Kan, Joseph Yun Kwong; Rungcharassaeng, Kitchai; Deflorian, Matteo; Weinstein, Tommaso; Wang, Hom-Lay; Testori, Tiziano
An inevitable loss of soft and hard tissue after tooth extraction often results in a compromised site for anterior implant esthetics in both vertical and horizontal dimensions. Immediate implant placement and provisionalization has been a viable option for replacing failing maxillary anterior teeth as it preserves the vertical existing osseous and gingival architecture. With the simultaneous addition of soft- and hard-tissue grafts, the peri-implant horizontal tissue topography can also be maintained. The esthetic success of immediate implant placement and provisionalization procedures is influenced by a number of factors that can be identified as patient-dependent or clinician-dependent. This article describes in detail the process of patient selection, indications, contraindications, diagnosis, treatment planning and treatment execution required to achieve functional and esthetic success with immediate implant placement and provisionalization. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available An advanced technology with implants based has now been developed in recent years.Implant with the bridge superstructure method is employed after variety of considerations where it is expected to meet its function, aesthetics, and comfortability.The alveolar bone existed is one reason for the process of adding bone (bonegraft.This case report proposes to determine the successful insertion of a superstructure anterior implant bridge post autograft.Two female patients were asked to use dental implant anterior with bridge system.The first case, the autograft application is made for a 20-year-old woman with edentulous teeth 11, 21, 22. One year later it was then inserted in the area of dental implant fixture 11 and 22. After 9 months, the healing abutments and the superstructure were inserted too.2 weeks after, the abutments of bridge and crowns of teeth 11, 21 and 22 with a pontic in the teeth 21 had been inserted. The second case, a 46-year-old woman with edentulous 11,12,21,22.They want to change the denture because they did not feel comfortable with the removable denture acrylic.Fixture placement was done a year after autograft.Insertion of healing abutments and the superstructure printing can be done after 6 months.A month later implant abutments and crowns could be inserted.Labial fullness is corrected; an implant-retained in the region of 12 and 21, 12, and 22 used the pontic.Prosthodontic rehabilitation with a fixed denture using the implant bridge after autograft anterior maxilla is an alternative fixed denture placement with satisfactory results, aesthetic correction and comfortably.
Hviid, Ulla; Hviid, Thomas Vauvert F; Rudnicki, Martin
INTRODUCTION AND HYPOTHESIS: The effect of a Pelvicol graft compared with a conventional anterior vaginal repair was evaluated in this randomised controlled study. METHODS: Only patients with a stage II or higher (Ba >or= -1) defect were included. RESULTS: Thirty-one patients were allocated to a ...... group, the difference was 7.0 cm (P implantation of a Pelvicol graft does not improve the POP-Q stage....
Suphanantachat, Supreda; Thovanich, Ketsuda; Nisapakultorn, Kanokwan
The aim of this study was to determine variables associated with implant satisfaction and to evaluate the influence of peri-implant mucosal level on implant satisfaction. Forty patients restored with single-tooth anterior maxillary implants were recruited for the study. The facial and inter-proximal mucosal level of implants was measured. The patients and clinicians were asked to rate their satisfaction with dental implants on various aspects, using the visual analog scale (VAS). The VAS scores of patients and clinicians were compared and correlated. Variables associated with implant satisfaction as well as the influence of peri-implant mucosal level on implant satisfaction were determined. The patients showed high overall esthetic satisfaction (84.5%) with their implants. However, their satisfaction on the harmonization of gingiva (67.4%) was relatively low. The patient's overall esthetic satisfaction was significantly associated with crown color, crown shape, and confidence when smiling, but not the harmonization of gingival margin. The patient's satisfaction with the worth for expense was significantly associated with overall esthetic satisfaction, confidence when smiling, and speaking well. The presence of facial mucosal level ≥ 1 mm (compared with the contralateral tooth) and less than half papilla fill had no significant effect on the overall esthetic satisfaction assessed by patients. However, the presence of less than half papilla fill affected the patient's satisfaction on speech. Peri-implant mucosal level is not a significant factor for the patient's esthetic satisfaction with their anterior maxillary implants. Papillary recession, however, appeared to affect their satisfaction on speech. © 2011 John Wiley & Sons A/S.
Brian R. Subach
Full Text Available Object. The implantation of interbody fusion cages allows for the restoration of disc height and the enlargement of the neuroforaminal space. The purpose of this study was to compare the extent of subsidence occurring after conventional cage placement compared to a novel wider cage placement technique. Methods. This study is a retrospective evaluation of radiographs of patients who underwent stand-alone single level anterior lumbar interbody fusion with lordotic titanium cages and rhBMP-2. Fifty-three patients were evaluated: 39 patients had wide cage placement (6 mm interdevice distance and 14 had narrow cage placement (2 mm interdevice distance. Anterior and posterior intervertebral disc space heights were measured post-operatively and at follow-up imaging. Results. The decrease in anterior intervertebral disc space height was 2.05 mm versus 3.92 mm (<.005 and 1.08 mm versus 3.06 mm in posterior disc space height for the wide cage placement and the narrow cage placement respectively. The proportion of patients with subsidence greater than 2 mm was 41.0% in the wide cage patients and 85.7% for the narrow cage patients (<.005. Conclusions. The wider cage placement significantly reduced the amount of subsidence while allowing for a greater exposed surface area for interbody fusion.
Background The aims and objectives of this study were placement of implants in freshly extracted sockets of anterior teeth and to evaluate the implant stability, peri-implant radiolucency and gingival inflammation around implant over a short period of 30 months. Materials and Methods A total of 12 patients (8 male and 4 female), ranging in the age from 20 to 50 years, from March 2007 to June 2007, were evaluated for immediate implant placement into 22 fresh extraction sockets. Only maxillary and mandibular anterior teeth/roots (central incisors, lateral incisors and canines) were considered for replacement with implants. One piece implant with integrated abutment and integrated surface, non-submerged, threaded and tapered at apical 5 mm, sand-blasted and acid etched surfaced implants (HI-TEC TRX-OP Implants of Life Care Company) were used. Results The mobility was not present in any of the implants at all the follow up visits. There were 2 implants at 6 month, 1 implant at 12 month, 1 implant at 18 month visits, showing peri-implant radiolucency at some sites at bone to implant contact site. Severe gingival inflammation was not observed in any of the implant site. At every follow-up visit, every implant met the criteria of success and none was found to be failed over a 30 months duration i.e. 100% success rate was achieved by implants in immediate extraction socket. Conclusion The success rate of implant survival in this study was found 100%. These implants have fulfilled all the criteria of implant success and based on the defined criteria, the success rate of implants placed in immediate extraction sockets of anterior teeth compared favorably with the conventional implants. The early results of the present study showed that high survival rates with the implants in immediate extraction sockets can be achieved. PMID:26266220
Sabir, Mohammad; Alam, Mohammad Nazish
The aims and objectives of this study were placement of implants in freshly extracted sockets of anterior teeth and to evaluate the implant stability, peri-implant radiolucency and gingival inflammation around implant over a short period of 30 months. A total of 12 patients (8 male and 4 female), ranging in the age from 20 to 50 years, from March 2007 to June 2007, were evaluated for immediate implant placement into 22 fresh extraction sockets. Only maxillary and mandibular anterior teeth/roots (central incisors, lateral incisors and canines) were considered for replacement with implants. One piece implant with integrated abutment and integrated surface, non-submerged, threaded and tapered at apical 5 mm, sand-blasted and acid etched surfaced implants (HI-TEC TRX-OP Implants of Life Care Company) were used. The mobility was not present in any of the implants at all the follow up visits. There were 2 implants at 6 month, 1 implant at 12 month, 1 implant at 18 month visits, showing peri-implant radiolucency at some sites at bone to implant contact site. Severe gingival inflammation was not observed in any of the implant site. At every follow-up visit, every implant met the criteria of success and none was found to be failed over a 30 months duration i.e. 100% success rate was achieved by implants in immediate extraction socket. The success rate of implant survival in this study was found 100%. These implants have fulfilled all the criteria of implant success and based on the defined criteria, the success rate of implants placed in immediate extraction sockets of anterior teeth compared favorably with the conventional implants. The early results of the present study showed that high survival rates with the implants in immediate extraction sockets can be achieved.
AR. Rokn; F. Geramipanah
A 48 year old patient was candidate for anterior mandibular reconstruction by 2 fixtures of Branemark implant. Residual infection lead to removal of one of the implants from the extracted tooth socket. Afterwards, 2 fixtures of Bonefit was inserted adjacent to previously placed Branemark implants and final prosthesis were loaded in a joint cemented and screwed design.
Full Text Available A 48 year old patient was candidate for anterior mandibular reconstruction by 2 fixtures of Branemark implant. Residual infection lead to removal of one of the implants from the extracted tooth socket. Afterwards, 2 fixtures of Bonefit was inserted adjacent to previously placed Branemark implants and final prosthesis were loaded in a joint cemented and screwed design.
Full Text Available Atrophy is most severe during the first month of post-extraction in the anterior maxilla with the degree of horizontal bone resorption being nearly twice as high as that of vertical bone resorption. The loss of the buccal alveolar plate following tooth extraction may lead to palatal implant positioning of the implants. Thus, immediate or early implant placement in the extraction socket has been suggested, because it would reduce the time period and the number of surgical intervention and yield higher patient satisfaction compared with delayed placed implants. However, placement of an implant immediately after tooth extraction may result in a gap between the occlusal portion of the implant and the surrounding alveolar bone crest. In this case report, an implant-supported restoration which is in harmony with the surrounding hard and soft tissue was created by the immediate implant placement with ridge augmentation in anterior region with high satisfaction from the patient.
Full Text Available INTRODUÇÃO: os mini-implantes ortodônticos se estabeleceram como um importante método de ancoragem e vêm auxiliando os ortodontistas nas várias etapas do tratamento ortodôntico, eliminando, em grande parte, a necessidade de colaboração dos pacientes e tornando os resultados mais previsíveis. OBJETIVO: este artigo descreve os principais aspectos do uso dos mini-implantes como auxiliares da fase de retração anterior, trazendo considerações sobre suas indicações, quantidade de movimentação dos dentes anteriores, os vetores de força de retração, o controle vertical, o posicionamento dos mini-implantes, os tipos de apoio na região anterior e a força a ser utilizada. São citados os sítios de instalação mais usados para a retração anterior e abordados fatores que deverão ser controlados durante o fechamento de espaço. Por fim, são citadas algumas considerações clínicas sobre o uso dos mini-implantes nessa importante fase do tratamento ortodôntico.INTRODUCTION: The use of orthodontic mini-implants has settled as an important anchorage method and is aiding the orthodontists in the several stages of the treatment, largely eliminating the need of patients' compliance, and turning the results more predictable. AIM: This article describes the main aspects of the use of mini-implants as auxiliaries on the retraction phase of the anterior teeth, bringing considerations about their indications, amount of movement of the anterior teeth, the vectors of retraction force, the vertical control and evaluation of the incisors vestibulolingual tipping, the positioning of the mini-implants, the support types in the anterior area and the force to be applied. The placement sites best used for the anterior retraction are mentioned, and the factors that should be controlled during the space closure are approached. Lastly, some clinical considerations on the use of mini-implants in such important phase of the orthodontic treatment are
Henningsen, Anders; Smeets, Ralf; Köppen, Kai; Sehner, Susanne; Kornmann, Frank; Gröbe, Alexander; Heiland, Max; Gerlach, Till
Immediate loading of dental implants has been evolving into an appropriate procedure for the treatment of partially edentulous jaws. The purpose of this study was to evaluate the clinical success and radiological outcome of immediately and delayed loaded dental implants in anterior and premolar sites. In this retrospective study, data of 163 individuals requiring tooth removal with subsequent implant placement in anterior and premolar sites were analyzed. Implants were immediately loaded by provisional acrylic resin bridges or loaded with delay. Implants were followed up annually for up to 9 years including intraoral radiographs. A total of 285 implants in 163 patients were placed. 218 implants were immediately loaded and 67 implants with delay. Fifteen implants failed during the follow-up period resulting in survival rates of 94.5% for immediate loading and 95.5% for delayed loading. After an initial decrease of 0.3 mm in the first 12 months the marginal bone level remained stable. No statistically significant differences were found in marginal bone loss between immediately and delayed loaded implants (P = 0.518, 95% CI). Within the limits of this study, immediate loading of immediately subcrestally placed dental implants in anterior and premolar sites is a reliable treatment option for dental rehabilitation. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Seyedan K; Nahidi R
"nBackground and Aims: Soft tissue management with providing the esthetic for restoration of a single implant in the anterior maxilla is of great importance. Tissue training helps to develop a proper emergence profile and natural tooth appearance. The aim of this article was to report a nonsurgical management of undesirable contours of soft tissue around maxillary anterior implants to achieve an optimum appearance. "nMaterials and Methods: A 23-year-old female with congenital missin...
den Hartog, Laurens; Meijer, Henny J A; Vissink, Arjan; Raghoebar, Gerry M
BACKGROUND: The design of the implant neck might be significant for preservation of marginal bone. PURPOSE: To compare the 5-year radiographic and clinical outcome of single anterior implants provided with a smooth neck, a rough neck or a scalloped rough neck. MATERIALS AND METHODS: 93 Patients with
Arjmand, Parnian; Gooi, Patrick; Ahmed, Iqbal Ike K
The Newcoloriris is a silicone implant for cosmetic alteration of iris color. Implantation is associated with significant ocular complications of decreased vision, glaucoma, and corneal edema. Although removal of the implant also entails risks, it is ultimately necessary to preserve vision. We describe a technique for removing the implant that may also reduce intraoperative complications. The implant is explanted using a bimanual technique with small incisions in 3 sections via a "slicing-the-pie" technique using iris microforceps, microscissors, and microinstrumentation. Our patient required removal 5 years after implantation, which is the longest reported interval in the literature. This suggests that as long as these implants are present, ocular structures are at risk. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
Kourtis, Stefanos; Psarri, Christina; Andritsakis, Panagiotis; Doukoudakis, Asterios
The use of implants for the restoration of anterior missing teeth has been established and documented during the past years. However, the use of dental implants in the anterior region is a technique-sensitive procedure. The placement of implants in an ideal position is often not possible because of the lack of sufficient bone. The clinical situation can be further complicated if the teeth were lost as a result of trauma and there is possible damage to the surrounding soft and hard tissues. The restoration of lost anterior teeth and maintenance of the surrounding soft tissues with adequate surgical and prosthetic techniques are a real challenge for the clinician. The aim of this article was to report the laboratory and clinical stages in the restoration of anterior maxillary teeth, which were lost as a result of trauma with implant-supported fixed partial denture. In this case, an intraoperative transfer of the impression posts allowed the construction of provisional restorations, which were inserted at implant uncoverage surgery and contributed significantly to the creation of a better emergence profile and to the final esthetic result. Provisional restorations are an important stage in anterior maxillary implants, allowing guided soft tissue management and creating an esthetic emergence profile.
