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Micea, Andrei Stancovici and Sînziana Indreica",reviewType:"peer-reviewed",authors:[{id:"64622",title:"Dr.",name:"Mihai",middleName:null,surname:"Micea",fullName:"Mihai Micea",slug:"mihai-micea"},{id:"72210",title:"Mr.",name:"Andrei",middleName:null,surname:"Stancovici",fullName:"Andrei Stancovici",slug:"andrei-stancovici"},{id:"119880",title:"Ms.",name:"Sinziana",middleName:null,surname:"Indreica",fullName:"Sinziana Indreica",slug:"sinziana-indreica"}]},{id:"24667",type:"chapter",title:"Improvement of RISE Mobile Robot Operator Training Tool",slug:"improvement-of-rise-mobile-robot-operator-training-tool",totalDownloads:2488,totalCrossrefCites:0,signatures:"Janusz Będkowski and Andrzej Masłowski",reviewType:"peer-reviewed",authors:[{id:"63695",title:"Dr.",name:"Janusz",middleName:null,surname:"Bȩdkowski",fullName:"Janusz Bȩdkowski",slug:"janusz-bdkowski"}]}]},relatedBooks:[{type:"book",id:"3637",title:"Cutting Edge Robotics 2010",subtitle:null,isOpenForSubmission:!1,hash:null,slug:"cutting-edge-robotics-2010",bookSignature:"Vedran Kordic",coverURL:"https://cdn.intechopen.com/books/images_new/3637.jpg",editedByType:"Edited by",editors:[{id:"396",title:"Dr.",name:"Vedran",surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"},chapters:[{id:"12194",title:"Motion Control of Robots Based on Sensings of Human Forces and Movements",slug:"motion-control-of-robots-based-on-sensings-of-human-forces-and-movements",signatures:"Tao Liu, Chunguang Li, Kyoko Shibata and Yoshio Inoue",authors:[null]},{id:"12209",title:"Reactive Robot Control with Hybrid Operational Techniques in a Seaport Container Terminal Considering the Reliability",slug:"reactive-robot-control-with-hybrid-operational-techniques-in-a-seaport-container-terminal-considerin",signatures:"Satoshi Hoshino and Jun Ota",authors:[null]},{id:"12195",title:"Robust Nonlinear Control of a 7 DOF Model-Scale Helicopter Under Wind Gusts Using Disturbance Observers",slug:"robust-nonlinear-control-of-a-7-dof-model-scale-helicopter-under-wind-gusts-using-disturbance-observ",signatures:"Adnan Martini, Frangois Leonard and Gabriel Abba",authors:[null]},{id:"12205",title:"Pursiut-Evasion Games in Presence of Obstacles in Unknown Environments: towards an Optimal Pursuit Strategy",slug:"pursiut-evasion-games-in-presence-of-obstacles-in-unknown-environments-towards-an-optimal-pursuit-st",signatures:"C. Giovannangeli, M. Heymann and E. Rivlin",authors:[null]},{id:"12210",title:"Motion Planning by Integration of Multiple Policies for Complex Assembly Tasks",slug:"motion-planning-by-integration-of-multiple-policies-for-complex-assembly-tasks",signatures:"Natsuki Yamanobe, Hiromitsu Fujii, Tamio Arai and Ryuichi Ueda",authors:[null]},{id:"12196",title:"Robotic Strategies to Assist Pilots in Landing and Takeoff of Helicopters on Ships and Offshore",slug:"robotic-strategies-to-assist-pilots-in-landing-and-takeoff-of-helicopters-on-ships-and-offshore",signatures:"Alexandre Campos, Jacqueline Quintero, Roque Saltaren, Manuel Ferre and Rafael Aracil",authors:[null]},{id:"12203",title:"Optimality Principles and Motion Planning of Human-Like Reaching Movements",slug:"optimality-principles-and-motion-planning-of-human-like-reaching-movements",signatures:"Mikhail M. Svinin, Igor A. Goncharenko, Shigeyuki Hosoe and Yoshihito Osada",authors:[null]},{id:"12215",title:"An Experimental Study of Three-Dimensional Passive Dynamic Walking with Flat Feet and Ankle Springs",slug:"an-experimental-study-of-three-dimensional-passive-dynamic-walking-with-flat-feet-and-ankle-springs",signatures:"Terumasa Narukawa, Kazuto Yokoyama, Masaki Takahashi and Kazuo Yoshida",authors:[null]},{id:"12190",title:"Active Knee-Release Mechanism for Passive-Dynamic Walking Machines",slug:"active-knee-release-mechanism-for-passive-dynamic-walking-machines",signatures:"Kalin Trifonov and Shuji Hashimoto",authors:[null]},{id:"12214",title:"Simplified Human Hand Models for Manipulation Tasks",slug:"simplified-human-hand-models-for-manipulation-tasks",signatures:"Salvador Cobos, Manuel Ferre, Rafael Aracil, Javier Ortego and M. 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Nishio, N. Hagita, T. Miyashita, T. Kanda, N. Mitsunaga, M. Shiomi and T. Yamazaki",authors:[null]},{id:"12199",title:"Minimally Invasive Force Sensing for Tendon-driven Robots",slug:"minimally-invasive-force-sensing-for-tendon-driven-robots",signatures:"Alberto Cavallo, Guiseppe De Maria, Ciro Natale and Salvatore Pirozzi",authors:[null]},{id:"12213",title:"Tweezers Type Tool Manipulation by a Multifinger Hand Using a High-Speed Visual Servoing",slug:"tweezers-type-tool-manipulation-by-a-multifinger-hand-using-a-high-speed-visual-servoing",signatures:"Satoru Mizusawa, Akio Namiki, Taku Senoo and Masatoshi Ishikawa",authors:[null]},{id:"12206",title:"Vision-Based Haptic Feedback with Physically-Based Model for Telemanipulation",slug:"vision-based-haptic-feedback-with-physically-based-model-for-telemanipulation",signatures:"Jungsik Kim and Jung Kim",authors:[null]},{id:"12193",title:"Image Sabilization for In Vivo Microscopic Imaging",slug:"image-sabilization-for-in-vivo-microscopic-imaging",signatures:"Sungon Lee",authors:[null]}]}],publishedBooks:[{type:"book",id:"3637",title:"Cutting Edge Robotics 2010",subtitle:null,isOpenForSubmission:!1,hash:null,slug:"cutting-edge-robotics-2010",bookSignature:"Vedran Kordic",coverURL:"https://cdn.intechopen.com/books/images_new/3637.jpg",editedByType:"Edited by",editors:[{id:"396",title:"Dr.",name:"Vedran",surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],publishedBooksByAuthor:[]},onlineFirst:{chapter:{type:"chapter",id:"79148",title:"Strategic Implants under Existing Partial Removable Dentures, Why, How Many, and Which Type?",doi:"10.5772/intechopen.100191",slug:"strategic-implants-under-existing-partial-removable-dentures-why-how-many-and-which-type",body:'Dental implant service is a life-changing treatment modality for many patients. Giving our patients a fixed restoration is a very rewarding procedure, especially if the patients have difficulties: gage reflex, bulky prostheses, lack in retention, stability, or support. Unfortunately, this is not applicable for all patients, especially patients who cannot afford multiple implants or bone grafting. By considering the strategic implants under the existing removable partial denture (RPD), we make implant treatment simple and affordable for more patients.
The removable partial denture (RPD) is the dental prostheses that the patient, who suffers the absence of some but not all the natural teeth, can readily insert and remove from his/her mouth. The prostheses restore the missing teeth as well as the gingiva and the missing bone if needed. Removable partial dentures (RPDs) are indicated for patients with a long edentulous span, too long for a fixed prosthesis. The RPD is indicated for a patient with no posterior abutment to support a fixed prosthesis, and the cantilever bridge is contraindicated. Also, it is preferred if excessive alveolar bone loss is encountered, especially in the esthetic zone. Those patients who are not indicated for bone grafting or unable to afford the costly treatment are good candidates for the removable denture (RD). The acrylic flang is a good approach to compensate for the bone and soft tissue deficiency within a short fabrication time and a less aggressive approach. Moreover, this treatment option allows the patient to remove his prostheses for easier intraoral access, subsequently, better oral hygiene. The RD enables the dentist to repair or adjust the prostheses easily.
On the other hand, RD is less secure with limited retention and stability than fixed prostheses. RD metal clasp may compromise the final esthetic result. It may act as a gum stripper and accelerate alveolar bone resorption. These drawbacks in the RD can be managed by upgrading the RD using strategic implants, which are “the implants that change the prosthetic support type to a more favorable configuration” [1].
In this chapter the folllowing points is going to be discussed:
Classification as a systematic approach for communication and planning:
Kennedy classification system
Steffel classification and modified Steffel classification
Implant-Corrected Kennedy (ICK) Classification System for Partially Edentulous Arches
Strategic mini dental implants (MDI) and standard dental implant (SDI) under existing RPD, how many implant?
The abutment prosthetic value
Immediate and delayed restoration/loading, what is the difference?
Why strategic implant?
Mini-implant-assisted removable partial denture
Conclusion
A classification is a systematic approach in which the items or units are categories in groups or subgroups according to specific criteria. This approach facilitates the discussion regarding the most suitable treatment options, eases the communication between the dentist and the technician. The classification also allows for visualization and differentiation between the RPD support types: tooth-supported, tooth tissue-supported, tissue-supported, implant-supported, implant tissue-supported, and implant tooth-supported.
In 1925 Dr. Edward Kennedy introduced his approach of categorizing partially edentulous arches into four classes. He categorized the partially edentulous arches in a way that considered the edentulous area position in the arch and if it was surrounded with teeth or not. This approach was beneficial in visualizing the cases and reaching the decisions regarding the RPD designs.
