction. Walton reciprocates this in Victor as well. Walton is the only human to hear his story, which, in a deeper sense, means that he allows Victor to live on. Victor says, â€Å"But when you speak of new ties, and fresh affections, think you that any can replace those who are gone?† (180). Here Victor tells Walton that it is not conceivabl...

MID-YEAR ASSESSMENT Management Finance Assignment

MID-YEAR ASSESSMENT Management Finance - Assignment Example One of the behavioural issues that have been noticed within the case study is that of resistance from employees. It is a common observance within an organization to have employees refuses to work with the new system or processes. In some cases employees regard the new system as redundant or unnecessary altogether (Attwood, 1996). In such cases usually employees feel threatened by the new system and feel that it challenges their methods of working and makes them feel redundant. In the case provided it was observed that the supervisor of department D Janet was extremely unhappy after viewing the performance report. This behaviour shown by Janet shows that she felt threatened by the report and refused to accept the system altogether. In some cases employees tend to agree to the new budgeting system but ignore its implementation. Employees tend to assure executives of the organization that they would commit to the processes of the system but in reality tend to hold reservations about it, causing reluctance in the implementation of its implementation (Woldring, 2010). As seen in the case out of all the directors only one of the director was interested in its implementations whereas others were uncertain about it. This caused the directors to become uninterested in its effective implementation. Another behavioural issue that can be seen the company is confusion amongst the employees. While developing a budgeting plan it is vital to communicate with employees to investigate the factors that were involved in formation of the actual budget. Since communication between the executives of the company and the employees was not clear misunderstandings are created during the formation of performance reports (Poornima & Charantimath, 2011). This in turn causes employees to disown the report claiming that information provided in the report is baseless and has little or no significance when placed under practical circumstances. Furthermore, there was no training provided to the employees prior to implementing the new financial control system. Direct implementation of the new system caused a great deal of confusion amongst employees who were taken aback on receiving their department’s performance report. Changes to be introduced in the Existing Report System In order to ensure that the current budgeting system is more easily accepted by the company’s employees it is vital that the management removes uncertainty and insecurity that the company employees have regarding it. The first and foremost step that the company could take is to initiate a training program for its employees. The main aim of the training program should be to increase the knowledge and awareness of the employees regarding budgeting and comparative analysis. The training sessions must inform employees of the exact advantages that budgeting and comparative analysis would bring about to the company. The process of training must start with the top executives of the company. Obtai ning the consent and backing of the top executives would help in the implementation process (Finkelstein et al., 2008). Moreover, knowing that all the organizational executives share the same vision convincing employees at the lower level makes it a lot easier. Once the company’s executives have been briefed it is then time to convince employees working at the lower level

Demographic transition Essay Example | Topics and Well Written Essays - 500 words

Demographic transition - Essay Example Phase I is mostly seen in pre-industrialized countries (Galloway & Patrick,1986). Most developing countries are in the Phase II of the transition. In the second phase, the state of equilibrium in the population is lost and death rate is exceeded by birth rate thereby leading to a â€Å"population explosion.† This change is subjected to the fact that better facilities such as good sanitation, nutrition, health facilities etc. are implemented. Such measures help in checking the rate of mortality and increase the lifespan. Though the death rate is lowered the birth rate remains high because most of the people looks upon children as assets who will help bring in money into the family. These growths in population triggers the next stage of transition i.e. Phase III. In this phase a decline in birth rate is seen. This decline is seen because the population is educated and use contraception. Most of the people earn more and therefore do not look upo children as assets and parents realize that children need to be looked after well (Lee, 2003,p 170).â€Å"Some of the improvement in child survival is itself a response to parental decisions to invest more in the health and welfare of a smaller number of children† (Nerlove, 1974). In phase IV, both birth and death rates reduce drastically. This is because of societal changes where too many children are looked upon as hindrance in leading a good satisfactory life and hence both fertility and birth rate falls. According to researchers, the factors that are primarily responsible for declination in the Crude Birth rate include education among women, use of contraceptives, medical facilities which help in survival of babies thereby eliminating need for reproduction of more babies. On the other hand better health facilities, newer technologies and infrastructure, faster transport and higher earnings trigger declination in Crude Death rate. All developed