Andreas L. Ioannou
Full Text Available Implant dentistry has been established as a predictable treatment with excellent clinical success to replace missing or nonrestorable teeth. A successful esthetic implant reconstruction is predicated on two fundamental components: the reproduction of the natural tooth characteristics on the implant crown and the establishment of soft tissue housing that will simulate a healthy periodontium. In order for an implant to optimally rehabilitate esthetics, the peri-implant soft tissues must be preserved and/or augmented by means of periodontal surgical procedures. Clinicians who practice implant dentistry should strive to achieve an esthetically successful outcome beyond just osseointegration. Knowledge of a variety of available techniques and proper treatment planning enables the clinician to meet the ever-increasing esthetic demands as requested by patients. The purpose of this paper is to enhance the implant surgeon’s rationale and techniques beyond that of simply placing a functional restoration in an edentulous site to a level whereby an implant-supported restoration is placed in reconstructed soft tissue, so the site is indiscernible from a natural tooth.
Replacing an anterior tooth using a dental implant has long been a challenge for most clinicians. Implant abutment selection is a crucial aspect of maximizing esthetics, strength, and customization. The author has experienced significant success in this regard over a period of more than 7 years using a lithium-disilicate "H" ("Hybrid") abutment. In this case presentation, a procedure is described for providing these highly esthetic abutment-supported restorations, which may offer significant advantages over traditional options.
Al-Dosari, Abdullah; Al-Rowis, Ra'ed; Moslem, Feras; Alshehri, Fahad; Ballo, Ahmed M.
PURPOSE The aim of this study was to assess the esthetic outcome of maxillary anterior single implants by comparing the esthetic perception of dental professionals and patients. MATERIALS AND METHODS Twenty-three patients with single implants in the esthetic zone were enrolled in this study. Dentists of four different dental specialties (Three orthodontists, three oral surgeons, three prosthodontists, and three periodontists) evaluated the pink esthetic score (PES)/white esthetic score (WES) ...
Rosentritt, Martin; Heidtkamp, Felix; Hösl, Helmut; Hahnel, Sebastian; Preis, Verena
Removable dentures with different denture teeth may provide different performance and resistance in implant and gingival situations, or anterior and posterior applications. Two situations of removable dentures were investigated: gingiva (flexible) and implant (rigid) bearing. For simulating the gingiva/jaw situation, the dentures were supported with flexible lining material. For the implant situation, implants (d = 4.1 mm) were screwed into polymethylenmethacrylate (PMMA) resin. Two commercial (Vita-Physiodens MRP, SR Vivodent/Orthotyp DCL) and two experimental materials (EXP1, EXP2) were investigated in anterior (A) and posterior (P) tooth locations. Chewing simulation was performed, and failures were analyzed (microscopy, SEM). Fracture strength of surviving dentures was determined. Only EXP1 revealed failures during chewing simulation. Failures varied between anterior and posterior locations, and between implant (P:4x; A:7x) or gingiva (P:1x; A:2x) situations. Kaplan-Meier log-rank test revealed significant differences for implant situations (p gingiva bearing (p > 0.093). Fracture testing in the implant situation provided significantly highest values for EXP2 (1476.4 ± 532.2 N) in posterior location, and for DCL (1575.4 ± 264.4 N) and EXP2 (1797.0 ± 604.2 N) in anterior location. For gingival bearing, significantly highest values were found for DCL/P (2148.3 ± 836.3 N), and significantly lowest results for EXP1/A (308.2 ± 115.6 N). For EXP1 + EXP2 + Vita/P and for EXP1/A no significant differences were found between implant- or gingiva-supported situations. Anterior and posterior teeth showed different material-dependent in vitro performance, further influenced by implant/gingiva bearing. While an implant in anterior application increased fracture strength of two materials, it decreased fracture values of 3/4 of the materials in posterior application. Survival of denture teeth may be influenced by material, oral
Bidra, Avinash S; Rungruanganunt, Patchanee
The clinical outcomes of anterior implant abutments are not well reported. Purpose of the Study To systematically review the existing literature to identify survival, mechanical, biological, and esthetic outcomes of anterior implant abutments. An electronic search was performed using PubMed/MEDLINE with specific search terms and predetermined criteria. After application of inclusion and exclusion criteria, the final list of articles was reviewed in-depth to meet the objectives of this review. Systematic application of inclusion and exclusion criteria resulted in identification of 27 studies that described outcomes of anterior implant abutments. Because of substantial heterogeneity of data, true survival, or cumulative survival of abutments could not be calculated. However, the mean failure of abutments was 1.15%, attributable to fractures restricted to ceramic abutments. Mechanical complications included abutment screw loosening, primarily restricted to external hex implants. Biological complications included fistulas and mucosal recession. Esthetic outcomes showed lesser gingival discoloration for zirconia abutments compared with metal abutments. Minimal anterior abutment fractures have been reported and are restricted to ceramic abutments. Studies using spectrophotometry showed lesser gingival discoloration with zirconia abutments, but there is no evidence for difference in patient's esthetic satisfaction between ceramic and metal abutments. For the anterior region, selection of an implant with internal connection and a customized metal abutment (titanium or cast metal) can have the least mechanical complications. Limited existing clinical data indicate reduced peri-implant mucosal discoloration from zirconia abutments, which may be preferable over metal abutments, in patients with thinner mucosal tissues or patients with high or gummy smiles. © 2013 Wiley Periodicals, Inc.
Jeon, Young Hwan; Oh, Joo Hyeong; Yoon, Yup; Kim, Si Young
To evaluate the technical aspects, results and complications of patients with implanted anterior chest wall port. Between April 1997 and June 1999, a total of 63 implanted ports were placed at the anterior chest wall of 63 consecutive patients by interventional radiologists. The indications were chemotherapy in 61 patients and total parenteral nutrition in two. The peripheral portion of the subclavian vein was punctured under fluoroscopic guidance via ipsilateral peripheral vein during venography. A central venous catheter was placed in the superior vena cava, and using the subcutaneous tunneling method, a connected infusion port was implanted at the anterior chest wall. Results and complications were reviewed, and by means of Kaplan-Meier survival analysis, the expected patency of the port was determined. The technical success rate for implanted port at the anterior chest wall was 100% (63/63 patients). In two patients, hematoma and oozing were treated by compression. The duration of port implantation ranged from 12 to 855 (mean, 187) days, and the port patency rate was 305.7±47.6 days. In seven patients (completed chemotherapy (n=3D3), central venous thrombosis (n=3D3) catheter-related infection (n=3D1)), the port was removed. Catheter obstruction occurred in two patients, and in one, the use of urokinase led to successful recanalization. Sixteen patients died of an underlying malignancy, but no catheter-related death was noted. Implantation of an anterior chest wall port is a safe and useful procedure, with long patency, for patients requiring chemotherapy and long-term venous access. (author)
Bell, Christopher; Bell, Robert E
The aim of this study is to compare the success rates of immediately placed and loaded NobelActive implants with the success rate of immediately placed implants that were allowed to osseointigrate prior to loading. The charts of all patients in a private oral surgery office receiving single-unit dental implants in the maxillary anterior region in fresh extraction sites from 2008-2011 were evaluated. All patients receiving NobelActive implants and immediate restorations were included in the study group, while those receiving implants with delayed restorations were included in the control group. Patient records were evaluated for variables such as age, gender, torque values at time of implant placement, smoking habits, use of bisphosphonates, and other significant diseases such as diabetes. The success rate of the study group was 92.9%, whereas the success rate of the control group was 97.6%. This was not statistically significant. Torque values of the failed implants of the study group were similar to those of successful implants in the study group. All implants placed in patients scheduled for immediate loading achieved high torque values and were able to be restored immediately. NobelActive implants were able to obtain high torque values for predictable immediate restoration in fresh extraction sites. Acceptable success rates with excellent soft tissue healing were achieved.
Hof, Markus; Tepper, Gabor; Koller, Barbara; Krainhöfner, Martin; Watzek, Georg; Pommer, Bernhard
Single-tooth replacement of anterior mandibular teeth is frequently complicated by insufficient bucco-lingual bone width and limited mesio-distal space available for implant placement. The aim of the present study was to assess implant esthetics in the partially edentulous anterior mandible. Esthetic evaluation of 43 anterior mandibular single-tooth implants in 15 women and 28 men was performed using esthetic indices (PES = Pink Esthetic Score, PI = Papilla Index, SES = Subjective Esthetic Score) as well as subjective patients' Visual Analogue Scale (VAS) ratings. Clinical and radiological parameters (implant and crown dimensions, pocket depth, bleeding on probing, plaque, keratinized mucosa, marginal bone level, and distance to adjacent teeth) were tested for influence. Implant esthetics were judged satisfactory (PES ≤10) in 42% of implants compared with a patient satisfaction rate of 87%. Correlation between objective indices (PES/PI: rs = 0.62, PES/SES: rs = -0.73, PI/SES: rs = -0.48) was highly significant (P ≤ 0.001); however, no association to subjective patients' ratings could be observed. Type of prosthetic restoration (single crown vs. tulip-shaped double crowns), mesio-distal crown width as well as anatomic crown length significantly affected esthetic scores. Patients' judgment, by contrast, could not be associated to any prognostic factor. Subjective patient satisfaction with implant esthetics in the partially edentulous anterior mandible is high, however, remains hard to predict or objectively quantify. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Raghoebar, GM; Batenburg, RHK; Vissink, A; Reintsema, H
Purpose: This study evaluated the applicability of intraorally harvested autogenous bone grafts for the augmentation of the narrow maxillary alveolar ridge to enable insertion of implants for single tooth replacement. Materials and Methods: Local defects of the anterior maxilla were reconstructed in
Purpose: The aim of the study was to evaluate the biological and technical outcomes of early and delayed placed single tooth implants after 10 years of follow-up. Materials and Methods: Twenty consecutive patients who needed a single tooth replacement in the anterior maxilla were included...... in this study. Ten implants were placed with an early placement protocol, that is, 4 weeks after tooth extraction, whereas the other 10 implants were placed with a conventional delayed placement protocol, for example, 12 weeks after tooth extraction. At the baseline and at the annual re-examinations, pain from...... and delayed implant placement. Patient satisfaction with the implant-supported single crowns reduced with time....
Cranham, J C; Konikoff, A B
This case represents how predictable results can be obtained in a difficult situation if a tried-and-true protocol is closely followed. An atraumatic surgical technique, followed by controlled healing through correct implant placement and the use of a custom-healing abutment, set up the success of the soft tissue component of the case. Meticulous laboratory communication, combined with correct restoration selection, was the final step in the creation of lifelike results.
Full Text Available Background: Dental implant is one of an alternative solutions reconstruction therapy for missing teeth. Complication of dental implant could occurs and leading to implant failure. In order to restore the complication, surgical treatment with guided bone regeneration (GBR is indicated. The potential use of bone substitutes is widely known to be able to regenerate the bone surrounding the implant and maintain bone volume. Purpose: The study aimed to demonstrate the effectiveness of implant-bone fully coverage by using sandwich technique of biphasic calcium phosphate (BCP and demineralized freeze-dried bone allografts (DFDBA bone substitutes combined with collagen resorbable membrane. Case: A 24-year-old male came with diagnosis of peri-implantitis on implant #11. Clinical finding indicated that implant thread was exposed on the labial aspect. Case management: After initial therapy including oral hygiene improvement performed, an operator did a contemporary GBR to correct the defect. Bone graft materials used were 40% β-tri calcium phosphate (β-TCP-60% hydroxyapatite (HA on the outer layer and DFDBA on the inner layer of the defect. Resorbable collagen membrane was used to cover the graft. Conclusion: GBR with sandwich technique could serve as one of the treatment choices for correcting an exposed anterior implant that would enhance the successful aesthetic outcome.