The following is the Kennedy classification:
Class I: Edentulous free-end areas located on both sides (bilateral), posterior to the remaining teeth (Figure 1).
Class I maxillary arch.
Class II: Edentulous free-end area located on one side (unilateral), posterior to the remaining teeth (Figure 2).
Class II maxillary arch.
Class III: Edentulous bounded area with natural teeth remaining both anterior and posterior to it (Figure 3). The area is located on one side (unilateral).
Class III maxillary arch.
Class IV: Edentulous bounded area with natural teeth remaining posterior to it. The area is located anteriorly and crossing the mid-line (Figure 4).
Class IV maxillary arch.
In 1965 Applegate’s added eight rules to the classification. The rules can be summarized by the following: The categorization (classification) is always determined by the most posterior edentulous region (or regions). Any additional edentulous area (other than those that define the categorization) is considered a modification (Figures 6 and 7). If the teeth posterior to the edentulous area are not used to support the RPD, the edentulous area is classified as a free end (Figures 5 and 7), and vice versa (Figures 6 and 7). If the posterior free end edentulous region is not going to receive artificial teeth, it will not be considered in the classification (Figures 6–8), and vice versa. Putting the design and the structure of the RPD into consideration is a cornerstone in giving the correct RPD classification. Subsequently, the classification will be the start point making the best clinical decision regarding the number and the position of strategic implants under the RPD.
No rest is going to be costructed on # 38 or 37 ➔ the arch has two free end areas ➔ Class I mandibular arch.
Direct retainer is going to be constructed on 37. No artificial teeth is going to replace 46, 47 or 48 ➔ no free end ➔ Class III mod 1 mandibular arch.
No artificial teeth is going to replace, 48. Direct retainer is going to be constructed on 37 but not on 47 ➔ one free end ➔ Class II mod 3 mandibular arch.
No artificial teeth is going to replace, 38, 37, 36, 47 or 48. Class IV mandibular arch.
In 1962 Steffel described six support possibilities that can be encountered in RPD.[2] He labeled the classification categories from A to F based on the fulcrum, and the number and distribution of the abutments, Figure 9. The fulcrum line is a hypothetical line formed between abutments, teeth or implants. The RPD may rotate somewhat around the fulcrum during function.
Steffel classification.
ICK I (# 25).
In this chapter, we suggest a modification to this classification to simplify the communication and decision-making regarding the strategic implant under the existing RPD. In the modification, B, C, and D will be labeled together.
The following is the
Punctual-support, only one abutment.
Linear-support, two abutments; separated with edentulous area or at least one tooth.
Triangular-support, three well-distributed abutments; separated with edentulous area or at least one tooth. One of the abutments should be on the opposite quadrant.
Quadrangular-support, two well-distributed abutments on every quadrant.
Providing the patient with a stable prosthesis is a crucial target for the dentist. However, the RPD is not rigidly attached to the intraoral hard (teeth) and soft (mucosa) tissues, which have different levels of compressibility and mobility. Subsequently, the chewing and occlusal forces may generate different levels of tissue stress and prosthesis mobility. Both (stress and mobility) should be within the physiological level and cause no harm or trauma. Achieving this critical goal depends on the clinician’s understanding of the biomechanics and the different design solutions. The RPD design should consider the unique nature of each clinical case and counter the expected RPD movement in response to loading. The design also should minimize the potentially destructive forces that may affect the supporting tissues; teeth, mucosa, and bone. That can be achieved by avoiding a long lever system, good selection for the RPD supporting elements, and wide symmetrical distribution of the functional forces [3, 4]. Many of the previous points (if not all) can be achieved (fully or partially) by delivering an RPD with quadrangular-support type.
According to the modified Steffel classification, there are four types of prosthetic support: punctual, linear, triangular, and quadrangular. The RPD support improves gradually as the classification change from I to IV. Classification IV provides the best support to the RPD with the highest resistance of rotation. The strategic implant aims to change the prosthetic support type to a more favorable configuration.
One of the simple classification systems for RPD supported with implants or implants and natural teeth is Implant-Corrected Kennedy (ICK) classification system for partially edentulous arches by Al-Johany et al.[5] The ICK is based on the Kennedy classification system and the Applegate eight rules (Applegate–Kennedy system).[6] According to the ICK classification system coding guidelines, the Kennedy classification comes first, followed by the number of modification spaces (Applegate rules). Finally, round brackets enclose # followed by the implant’s or implants’ position will be added, Figures 10–18.
ICK II mod 2 (# 33, 36). Direct retainer is going to be constructed on 28.
ICK II mod 3 (# 13, 23). Direct retainer is going to be constructed on 28.
Meeting our patient’s expectations is a priority. That cannot be reached if the dentist did not provide the patient with a full straightforward clarification for the treatment plan. The clarification should cover the advantages, disadvantages, risks, time, cost, and alternatives. The explanation should be done in a way that helps both the patient first and the dentist second to reach the decision that best matches the patients’ needs, health status, and financial ability, as well as respect the patient’s chief complaint and consideration. Generally speaking, teeth-implant- or implant-supported removable dentures reduce (and in many cases eliminate) traditional denture problems.[1, 7, 8, 9] It helps the dentist widen his options to meet the patient’s needs and expectations by inserting one or few implants in strategic positions, but how many implants?
The needed number of mini dental implants (MDIs) or standard dental implants (SDIs) under existing RPD is a multifactorial process (see paragraph 2.5) and taken on the quadrant level. To give the patient an RPD with acceptable retention, stability, and support, the abutments should be well distributed. Two abutments on every quadrant in symmetrical position as possible are needed. On every quadrant, the sum of the abutments prosthetic value should be ≥2, Table 1 and Figure 19.
ICK II mod 1 (# 16, 13, 23).
The abutments prosthetic value | ||
---|---|---|
Teeth | Upper or lower incisor or lateral incisor | 0–0.5* |
Upper or lower canine | 1.3** | |
Upper or lower premolar or molar | 1*** | |
MDI | Upper MDI | 0.5–0.7**** |
lower MDI | 1 | |
SDI | Upper Standard Implant | 1 |
Lower Standard Implant | 1 |
The prosthetic value of the available teeth and the planned MDIs and SDIs. The recommendations are on the quadrant level.
The numbers represent the prosthetic value if abutment rest is planned; if not, the value will be 0.
If the four natural anterior abutment teeth are missing (11, 12, 13, 14), strategic implant/s is recommended even if all posterior teeth are available, and vice versa.
If there is no space ( edentulous area or at least one natural tooth) between the abutment teeth, the prosthetic value will decrease to 0.5 for each abutment.
Bone quality impacts the MDI prosthetic value.
ICK II (# 35, 33, 43).
For partially edentulous patients, the abutments can be implants or natural teeth and should be well-distributed with a sum of the prosthetic value ≥2 on quadrant level.
ICK III mod 3 (# 41).
In the course of formulating the prosthodontic plan, not all teeth or abutments have the same prosthetic value. The prosthetic value stands for the importance of the tooth or implant from a specific prosthodontic point of view. The last first molar (#36) in Figure 20 has a very high prosthetic value than the lateral incisor #32. Extracting #36 shifts the treatment modality (if an implant is not feasible) from fixed partial denture to removable partial denture. Suppose the dentist changes his prosthodontic point of view by selecting RPD as a treatment modality. In that case, the prosthetic value of #36 will be reduced a little for this specific treatment modality. However, the prosthetic value for the same tooth (#36, Figure 20) and the same treatment modality (RPD) will be very high if the patient has a knife-edge thin, sensitive mucosa. Usually, this type of patient can tolerate tooth-tooth-supported RPD better than tooth tissue-supported RPD. Therefore, it can be concluded that:
ICK III mod 1 (# 34, 42).
ICK III mod 1 (# 13, 23).
ICK IV (# 33, 43). Direct retainers are going to be constructed on 36 and 47. No artificial teeth are going to replace 37 or 38.
(A1 upper jaw and A2 lower jaw to G1 upper jaw): The recommended number of strategic standard implants (SDIs) or mini dental implants (MDIs) under existing RPD.
The #36 has a very high prosthetic value because the extracting change the treatment modality (if implant is not feasible) from fixed partial denture to removable partial denture.
The SDI #23 and MDI #33 have very high esthetic value as they help the dentist avoiding anterior metal clasps. #27 and MDI 35 have relatively high prosthetic value as they shift the RPD from tooth tissue supported to more implant tooth-supprted or implat implant-supported RPD.
Upgrading the existing clasp retained lower RPD by inserting strategic mini-implants, immediate restoration with immediate loading/soft material. A- Intraoral image with lower RPD before implantation. B- Partial edentulous lower jaw before implantation. C- Tissue surface of the RPD before implantation. D- Four strategic mini-implants in the interforaminal region, tooth 32 was extracted. E- Tissue surface of the RPD after implantation, soft relining in the areas opposing the implants’ head. F- Tissue surface of the RPD after 4 months, the matrix pick-up (housings). G- Intraoral image with lower RPD after the housing, clasps in esthetic zone were removed.
Narrow bone can be treated with bone grafting. Unfortunately, this is not always feasible. A- Biomechanically, the narrow implant is not always the best approach, see paragraph 5. B- Osteoplasty is used to insert a wider implant by increasing the bone width, which will impact the crown-implant ratio negatively and may place the implant near vital anatomical structure. C- One-piece mini-implant with ball attachment and preferable crown-implant ratio can be used to stabilize a complete removable denture or partial removable denture.
