Nasina Jigeesh

Conventional osteotomy techniques can, in some cases, induce higher stress on bone during implant insertion as a result of higher torque. The aim of the present study was to evaluate and compare the stress exerted on the underlying osseous tissues during the insertion of a tapered implant using different osteotomy techniques through a dynamic finite element analysis which has been widely applied to study biomedical problems through computer-aided software. In three different types of osteotomy techniques, namely conventional (B1), bone tap (B2), and countersink (B3), five models and implants designed per technique were prepared, implant insertion was simulated, and stress exerted by the implant during each was evaluated. Comparison of stress scores on the cortical and cancellous bone at different time points and time intervals from initiation of insertion to the final placement of the implant was made. There was a highly statistically significant difference between B1 and B2 (p = 0.0001) and B2 and B3 (p = 0.0001) groups. In contrast, there was no statistically significant difference in the stress scores between B1 and B3 (p = 0.3080) groups at all time points of implant placement. Overall, a highly significant difference was observed between the stresses exerted in each technique. Within the limitations of our study, bone tap significantly exerted lesser stresses on the entire bone than conventional and countersink type of osteotomy procedures. Considering the stress distribution at the crestal region, the countersink showed lower values in comparison to others.

Aim The present study evaluated maximum principal stress, von Mises stress, and deformation on the mandible and surrounding structures during the insertion of an implant in various anatomical positions. Materials and Methods Finite clement models of straight two-piece implants of 4.5 mm x 11.5 mm were modeled using Ansys software, v. 16.0 (Ansys, Inc., Houston, TX, USA). The mandibular model was derived through cone-beam computed tomography of a cadaveric mandible using Mimics software (Materialise NV, Leuven, Belgium). An osteotomy was performed at the first molar region, second premolar region, lateral incisor region, central incisor region, canine region, and second molar region that had varying bone densities. Implant insertion was simulated with a variable load of 1 - 180 Newton, which was applied axially downward with a rotational velocity of 30 - 120 rpm. Maximum principal stresses, von Mises stress distribution at the implant insertion site, and maximum deformation on the entire mandible were recorded during the insertion of the implants. Results Maximum principal stress was highest in the crestal area of the right first molar region and least in the middle third of the central incisor region during implant insertion. Von Mises stress in the mandible was highest in the right first molar region and the least in the lateral incisor region during implant insertion. The extent deformation was recorded on the x-axis, y-axis, and z-axis of the mandible. Deformation on the x-axis was highest at the crestal region of the canine and least for the lateral incisor. On the y-axis, deformation was highest at the symphysis region during implant insertion at the first molar region and the least at the condylar area during implant placement in the canine area. On the z-axis, the deformation was highest at the condylar region during implant insertion at the first molar region, and the least was observed in the symphysis region during implant placement in the second molar region. Conclusion When overall stress was considered, there is a direct correlation between stress and quality of bone. The highest maximum principal stress and von Mises stress were recorded during the placement of implants in posterior regions of the mandible, which suggests that the presence of dense cortical bone results in higher stress values. The maximum deformation was observed at different regions of the mandible, away from the site of implant insertion. The resultant stress and deformation exerted on the bone during placement of implants at different sites in the mandible varies, which could be detrimental factors in the longevity of the implant.

The success of any project depends upon different dimensions like time, cost, quality and customer satisfaction. Of all these, time and cost have been treated as the most common and major tangible measures from the perspective of both developer and user. Each project phase has a unique set of activities and its successful completion will be influenced by such factors. This paper aims to examine the emphasis attributed to time and cost in handling different phases of pharmaceutical projects. From a survey around four big Indian pharmaceutical companies, useful feedback was collected. After weighing the importance of both time and cost dimensions, analytic hierarchy process (AHP) was used to prioritise different phases of pharmaceutical projects. Results top ranked 'execution' phase followed by 'monitoring and control' phase. The findings are helpful to pharmaceutical project people in successfully completing different phases of projects on the basis of time and cost dimensions.

Purpose: – The purpose of this paper is to examine different possible issues that can contribute to cost escalations in pharmaceutical capital projects and identify remedial measures to control them.Design/methodology/approach: – The study is supported by a detailed survey performed around some big pharmaceutical companies of Indian sub-continent. Various issues that lead to cost escalations of projects have been identified. Both exploratory and confirmatory factor analyzes have been applied to the feedback data.Findings: – The study derived and validated four prominent factors leading to cost escalations. The paper discusses these factors along with the remedies identified to control project cost. Convergent and discriminant validity have been well established for the model.Research limitations/implications: – The data needful for the study were collected from only four big pharmaceutical companies established in Southern India. Through frequent and elaborate interactions with senior project managers of those companies, it became possible to get a consolidated list of reasons that contribute to cost escalations in pharmaceutical projects. The list and the feedback data may be more exhaustive if some more companies would have been surveyed. Future research is committed to cover some more notable pharmaceutical companies both nationally and internationally and enhance the sample size. This would add more strength to the analysis and derive more consistent and validated results.Practical implications: – This study provides necessary support to the project people to analyze different issues that stand as hurdles for project success and enable them to look for remedies to resolve them. The results would help the project managers to enhance their awareness in controlling the project costs. The study stands as a stepping stone and a roadmap to embed further research in this direction.Originality/value: – Since several significant issues impact the progress of the projects, this work focussed on analyzing cost-related issues in projects; since there is meager research work done in the area of pharmaceutical project management, as an attempt to fill the research gap, this work carried out detailed analysis of different issues leading to cost escalations in pharmaceutical capital projects; factor analysis, including exploratory and confirmatory, has been applied to the data collected and several important factors derived and the measurement model well validated; the research work was done in close interaction with the project people working in four big Indian pharmaceutical companies and useful information was collected; in addition to generation of important factors from the factor analysis, the study was further extended to collect various remedies to mitigate the issues that lead to cost escalations; the research work has enough strength to act as a role model to motivate researchers and project people to further their research on other issues and also refine the present work.

Every project will have certain objectives and service levels to be achieved. The success of a project depends on several dimensions like time, cost/budget, quality, etc. and managing a project involves completing the project within time, within budget and with quality to satisfy the users. Because of the significance of health, pharmaceutical companies realized the importance of project management methods and techniques to make available the life saving drugs in time to the needy patients and hospitals. In literature, there is meager information about pharmaceutical project management oriented towards analysis of issues and factors that contribute to the failure or success of projects. This study attempts to analyse different issues that contribute to time delays in pharmaceutical product-based projects, group them under a finite set of prominent factors and identify remedial measures to control those delays. The feedback of project people of some big pharmaceutical firms of Indian sub-continent was collected for this purpose. Exploratory factor analysis (EFA) has been used to reduce the reasons for time delays to a limited number of prominent factors and the EFA model has been further examined by confirmatory factor analysis (CFA) for its validation. Remedial measures under each factor of time delays have been gathered and a framework designed to mitigate the time delays in pharmaceutical projects. The derived factors that delay the pharmaceutical projects include resource, monitoring & control, scheduling and planning problems. Important remedial measures like blended resource approach, estimation and forecast of shortage of labour and skills, regular quality training, etc. have been recommended.