Axmann, Shadi; Paridaens, Dion
Secondary orbital implantation surgery can be complex due to scarring of the orbital tissues and can be complicated by implant exposure and extrusion. To evaluate the incidence and risk factors of implant exposure and extrusion following secondary alloplastic orbital implantation surgery in anophthalmic patients. Retrospective analysis of a consecutive series of patients who underwent secondary placement of an alloplastic orbital implant by one surgeon between 2001 and 2016 in the Rotterdam Eye Hospital. implant exposure or extrusion. Other complications. Sixty-three patients underwent secondary orbital placement of scleral-wrapped acrylic (60) or silicone (three) spherical implants. A subset of 25 patients had undergone earlier secondary orbital implant placement (by other surgeons) with exposure/extrusion necessitating additional implant surgery. Two patients were excluded due to lack of follow-up (Implant exposure or extrusion occurred in six of 18 (33%) patients in whom no muscle had been reattached during secondary orbital implantation and in five of 43 (12%) patients in whom the extraocular recti muscles had been attached, but the follow-up time was shorter for the latter group. Surgical treatment for implant exposure/extrusion was required in eleven of 61 patients (18%). Other complications included postoperative volume deficiency despite optimal prosthesis (five of 61, 8%), inclusion cysts (four of 61, 7%) and conjunctivitis sicca (two of 61, 3%). Seven of 61 (11%) patients required fornix deepening and seven (11%) blepharoptosis correction. Secondary orbital implantation of sclera-wrapped alloplastic implants was complicated by implant extrusion or exposure in 12% of cases in which the extraocular muscles were attached to the implant. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Full Text Available The main goal of this study was to evaluate differences in stress distribution relevant to the number of implants under an anterior bridge when combined with a removable partial denture in the posterior region.Four three-dimensional finite element models (3D FEM were designed from a mandible containing an implant-supported bridge extending between canines, and a bilateral distal extension removable partial denture. A nonrigid connection was selected as the attachment method between the partial denture and the anterior implant-supported fixed prosthesis; 2, 3, 4 and 5 implants supporting the bridge all with 10mm length and 3.8 mm diameter were assessed. With the aid of the finite element program ANSYS 8.0, the models were loaded and von Mises stresses were evaluated.In spongy bone, stress forces showed a decrease from 2 implants to 4 implants but showed an increase in the 5-implant model. Stresses on cortical bone of terminal implants were in similar range in the 2-, 3- and 4-implant models. While, in the 5-implant model the amount of stresses on terminal implants increased dramatically. The stresses on implants were nearly similar in all models, with the greatest amount on terminal implants.Within the limitations of this study, 2-, 3- and 4-implant models showed less stress on cortical and spongy bone in comparison with the 5-implant model. The stresses transferred to implants were nearly similar.
Chu, Stephen J; Salama, Maurice A; Salama, Henry; Garber, David A; Saito, Hanae; Sarnachiaro, Guido O; Tarnow, Dennis P
Improvements in implant designs have helped advance successful immediate anterior implant placement into fresh extraction sockets. Clinical techniques described in this case enable practitioners to achieve predictable esthetic success using a method that limits the amount of buccal contour change of the extraction site ridge and potentially enhances the thickness of the peri-implant soft tissues coronal to the implant-abutment interface. This approach involves atraumatic tooth removal without flap elevation, and placing a bone graft into the residual gap around an immediate fresh-socket anterior implant with a screw-retained provisional restoration acting as a prosthetic socket seal device.
The aim of the study was to evaluate the biological and technical outcomes of early and delayed placed single tooth implants after 10 years of follow-up. Twenty consecutive patients who needed a single tooth replacement in the anterior maxilla were included in this study. Ten implants were placed with an early placement protocol, that is, 4 weeks after tooth extraction, whereas the other 10 implants were placed with a conventional delayed placement protocol, for example, 12 weeks after tooth extraction. At the baseline and at the annual re-examinations, pain from implant regions, mobility, plaque, mucositis, and marginal bone levels were recorded. Biological and technical complications were registered. The patients evaluated the functional and aesthetic outcomes subjectively on a visual analogue scale after 3 and 10 years. All implants were still in situ after 10 years. The cumulative implant survival rate was 100%. Two implant-supported crowns were remade because of ceramic fractures. The 10-year crown survival rate was 90%. No significant differences in implant survival rates were found between the early and delayed protocols, regarding plaque retention, mucositis, or marginal bone levels. After 10 years, the mean marginal bone loss at both sides of the implants was less than 1.0 mm in the two groups. During the 10-year interval, 1 patient lost more than 1.5 mm of marginal bone, 3 patients lost between 1.0 mm and 1.4 mm of bone, and 16 patients lost less than 1.0 mm of bone as an average of the mesial and distal bone loss. This 10-year prospective clinical trial demonstrated a 100% implant survival and a 90% crown survival. The average marginal bone level change was less than 1 mm, and there was no difference between early and delayed implant placement. Patient satisfaction with the implant-supported single crowns reduced with time. © 2009 Wiley Periodicals, Inc.
Bertl, Kristina; Gotfredsen, Klaus; Jensen, Simon S
OBJECTIVES: The present randomized controlled trial aimed to assess the effect of hyaluronan (HY) injections to augment deficient interproximal papillae at implant-supported crowns in the anterior maxilla. METHODS: Twenty-two patients with a deficient papilla in the anterior maxilla next to an im......OBJECTIVES: The present randomized controlled trial aimed to assess the effect of hyaluronan (HY) injections to augment deficient interproximal papillae at implant-supported crowns in the anterior maxilla. METHODS: Twenty-two patients with a deficient papilla in the anterior maxilla next...... to an implant-supported crown were randomly assigned to receive twice either HY (test) or saline solution (control) injection. The following parameters were recorded prior to injection (baseline) and 3 and 6 months after injection: distance between the papilla tip and contact point (PT-CP), modified papilla...... index score (MPIS), and standard clinical periodontal parameters. Pain level after injection was recorded on a visual analogue scale (VAS). The deficient area was evaluated on clinical photographs, and the esthetic appearance was recorded on a VAS. Differences in mucosal volume were assessed after 3...
Gozneli, Rifat; Ozkan, Yasar; Akalin, Zerrin Fidan; Ozkan, Yasemin
Esthetic reconstruction of severe soft and hard tissue deficiencies is the utmost challenge in implant dentistry. To prevent postoperative bone resorption and to control the amount of hard and soft tissue volume, distraction osteogenesis followed by immediate implant placement has been proven to be a promising combined technique. The aim of this report is to introduce a treatment strategy to maintain anterior esthetics and to control hard and soft tissue volume in a case, treated with the combined technique of vertical alveolar distraction and immediate implant placement. An osteotomy was performed by the use of an oscillating saw. Cut alveolar segment was mobilized, and a distractor device was inserted in between the segments. During the activation and consolidation periods of distraction, anterior esthetics was provided with removable acrylic provisional crowns placed on the distractor's rod. In 2 weeks of distraction period, vertically 10 mm of new bony segment was obtained, and 2 weeks after the removal of distractor, maxillary incisors were extracted. Four dental implants were placed according to the immediate placement protocol. In osseointegration period, provisional restorations were fabricated on abutments to form harmonious gingival contours and to maintain maxillary anterior esthetics until the fabrication of final restorations.
Full Text Available "nBackground and Aims: Soft tissue management with providing the esthetic for restoration of a single implant in the anterior maxilla is of great importance. Tissue training helps to develop a proper emergence profile and natural tooth appearance. The aim of this article was to report a nonsurgical management of undesirable contours of soft tissue around maxillary anterior implants to achieve an optimum appearance. "nMaterials and Methods: A 23-year-old female with congenital missing of maxillary lateral incisors, after completion of a fixed orthodontic treatment and gain enough space, received 2 dental implants. After second phase surgery and healing period, construction of the restorations was not possible through conventional method because of severe soft tissue collapse. In this case, soft tissue contours were corrected using a provisional restoration and then final restoration was made and delivered. "nConclusion: Tissue training with a provisional restoration helps to re-establish normal gingival tissue contours and interdental papillae around the restoration of maxillary anterior implants.
Full Text Available Introduction: Many clinical cases and the literature review have revealed implant-supported-overdentures’ (ISOs treatment success and predictability in elderly patients. According to the previous studies, all the mandibular ISOs used 2–4 implants anterior to mental foramen to retain the denture. Case Report: In this clinical report, two individual anterior standard implants and two individual posterior short implants were used to support the mandibular ISO, as well as to prevent further posterior bone resorption. This treatment option permits the patient to insert more implants in the future, and could be upgraded to implant-supported-fixed prosthesis. Discussion: The patient was completely satisfied about the final result, especially for upgrading the mastication efficiency. The patient was followed-up for more than 2 years without complication. The panoramic X-ray showed the preserved bone in the posterior region. This technique could be considered to be innovative, and more clinical cases are required to be documented as a predictable modality.
Yildiz, Pnar; Zortuk, Mustafa; Kiliç, Erdem; Dinçel, Mehmet; Albayrak, Haydar
This study compared the clinical outcomes of 1-year follow-up of immediate and late implant loading after implant restoration of a single tooth in the anterior maxilla. Thirty-three patients with missing teeth in the anterior maxilla were included in this study (18 immediate loading and 15 late loading). Standard periapical radiographs were obtained to evaluate the vertical bone loss around the implant. For both implant groups, periimplant parameters (probing depth, gingival bleeding index, gingival index (GI), modified plaque index, width of keratinized gingiva) were evaluated. There were no significant differences in bone loss, the widths of keratinized gingiva, the GI, and modified plaque index between the immediate implant loading and late implant loading groups (P > 0.05). A significant difference in the probing depth was observed between these groups at the initial and 1-month evaluations (P replacement of a missing tooth in anterior maxilla.
Gurgel, Júlio A; Tavarez, Rudys R; Ursi, Weber J; Neves, Murilo G; Bramante, Fausto S; Pinzan-Vercelino, Célia R M
This clinical report describes an adult patient referred for orthodontic treatment with mini-implants as anchorage to correct the root angulation of maxillary lateral incisors. The purpose of this report was to demonstrate the versatility of mini-implants placed in a vertical direction in esthetic areas. During orthodontic treatment, some aspects must be observed to preserve the interim restoration against the occlusal loads to avoid screw fracture. A fixed appliance was placed to correct the position of the maxillary anterior teeth and to complete the treatment. Acceptable esthetics and function were achieved. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Kammermeier, Armin; Rosentritt, Martin; Behr, Michael; Schneider-Feyrer, Sibylle; Preis, Verena
To investigate the long-term in vitro performance and fracture resistance of one-piece and bonded two-piece zirconia implant systems for anterior application. Two groups of bonded two-piece zirconia (ZZB), four groups of one-piece zirconia (Z), and two groups of two-piece titanium (TTS, reference) implant systems were restored with identical monolithic zirconia crowns (n=10/group). Eight specimens per group were mounted at an angle of 135° in the chewing simulator and subjected to thermal cycling (TC:18,000 cycles; 5°/55°) and mechanical loading (ML:3.6×10(6) cycles; 100N) simulating an anterior situation. Fracture resistance and maximum bending stress were determined for specimens that survived aging and for two references per group after 24h water storage. SEM pictures were used for failure analysis. Data were statistically analysed (one-way-ANOVA, post-hoc Bonferroni, Kaplan-Meier-Log-Rank, α=0.05). A one-piece zirconia and a two-piece titanium implant system survived TCML without failures. Both bonded two-piece zirconia implant systems and a one-piece zirconia implant system totally failed (fractures of abutment or implant). Failure numbers of the other systems varied between 1× (1 group) and 5× (2 groups). Significantly different survival rates were found (Log-Rank-test: p=0.000). Maximum fracture forces/bending stresses varied significantly ( p=0.000) between 188.00±44.80N/381.02±80.15N/mm(2) and 508.67±107.00N/751.45±36.73N/mm(2). Mean fracture values after 24h water storage and TCML were not significantly different. Zirconia implant systems partly showed material defects or connection insufficiencies. Bonded two-piece systems had higher failure rates and lower fracture resistance than one-piece implants. Individual zirconia implant systems may be applied in anterior regions with limitations. Copyright © 2016 Elsevier Ltd. All rights reserved.
de Oliveira, Natalice Sousa; Barbosa, Gabriella Lopes de Rezende; Lanza, Lincoln Dias; Pretti, Henrique
The treatment of choice in cases of avulsed permanent teeth is the immediate reimplantation. However, this conduct does not always work favorably, either by failures in the initial approach or by inappropriate interventions. In this sense, the aim of this study is to present an alternative prosthetic rehabilitation with the use of orthodontic mini-implants in the anterior region. This case reports a ten-year-old child with history of avulsion of superior central incisors. The therapeutic appr...