Upgrading the existing double crown retained upper RPD by inserting strategic mini-implants, immediate restoration, and delayed loading. A- Partial edentulous upper jaw before implantation. B- Tissue surface of the RPD before implantation. C- Five strategic mini-implants. D- Tissue surface of the RPD after implantation, recesses (empty notches) against the mini-implants. E- Tissue surface of the RPD after 4 months, the matrix pick-up (housings). The palate coverage was reduced. F- Intraoral image with the RPD after the housing.
Upgrading the existing double crown retained lower RPD by inserting strategic mini-implants, immediate restoration and immediate loading. A- Partial edentulous lower jaw before implantation. B- Tissue surface of the RPD before implantation. C- Two strategic mini-implants. D- Tissue surface of the RPD after implantation, the matrix pick-up (housings) inserted in the same implantation session. E- Intraoral image with the RPD in place after implantation.
The hidden #23 MDI under the saddle (Figure 21) has a very high esthetic value as it helps the dentist avoid metal clasp in the esthetic zone. In some cases, strategic implants enable the dentist to reduce or remove the flange to achieve a better esthetic result by reducing lip protrusion. In other cases, it gives the dentist the ability to minimize the RPD size (palate, Figure 24) and increase patient acceptance.
The prosthetic value (importance) for each abutment is estimated according to Table 1 and mainly the following points: [11, 12, 17, 18].
Periodontal status, mobility, and bone level around the abutment.
Crown-root ratio.
Tooth vitality, size of the defect (caries), size, and type of the restoration.
The shape and number of the abutment roots.
Occlusion, parafunctional activity and opposite jaw status: natural teeth, implant, fixed partial denture, complete denture, or partial denture.
In 1981 Albrektsson et al. suggested a protocol in which the implants are left to heal in situ for at least 3 to 4 months without loading.[19] He considered the non-loading phase a crucial period to achieve successful osseointegration and avoid fibrous tissue formation between the implant surface and the bone. On the other hand, many clinical studies proved that immediate restoration, immediate loading, or early loading are acceptable treatment modalities.[20, 21] These studies were in response to the social and psychological needs of many patients. The immediate or early treatment modalities aim to reduce the overall recovery time between the surgical intervention and the insertion of the final restoration. These approaches are known as immediate restoration protocol, immediate loading protocol, and early loading protocol.
Patients typically are uncomfortable and, in many cases, refuse to stay without their RPD for a long time, especially if it restores a lot of missing teeth or teeth in the esthetic zone. The immediate protocols can reduce the patient concerns related to the final restoration by reducing the waiting period. In some cases, a temporary restoration is immediately delivered to give the patient a hint on the form, size, and position (in some cases, the shade) of the final restoration. Moreover, the second surgical intervention can be averted through immediate protocols. To achieve a good success rate in this treatment modality, a good understanding of the topic, terminology, limitation, and biology is essential. These topics will be discussed in other chapters, but it is crucial to clarify a few terms.
The loading can be classified into four categories:
Conventional loading: The implants are left without loading for around two to three months.
Delayed loading: If the loading on the implant is applied after the conventional loading time, it is classified as delayed. That can be indicated if the tissue needs more healing time, such as external sinus lift with bone grafting. In such cases, the final restoration and implant loading may be applied after six to nine months.
Early loading: The implant is loaded by placing dental restoration in contact with opposing dentition at any time after one week but within two months after implant insertion.
Immediate loading: The dental restoration is inserted intraorally and placed in contact with opposing dentition within one week after the surgical intervention.
The timing of dental restoration can also be categorized to:
Conventional restoration in which the implant is left without temporary or final restoration for around two to three months.
Immediate restoration: The temporary or final restoration is placed within one week after surgical intervention.
Early restoration: The temporary or final restoration is placed any time after one week but within two months after implant insertion.
Delayed restoration: If the dental restoration is placed intraorally after the conventional loading time, the restoration is classified as delayed restoration.
According to the previous classifications, the dentist has different types of intervention. For example, he can go for immediate restoration with conventional loading or implement early restoration with delayed loading.
In the case of the strategic implant under existing RPD, there are seven scenarios: immediate restoration with one of the four loading types, or early restoration with early, conventional, or delayed loading. The decision regarding the best approach is multifactorial: age, esthetic expectations, oral hygiene level, bone quality and quantity, and treatment expenses. According to the 2018 census supported by the International Team for Implantology (ITI), the most critical factors that may impact the loading protocol selection are patient-related factors, especially patient’s general health, implant primary stability (ISQ), bone grafting, the size and shape of the implant, and the doctor skills and experience.[22] Moreover, the ITI tried to unify the two classifications (loading and restoration timing) to make it less complicated for the clinician and easier for the researchers to perform clinical studies and compare their results. They described four protocols:
Immediate loading: Within one week after implant placement, dental implants are linked to a prosthesis in occlusion with the opposing arch.
Immediate restoration: Within one week after implant placement, dental implants are linked to the dental restoration and are kept out of occlusion.
Early loading: Between one week and two months following implant placement, dental implants are linked to the prosthesis.
Conventional loading: dental implants are linked to the prosthesis after two months of implantation.
Improving dental treatment output by using implants to enhance the functional performance of the complete denture is a well-known approach in prosthodontics. The McGill Consensus Statement stated that the first option in treating the lower jaw edentulous patient should be two implants retained overdenture and not lower jaw conventional complete denture (CD).[23] Overwhelming scientific evidence supports the statement.[23] The evidence emphasized the superiority of two implants retained overdenture treatment modality on the conventional CD in many aspects, such as patients’ chewing efficiency, positive modification in patients’ diet, patients’ satisfaction with the CD stability, retention, and comfort as well as quality of life.[23] Although a lot of scientific evidence highlighted the positive impact of inserting implants under existing RPD, no similar Consensus Statement is available regarding implant-retained or implant-assisted removable partial denture. [24, 25, 26].
Not all patients are suitable for implant-supported fixed dental prostheses. For example, many patients are unwilling to have an extra surgical intervention (bone grafting, sinus lifting, bone splitting, or expansion). Other patients are not suitable for such intervention because they are medically compromised or do not have adequate financial flexibility. As an alternative to inserting multiple implants, the dentist can improve the quality of the prosthodontic treatment by changing the support type of the RPD to the quadrangular-support type. The improvement can be achieved by inserting one/two standard implants or one/two/three mini-implants per quadrant to reach a symmetrical quadrangular-support type. The prostheses will be tooth implant-supported RPD instead of tooth tissue-supported RPD. This prosthodontic approach is affordable to many patients.
The strategic implant is “the implant that can change the prosthetic support type to a more favorable configuration”.[1] It is a reliable way of treatment with an implant survival rate of 91.7–100%.[4] Also, it can support both the RPD and the other abutments effectively. In two clinical studies with 2 and 3 years follow-up, the survival rate of the natural teeth abutments was 100%.[9, 24].
Moreover, it can improve the survival rate of the RPD. The 10-year survival rate of RPDs; clasp-retained removable partial dentures, conical crown-retained dentures, or a combination of conical crown and clasp-retained dentures is 71.3%.[27] On the other hand, clinical studies with observation periods between 1 and 12.2 years reported survival rates of 90–100% for the implant-assisted removable partial denture prostheses.[7, 28, 29, 30, 31] This remarked difference in the survival rate plays an essential role in formulating the prosthodontic plan.
Many clinical studies have shown that implant placement in strategic locations under an existing RPD can enhance chewing efficiency, dental health-related quality of life, and patient satisfaction with speaking and eating, as well as RPD retention, stability, and support.[1, 8, 32] Above that, it gives the dentist the ability to reduce the tissue coverage and reduce the size of the RPD, which can positively impact the patient’s acceptance of the RPD, especially if he suffers hyperactive gag reflex, Figure 24. Also, it can improve the final esthetic result by avoiding the traditional metal clasp, Figures 19 and 22.
Unfortunately, inserting a standard implant under the existing RPD is not always feasible. The patient may have a very narrow bone that prevents inserting a standard implant without bone grafting. A procedure that is not suitable or acceptable by some patients. In this case, mini-implants can be considered a good alternative, Figures 22 and 25 [1, 8, 16].
In 1976, the U.S. Food and Drug Administration (FDA) approved the 3 mm root-form dental implant. With time, dental implants proved to be a predictable and reliable prosthodontic treatment modality with a high success rate.[33, 34, 35] After 21 years, the approval was cleared for implants less than 3 mm. The approval widens the spectrum of the patients treated with dental implants, particularly the cases with reduced bone width.
In literature, there is no standardization regarding the terminology of dental implant diameter.[36] For example, some authors considered the implants with diameters from 1.8 to 2.9 mm as small implants; others call them mini-implants.[37] Some authors defined the mini-implant as the implant with 2.2 mm.[38] Al-Johany et al. proposed a classification scheme and used four terms: Extra-narrow <3.0 mm, Narrow ≥3.0 mm to <3.75 mm, Standard 3.75 mm to <5 mm, and Wide ≥5 mm.[36] In this text, we will follow the lead of Resnik et al. and Schiegnitz et al. by considering the mini-implant as the implant with a diameter < 3.0 and the narrow-diameter implant as the implant with a diameter ≤ 3.5.[25, 37] This implant type is mainly used in heavily atrophic jaws but with sufficient bone height. The mini-implant gives the dentist the ability to avoid bone augmentation procedure, which is considered a time and cost-consuming surgical intervention. Avoiding additional surgical procedures can reduce morbidity and possible complications such as nerve trauma, hemorrhage, postoperative pain, or infection.[25] The infection may lead to the failure of bone grafting.[25] Above that, it is less invasive than the standard implant as it requires a smaller implant bed and no flap in a considerable number of cases.[26] Therefore, it is more appropriate for the compromised or elderly patients. Moreover, it is cost-effective and affordable. On the other hand, the small diameter of the implant may create a shear load to the crestal bone. That may increase the risk of bone resorption.[37, 39] Narrow -implant has been linked to biomechanical risk factors as implant fatigue or fracture, particularly when used in the canine area where high occlusal loads are applied or in parafunctional habits patients.[40].
A systematic review and meta-analysis reported that mini-implants (diameter < 3.0 mm) performed substantially worse than standard diameter implants with survival rates of 94.7 ± 5%.[25] However, narrow implants with a diameter (3–3.5 mm) have a better survival rate of 97.7 ± 2.3%.[25] Therefore, some researchers believe the best approach for a thin bone is bone augmentation.[37] If this is not feasible, narrow implant, osteoplasty and standard implant, or one-piece mini-implant with ball attachment and removable denture can be considered, Figure 23.
The small diameter implant is used to replace missing individual teeth in the anterior region, lower and upper jaw [41, 42]. Mini-implant is used as an orthodontic implant or transitional or provisional implant to support interim prostheses during the healing period after extensive implantations or augmentations and bone grafting.[43] The one-piece mini-implant with ball attachment is used as assisting / anchoring element under the removable denture.[1] Strategic min-implant under existing RPD and CD proved to be a reliable and straightforward approach.[1, 8, 44] New studies reported that the one-piece mini-implant with ball attachment has a significant advantage on the final prosthodontic treatment.[1, 8].
The one-piece implant mimics nature by having a solid unibody structure with no microgaps between the implant and the abutment. As a result, the possible biological complication (bone resorption) and structural flaw are reduced. Also, the flap or flapless single-stage surgery allows the dentist to implement immediate loading or immediate restoration.[42] Moreover, delayed loading is possible by preparing a recess against the mini-implant in the RPD’s tissue surface. The treatment protocol can be conventional or delayed loading. However, the recess (cavity) distorts the fit of the RPD’s, Figure 24.
On the other hand, if the mini-implants are inserted in a healthy, not compromised patent with insertion torque ≥35 Ncm, immediate loading can be considered. The immediate restoration with immediate loading can be implemented through one of two forms:
immediate loading using soft relining material, Figure 22.
immediate loading using the matrix pick-up (housings), Figure 25.
After implantation, soft relining material can restore the fit of the RPD, ease tissue pressure, and give the patient a secure feeling because the relining material encircles the implant head and minimizes RPD rocking. If all mini-implants have a high insertion torque, the patient can receive the final restoration with matrix pick-up (housings). Subsequently, no additional session for adjusting the RPD is needed. In this approach, the patient can directly feel and recognize the significant improvement in the RPD in many domains especially, retention, support stability, and chewing.[1, 8].
Studies proved that inserting strategic implants under existing RPD improves patient satisfaction on short- and medium-term follow-up (3-years).[1, 43] The improvement can be explained by the symmetrical distribution of the abutments and the increased number of the rests/abutments.[1, 17] Gorai S, et al. study reported a correlation between the rests number and denture usage.[17].
To sum it up, using strategic implants under existing RPD upgrade the design to more favorable support type and improve patient satisfaction with the RPD on several domains like speaking, chewing, retention, stability, and support of the RPD. This improvement could be reached earlier if the patient received immediate loading.[1].
In many cases, after putting into consideration the patient’s main complaint, expectation, desire, general health, intraoral/extraoral findings, evaluating the risks (do no harm) and the benefits of bone grafting and several implants, the dentist is able to provide his patient with one or few strategic standard or mini-implants that can satisfy the patients’ needs
Strategic implants can also improve chewing ability, stabilize the occlusion, increase bite force and improve patient oral health-related quality of life. Moreover, better distribution of occlusal forces that may reduce bone resorption may be gained. Furthermore, strategic implants can improve comfort, confidence, and esthetics by reducing the RPD size and removing metal clasps from the esthetic zone.
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She obtained a BSc from the University of Derby, England, a master’s degree from Technische Universität München, Germany, and a Ph.D. from the University of Nottingham. She undertook a post-doctoral research fellowship in the School of Medicine before accepting tenure in Veterinary Medicine and Science. Dr. Rutland also obtained an MMedSci (Medical Education) and a Postgraduate Certificate in Higher Education (PGCHE). She is the author of more than sixty peer-reviewed journal articles, twelve books/book chapters, and more than 100 research abstracts in cardiovascular biology and oncology. She is a board member of the European Association of Veterinary Anatomists, Fellow of the Anatomical Society, and Senior Fellow of the Higher Education Academy. 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He studied \r\nchemistry at the Universidad Nacional de La Plata, Argentina, where received aPh.D. degree in chemistry (Biological Branch) in 1965. From\r\n1964 to 1974, he worked as Assistant in Biochemistry at the School of MedicineUniversidad Nacional de La Plata, Argentina. From 1974 to 1976, he was a Fellowof the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor oBiochemistry at the Universidad Nacional de La Plata, Argentina. He is Member ofthe National Research Council (CONICET), Argentina, and Argentine Society foBiochemistry and Molecular Biology (SAIB). His laboratory has been interested for manyears in the lipid peroxidation of biological membranes from various tissues and different species. Professor Catalá has directed twelve doctoral theses, publishedover 100 papers in peer reviewed journals, several chapters in books andtwelve edited books. 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Angel Catalá belongto the Editorial Board of Journal of lipids, International Review of Biophysical ChemistryFrontiers in Membrane Physiology and Biophysics, World Journal oExperimental Medicine and Biochemistry Research International, W orld Journal oBiological Chemistry, Oxidative Medicine and Cellular Longevity, Diabetes and thePancreas, International Journal of Chronic Diseases & Therapy, International Journal oNutrition, Co-Editor of The Open Biology Journal.",institutionString:null,institution:{name:"National University of La Plata",institutionURL:null,country:{name:"Argentina"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"186048",title:"Prof.",name:"Ines",middleName:null,surname:"Drenjančević",slug:"ines-drenjancevic",fullName:"Ines Drenjančević",profilePictureURL:"https://mts.intechopen.com/storage/users/186048/images/5818_n.jpg",institutionString:null,institution:{name:"University of Osijek",institutionURL:null,country:{name:"Croatia"}}},{id:"187859",title:"Prof.",name:"Kusal",middleName:"K.",surname:"Das",slug:"kusal-das",fullName:"Kusal Das",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBDeQAO/Profile_Picture_1623411145568",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"79615",title:"Dr.",name:"Robson",middleName:null,surname:"Faria",slug:"robson-faria",fullName:"Robson Faria",profilePictureURL:"https://mts.intechopen.com/storage/users/79615/images/system/79615.png",institutionString:null,institution:{name:"Oswaldo Cruz Foundation",institutionURL:null,country:{name:"Brazil"}}},{id:"84459",title:"Prof.",name:"Valerie",middleName:null,surname:"Chappe",slug:"valerie-chappe",fullName:"Valerie Chappe",profilePictureURL:"https://mts.intechopen.com/storage/users/84459/images/system/84459.jpg",institutionString:null,institution:{name:"Dalhousie University",institutionURL:null,country:{name:"Canada"}}}]},{id:"12",title:"Human Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. 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His research interest focuses on computational chemistry and molecular modeling of diverse systems of pharmacological, food, and alternative energy interests by resorting to DFT and Conceptual DFT. He has authored a coauthored more than 255 peer-reviewed papers, 32 book chapters, and 2 edited books. He has delivered speeches at many international and domestic conferences. He serves as a reviewer for more than eighty international journals, books, and research proposals as well as an editor for special issues of renowned scientific journals.",institutionString:"Centro de Investigación en Materiales Avanzados",institution:{name:"Centro de Investigación en Materiales Avanzados",country:{name:"Mexico"}}},{id:"76477",title:"Prof.",name:"Mirza",middleName:null,surname:"Hasanuzzaman",slug:"mirza-hasanuzzaman",fullName:"Mirza Hasanuzzaman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/76477/images/system/76477.png",biography:"Dr. Mirza Hasanuzzaman is a Professor of Agronomy at Sher-e-Bangla Agricultural University, Bangladesh. He received his Ph.D. in Plant Stress Physiology and Antioxidant Metabolism from Ehime University, Japan, with a scholarship from the Japanese Government (MEXT). Later, he completed his postdoctoral research at the Center of Molecular Biosciences, University of the Ryukyus, Japan, as a recipient of the Japan Society for the Promotion of Science (JSPS) postdoctoral fellowship. He was also the recipient of the Australian Government Endeavour Research Fellowship for postdoctoral research as an adjunct senior researcher at the University of Tasmania, Australia. Dr. Hasanuzzaman’s current work is focused on the physiological and molecular mechanisms of environmental stress tolerance. Dr. Hasanuzzaman has published more than 150 articles in peer-reviewed journals. He has edited ten books and written more than forty book chapters on important aspects of plant physiology, plant stress tolerance, and crop production. According to Scopus, Dr. Hasanuzzaman’s publications have received more than 10,500 citations with an h-index of 53. He has been named a Highly Cited Researcher by Clarivate. He is an editor and reviewer for more than fifty peer-reviewed international journals and was a recipient of the “Publons Peer Review Award” in 2017, 2018, and 2019. He has been honored by different authorities for his outstanding performance in various fields like research and education, and he has received the World Academy of Science Young Scientist Award (2014) and the University Grants Commission (UGC) Award 2018. He is a fellow of the Bangladesh Academy of Sciences (BAS) and the Royal Society of Biology.",institutionString:"Sher-e-Bangla Agricultural University",institution:{name:"Sher-e-Bangla Agricultural University",country:{name:"Bangladesh"}}},{id:"187859",title:"Prof.",name:"Kusal",middleName:"K.",surname:"Das",slug:"kusal-das",fullName:"Kusal