Chen, Stephen T; Buser, Daniel
The objectives of this systematic review are (1) to quantitatively estimate the esthetic outcomes of implants placed in postextraction sites, and (2) to evaluate the influence of simultaneous bone augmentation procedures on these outcomes. Electronic and manual searches of the dental literature were performed to collect information on esthetic outcomes based on objective criteria with implants placed after extraction of maxillary anterior and premolar teeth. All levels of evidence were accepted (case series studies required a minimum of 5 cases). From 1,686 titles, 114 full-text articles were evaluated and 50 records included for data extraction. The included studies reported on single-tooth implants adjacent to natural teeth, with no studies on multiple missing teeth identified (6 randomized controlled trials, 6 cohort studies, 5 cross-sectional studies, and 33 case series studies). Considerable heterogeneity in study design was found. A meta-analysis of controlled studies was not possible. The available evidence suggests that esthetic outcomes, determined by esthetic indices (predominantly the pink esthetic score) and positional changes of the peri-implant mucosa, may be achieved for single-tooth implants placed after tooth extraction. Immediate (type 1) implant placement, however, is associated with a greater variability in outcomes and a higher frequency of recession of > 1 mm of the midfacial mucosa (eight studies; range 9% to 41% and median 26% of sites, 1 to 3 years after placement) compared to early (type 2 and type 3) implant placement (2 studies; no sites with recession > 1 mm). In two retrospective studies of immediate (type 1) implant placement with bone graft, the facial bone wall was not detectable on cone beam CT in 36% and 57% of sites. These sites had more recession of the midfacial mucosa compared to sites with detectable facial bone. Two studies of early implant placement (types 2 and 3) combined with simultaneous bone augmentation with GBR
Hourfar, Jan; Bister, Dirk; Lisson, Jörg A; Ludwig, Björn
The aim of this retrospective investigation was to evaluate the incidence of loss to pulp sensibility testing (PST) of maxillary front teeth after paramedian (3 to 5 mm away from the suture) orthodontic mini-implant (OMI) insertion in the anterior palate. A total of 284 patients (102 males, 182 females; mean age was 14.4 years (±8.8) years at time of OMI-Insertion) with a total of 568 OMIs (1.7 mm diameter, length 8 mm) were retrospectively investigated. A binomial regression analysis was performed to explore covariates, such as age, gender, inclination of upper central incisors, dentition status and insertion position of OMIs that could have contributed to loss of sensibility. Statistical significance was set at p < 0.05. Loss of response to PST was encountered during retention in 3 out of 284 patients and the respective OMIs had been placed at height of the second rugae (R-2). Affected teeth were a right canine, a left lateral and a left central incisor. Subsequent root canal treatment was successful. Results of the binomial regression analysis revealed that the covariate insertion position (R-2) of OMIs (p = 0.008) had statistically significant influence on loss of response to PST. (1) Although there was no radiographic evidence for direct root injury, the proximity of the implants to the anterior teeth was nevertheless statistically related to loss of PST. (2) In all cases of PST loss OMIs were inserted at the second rugae. Therefore OMIs should be placed either more posteriorly, at the third rugae or in the median plane. (3). Loss of PST was not increased for patients with palatal OMI (0.18%) compared to samples without OMI (0.25%).
Stanley, Miguel; Jordao, Beatriz Mota
Purpose To present the outcomes of immediately loaded single implants placed in the anterior maxilla. Methods Over a 2-year period, all patients referred to a private clinic were considered for enrolment in this study. Inclusion criteria were single-tooth placement in postextraction sockets or healed sites of the anterior maxilla. All implants were immediately loaded and followed for a period of 1 year after the placement of definitive crowns. The outcome measures were implant stability, survival, and success. Results 34 patients were selected and 43 tapered implants with a knife-edge thread design and a nanostructured, calcium-incorporated surface (Anyridge®, Megagen, Gyeongsang, Korea) were installed. Two implants were not sufficiently stable at placement (ISQ immediate loading; 41 implants had an ISQ ≥ 60 at placement and were immediately loaded. One year after the placement of definitive crowns, no implant failures were reported, for a survival rate of 100%. No biological complications were found, but 2 implants had their prosthetic abutments loosened: the implant success rate was 95.2%. Conclusions In the present study on the immediate loading of single implants in the anterior maxilla, positive outcomes were reported, with high survival (100%) and success (95.2%) rates (the present study has been registered in the ISRCTN registry, a publicly available trial register recognized by WHO and ICMJE, with number ISRCTN12935478). PMID:28611844
Full Text Available Purpose. To present the outcomes of immediately loaded single implants placed in the anterior maxilla. Methods. Over a 2-year period, all patients referred to a private clinic were considered for enrolment in this study. Inclusion criteria were single-tooth placement in postextraction sockets or healed sites of the anterior maxilla. All implants were immediately loaded and followed for a period of 1 year after the placement of definitive crowns. The outcome measures were implant stability, survival, and success. Results. 34 patients were selected and 43 tapered implants with a knife-edge thread design and a nanostructured, calcium-incorporated surface (Anyridge®, Megagen, Gyeongsang, Korea were installed. Two implants were not sufficiently stable at placement (ISQ < 60 and were considered failed for immediate loading; 41 implants had an ISQ ≥ 60 at placement and were immediately loaded. One year after the placement of definitive crowns, no implant failures were reported, for a survival rate of 100%. No biological complications were found, but 2 implants had their prosthetic abutments loosened: the implant success rate was 95.2%. Conclusions. In the present study on the immediate loading of single implants in the anterior maxilla, positive outcomes were reported, with high survival (100% and success (95.2% rates (the present study has been registered in the ISRCTN registry, a publicly available trial register recognized by WHO and ICMJE, with number ISRCTN12935478.
Stanley, Miguel; Braga, Filipa Calheiros; Jordao, Beatriz Mota
To present the outcomes of immediately loaded single implants placed in the anterior maxilla. Over a 2-year period, all patients referred to a private clinic were considered for enrolment in this study. Inclusion criteria were single-tooth placement in postextraction sockets or healed sites of the anterior maxilla. All implants were immediately loaded and followed for a period of 1 year after the placement of definitive crowns. The outcome measures were implant stability, survival, and success. 34 patients were selected and 43 tapered implants with a knife-edge thread design and a nanostructured, calcium-incorporated surface (Anyridge®, Megagen, Gyeongsang, Korea) were installed. Two implants were not sufficiently stable at placement (ISQ immediate loading; 41 implants had an ISQ ≥ 60 at placement and were immediately loaded. One year after the placement of definitive crowns, no implant failures were reported, for a survival rate of 100%. No biological complications were found, but 2 implants had their prosthetic abutments loosened: the implant success rate was 95.2%. In the present study on the immediate loading of single implants in the anterior maxilla, positive outcomes were reported, with high survival (100%) and success (95.2%) rates (the present study has been registered in the ISRCTN registry, a publicly available trial register recognized by WHO and ICMJE, with number ISRCTN12935478).
Sullivan, Daniel Y
Significant contributions by clinicians, researchers, and manufacturers have brought us to a previously almost unimaginable point in time, where it is possible to place and restore a single dental implant in the esthetic zone with a success rate above 96% and with the probability that it will look very much like a natural tooth. In addition, in select cases it is possible to do the extraction, implant placement, and provisional restoration on the same day. There is very little trauma at the implant site, which results in greater comfort for the patient and ultimately greater tissue preservation long-term. We have now observed single-tooth anterior implant cases for 15 years and have every belief that these implants will continue to function in health for many years. So what is next? We will have to wait and see, but it is this clinician's hope that the next 15 years will bring us more of these cooperative efforts that have so dramatically improved our patients' lives.
Gao, EnFeng; Hei, Wei-Hong; Park, Jong-Chul; Pang, KangMi; Kim, Sun Kyung; Kim, Bongju; Kim, Soung-Min; Lee, Jong-Ho
Purpose This study assessed marginal bone remodeling and soft tissue esthetics after the loading of single bone-level implants in the anterior maxilla. Methods An open, single-arm observational clinical trial with 3 years of follow-up was performed, including 22 implants. The patients presented with a single tooth gap in the anterior maxilla (tooth positions 14–24), with natural or restored adjacent teeth. An implant was placed at least 8 weeks post-extraction and healed submerged for 6 weeks...
Full Text Available This retrospective study was undertaken to determine survival rates and aesthetic outcomes of immediate placement of multiple implants at anterior maxilla sites. One hundred and eighteen implants placed in 39 patients (21 women and 18 men; average age 58.3 years were immediately restored (24–72 h after placement. Aesthetic assessment, radiographic bone loss, and biological and prosthetic complications were evaluated. Data collection between 12 and 84 months (mean 32.2 ± 18 after final prosthetic installation revealed that no implants were lost, and that 106/118 (89.8% implants had no more than 1.5 mm of bone loss by the end of the first year and an additional 0.2 mm for each successive year. The marginal bone loss was higher for extractions due to periodontitis compared to extractions due to caries (mean mesial loss of 1.37 mm vs. 1.01 mm, respectively, and mean distal loss of 1.37 mm and 0.99 mm, respectively, p = 0.001. The mesial papilla was present in 83/118 implants (70.3%, while the distal papilla was present in 76/118 implants (64.4%. The cervical metallic part of the abutment was exposed in 16/118 (13.5% implants. There was a higher ratio of recessions and missing papillae in patients in whom the extractions were performed due to periodontal reasons. Within the limitations of the present study, aesthetic and radiographic parameters support immediate restoration of partially edentulous maxillae.
Preis, Verena; Kammermeier, Armin; Handel, Gerhard; Rosentritt, Martin
To investigate the influence of the implant-abutment connection on the long-term in vitro performance and fracture resistance of two-piece zirconia implant systems for anterior application. Six groups of two-piece zirconia implant systems (n=10/group) with screw-retained (5×) or bonded (1×) connections were restored with full-contour zirconia crowns. A two-piece screw-retained titanium system served as reference. For simulating anterior loading the specimens (n=8/group) were mounted at an angle of 135° in the chewing simulator, and subjected to thermal cycling (TC: 2×9000×5°/55°C) and mechanical loading (ML: 3.6×10(6)×100N). Failed restorations were examined (scanning electron microscopy). Fracture resistance and maximum bending stress of surviving restorations were determined. 2 specimens per group were loaded to fracture after 24h water storage without TCML. Data were statistically analyzed (ANOVA; Bonferroni; Kaplan-Meier-Log-Rank; α=0.05). The bonded zirconia system and the titanium reference survived TCML without any failures. Screw-retained zirconia systems showed fractures of abutments and/or implants, partly combined with screw fracture/loosening. Failure frequency (F) varied between the groups (F=8×: 3 groups, F=3×: 1 group, F=1×: 1 group). The Log-Rank-test showed significant (p=0.000) differences. Fracture forces and maximum bending stresses (mean±standard deviation) differed significantly ( p=0.000) between 233.4±31.4N/317.1±42.6N/mm(2) and 404.3±15.1N/549.2±20.5N/mm(2). Fracture forces after TCML were similar to 24h fracture forces. Screw-retained two-piece zirconia implant systems showed higher failure rates and lower fracture resistance than a screw-retained titanium system, and may be appropriate for clinical anterior requirements with limitations. Failures involved the abutment/implant region around the screw, indicating that the connecting design is crucial for clinical success. Copyright © 2016 Academy of Dental Materials
Luis Bueno Rossy
Full Text Available Resumen Las recesiones gingivales son un hallazgo clínico frecuente. Son un problema estético, causan hipersensibilidad y dificultad el buen control de placa microbiana. En el caso de implantes las recesiones ocasionan problemas estéticos y su progresión parece no ser frecuente (1. Los procedimientos de cirugía plástica periodontal son los indicados en estos casos, y estas técnicas serán adaptadas” para el tratamiento de áreas peri-implantarias (1. En la literatura existen diferentes propuestas de tratamiento, siendo el Gold Standard el injerto de tejido conjuntivo ya que nos ofrece una mayor tasa de éxito y predicibilidad
de Oliveira, Natalice Sousa; Barbosa, Gabriella Lopes de Rezende; Lanza, Lincoln Dias; Pretti, Henrique
The treatment of choice in cases of avulsed permanent teeth is the immediate reimplantation. However, this conduct does not always work favorably, either by failures in the initial approach or by inappropriate interventions. In this sense, the aim of this study is to present an alternative prosthetic rehabilitation with the use of orthodontic mini-implants in the anterior region. This case reports a ten-year-old child with history of avulsion of superior central incisors. The therapeutic approach was planned to promote physiological teeth contacts and acceptable esthetics and phonetics. First, the occlusal-gingival insertion of two orthodontic mini-implants was performed in the alveolar ridge, and, immediately after that, two provisional crowns were attached to the implants. The interventions achieved satisfactory cosmetic and functional results. After one-year follow-up, the adjacent periodontal tissues remained without signs and/or symptoms of inflammation. The provisional crowns presented no mobility and fractures. During radiographic examination, a healthy bone tissue appearance was observed. The simplicity of mini-implant installation makes them a promising alternative for temporary prosthetic rehabilitation of patients undergoing growth and development. The technique provides positive aesthetic and functional results that may reflect on self-esteem and social inclusion of children and adolescents.
Barbosa, Gabriella Lopes de Rezende; Lanza, Lincoln Dias
The treatment of choice in cases of avulsed permanent teeth is the immediate reimplantation. However, this conduct does not always work favorably, either by failures in the initial approach or by inappropriate interventions. In this sense, the aim of this study is to present an alternative prosthetic rehabilitation with the use of orthodontic mini-implants in the anterior region. This case reports a ten-year-old child with history of avulsion of superior central incisors. The therapeutic approach was planned to promote physiological teeth contacts and acceptable esthetics and phonetics. First, the occlusal-gingival insertion of two orthodontic mini-implants was performed in the alveolar ridge, and, immediately after that, two provisional crowns were attached to the implants. The interventions achieved satisfactory cosmetic and functional results. After one-year follow-up, the adjacent periodontal tissues remained without signs and/or symptoms of inflammation. The provisional crowns presented no mobility and fractures. During radiographic examination, a healthy bone tissue appearance was observed. The simplicity of mini-implant installation makes them a promising alternative for temporary prosthetic rehabilitation of patients undergoing growth and development. The technique provides positive aesthetic and functional results that may reflect on self-esteem and social inclusion of children and adolescents. PMID:29093976
Natalice Sousa de Oliveira
Full Text Available The treatment of choice in cases of avulsed permanent teeth is the immediate reimplantation. However, this conduct does not always work favorably, either by failures in the initial approach or by inappropriate interventions. In this sense, the aim of this study is to present an alternative prosthetic rehabilitation with the use of orthodontic mini-implants in the anterior region. This case reports a ten-year-old child with history of avulsion of superior central incisors. The therapeutic approach was planned to promote physiological teeth contacts and acceptable esthetics and phonetics. First, the occlusal-gingival insertion of two orthodontic mini-implants was performed in the alveolar ridge, and, immediately after that, two provisional crowns were attached to the implants. The interventions achieved satisfactory cosmetic and functional results. After one-year follow-up, the adjacent periodontal tissues remained without signs and/or symptoms of inflammation. The provisional crowns presented no mobility and fractures. During radiographic examination, a healthy bone tissue appearance was observed. The simplicity of mini-implant installation makes them a promising alternative for temporary prosthetic rehabilitation of patients undergoing growth and development. The technique provides positive aesthetic and functional results that may reflect on self-esteem and social inclusion of children and adolescents.
Ren, Shu-Xin; Hu, Xiu-Lian; Li, Jian-Hui; Jiang, Xi; Lin, Ye
To evaluate the feasibility and clinical outcomes of an atraumatic extraction technique using Benex Extraction System in flapless immediate implant placement in anterior teeth. Twenty-five patients with single hopeless anterior maxillary teeth were enrolled in the study. The involved teeth were extracted using Benex Extraction System and implants were immediately placed in a flapless way. Healing abutments were connected immediately. After 4-6 months of healing, screw-retained implant temporary crowns were used to reshape the peri-implant gingiva. Permanent restorations were delivered 3 months later. Extraction time was recorded and the technique feasibility was evaluated using visual analogue scale (VAS). Peri-implant marginal bone resorption was measured in X- ray films after loading for 1 year later. Pink esthetic score (PES) was checked to evaluate the gingival esthetics. Questionnaire was delivered and collected to assess patients' satisfaction on surgical experience and esthetic outcomes. SPSS 13.0 software package was used for statistical analysis. Twenty-five implants osseointegrated successfully. The marginal bone resorption was (0.21±0.23) mm and PES was 8.8±1.19 after loading for 1 year. The mean extraction time was 6.87 minutes and the VAS was 3.32. All patients were satisfied with the final esthetic outcomes and felt comfort during surgery. According to the limited data in the study, Benex extraction System is a convenient, atraumatic and predictable technique during flapless immediate implant placement in anterior teeth.
Cutrim, Emerson Souza; Peruzzo, Daiane Cristina; Benatti, Bruno
Implant-supported restorations can be attached as screw-retained or cemented prostheses. In both situations, the characteristics of the soft tissues around the implants are crucial for oral rehabilitation and patient satisfaction. Therefore, this study uses the Pink Esthetic Score (PES), which allows evaluation of gingival esthetics around implants, to evaluate the soft tissues around implants in the anterior maxilla rehabilitated with cemented prostheses (CP) and screw-retained prostheses (SP). Forty implants placed in the anterior maxilla were evaluated, and these had been rehabilitated with prosthetic crowns for a minimum of 1 year. Periodontal examination was performed to evaluate probing depth (PD) and bleeding on probing (BOP) of the implant and the corresponding natural tooth. The total mean (±SD) PES for SP was 10.73 (±1.98) and 10.41 (±2.67) for CP, which was not statistically significant (P ≥ .05). Periodontal examination revealed that CP and SP showed no difference for BOP (P ≥ .05). Differences were only detected in PD when comparing the reference teeth of both groups to CP and SP (P ≤ .05). The present study demonstrates that the PES proved to be an efficient index to assess peri-implant tissues, and that the type of crown retention does not influence the health and quality of the soft tissues around implants.
Grandi, Tommaso; Guazzi, Paolo; Samarani, Rawad; Grandi, Giovanni
The purpose of the study was to compare the clinical and aesthetic outcome of single post-extractive implants versus implants placed in a preserved socket after 4 months of healing in the anterior maxilla. All of the implants were immediately non-occlusally loaded. A total of 50 patients were treated in the two groups of study. The Delayed Group had a maxillary tooth (premolar, canine, lateral or central incisor) removed, with immediate socket grafting, followed by implant placement and provisionalisation 4 months later. The Immediate Group had immediate implant placement and provisionalisation. Outcome measures were implant failures, biological and biomechanical complications, peri-implant radiographic bone level changes, and gingival aesthetics. At the 12-month follow-up, two implants failed in the Immediate Group (8%) versus one in the Delayed Group (4%), with a comparable rate of implant failure (P = 0.55). No complications occurred for either group. The 12-month peri-implant bone resorption was similar in both groups (P = 0.23): 0.71 mm (95% CI 0.45, 0.97) in the Immediate Group versus 0.60 mm (95% CI 0.38, 0.82) in the Delayed Group. The mean difference in bone resorption was 0.13 mm (95% CI -0.21, 0.47). An ideal gingival marginal level was reached most frequently in the Delayed Group (83.3% versus 52.1%, P = 0.04). Rates of full closure of the papilla were similar between the two groups (82.6% for the Immediate Group versus 62.5% for the Delayed Group, P = 0.12). Given the limitation that this was not a randomised controlled trial, there were no differences in complications or crestal bone response at immediate post-extractive implants when compared to delayed implants. A delayed protocol might be considered in the aesthetic zone due to the gingival recession that occurs after post-extractive implant placement.
Kang, Hyunseung; Lee, Min Woo; Byeon, Suk Ho; Koh, Hyoung Jun; Lee, Sung Chul; Kim, Min
Our purpose was to describe the clinical course, and individualized management approaches, of patients with migration of a dexamethasone implant into the anterior chamber. This was a retrospective review of four patients with seven episodes of anterior chamber migration of a dexamethasone implant. After 924 intravitreal dexamethasone injections, anterior migration of the implant occurred in four eyes of four patients (0.43%). All four eyes were pseudophakic: one eye had a posterior chamber intraocular lens in the capsular bag but in a post-laser posterior capsulotomy state, two eyes had a sulcus intraocular lens (IOL), and one eye had an iris-fixated retropupillary IOL. All eyes had a prior vitrectomy and no lens capsule. The time interval from injection to detection of the implant migration ranged from 2 to 6 weeks. Of the four eyes with corneal edema, only one eye required a corneal transplantation, although it was unclear whether the implant migration was the direct cause of the corneal decompensation because the patient had a history of bullous keratopathy resulting from an extended history of uveitis. All patients underwent surgical intervention: two patients with a repositioning procedure, and the other two patients with removal due to repeated episodes, although surgical removal was not always necessary to reverse the corneal complications. In our study, not all patients required surgical removal of the implants. Repositioning the implant back into the vitreous cavity may be considered as an option in cases involving the first episode with no significant corneal endothelial decompensation. Considering potential anterior segment complications and the loss of drug effectiveness together, an individualized approach is recommended to obtain the best treatment outcomes and to minimize the risk of corneal complications.
Kamperos, Georgios; Zambara, Ioanna; Petsinis, Vassileios; Zambaras, Dimitrios
This study aimed to evaluate the impact of buccal bone defects and immediate placement on the esthetic outcome of maxillary anterior single-tooth implants. The archives of the Department of Dental Implants & Tissue Regeneration at Hygeia Hospital during a 5-year period (2010-2014) were retrospectively analyzed, in search of patients treated with a single-tooth implant after extraction of a maxillary incisor. The status of the buccal bone plate and the time of implant placement were recorded. The pink esthetic score (PES) of each case was evaluated, with a maximum score of 14. In total, 91 patients were included in the study. The mean PES was 10.5. The outcome was considered satisfactory (PES ≥ 8) in 89% and (almost) perfect (PES ≥ 12) in 35% of the cases. Immediate implant placement had no impact on PES (P > .05), even though it demonstrated slightly greater variability. On the other hand, buccal bone defects had a negative effect on PES (P implants in the anterior maxilla. The presence of buccal bone defects is considered a negative prognostic factor, whereas immediate implant placement does not affect the esthetic outcome.
Nakamoto, Tetsuji; Kanao, Masato; Kondo, Yusuke; Kajiwara, Norihiro; Masaki, Chihiro; Takahashi, Tetsu; Hosokawa, Ryuji
The aims of this study were to (1) evaluate the basic nature of soft tissue surrounding maxillary anterior implants by simultaneous measurements of blood flow and surface temperature and (2) analyze differences with and without bone grafting associated with implant placement to try to detect the signs of surface morphology change. Twenty maxillary anterior implant patients, 10 bone grafting and 10 graftless, were involved in this clinical trial. Soft tissue around the implant was evaluated with 2-dimensional laser speckle imaging and a thermograph. Blood flow was significantly lower in attached gingiva surrounding implants in graftless patients (P = 0.0468). On the other hand, it was significantly lower in dental papillae (P = 0.0254), free gingiva (P = 0.0198), and attached gingiva (P = 0.00805) in bone graft patients. Temperature was significantly higher in free gingiva (P = 0.00819) and attached gingiva (P = 0.00593) in graftless patients, whereas it was significantly higher in dental papilla and free gingiva in implants with bone grafting. The results suggest that simultaneous measurements of soft-tissue blood flow and temperature is a useful technique to evaluate the microcirculation of soft tissue surrounding implants.
den Hartog, Laurens; Raghoebar, Gerry M.; Stellingsma, Kees; Vissink, Arjan; Meijer, Henny J. A.
Purpose: The aim of this study was to compare the 5-year outcome of immediate loading with that of conventional loading for anterior single-tooth implants placed in healed sites. It was hypothesized that immediate loading is not inferior to conventional loading. Materials and Methods: A total of 62
Slot, Wim; Raghoebar, Gerry M.; Vissink, Arjan; Meijer, Henny J. A.
Objective Comparing treatment outcome of four and six bar-connected implants in the anterior maxillary region to support an overdenture during a 1-year follow-up period. Material and methods Fifty edentulous patients with lack of retention and stability of the upper denture, but with sufficient bone
Shrinivas S Ashekar
Results and conclusions: In low OMI (6 mm anteriors showed tipping movement. Mid implant condition (8 mm showed more of bodily movement during retraction as the force passes near or through the CRs of all the six anterior teeth. In high OMI (10 mm and 0 mm ARH condition, all the six anterior teeth showed intrusion with retraction.
Arora, Himanshu; Khzam, Nabil; Roberts, David; Bruce, William L; Ivanovski, Saso
Immediate implant placement followed by an immediate restoration has proven to be a viable technique in the anterior maxillary region. This prospective study evaluated the mid-long term (2-5 years) tissue changes around immediately placed and restored implants in the anterior maxilla using flapless surgery and simultaneous hard tissue augmentation. Thirty AstraTech implants were immediately placed in 30 patients, followed by the delivery of an immediate provisional restoration on the same day. All participating 30 patients underwent the same treatment strategy that involved flapless removal of a failing maxillary anterior tooth, immediate implant placement, simultaneous augmentation with a deproteinized particulate xenograft, followed by the connection of a screw-retained provisional restoration. Radiographs and photographs were used to measure hard and soft tissue changes. Aesthetic evaluation was performed using the Pink Esthetic Score (PES). All implants remained osseointegrated during the follow up period of 2-5 years (mean 47 ± 15 months). Twelve of the thirty patients completed the 5 year follow up. Radiographic evaluation revealed average gains in bone levels of 0.18 and 0.34 mm mesially and distally, respectively. Soft tissue evaluation showed a mean tissue loss of 0.05 ± 0.64 mm and 0.16 ± 0.63 mm at the mesial and distal papillae, respectively, while mid-facial mucosal recession was 0.29 ± 0.74 mm. A significant improvement in the Pink Esthetic Scores was seen at the final follow-up (mean PES 11.50), as compared to the baseline (mean PES 10.27) (P = .001). In addition to a favorable implant success rate and peri-implant bony response, the soft tissue levels and overall aesthetics around single immediately placed and restored implants can also be maintained in the mid-long term. © 2017 Wiley Periodicals, Inc.