Das",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBDeQAO/Profile_Picture_1623411145568",biography:"Kusal K. Das is a Distinguished Chair Professor of Physiology, Shri B. M. Patil Medical College and Director, Centre for Advanced Medical Research (CAMR), BLDE (Deemed to be University), Vijayapur, Karnataka, India. Dr. Das did his M.S. and Ph.D. in Human Physiology from the University of Calcutta, Kolkata. His area of research is focused on understanding of molecular mechanisms of heavy metal activated low oxygen sensing pathways in vascular pathophysiology. He has invented a new method of estimation of serum vitamin E. His expertise in critical experimental protocols on vascular functions in experimental animals was well documented by his quality of publications. He was a Visiting Professor of Medicine at University of Leeds, United Kingdom (2014-2016) and Tulane University, New Orleans, USA (2017). For his immense contribution in medical research Ministry of Science and Technology, Government of India conferred him 'G.P. Chatterjee Memorial Research Prize-2019” and he is also the recipient of 'Dr.Raja Ramanna State Scientist Award 2015” by Government of Karnataka. He is a Fellow of the Royal Society of Biology (FRSB), London and Honorary Fellow of Karnataka Science and Technology Academy, Department of Science and Technology, Government of Karnataka.",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"243660",title:"Dr.",name:"Mallanagouda Shivanagouda",middleName:null,surname:"Biradar",slug:"mallanagouda-shivanagouda-biradar",fullName:"Mallanagouda Shivanagouda Biradar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243660/images/system/243660.jpeg",biography:"M. S. Biradar is Vice Chancellor and Professor of Medicine of\nBLDE (Deemed to be University), Vijayapura, Karnataka, India.\nHe obtained his MD with a gold medal in General Medicine and\nhas devoted himself to medical teaching, research, and administrations. He has also immensely contributed to medical research\non vascular medicine, which is reflected by his numerous publications including books and book chapters. Professor Biradar was\nalso Visiting Professor at Tulane University School of Medicine, New Orleans, USA.",institutionString:"BLDE (Deemed to be University)",institution:{name:"BLDE University",country:{name:"India"}}},{id:"289796",title:"Dr.",name:"Swastika",middleName:null,surname:"Das",slug:"swastika-das",fullName:"Swastika Das",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/289796/images/system/289796.jpeg",biography:"Swastika N. Das is Professor of Chemistry at the V. P. Dr. P. G.\nHalakatti College of Engineering and Technology, BLDE (Deemed\nto be University), Vijayapura, Karnataka, India. She obtained an\nMSc, MPhil, and PhD in Chemistry from Sambalpur University,\nOdisha, India. Her areas of research interest are medicinal chemistry, chemical kinetics, and free radical chemistry. She is a member\nof the investigators who invented a new modified method of estimation of serum vitamin E. She has authored numerous publications including book\nchapters and is a mentor of doctoral curriculum at her university.",institutionString:"BLDEA’s V.P.Dr.P.G.Halakatti College of Engineering & Technology",institution:{name:"BLDE University",country:{name:"India"}}},{id:"248459",title:"Dr.",name:"Akikazu",middleName:null,surname:"Takada",slug:"akikazu-takada",fullName:"Akikazu Takada",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248459/images/system/248459.png",biography:"Akikazu Takada was born in Japan, 1935. After graduation from\nKeio University School of Medicine and finishing his post-graduate studies, he worked at Roswell Park Memorial Institute NY,\nUSA. He then took a professorship at Hamamatsu University\nSchool of Medicine. In thrombosis studies, he found the SK\npotentiator that enhances plasminogen activation by streptokinase. He is very much interested in simultaneous measurements\nof fatty acids, amino acids, and tryptophan degradation products. By using fatty\nacid analyses, he indicated that plasma levels of trans-fatty acids of old men were\nfar higher in the US than Japanese men. . He also showed that eicosapentaenoic acid\n(EPA) and docosahexaenoic acid (DHA) levels are higher, and arachidonic acid\nlevels are lower in Japanese than US people. By using simultaneous LC/MS analyses\nof plasma levels of tryptophan metabolites, he recently found that plasma levels of\nserotonin, kynurenine, or 5-HIAA were higher in patients of mono- and bipolar\ndepression, which are significantly different from observations reported before. In\nview of recent reports that plasma tryptophan metabolites are mainly produced by\nmicrobiota. He is now working on the relationships between microbiota and depression or autism.",institutionString:"Hamamatsu University School of Medicine",institution:{name:"Hamamatsu University School of Medicine",country:{name:"Japan"}}},{id:"137240",title:"Prof.",name:"Mohammed",middleName:null,surname:"Khalid",slug:"mohammed-khalid",fullName:"Mohammed Khalid",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/137240/images/system/137240.png",biography:"Mohammed Khalid received his B.S. degree in chemistry in 2000 and Ph.D. degree in physical chemistry in 2007 from the University of Khartoum, Sudan. He moved to School of Chemistry, Faculty of Science, University of Sydney, Australia in 2009 and joined Dr. Ron Clarke as a postdoctoral fellow where he worked on the interaction of ATP with the phosphoenzyme of the Na+/K+-ATPase and dual mechanisms of allosteric acceleration of the Na+/K+-ATPase by ATP; then he went back to Department of Chemistry, University of Khartoum as an assistant professor, and in 2014 he was promoted as an associate professor. In 2011, he joined the staff of Department of Chemistry at Taif University, Saudi Arabia, where he is currently an assistant professor. His research interests include the following: P-Type ATPase enzyme kinetics and mechanisms, kinetics and mechanisms of redox reactions, autocatalytic reactions, computational enzyme kinetics, allosteric acceleration of P-type ATPases by ATP, exploring of allosteric sites of ATPases, and interaction of ATP with ATPases located in cell membranes.",institutionString:"Taif University",institution:{name:"Taif University",country:{name:"Saudi Arabia"}}},{id:"63810",title:"Prof.",name:"Jorge",middleName:null,surname:"Morales-Montor",slug:"jorge-morales-montor",fullName:"Jorge Morales-Montor",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/63810/images/system/63810.png",biography:"Dr. Jorge Morales-Montor was recognized with the Lola and Igo Flisser PUIS Award for best graduate thesis at the national level in the field of parasitology. He received a fellowship from the Fogarty Foundation to perform postdoctoral research stay at the University of Georgia. He has 153 journal articles to his credit. He has also edited several books and published more than fifty-five book chapters. He is a member of the Mexican Academy of Sciences, Latin American Academy of Sciences, and the National Academy of Medicine. He has received more than thirty-five awards and has supervised numerous bachelor’s, master’s, and Ph.D. students. Dr. Morales-Montor is the past president of the Mexican Society of Parasitology.",institutionString:"National Autonomous University of Mexico",institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}},{id:"217215",title:"Dr.",name:"Palash",middleName:null,surname:"Mandal",slug:"palash-mandal",fullName:"Palash Mandal",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217215/images/system/217215.jpeg",biography:null,institutionString:"Charusat University",institution:null},{id:"49739",title:"Dr.",name:"Leszek",middleName:null,surname:"Szablewski",slug:"leszek-szablewski",fullName:"Leszek Szablewski",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49739/images/system/49739.jpg",biography:"Leszek Szablewski is a professor of medical sciences. He received his M.S. in the Faculty of Biology from the University of Warsaw and his PhD degree from the Institute of Experimental Biology Polish Academy of Sciences. He habilitated in the Medical University of Warsaw, and he obtained his degree of Professor from the President of Poland. Professor Szablewski is the Head of Chair and Department of General Biology and Parasitology, Medical University of Warsaw. Professor Szablewski has published over 80 peer-reviewed papers in journals such as Journal of Alzheimer’s Disease, Biochim. Biophys. Acta Reviews of Cancer, Biol. Chem., J. Biomed. Sci., and Diabetes/Metabol. Res. Rev, Endocrine. He is the author of two books and four book chapters. He has edited four books, written 15 scripts for students, is the ad hoc reviewer of over 30 peer-reviewed journals, and editorial member of peer-reviewed journals. Prof. Szablewski’s research focuses on cell physiology, genetics, and pathophysiology. He works on the damage caused by lack of glucose homeostasis and changes in the expression and/or function of glucose transporters due to various diseases. He has given lectures, seminars, and exercises for students at the Medical University.",institutionString:"Medical University of Warsaw",institution:{name:"Medical University of Warsaw",country:{name:"Poland"}}},{id:"173123",title:"Dr.",name:"Maitham",middleName:null,surname:"Khajah",slug:"maitham-khajah",fullName:"Maitham Khajah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/173123/images/system/173123.jpeg",biography:"Dr. Maitham A. Khajah received his degree in Pharmacy from Faculty of Pharmacy, Kuwait University, in 2003 and obtained his PhD degree in December 2009 from the University of Calgary, Canada (Gastrointestinal Science and Immunology). Since January 2010 he has been assistant professor in Kuwait University, Faculty of Pharmacy, Department of Pharmacology and Therapeutics. His research interest are molecular targets for the treatment of inflammatory bowel disease (IBD) and the mechanisms responsible for immune cell chemotaxis. He cosupervised many students for the MSc Molecular Biology Program, College of Graduate Studies, Kuwait University. Ever since joining Kuwait University in 2010, he got various grants as PI and Co-I. He was awarded the Best Young Researcher Award by Kuwait University, Research Sector, for the Year 2013–2014. He was a member in the organizing committee for three conferences organized by Kuwait University, Faculty of Pharmacy, as cochair and a member in the scientific committee (the 3rd, 4th, and 5th Kuwait International Pharmacy Conference).",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"195136",title:"Dr.",name:"Aya",middleName:null,surname:"Adel",slug:"aya-adel",fullName:"Aya Adel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/195136/images/system/195136.jpg",biography:"Dr. Adel works as an Assistant Lecturer in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. Dr. Adel