Full Text Available Background: Tibial attachment preserving hamstring graft could prevent potential problems of free graft in anterior cruciate ligament (ACL reconstruction such as pull out before graft-tunnel healing or rupture before ligamentization. Different implants have been reportedly used for tibial side fixation with this technique. We investigated short-term outcome of ACL reconstruction (ACLR with tibial attachment sparing hamstring graft without implant on the tibial side by outside in technique. Materials and Methods: Seventy nine consecutive cases of ACL tear having age of 25.7 ± 6.8 years were included after Institutional Board Approval. All subjects were male. The mean time interval from injury to surgery was of 7.5 ± 6.4 months. Hamstring tendons were harvested with open tendon stripper leaving the tibial insertion intact. The free ends of the tendons were whip stitched, quadrupled, and whip stitched again over the insertion site of hamstring with fiber wire (Arthrex. Single bundle ACLR was done by outside in technique and the femoral tunnel was created with cannulated reamer. The graft was pulled up to the external aperture of femoral tunnel and fixed with interference screw (Arthrex. The scoring was done by Lysholm, Tegner, and KT 1000 by independent observers. All cases were followed up for 2 years. Results: The mean length of quadrupled graft attached to tibia was 127.65 ± 7.5 mm, and the mean width was 7.52 ± 0.78 mm. The mean preoperative Lysholm score of 47.15 ± 9.6, improved to 96.8 ± 2.4 at 1 year. All cases except two returned to the previous level of activity after ACLR. There was no significant difference statistically between preinjury (5.89 ± 0.68 and postoperative (5.87 ± 0.67 Tegner score. The anterior tibial translation (ATT (KT 1000 improved from 11.44 ± 1.93 mm to 3.59 ± 0.89 mm. The ATT of operated knee returned to nearly the similar value as of the opposite knee (3.47 ± 1.16 mm. The Pivot shift test was negative in
Gao, EnFeng; Hei, Wei-Hong; Park, Jong-Chul; Pang, KangMi; Kim, Sun Kyung; Kim, Bongju; Kim, Soung-Min; Lee, Jong-Ho
This study assessed marginal bone remodeling and soft tissue esthetics after the loading of single bone-level implants in the anterior maxilla. An open, single-arm observational clinical trial with 3 years of follow-up was performed, including 22 implants. The patients presented with a single tooth gap in the anterior maxilla (tooth positions 14-24), with natural or restored adjacent teeth. An implant was placed at least 8 weeks post-extraction and healed submerged for 6 weeks. After the second-stage operation, a fixed provisional prosthesis was provided. The final restoration was placed 6 months after the provisional restoration. The time of the provisional crown connection was considered to be the baseline in this study. Esthetic parameters and the marginal bone level were assessed at 6, 12, 24, and 36 months. All implants were well integrated in the bone. A statistically significant increase was found in the mean implant stability quotient between the time of the provisional prosthesis and the time of the final prosthesis. Most implants (95.5%) revealed marginal bone resorption (implant (4.5%) showed a change of 2.12 mm from baseline to 36 months (mean 0.07±0.48 mm), while the crestal bone level decreased significantly, from 2.34±0.93 mm at baseline to 1.70±1.10 mm at 36 months. The facial gingival margin and papilla were stable and the esthetic scores indicated high patient and dentist satisfaction. Platform-switching bone-level implants placed in maxillary single-tooth gaps resulted in successful osseointegration with minimal marginal bone resorption. The peri-implant soft tissue was also esthetically satisfying and stable.
Purpose This study assessed marginal bone remodeling and soft tissue esthetics after the loading of single bone-level implants in the anterior maxilla. Methods An open, single-arm observational clinical trial with 3 years of follow-up was performed, including 22 implants. The patients presented with a single tooth gap in the anterior maxilla (tooth positions 14–24), with natural or restored adjacent teeth. An implant was placed at least 8 weeks post-extraction and healed submerged for 6 weeks. After the second-stage operation, a fixed provisional prosthesis was provided. The final restoration was placed 6 months after the provisional restoration. The time of the provisional crown connection was considered to be the baseline in this study. Esthetic parameters and the marginal bone level were assessed at 6, 12, 24, and 36 months. Results All implants were well integrated in the bone. A statistically significant increase was found in the mean implant stability quotient between the time of the provisional prosthesis and the time of the final prosthesis. Most implants (95.5%) revealed marginal bone resorption (<0.5 mm), and just 1 implant (4.5%) showed a change of 2.12 mm from baseline to 36 months (mean 0.07±0.48 mm), while the crestal bone level decreased significantly, from 2.34±0.93 mm at baseline to 1.70±1.10 mm at 36 months. The facial gingival margin and papilla were stable and the esthetic scores indicated high patient and dentist satisfaction. Conclusions Platform-switching bone-level implants placed in maxillary single-tooth gaps resulted in successful osseointegration with minimal marginal bone resorption. The peri-implant soft tissue was also esthetically satisfying and stable. PMID:29093988
Wünschel, Markus; Treffler, Florian; Ketelsen, Dominik; Lo, Jiahsuan; Müller, Otto; Suckel, Andreas
Reconstruction of the anterior cruciate ligament is a standard surgical procedure in sports traumatology. The widespread replacement method using hamstring tendons has an important shortcoming namely delayed or missing bony healing in contrast to patellar tendon grafts where implant-free fixation is established by using the adjacent bone blocks. The purpose of this study was to describe a new implant-free surgical procedure using hamstring tendon grafts and to analyse the influence on tibiofemoral kinematics in vitro. Nine human knee specimens with arthroscopically transected anterior cruciate ligaments were mounted on a dynamic knee simulator and weight-bearing muscle-loaded knee flexions were simulated while a robotic universal force sensor system was used to provide external tibial loads. Three different loading conditions were simulated including partial body weight only, an additional 50 N anterior tibial force or an additional Five Nm of internal rotational torque. After reconstruction of the anterior cruciate ligament using a tibial bone block hybrid technique these three trials were repeated. The kinematics was measured with an ultrasonic measuring system and different loading and ligament conditions were examined. Graft tunnel placement was verified by computed tomography. Our fixation method achieved stability to anterior tibial drawer force whereas internal tibial rotation did not change before and after the reconstruction. Computed tomography confirmed anatomical graft and tunnel placement. The presented operative procedure is technically feasible and leads to reproducible results concerning knee joint kinematics and graft placement. Copyright © 2011 Elsevier Ltd. All rights reserved.
Miyamoto, Yasukazu; Obama, Tadakazu
This study aimed to evaluate the influence of labial alveolar bone thickness and the corresponding vertical bone loss on postoperative gingival recessions around anterior maxillary dental implants. Using cone beam computed tomography (CBCT) scanning, the temporal changes of three-dimensional images of alveolar bone were monitored to determine hard and soft tissue outcomes of two different implant placement techniques: delayed two-stage and immediate placement. Furthermore, for the delayed two-stage placement, guided bone regeneration was applied using either nonresorbable or resorbable membranes combined with anorganic bovine bone matrix. The comparative results suggested that gingival recessions were significantly lower in delayed two-stage placement, especially when using a nonresorbable membrane, compared to immediate placement, and labial bone thickness, measured by CBCT, offered an effectual indicator to assess gingival recession in the anterior region.
Gilmanov, Daniyar; Miceli, Antonio; Bevilacqua, Stefano; Farneti, Pierandrea; Solinas, Marco; Ferrarini, Matteo; Glauber, Mattia
Many new, less invasive strategies are proposed for aortic valve operation in elderly patients. Rapid deployment sutureless aortic valve prosthesis has been recently introduced. We analyzed our experience with a sutureless valve implanted through a minimally invasive approach. A retrospective observational study with prospectively registered data was conducted on 137 patients undergoing aortic valve replacement through a right anterior minithoracotomy. Between April 2011 and January 2013, 137 consecutive patients underwent aortic valve replacement with a recently introduced, rapid deployment, sutureless pericardial valve in minithoracotomy access (47 men; mean age, 76.6 ± 7.1 years). There were 35 obese patients with a body mass index of more than 30 kg/m(2). Mean logistic EuroSCORE I was 10.0; 74 (54%) patients were in New York Heart Association functional class III and IV. In all, 19 (13.9%), 45 (32.8%), and 73 (53.3%) patients received 21-, 23-, and 25-mm valve prostheses, respectively. The mean aortic cross-clamp and cardiopulmonary bypass times were 59.3 ± 19 min and 92.3 ± 27 min, respectively. No operative mortality occurred. Median stay in the intensive care unit was 1 day, with assisted ventilation necessary for a median of 6 hours. Three cases of postoperative ischemic stroke were observed (1 patient with a previous history of an ischemic cerebral event). Median hospital length of stay was 6 days. A sutureless valve for minimally invasive aortic valve replacement is a feasible, effective, and safe tool. Ultimately amplifying indications for less invasive aortic valve replacement in a high surgical risk subset of patients, it can become a valid alternative for transcatheter aortic valve implantation. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Full Text Available This article describes the immediate placement and loading of implants in the aesthetic zone using an implant-retained, fixed prosthesis with a modified design. One section of the implant prosthesis has cemented crowns and the other section is the conventional screw-retained. This combined approach significantly offsets the unsuitable implant position, alignment or angulation, while ensuring the easy retrievability, repair and maintenance of the prosthesis at the same time.
Francesco Guido Mangano
Full Text Available The aim of this study was to achieve aesthetically pleasing soft tissue contours in a severely compromised tooth in the anterior region of the maxilla. For a right-maxillary central incisor with localized advanced chronic periodontitis a tooth extraction followed by reconstructive procedures and delayed implant placement was proposed and accepted by the patient. Guided bone regeneration (GBR technique was employed, with a biphasic calcium-phosphate (BCP block graft placed in the extraction socket in conjunction with granules of the same material and a resorbable barrier membrane. After 6 months of healing, an implant was installed. The acrylic provisional restoration remained in situ for 3 months and then was substituted with the definitive crown. This ridge reconstruction technique enabled preserving both hard and soft tissues and counteracting vertical and horizontal bone resorption after tooth extraction and allowed for an ideal three-dimensional implant placement. Localized severe alveolar bone resorption of the anterior maxilla associated with chronic periodontal disease can be successfully treated by means of ridge reconstruction with GBR and delayed implant insertion; the placement of an early-loaded, Morse taper connection implant in the grafted site was effective to create an excellent clinical aesthetic result and to maintain it along time.
Shao, Haiyu; Chen, Jinping; Ru, Bin; Yan, Feifei; Zhang, Jun; Xu, Shaonan; Huang, Yazeng
Zero-profile implant has become more and more popular in anterior cervical discectomy and fusion (ACDF) for the treatment of degenerative cervical spondylosis. However, there was no enough evidence judging its efficiency and safety. The aim of this analysis was to evaluate the efficacy and safety of Zero-profile implant compared with conventional cage-plate (CCP) in ACDF. All studies directly comparing the outcomes between the Zero-profile implant and CCP implant in ACDF were included, and the search strategy followed the requirements of the Cochrane Library Handbook. Two of the authors extracted relevant data and checked the accuracy independently using standardized data collection form. Seven studies involving 560 patients were included, 262 in the Zero-profile group and 298 in the CCP group. Zero-profile implant had a lower rate of postoperative dysphagia at 2 weeks, 6 months, and 1 year (p = 0.0002, p = 0.008, and p = 0.001, respectively) than CCP implant. Zero-profile also reduced blood loss (p = 0.0001), while operation time and incidence of postoperative transient dysphagia had no statistical significance (p = 0.92, p = 0.42, respectively) between two groups. Based on the results of our analysis, the application of Zero-profile implant in ACDF had a lower rate of postoperative dysphagia at 2 weeks, 6 months, and 1 year than CCP implant. Zero-profile implant also had fewer blood loss during operation. More rigorous and adequately powered prospective randomized controlled trials with larger sample size are required to elucidate a more objective outcome.
Hart, Tyler R; Cousley, Richard R J; Fishman, Leonard S; Tallents, Ross H
To evaluate skeletal and dental changes after intrusion of the maxillary molars in subjects with anterior open bite. This retrospective cephalometric study evaluated skeletal and dental changes resulting from the use of maxillary orthodontic mini-implants in 31 consecutively treated patients. Radiographs were taken at the start and end of maxillary molar intrusion to evaluate the associated changes. Statistical analysis was performed using a one-sample t-test. The mean treatment observation time was 1.31 years (SD = 2.03). The maxillary first molars (P = 0.0026) and second molars (P = 0.039) were intruded. However, the mandibular first molars (P = 0.0004) and second molars (P = 0.003) erupted in adolescent patients. Both the maxillary and mandibular first molars inclined distally (P = 0.025 and P = 0.044, respectively). The mandibular plane angle decreased (P = 0.036), lower facial height decreased (P = 0.002), and the occlusal plane angle increased (P = 0.009). The overbite increased (P open bite. However, simultaneous eruption or extrusion of the mandibular molars should be controlled. Adolescent patients tend to demonstrate more favorable effects of mandibular autorotation than do adults.
Sanjeev Kumar Salaria
Full Text Available Dental implant is being considered successful if the patient is pleased with both of its functional and esthetic outcome. As implant complications (such as peri-implantitis, inappropriate implant position, wrong angulation, and implant location too close to anatomical structures have been frequently encountered in dental practice, therefore, thorough knowledge to manage such complications is the key prerequisite to prevent the failure of implant. The present case report discussed the etiology, diagnosis of early peri-implantitis, and periodontal abscess with their successful management through periodontal regeneration and diode laser-assisted therapy.