is especially interested in joint attention and its impairment in autism spectrum disorder",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"94911",title:"Dr.",name:"Boulenouar",middleName:null,surname:"Mesraoua",slug:"boulenouar-mesraoua",fullName:"Boulenouar Mesraoua",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94911/images/system/94911.png",biography:"Dr Boulenouar Mesraoua is the Associate Professor of Clinical Neurology at Weill Cornell Medical College-Qatar and a Consultant Neurologist at Hamad Medical Corporation at the Neuroscience Department; He graduated as a Medical Doctor from the University of Oran, Algeria; he then moved to Belgium, the City of Liege, for a Residency in Internal Medicine and Neurology at Liege University; after getting the Belgian Board of Neurology (with high marks), he went to the National Hospital for Nervous Diseases, Queen Square, London, United Kingdom for a fellowship in Clinical Neurophysiology, under Pr Willison ; Dr Mesraoua had also further training in Epilepsy and Continuous EEG Monitoring for two years (from 2001-2003) in the Neurophysiology department of Zurich University, Switzerland, under late Pr Hans Gregor Wieser ,an internationally known epileptologist expert. \n\nDr B. Mesraoua is the Director of the Neurology Fellowship Program at the Neurology Section and an active member of the newly created Comprehensive Epilepsy Program at Hamad General Hospital, Doha, Qatar; he is also Assistant Director of the Residency Program at the Qatar Medical School. \nDr B. Mesraoua's main interests are Epilepsy, Multiple Sclerosis, and Clinical Neurology; He is the Chairman and the Organizer of the well known Qatar Epilepsy Symposium, he is running yearly for the past 14 years and which is considered a landmark in the Gulf region; He has also started last year , together with other epileptologists from Qatar, the region and elsewhere, a yearly International Epilepsy School Course, which was attended by many neurologists from the Area.\n\nInternationally, Dr Mesraoua is an active and elected member of the Commission on Eastern Mediterranean Region (EMR ) , a regional branch of the International League Against Epilepsy (ILAE), where he represents the Middle East and North Africa(MENA ) and where he holds the position of chief of the Epilepsy Epidemiology Section; Dr Mesraoua is a member of the American Academy of Neurology, the Europeen Academy of Neurology and the American Epilepsy Society.\n\nDr Mesraoua's main objectives are to encourage frequent gathering of the epileptologists/neurologists from the MENA region and the rest of the world, promote Epilepsy Teaching in the MENA Region, and encourage multicenter studies involving neurologists and epileptologists in the MENA region, particularly epilepsy epidemiological studies. \n\nDr. Mesraoua is the recipient of two research Grants, as the Lead Principal Investigator (750.000 USD and 250.000 USD) from the Qatar National Research Fund (QNRF) and the Hamad Hospital Internal Research Grant (IRGC), on the following topics : “Continuous EEG Monitoring in the ICU “ and on “Alpha-lactoalbumin , proof of concept in the treatment of epilepsy” .Dr Mesraoua is a reviewer for the journal \"seizures\" (Europeen Epilepsy Journal ) as well as dove journals ; Dr Mesraoua is the author and co-author of many peer reviewed publications and four book chapters in the field of Epilepsy and Clinical Neurology",institutionString:"Weill Cornell Medical College in Qatar",institution:{name:"Weill Cornell Medical College in Qatar",country:{name:"Qatar"}}},{id:"282429",title:"Prof.",name:"Covanis",middleName:null,surname:"Athanasios",slug:"covanis-athanasios",fullName:"Covanis Athanasios",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/282429/images/system/282429.jpg",biography:null,institutionString:"Neurology-Neurophysiology Department of the Children Hospital Agia Sophia",institution:null},{id:"190980",title:"Prof.",name:"Marwa",middleName:null,surname:"Mahmoud Saleh",slug:"marwa-mahmoud-saleh",fullName:"Marwa Mahmoud Saleh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/190980/images/system/190980.jpg",biography:"Professor Marwa Mahmoud Saleh is a doctor of medicine and currently works in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. She got her doctoral degree in 1991 and her doctoral thesis was accomplished in the University of Iowa, United States. Her publications covered a multitude of topics as videokymography, cochlear implants, stuttering, and dysphagia. She has lectured Egyptian phonology for many years. Her recent research interest is joint attention in autism.",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"259190",title:"Dr.",name:"Syed Ali Raza",middleName:null,surname:"Naqvi",slug:"syed-ali-raza-naqvi",fullName:"Syed Ali Raza Naqvi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259190/images/system/259190.png",biography:"Dr. Naqvi is a radioanalytical chemist and is working as an associate professor of analytical chemistry in the Department of Chemistry, Government College University, Faisalabad, Pakistan. Advance separation techniques, nuclear analytical techniques and radiopharmaceutical analysis are the main courses that he is teaching to graduate and post-graduate students. In the research area, he is focusing on the development of organic- and biomolecule-based radiopharmaceuticals for diagnosis and therapy of infectious and cancerous diseases. Under the supervision of Dr. Naqvi, three students have completed their Ph.D. degrees and 41 students have completed their MS degrees. He has completed three research projects and is currently working on 2 projects entitled “Radiolabeling of fluoroquinolone derivatives for the diagnosis of deep-seated bacterial infections” and “Radiolabeled minigastrin peptides for diagnosis and therapy of NETs”. He has published about 100 research articles in international reputed journals and 7 book chapters. Pakistan Institute of Nuclear Science & Technology (PINSTECH) Islamabad, Punjab Institute of Nuclear Medicine (PINM), Faisalabad and Institute of Nuclear Medicine and Radiology (INOR) Abbottabad are the main collaborating institutes.",institutionString:"Government College University",institution:{name:"Government College University, Faisalabad",country:{name:"Pakistan"}}},{id:"58390",title:"Dr.",name:"Gyula",middleName:null,surname:"Mozsik",slug:"gyula-mozsik",fullName:"Gyula Mozsik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/58390/images/system/58390.png",biography:"Gyula Mózsik MD, Ph.D., ScD (med), is an emeritus professor of Medicine at the First Department of Medicine, Univesity of Pécs, Hungary. He was head of this department from 1993 to 2003. His specializations are medicine, gastroenterology, clinical pharmacology, clinical nutrition, and dietetics. His research fields are biochemical pharmacological examinations in the human gastrointestinal (GI) mucosa, mechanisms of retinoids, drugs, capsaicin-sensitive afferent nerves, and innovative pharmacological, pharmaceutical, and nutritional (dietary) research in humans. He has published about 360 peer-reviewed papers, 197 book chapters, 692 abstracts, 19 monographs, and has edited 37 books. He has given about 1120 regular and review lectures. He has organized thirty-eight national and international congresses and symposia. He is the founder of the International Conference on Ulcer Research (ICUR); International Union of Pharmacology, Gastrointestinal Section (IUPHAR-GI); Brain-Gut Society symposiums, and gastrointestinal cytoprotective symposiums. He received the Andre Robert Award from IUPHAR-GI in 2014. Fifteen of his students have been appointed as full professors in Egypt, Cuba, and Hungary.",institutionString:"University of Pécs",institution:{name:"University of Pecs",country:{name:"Hungary"}}},{id:"277367",title:"M.Sc.",name:"Daniel",middleName:"Martin",surname:"Márquez López",slug:"daniel-marquez-lopez",fullName:"Daniel Márquez López",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/277367/images/7909_n.jpg",biography:"Msc Daniel Martin Márquez López has a bachelor degree in Industrial Chemical Engineering, a Master of science degree in the same área and he is a PhD candidate for the Instituto Politécnico Nacional. His Works are realted to the Green chemistry field, biolubricants, biodiesel, transesterification reactions for biodiesel production and the manipulation of oils for therapeutic purposes.",institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"196544",title:"Prof.",name:"Angel",middleName:null,surname:"Catala",slug:"angel-catala",fullName:"Angel Catala",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/196544/images/system/196544.jpg",biography:"Angel Catalá studied chemistry at Universidad Nacional de La Plata, Argentina, where he received a Ph.D. in Chemistry (Biological Branch) in 1965. From 1964 to 1974, he worked as an Assistant in Biochemistry at the School of Medicine at the same university. From 1974 to 1976, he was a fellow of the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor of Biochemistry at the Universidad Nacional de La Plata. He is a member of the National Research Council (CONICET), Argentina, and the Argentine Society for Biochemistry and Molecular Biology (SAIB). His laboratory has been interested for many years in the lipid peroxidation of biological membranes from various tissues and different species. Dr. Catalá has directed twelve doctoral theses, published more than 100 papers in peer-reviewed journals, several chapters in books, and edited twelve books. He received awards at the 40th International Conference Biochemistry of Lipids 1999 in Dijon, France. He is the winner of the Bimbo Pan-American Nutrition, Food Science and Technology Award 2006 and 2012, South America, Human Nutrition, Professional Category. In 2006, he won the Bernardo Houssay award in pharmacology, in recognition of his meritorious works of research. Dr. Catalá belongs to the editorial board of several journals including Journal of Lipids; International Review of Biophysical Chemistry; Frontiers in Membrane Physiology and Biophysics; World Journal of Experimental Medicine and Biochemistry Research International; World Journal of Biological Chemistry, Diabetes, and the Pancreas; International Journal of Chronic Diseases & Therapy; and International Journal of Nutrition. He is the co-editor of The Open Biology Journal and associate editor for Oxidative Medicine and Cellular Longevity.",institutionString:"Universidad Nacional de La Plata",institution:{name:"National University of La Plata",country:{name:"Argentina"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",slug:"francisco-javier-martin-romero",fullName:"Francisco Javier Martin-Romero",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",biography:"Francisco Javier Martín-Romero (Javier) is a Professor of Biochemistry and Molecular