Manikandan, D; Balaji, V R; Lamobodharan, R; Mahalakshmi, R
Although implant is the treatment of choice for rehabilitation of patients with aggressive periodontitis, it is also challenging for the dentists. There are various views about success of implant therapy for these patients. Few authors have proposed that aggressive periodontitis patients have less success rate of implant survival, while many authors have shown successful management of aggressive periodontitis patients with implants. For implants to be successful in these patient, it is important to control the periodontal disease before placement of implants. Thus a multidisciplinary approach is essential for successful rehabilitation of these patients. This case report aims at discussing the periodontal management and implant rehabilitation in a patient with aggressive periodontitis.
Lesmes Bernal, Sandra Catherine
La sociedad se está concientizando sobre la importancia de la salud y de la estética, de esta manera, la demanda por tratamientos estéticos rehabilitadores en casos de desgaste dental patológico ha aumentado. Con la evolución de los sistemas adhesivos, asociado a las mejoras en las propiedades químicas, mecánicas y estéticas de las resinas compuestas, tratamientos restauradores extensos, como la reconstrucción directa de las guías anteriores en los casos de desgaste dental patológico, se torn...
De Rouck, Tim; Collys, Kristiaan; Cosyn, Jan
The objective of this study was to assess to what extent the outcome of immediate implantation and provisionalization for replacing single maxillary teeth in the esthetic zone is favorable and predictable from biologic and esthetic points of view. An electronic search (MEDLINE and Cochrane Oral Health Group Specialized Trials Register) and a manual search were performed to detect studies concerning maxillary single-tooth replacements by means of dental implants immediately placed into fresh extraction sockets and provisionalized within the first 24 hours. Only full-text reports on clinical studies published in English up to June 2006 were included. Case reports and reviews on the topic of interest were excluded. Eleven studies were selected. Based on a qualitative data analysis, implant survival and even management of papilla levels seem predictable following immediate implantation and provisionalization. However, maintaining the midfacial gingival margin may be more problematic, since postextraction bone remodeling and therefore marginal gingival changes will occur irrespective of the timing of the placement of an implant. The long-term impact of this remodeling is currently unclear and needs to be elucidated in future research. The clinician is recommended to be reserved when considering immediate implant placement and provisionalization for replacing single maxillary teeth in the anterior zone. At the very least, a number of guidelines and prerequisites need to be taken into consideration.
Abarca, M.; van Steenberghe, D.; Malevez, C.; De Ridder, J.
The aim of the study was to assess past and present neurosensory disturbances using a questionnaire and a psychophysical approach in patients treated with immediate loaded implants in the edentulous anterior mandible. A group of 65 patients (age range 30–84 years, mean 58 years, 30 women) was enrolled. All were treated by means of three immediately loaded implants (Branemark Novum System®). A self-designed questionnaire was used for data collection. The response rate was 89%. Of the 58 responders, 33% (n=19) reported neurosensory disturbances after implant surgery. Nine of these patients (mean age 56 years, seven women) participated in an objective evaluation and were subjected to a psychological and several psychophysical tests. At the moment of the evaluation none of the nine patients still had clinical complaints. Psychological testing revealed no statistical differences between the patients, who had previously experienced subjective complaints, and the control group. Two-point discrimination and thermal sensation tests revealed no sensory lesions. The light touch sensation test at the lower lip indicated a more frequent reduction of tactility for the test group (p≤0.03). Neurosensory disturbances can occur in the anterior region of the mandible after implant surgery. PMID:16937108
Fürhauser, Rudolf; Mailath-Pokorny, Georg; Haas, Robert; Busenlechner, Dieter; Watzek, Georg; Pommer, Bernhard
Flapless implant placement using surgical templates may guarantee predictable and esthetic results provided that preplanned implant positions are transfered precisely into surgical reality. The study aims to investigate the effect of three-dimensional accuracy in guided implant surgery on the esthetic outcome of single-tooth implants in the anterior maxilla. Single-tooth implants for delayed replacement of upper incisors were inserted in 27 patients using stereolithographic templates. Superimposition of postoperative cone beam computed tomography (CBCT) scans allowed assessment of positional inaccuracy at the implant shoulder and apex, as well as angular deviation. Objective evaluation of implant esthetics was performed after a mean follow-up of 2.3 years using the Pink Esthetic Score (PES). Mean deviation between planned and actual implant position was 0.84 mm at the implant shoulder and significantly correlated to average PES of 12 (p = .031). Inaccuracy toward the buccal side was most frequent (70%). Deviations ≥ 0.8 mm resulted in significantly worse implant esthetics (median PES: 9.5, interquartile range [IQR]: 8-11) compared with more accurate implant positions (median PES: 13, IQR: 12-13, p = .039). Positional inaccuracy is low in guided implant surgery, but may however significantly compromise implant esthetics in the anterior maxilla. © 2014 Wiley Periodicals, Inc.
Full Text Available Objective: to improve surgical results of patients with complete tears of anterior cruciate ligament by synthetic implant Don-M. Materials and Methods. 7 patients with ACL complete tear who underwent two-bundle plastics with synthetic en-doprosthetic implant Don-M were investigated. Results. The application of ACL two-bundle plastics with synthetic Don-M implant allowed reaching complete knee joint stability during the first several hours after surgery and completely restore knee joint motion range in the course of 6 months. Conclusion. The application of ACL two-bundle plastics is anatomically justified and provides knee joint stability as well as early activation and rehabilitation opportunities.
Full Text Available Although implant is the treatment of choice for rehabilitation of patients with aggressive periodontitis, it is also challenging for the dentists. There are various views about success of implant therapy for these patients. Few authors have proposed that aggressive periodontitis patients have less success rate of implant survival, while many authors have shown successful management of aggressive periodontitis patients with implants. For implants to be successful in these patient, it is important to control the periodontal disease before placement of implants. Thus a multidisciplinary approach is essential for successful rehabilitation of these patients. This case report aims at discussing the periodontal management and implant rehabilitation in a patient with aggressive periodontitis.
Pavel Osmancik, MD, PhD, FESC, Petr Stros, MD
Full Text Available Right ventricular (RV mid-septal pacing should have fewer negative effects on left ventricular function compared to apical pacing. However, targeting the mid-septum may be technically challenging since it is usually done with two-dimensional fluoroscopy. The rotation of the heart and various shapes of the RV make it difficult to assess, whether the lead is really anchored in the septum. Many leads, apparently anchored in the septum, are in fact anchored in the anterior wall or anteroseptal groove, and some can get anchored in close proximity to the left anterior descending artery (LAD. We report three cases from our series of 51 patients, in whom the RV lead thought to be implanted in the mid-septum was in fact anchored in close proximity of LAD when assessed using computed tomography.
Nimet Yeşim Erçalık
Full Text Available Objectives: To compare the visual prognosis and postoperative complication rates of secondary anterior chamber (AC IOL and scleralfixated (SF intraocular lenses (IOL after complicated phacoemulsification surgery. Materials and Methods: Thirty eyes of thirty patients were reviewed for this retrospective study. The patients with secondary AC IOL implantation formed group 1 (n=15, and the patients with secondary SF IOL implantation formed group 2 (n=15. Best-corrected visual acuity (BCVA with Snellen chart, biomicroscopic examination, intraocular pressure (IOP measurement with applanation tonometer, gonioscopy performed by Goldmann’s 3-mirror contact lens, and fundus examination were performed preoperatively in all patients. Results: There was no statistically significant difference in postoperative BCVA (p=0.492 and postoperative success (BCVA not changed or better postoperatively between the 2 groups (p=0.598. Postoperative success rate was 80% in group 1 and 93.7% in Group 2. The postoperative cylindrical power of the eyes did not differ significantly between the groups (p=0.220. The postoperative complications in group 1 were as follows: transient corneal edema in 5 eyes, transient IOP elevation in 2 eyes, postoperative fibrinous reaction in the anterior chamber in one eye, late-onset secondary glaucoma in one eye, hyphema in one eye, cystoid macular edema in one eye, vitreous prolapse into the anterior chamber in one eye, and IOL malposition in one eye. The postoperative complications in group 2 were as follows: transient corneal edema in 3 eyes, vitreous prolapse into the anterior chamber in 2 eyes, IOL malposition in 2 eyes, transient IOP elevation in one eye, and retinal detachment in one eye. Conclusion: In this study, both IOL types were observed to be preferable in cases without adequate capsular support following complicated cataract surgery. However, further studies with large numbers of patients are needed to define the best choice
Torres, Érica Miranda De; Naldi, Luis Fernando; Bernades, Karina Oliveira; Carvalho, Alexandre Leite
Tooth loss promotes bone and gingival tissue remodeling, thus breaking the harmony between the residual ridge and natural teeth. This is critical in the anterior region of the mouth, and the integration of several dental specialties is often essential to successful rehabilitation with implants. This article describes a multidisciplinary approach to implant-supported oral rehabilitation in the maxillary anterior region, presenting a new technique for optimizing esthetics in implants. A 19-year-old woman was missing her central and lateral incisors and had 2 dental implants in the lateral incisor sites. The patient exhibited deficient thickness of the alveolar edge, loss of lip support, and absence of gingival architecture, and the implants were improperly placed. A multidisciplinary team created a correct emergence profile through a polymethyl methacrylate-based bone cement graft along with connective tissue grafts. This technique may be a useful therapeutic adjunct in dental implantology, showing good predictability and regular healing procedures.
A contemporary approach for treatment planning of horizontally resorbed alveolar ridge: Ridge split technique with simultaneous implant placement using platelet rich fibrin membrane application in mandibular anterior region
Prathahini S Parthiban
Full Text Available Treatment of edentulous sites with horizontal atrophy represents a clinical situation in which the positioning of endosseous implants might be complex or sometimes impossible without a staged regenerative approach. This case report presents management of horizontally deficient mandibular anterior ridge with a contemporary approach to treatment planning and application of platelet-rich fibrin membrane for ridge split technique and simultaneous implant placement. Implants in anterior mandibular area are considered to be most predictable, stable, with high success rate and patients' satisfaction with implant esthetics. In contrast to traditional ridge augmentation techniques, ridge splitting allows for immediate implant placement following surgery and eradicates the possible morbidity from a second surgical site.
Droghetti, Andrea; Basso Ricci, Erika; Scimia, Paolo; Harizai, Fabiola; Marini, Massimiliano
The standard technique for implanting a subcutaneous defibrillator (S-ICD) requires three incisions and the pocket of the device is created in the subcutaneous tissue of the left lateral thoracic wall. However, a two-incision technique may be adopted, in which the cranial parasternal region is avoided and the device is positioned more deeply, completely under the latissimus dorsi muscle. This can also be combined with Ultrasound-Guided Serratus Anterior Plane Block (US-SAPB) for intraoperative anesthesia and perioperative analgesia. We describe our preliminary experience of US-SAPB combined with the two-incision intermuscular technique. We performed US-SAPB 40 minutes before starting the procedure, while the patient was in the supine position. The devices were implanted under the latissimus dorsi muscle. All patients were followed up after hospital discharge. Twelve patients (male 50%, 53±16 years, body mass index 23±4) underwent the S-ICD implantation with the combined technique. The mean procedure duration was 47±11 min. The procedure was successful and a shock energy of 65J was successful in converting the induced ventricular fibrillation in all patients. The US-SAPB was successful in 92% of cases only one patient required convertion into general anesthesia, due to pain during the procedure. In the post-operative period, patients did not report major discomfort and analgesics were not required. During a median follow-up of 12 months, no complications were reported. Serratus Anterior Plane Block combined with the intermuscular and two-incision technique proved to be safe and effective during the S-ICD implantation procedure. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Pauzenberger, Leo; Dyrna, Felix; Obopilwe, Elifho; Heuberer, Philipp R; Arciero, Robert A; Anderl, Werner; Mazzocca, Augustus D
The anatomic restoration of glenoid morphology with an implant-free J-shaped iliac crest bone graft offers an alternative to currently widely used glenoid reconstruction techniques. No biomechanical data on the J-bone grafting technique are currently available. To evaluate (1) glenohumeral contact patterns, (2) graft fixation under cyclic loading, and (3) the initial stabilizing effect of anatomic glenoid reconstruction with the implant-free J-bone grafting technique. Controlled laboratory study. Eight fresh-frozen cadaveric shoulders and J-shaped iliac crest bone grafts were used for this study. J-bone grafts were harvested, prepared, and implanted according to a previously described, clinically used technique. Glenohumeral contact patterns were measured using dynamic pressure-sensitive sensors under a compressive load of 440 N with the humerus in (a) 30° of abduction, (b) 30° of abduction and 60° of external rotation, (c) 60° of abduction, and (d) 60° of abduction and 60° of external rotation. Using a custom shoulder-testing system allowing positioning with 6 degrees of freedom, a compressive load of 50 N was applied, and the peak force needed to translate the humeral head 10 mm anteriorly at a rate of 2.0 mm/s was recorded. All tests were performed (1) for the intact glenoid, (2) after the creation of a 30% anterior osseous glenoid defect parallel to the longitudinal axis of the glenoid, and (3) after anatomic glenoid reconstruction with an implant-free J-bone graft. Furthermore, after glenoid reconstruction, each specimen was translated anteriorly for 5 mm at a rate of 4.0 mm/s for a total of 3000 cycles while logging graft protrusion and mediolateral bending motions. Graft micromovements were recorded using 2 high-resolution, linear differential variable reluctance transducer strain gauges placed in line with the long leg of the graft and the mediolateral direction, respectively. The creation of a 30% glenoid defect significantly decreased glenohumeral
René Abel Salso Morell
Full Text Available La disponibilidad ósea es uno de los principales elementos a tener en cuenta en la planificación del tratamiento implantológico. La posibilidad de optar por este se encuentra limitada en pacientes con déficit óseo, tanto en cantidad, como en calidad. La regeneración ósea guiada es una técnica quirúrgica, que permite estimular la formación de hueso en zonas específicas, permitiendo una disponibilidad adecuada del mismo, facilitando así esta terapéutica. Pueden realizarse previamente a la colocación de los implantes o durante la colocación de los mismos. Se presenta un caso de rehabilitación protésica por medio de implantes de carga inmediata utilizando una técnica de regeneración ósea, guiada en el momento de la implantación. Se realizó seguimiento por seis meses, constatándose la integración del implante, así como la adecuada adaptación de la rehabilitación protésica.