Biology at the University of Extremadura, Spain. He is also a group leader at the Biomarkers Institute of Molecular Pathology. Javier received his Ph.D. in 1998 in Biochemistry and Biophysics. At the National Cancer Institute (National Institute of Health, Bethesda, MD) he worked as a research associate on the molecular biology of selenium and its role in health and disease. After postdoctoral collaborations with Carlos Gutierrez-Merino (University of Extremadura, Spain) and Dario Alessi (University of Dundee, UK), he established his own laboratory in 2008. The interest of Javier's lab is the study of cell signaling with a special focus on Ca2+ signaling, and how Ca2+ transport modulates the cytoskeleton, migration, differentiation, cell death, etc. He is especially interested in the study of Ca2+ channels, and the role of STIM1 in the initiation of pathological events.",institutionString:null,institution:{name:"University of Extremadura",country:{name:"Spain"}}},{id:"217323",title:"Prof.",name:"Guang-Jer",middleName:null,surname:"Wu",slug:"guang-jer-wu",fullName:"Guang-Jer Wu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217323/images/8027_n.jpg",biography:null,institutionString:null,institution:null},{id:"148546",title:"Dr.",name:"Norma Francenia",middleName:null,surname:"Santos-Sánchez",slug:"norma-francenia-santos-sanchez",fullName:"Norma Francenia Santos-Sánchez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/148546/images/4640_n.jpg",biography:null,institutionString:null,institution:null},{id:"272889",title:"Dr.",name:"Narendra",middleName:null,surname:"Maddu",slug:"narendra-maddu",fullName:"Narendra Maddu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272889/images/10758_n.jpg",biography:null,institutionString:null,institution:null},{id:"242491",title:"Prof.",name:"Angelica",middleName:null,surname:"Rueda",slug:"angelica-rueda",fullName:"Angelica Rueda",position:"Investigador Cinvestav 3B",profilePictureURL:"https://mts.intechopen.com/storage/users/242491/images/6765_n.jpg",biography:null,institutionString:null,institution:null},{id:"88631",title:"Dr.",name:"Ivan",middleName:null,surname:"Petyaev",slug:"ivan-petyaev",fullName:"Ivan Petyaev",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Lycotec (United Kingdom)",country:{name:"United Kingdom"}}},{id:"423869",title:"Ms.",name:"Smita",middleName:null,surname:"Rai",slug:"smita-rai",fullName:"Smita Rai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"424024",title:"Prof.",name:"Swati",middleName:null,surname:"Sharma",slug:"swati-sharma",fullName:"Swati Sharma",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"439112",title:"MSc.",name:"Touseef",middleName:null,surname:"Fatima",slug:"touseef-fatima",fullName:"Touseef Fatima",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"424836",title:"Dr.",name:"Orsolya",middleName:null,surname:"Borsai",slug:"orsolya-borsai",fullName:"Orsolya Borsai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca",country:{name:"Romania"}}},{id:"422262",title:"Ph.D.",name:"Paola Andrea",middleName:null,surname:"Palmeros-Suárez",slug:"paola-andrea-palmeros-suarez",fullName:"Paola Andrea Palmeros-Suárez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Guadalajara",country:{name:"Mexico"}}}]}},subseries:{item:{id:"8",type:"subseries",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",hasOnlineFirst:!1,hasPublishedBooks:!0,annualVolume:11404,editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",slug:"adriano-andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",biography:"Dr. Adriano de Oliveira Andrade graduated in Electrical Engineering at the Federal University of Goiás (Brazil) in 1997. He received his MSc and PhD in Biomedical Engineering respectively from the Federal University of Uberlândia (UFU, Brazil) in 2000 and from the University of Reading (UK) in 2005. He completed a one-year Post-Doctoral Fellowship awarded by the DFAIT (Foreign Affairs and International Trade Canada) at the Institute of Biomedical Engineering of the University of New Brunswick (Canada) in 2010. Currently, he is Professor in the Faculty of Electrical Engineering (UFU). He has authored and co-authored more than 200 peer-reviewed publications in Biomedical Engineering. He has been a researcher of The National Council for Scientific and Technological Development (CNPq-Brazil) since 2009. He has served as an ad-hoc consultant for CNPq, CAPES (Coordination for the Improvement of Higher Education Personnel), FINEP (Brazilian Innovation Agency), and other funding bodies on several occasions. He was the Secretary of the Brazilian Society of Biomedical Engineering (SBEB) from 2015 to 2016, President of SBEB (2017-2018) and Vice-President of SBEB (2019-2020). He was the head of the undergraduate program in Biomedical Engineering of the Federal University of Uberlândia (2015 - June/2019) and the head of the Centre for Innovation and Technology Assessment in Health (NIATS/UFU) since 2010. He is the head of the Postgraduate Program in Biomedical Engineering (UFU, July/2019 - to date). He was the secretary of the Parkinson's Disease Association of Uberlândia (2018-2019). Dr. Andrade's primary area of research is focused towards getting information from the neuromuscular system to understand its strategies of organization, adaptation and controlling in the context of motor neuron diseases. His research interests include Biomedical Signal Processing and Modelling, Assistive Technology, Rehabilitation Engineering, Neuroengineering and Parkinson's Disease.",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,series:{id:"7",title:"Biomedical Engineering",doi:"10.5772/intechopen.71985",issn:"2631-5343"},editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",slug:"hitoshi-tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",slug:"marcus-vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",slug:"ramana-vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},onlineFirstChapters:{paginationCount:0,paginationItems:[]},publishedBooks:{paginationCount:6,paginationItems:[{type:"book",id:"9008",title:"Vitamin K",subtitle:"Recent Topics on the Biology and Chemistry",coverURL:"https://cdn.intechopen.com/books/images_new/9008.jpg",slug:"vitamin-k-recent-topics-on-the-biology-and-chemistry",publishedDate:"March 23rd 2022",editedByType:"Edited by",bookSignature:"Hiroyuki Kagechika and Hitoshi Shirakawa",hash:"8b43add5389ba85743e0a9491e4b9943",volumeInSeries:27,fullTitle:"Vitamin K - Recent Topics on the Biology and Chemistry",editors:[{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",institutionURL:null,country:{name:"Japan"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"9759",title:"Vitamin E in Health and Disease",subtitle:"Interactions, Diseases and Health Aspects",coverURL:"https://cdn.intechopen.com/books/images_new/9759.jpg",slug:"vitamin-e-in-health-and-disease-interactions-diseases-and-health-aspects",publishedDate:"October 6th 2021",editedByType:"Edited by",bookSignature:"Pınar Erkekoglu and Júlia Scherer Santos",hash:"6c3ddcc13626110de289b57f2516ac8f",volumeInSeries:22,fullTitle:"Vitamin E in Health and Disease - Interactions, Diseases and Health Aspects",editors:[{id:"109978",title:"Prof.",name:"Pınar",middleName:null,surname:"Erkekoğlu",slug:"pinar-erkekoglu",fullName:"Pınar Erkekoğlu",profilePictureURL:"https://mts.intechopen.com/storage/users/109978/images/system/109978.jpg",institutionString:"Hacettepe University",institution:{name:"Hacettepe University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7004",title:"Metabolomics",subtitle:"New Insights into Biology and Medicine",coverURL:"https://cdn.intechopen.com/books/images_new/7004.jpg",slug:"metabolomics-new-insights-into-biology-and-medicine",publishedDate:"July 1st 2020",editedByType:"Edited by",bookSignature:"Wael N. 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Fungal infectious illness prevalence and prognosis are determined by the exposure between fungi and host, host immunological state, fungal virulence, and early and accurate diagnosis and treatment. \r\nPatients with both congenital and acquired immunodeficiency are more likely to be infected with opportunistic mycosis. Fungal infectious disease outbreaks are common during the post- disaster rebuilding era, which is characterised by high population density, migration, and poor health and medical conditions.\r\nSystemic or local fungal infection is mainly associated with the fungi directly inhaled or inoculated in the environment during the disaster. The most common fungal infection pathways are human to human (anthropophilic), animal to human (zoophilic), and environment to human (soilophile). Diseases are common as a result of widespread exposure to pathogenic fungus dispersed into the environment. \r\nFungi that are both common and emerging are intertwined. In Southeast Asia, for example, Talaromyces marneffei is an important pathogenic thermally dimorphic fungus that causes systemic mycosis. Widespread fungal infections with complicated and variable clinical manifestations, such as Candida auris infection resistant to several antifungal medicines, Covid-19 associated with Trichoderma, and terbinafine resistant dermatophytosis in India, are among the most serious disorders. \r\nInappropriate local or systemic use of glucocorticoids, as well as their immunosuppressive effects, may lead to changes in fungal infection spectrum and clinical characteristics. Hematogenous candidiasis is a worrisome issue that affects people all over the world, particularly ICU patients. CARD9 deficiency and fungal infection have been major issues in recent years. Invasive aspergillosis is associated with a significant death rate. Special attention should be given to endemic fungal infections, identification of important clinical fungal infections advanced in yeasts, filamentous fungal infections, skin mycobiome and fungal genomes, and immunity to fungal infections.\r\nIn addition, endemic fungal diseases or uncommon fungal infections caused by Mucor irregularis, dermatophytosis, Malassezia, cryptococcosis, chromoblastomycosis, coccidiosis, blastomycosis, histoplasmosis, sporotrichosis, and other fungi, should be monitored. \r\nThis topic includes the research progress on the etiology and pathogenesis of fungal infections, new methods of isolation and identification, rapid detection, drug sensitivity testing, new antifungal drugs, schemes and case series reports. It will provide significant opportunities and support for scientists, clinical doctors, mycologists, antifungal drug researchers, public health practitioners, and epidemiologists from all over the world to share new research, ideas and solutions to promote the development and progress of medical mycology.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",keywords:"Emerging Fungal Pathogens, Invasive Infections, Epidemiology, Cell Membrane, Fungal Virulence, Diagnosis, Treatment"},{id:"5",title:"Parasitic Infectious Diseases",scope:"Parasitic diseases have evolved alongside their human hosts. In many cases, these diseases have adapted so well that they have developed efficient resilience methods in the human host and can live in the host for years. Others, particularly some blood parasites, can cause very acute diseases and are responsible for millions of deaths yearly. Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. Therefore, it is important to conduct studies that examine parasitic infections in the context of the coronavirus pandemic for the benefit of all communities to help foster more informed decisions for the betterment of human and animal health.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology"},{id:"6",title:"Viral Infectious Diseases",scope:"The Viral Infectious Diseases Book Series aims to provide a comprehensive overview of recent research trends and discoveries in various viral infectious diseases emerging around the globe. The emergence of any viral disease is hard to anticipate, which often contributes to death. A viral disease can be defined as an infectious disease that has recently appeared within a population or exists in nature with the rapid expansion of incident or geographic range. This series will focus on various crucial factors related to emerging viral infectious diseases, including epidemiology, pathogenesis, host immune response, clinical manifestations, diagnosis, treatment, and clinical recommendations for managing viral infectious diseases, highlighting the recent issues with future directions for effective therapeutic strategies.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/6.jpg",keywords:"Novel Viruses, Virus Transmission, Virus Evolution, Molecular Virology, Control and Prevention, Virus-host Interaction"}],annualVolumeBook:{},thematicCollection:[],selectedSeries:null,selectedSubseries:null},seriesLanding:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"May 15th, 2022",hasOnlineFirst:!0,numberOfOpenTopics:4,numberOfPublishedChapters:286,numberOfPublishedBooks:27,editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}},subseries:[{id:"14",title:"Cell and Molecular Biology",keywords:"Omics (Transcriptomics; Proteomics; Metabolomics), Molecular Biology, Cell Biology, Signal Transduction and Regulation, Cell Growth and Differentiation, Apoptosis, Necroptosis, Ferroptosis, Autophagy, Cell Cycle, Macromolecules and Complexes, Gene Expression",scope:"The Cell and Molecular Biology topic within the IntechOpen Biochemistry Series aims to rapidly publish contributions on all aspects of cell and molecular biology, including aspects related to biochemical and genetic research (not only in humans but all living beings). We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics include, but are not limited to: Advanced techniques of cellular and molecular biology (Molecular methodologies, imaging techniques, and bioinformatics); Biological activities at the molecular level; Biological processes of cell functions, cell division, senescence, maintenance, and cell death; Biomolecules interactions; Cancer; Cell biology; Chemical biology; Computational biology; Cytochemistry; Developmental biology; Disease mechanisms and therapeutics; DNA, and RNA metabolism; Gene functions, genetics, and genomics; Genetics; Immunology; Medical microbiology; Molecular biology; Molecular genetics; Molecular processes of cell and organelle dynamics; Neuroscience; Protein biosynthesis, degradation, and functions; Regulation of molecular interactions in a cell; Signalling networks and system biology; Structural biology; Virology and microbiology.",annualVolume:11410,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",editor:{id:"165627",title:"Dr.",name:"Rosa María",middleName:null,surname:"Martínez-Espinosa",fullName:"Rosa María Martínez-Espinosa",profilePictureURL:"https://mts.intechopen.com/storage/users/165627/images/system/165627.jpeg",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"79367",title:"Dr.",name:"Ana Isabel",middleName:null,surname:"Flores",fullName:"Ana Isabel Flores",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRpIOQA0/Profile_Picture_1632418099564",institutionString:null,institution:{name:"Hospital Universitario 12 De Octubre",institutionURL:null,country:{name:"Spain"}}},{id:"328234",title:"Ph.D.",name:"Christian",middleName:null,surname:"Palavecino",fullName:"Christian Palavecino",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000030DhEhQAK/Profile_Picture_1628835318625",institutionString:null,institution:{name:"Central University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",fullName:"Francisco Javier Martin-Romero",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",institutionString:null,institution:{name:"University of Extremadura",institutionURL:null,country:{name:"Spain"}}}]},{id:"15",title:"Chemical Biology",keywords:"Phenolic Compounds, Essential Oils, Modification of Biomolecules, Glycobiology, Combinatorial Chemistry, Therapeutic peptides, Enzyme Inhibitors",scope:"Chemical biology spans the fields of chemistry and biology involving the application of biological and chemical molecules and techniques. In recent years, the application of chemistry to biological molecules has gained significant interest in medicinal and pharmacological studies. This topic will be devoted to understanding the interplay between biomolecules and chemical compounds, their structure and function, and their potential applications in related fields. Being a part of the biochemistry discipline, the ideas and concepts that have emerged from Chemical Biology have affected other related areas. This topic will closely deal with all emerging trends in this discipline.",annualVolume:11411,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",institutionString:null,institution:{name:"Anadolu University",institutionURL:null,country:{name:"Turkey"}}},editorTwo:{id:"13652",title:"Prof.",name:"Deniz",middleName:null,surname:"Ekinci",fullName:"Deniz Ekinci",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYLT1QAO/Profile_Picture_1634557223079",institutionString:null,institution:{name:"Ondokuz Mayıs University",institutionURL:null,country:{name:"Turkey"}}},editorThree:null,editorialBoard:[{id:"241413",title:"Dr.",name:"Azhar",middleName:null,surname:"Rasul",fullName:"Azhar Rasul",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRT1oQAG/Profile_Picture_1635251978933",institutionString:null,institution:{name:"Government College University, Faisalabad",institutionURL:null,country:{name:"Pakistan"}}},{id:"178316",title:"Ph.D.",name:"Sergey",middleName:null,surname:"Sedykh",fullName:"Sergey Sedykh",profilePictureURL:"https://mts.intechopen.com/storage/users/178316/images/system/178316.jfif",institutionString:null,institution:{name:"Novosibirsk State University",institutionURL:null,country:{name:"Russia"}}}]},{id:"17",title:"Metabolism",keywords:"Biomolecules Metabolism, Energy Metabolism, Metabolic Pathways, Key Metabolic Enzymes, Metabolic Adaptation",scope:"Metabolism is frequently defined in biochemistry textbooks as the overall process that allows living systems to acquire and use the free energy they need for their vital functions or the chemical processes that occur within a living organism to maintain life. Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. Thus all studies on metabolism will be considered for publication.",annualVolume:11413,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",institutionString:null,institution:{name:"Artois University",institutionURL:null,country:{name:"France"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"243049",title:"Dr.",name:"Anca",middleName:null,surname:"Pantea Stoian",fullName:"Anca Pantea Stoian",profilePictureURL:"https://mts.intechopen.com/storage/users/243049/images/system/243049.jpg",institutionString:null,institution:{name:"Carol Davila University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"203824",title:"Dr.",name:"Attilio",middleName:null,surname:"Rigotti",fullName:"Attilio Rigotti",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institutionString:null,institution:{name:"Pontifical Catholic University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"300470",title:"Dr.",name:"Yanfei (Jacob)",middleName:null,surname:"Qi",fullName:"Yanfei (Jacob) Qi",profilePictureURL:"https://mts.intechopen.com/storage/users/300470/images/system/300470.jpg",institutionString:null,institution:{name:"Centenary Institute of Cancer Medicine and Cell Biology",institutionURL:null,country:{name:"Australia"}}}]},{id:"18",title:"Proteomics",keywords:"Mono- and Two-Dimensional Gel Electrophoresis (1-and 2-DE), Liquid Chromatography (LC), Mass Spectrometry/Tandem Mass Spectrometry (MS; MS/MS), Proteins",scope:"With the recognition that the human genome cannot provide answers to the etiology of a disorder, changes in the proteins expressed by a genome became a focus in research. Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. The Proteomics topic aims to attract contributions on all aspects of MS-based proteomics that, by pushing the boundaries of MS capabilities, may address biological problems that have not been resolved yet.",annualVolume:11414,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",editor:{id:"200689",title:"Prof.",name:"Paolo",middleName:null,surname:"Iadarola",fullName:"Paolo Iadarola",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSCl8QAG/Profile_Picture_1623568118342",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorTwo:{id:"201414",title:"Dr.",name:"Simona",middleName:null,surname:"Viglio",fullName:"Simona Viglio",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKDHQA4/Profile_Picture_1630402531487",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null,editorialBoard:[{id:"72288",title:"Dr.",name:"Arli Aditya",middleName:null,surname:"Parikesit",fullName:"Arli Aditya Parikesit",profilePictureURL:"https://mts.intechopen.com/storage/users/72288/images/system/72288.jpg",institutionString:null,institution:{name:"Indonesia International Institute for Life Sciences",institutionURL:null,country:{name:"Indonesia"}}},{id:"40928",title:"Dr.",name:"Cesar",middleName:null,surname:"Lopez-Camarillo",fullName:"Cesar Lopez-Camarillo",profilePictureURL:"https://mts.intechopen.com/storage/users/40928/images/3884_n.png",institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",institutionURL:null,country:{name:"Mexico"}}},{id:"81926",title:"Dr.",name:"Shymaa",middleName:null,surname:"Enany",fullName:"Shymaa Enany",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRqB9QAK/Profile_Picture_1626163237970",institutionString:null,institution:{name:"Suez Canal University",institutionURL:null,country:{name:"Egypt"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"chapter.detail",path:"/chapters/24658",hash:"",query:{},params:{id:"24658"},fullPath:"/chapters/24658",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()