We aimed to assess the stability over time of dental implants placed in grafted bone in the maxilla using resonance frequency analysis, and to compare the stability of implants placed in grafted and non-grafted bone. Data were collected from 23 patients (15 test and 8 controls) in whom 64 implants (Brånemark system, Nobel Biocare, Göteborg, Sweden) were placed in accordance with the two-stage surgical protocol. In the test group 36 fixtures were placed in grafted bone, and in the control group 28 fixtures were placed in non-grafted bone. Resonance frequency analysis was used to assess the test sites at implant placement and abutment connection. The mean (SD) implant stability quotient (ISQ) for test sites at the time of implant placement was 61.91 (6.68), indicating excellent primary stability, and was 63.53 (5.76) at abutment connection. ISQ values at abutment connection were similar for test and control sites. Implants placed in grafted bone compared favourably with those in non-grafted bone, and showed excellent stability.
Vanlıoğlu, Burçin Akoğlu; Kahramanoğlu, Erkut; Yıldız, Coşkun; Ozkan, Yaşar; Kulak-Özkan, Yasemin
The aim of this study was to evaluate the treatment outcome of implants placed in the maxillary anterior segment. Patients were treated with bone-level implants (Straumann Bone Level Implant, Institut Straumann) that supported all-ceramic single crowns and were followed for 2 to 4 years. Titanium or ceramic abutments were used according to the quality of the soft tissue at each site. Esthetic parameters were recorded to assess treatment outcomes. Pink esthetic scores (PES) and white esthetic scores (WES) were used to evaluate the esthetic outcome of anterior single-tooth implant-supported crowns. Patient satisfaction was also evaluated by means of a questionnaire. Fifty-five implants were placed in 47 patients. At the recall examinations, all implants were confirmed to have successfully integrated and demonstrated healthy peri-implant soft tissues, as documented by generally accepted clinical parameters. Overall, the esthetic results were considered favorable, and there were no significant differences between restorations with ceramic or titanium abutments. WES values were slightly superior to PES values. None of the implants had mucosal recession. Objective and subjective evaluation of maxillary bone-level implants in the esthetic zone yielded satisfactory results. Pleasing esthetic outcomes and stable facial soft tissues were achieved.
den Hartog, Laurens; Raghoebar, Gerry M; Stellingsma, Kees; Vissink, Arjan; Meijer, Henny Ja
The aim of this study was to compare the 5-year outcome of immediate loading with that of conventional loading for anterior single-tooth implants placed in healed sites. It was hypothesized that immediate loading is not inferior to conventional loading. A total of 62 patients with a missing maxillary anterior tooth were included. At random, patients were treated with an implant that was restored either with a nonoccluding temporary crown within 24 hours after implant placement (immediate group) or according to a two-stage procedure after 3 months (conventional group). All implants were placed in healed sites. Follow-up visits were performed after definitive crown delivery and 1 and 5 years thereafter. Outcome measures were radiographic marginal bone level changes, implant survival, complications, soft tissue aspects (probing depth, plaque, bleeding, soft tissue level changes), esthetic outcome, and patient satisfaction. Three patients in each study group were lost to follow-up. No significant differences were found in terms of marginal bone loss (1.16 ± 0.93 mm in the immediate group and 1.20 ± 1.10 mm in the conventional group), survival (one implant lost in the immediate group), complications, soft tissue aspects, esthetic outcome, and patient satisfaction. For anterior single-tooth implants placed in healed sites, the outcome of immediate loading is not inferior to conventional loading.
J. Bisbal Piazuelo
Full Text Available Las depresiones de la región condroesternal, conocidas como tórax en embudo o pectus excavatum, son una de las anomalías congénitas mas frecuentes de la pared anterior del tórax. Su corrección ha sido siempre quirúrgica, para lo cual están descritas varias técnicas que pueden clasificarse en dos grupos: 1 Las que actúan modificando la anatomía costal y esternal y 2 Las que se limitan a disimular el defecto mediante rellenos. Ante casos de pectus excavatum en adultos, en los que se ha descartado totalmente la problemática cardiorrespiratoria y que por consiguiente, consideramos como un problema estético, estamos empleando desde hace 8 años una técnica consistente en la aplicación de prótesis de silicona hechas a medida, con resultados muy satisfactorios y con un nivel de complicaciones prácticamente nulo.The depressions in the chondrosternal region, known as pectus excavatum, are the most usual congenital problems of the anterior chest-wall. Its correction has always been surgical, using two different techniques, as follows: 1 The ones that works changing the costal anatomy; and 2 The ones that just covers the defect up with fillers. For those cases of pectus excavatum in adults, in which the cardiorespiratory problems have been completely ruled out, and are considered as aesthetic problems, we have been using a corrective technique for the last 8 years with a made to measure silicone prosthesis, with very satisfactory results and with almost no complications.
Calha, Nuno; Messias, Ana; Guerra, Fernando; Martinho, Beatriz; Neto, Maria Augusta; Nicolau, Pedro
To evaluate the effect of geometry on the displacement and the strain distribution of anterior implant-supported zirconia frameworks under static load using the 3D digital image correlation method. Two groups (n=5) of 4-unit zirconia frameworks were produced by CAD/CAM for the implant-abutment assembly. Group 1 comprised five straight configuration frameworks and group 2 consisted of five curved configuration frameworks. Specimens were cemented and submitted to static load up to 200N. Displacements were captured with two high-speed photographic cameras and analyzed with video correlation system in three spacial axes U, V, W. Statistical analysis was made using the nonparametric Mann-Whitney test. Up to 150N loads, the vertical displacements (V axis) were statistically higher for curved frameworks (-267.83±23.76μm), when compared to the straight frameworks (-120.73±36.17μm) (p=0.008), as well as anterior displacements in the W transformed axis (589.55±64.51μm vs 224.29±50.38μm for the curved and straight frameworks), respectively (p=0.008). The mean von Mises strains over the surface frameworks were statistically higher for the curved frameworks under any load. Within the limitations of this in vitro study, it is possible to conclude that the geometric configuration influences the deformation of 4-unit anterior frameworks under static load. The higher strain distribution and micro-movements of the curved frameworks reflect less rigidity and increased risk of fractures associated to FPDs. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Full Text Available To systematically measure and compare the stress distribution on the bone around an implant in the anterior maxilla using angled abutments by means of finite element analysis, three-dimensional finite element simplified patient-specific models and simplified models were created and analyzed. Systematically varied angled abutments were simulated, with angulation ranging from 0° to 60°. The materials in the current study were assumed to be homogenous, linearly elastic, and isotropic. Force of 100 N was applied to the central node on the top surface of the abutments to simulate the occlusal force. To simulate axial and oblique loading, the angle of loading was 0°, 15°, and 20° to the long axis of implant, respectively. There was the strong resemblance between the response curves for simplified patient-specific models and simplified models. Response curves under oblique loading were similar in both models. With abutments angulation increased, maximum von Mises stress firstly decreased to minimum point and then gradually increased to higher level. From a biomechanical point of view, favorable peri-implant stress levels could be induced by angled abutments under oblique loading if suitable angulation of abutments was selected.
J. S. Vieira
Full Text Available Fresh frozen allograft bone is routinely used in orthopedic surgery for the reconstruction of large bone defects, and its use in oral and maxillofacial surgery is increasing. The purpose of this case was to demonstrate the installation of dental implants and the use of fresh frozen bone for reconstruction of anterior maxilla in the same surgery. This case report presents the insertion of dental implants followed immediately by a placement of fresh frozen allograft in block and particle for a reconstruction of atrophic anterior maxillary in the same surgery. Ten months subsequent to this procedure, provisional fixed prosthesis was installed on the implants. Four months later (postoperative month 14, the final fixed prosthesis was installed and the clinical success was observed. The insertion of dental implants followed immediately by a placement of fresh frozen allograft is a safe and efficient process that results in the successful return of dental function and aesthetic rehabilitation for the patient.
Guarnieri, Renzo; Ceccherini, Alessandro; Grande, Maurizio
The hypothesis of the present study was that the early loading of single implants-supported restorations, replacing single extracting teeth in the anterior region of the maxilla in case of fresh extraction sockets with residual hard and soft tissue preservation, could be a successful procedure. Twenty-one implants were placed into maxillary anterior fresh extraction sockets using a flapless technique. Temporary restorations, which were fabricated from the impression taken immediately after implant placement, were connected within 2 weeks. These temporary restorations were adjusted in order to avoid any direct occlusive contacts. Six months after implantation, the implants were restored with single-teeth all-ceramic prostheses. Patients were followed for 5 years. Radiographic and clinical examinations were made at baseline, at time of definitive crowns delivery, and each subsequent year. Survival rate, cortical bone responses, and peri-implant mucosal responses were evaluated. One implant was lost at 6 months. Clinical osseointegration of 20 implants was achieved (95.2% implant survival rate after 5 years) with minimal gingival recession and papillae preservation. The mean change in marginal cortical bone level was 0.40 mm at 6 months and 0.83 mm at 5 years. Within the limit of the present study, the data indicate that, under a strictly controlled oral hygienic regimen, single-tooth implants, with immediate placement and early loading protocol, may be used in anterior maxillary fresh extraction sockets with residual hard and soft tissues preservation, if patients are selected carefully and if high primary stability is strictly followed. © 2013 Wiley Periodicals, Inc.
Mounir, M; Atef, M; Abou-Elfetouh, A; Hakam, M M
The aim of this study was to assess two new protocols for single-stage rehabilitation of the severely atrophic maxillary ridge using customized porous titanium or polyether ether ketone (PEEK) sub-periosteal implants. Ten patients with a severely atrophic anterior maxillary alveolar ridge were divided randomly into two groups (five patients in each) to receive customized sub-periosteal implants fabricated via CAD/CAM technology: group 1, porous titanium implants; group 2, PEEK implants. Prosthetic loading with fixed acrylic bridges was performed 1 month postoperative. The implants were followed-up for 12 months and evaluated for the presence of any sign of radiographic bone resorption, mobility, infection, prosthetic fracture, or implant exposure. The immediate postoperative period was uneventful except for one case complicated by wound dehiscence in group 1. At 12 months, all implants were functionally stable and the patients were comfortable with the prostheses. No signs of radiographic bone resorption, mobility, infection, or prosthetic fracture were observed. Within the limitations of this study, the application of customized porous titanium and PEEK sub-periosteal implants produced through CAD/CAM technology appears to be an acceptable method for single-stage prosthetic rehabilitation of the severely atrophic edentulous anterior maxilla. This study was awarded the best case study at the academy of osseintegration annual meeting 2017, Orlando, Florida. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Full Text Available Acute dislocation of the temporomandibular joint (TMJ is a relatively common occurrence; chronic long-term dislocation is rare. Variance in the duration of dislocation and anatomical considerations make the treatment for long-standing dislocation complex and controversial. This case report describes a new method of conservative management of a long-standing TMJ dislocation using orthodontic mini-implants.
Khzam, Nabil; Arora, Himanshu; Kim, Paul; Fisher, Anthony; Mattheos, Nikos; Ivanovski, Saso
The aim of this review is to assess the outcome of single-tooth immediate implant placement and restoration (IPR) in the maxillary anterior region, with a particular emphasis on soft tissue and esthetic outcomes. An electronic search in Medline, EBSCOhost, and Ovid (PubMed) was performed to identify studies that reported on soft tissue outcomes following immediate placement and restoration of implants in the maxillary esthetic region with a mean follow-up of ≥1 year. Nineteen studies on single implants inserted immediately into fresh extraction sockets and provisionally restored in the maxillary esthetic region were included. Soft tissue changes were found to be acceptable, with most studies reporting mean gingival recession of 0.27 ± 0.38 mm and mean papillary height loss of 0.23 ± 0.27 mm after follow-up of ≥1 year. Advanced buccal recession (>1 mm) occurred in 11% of cases. Long-term follow-up studies (>2 years) reported that the interdental papillae, in particular, showed a tendency to rebound over time. The few studies that reported on patient-centered outcomes showed a high level of patient satisfaction with the outcomes of IPR treatment. The IPR protocol resulted in generally acceptable soft tissue and esthetic outcomes, with suboptimal results reported in ≈11% of low-risk cases. Factors such as preoperative tissue biotype or use of a flap or connective tissue graft did not significantly influence soft tissue and esthetic outcomes. Long-term prospective controlled clinical trials are necessary to identify factors that may influence the esthetic outcomes associated with IPR.
Full Text Available Tooth extraction inevitably accompanies alveolar ridge resorption with loss of pre-existing tissue morphology. Replacing missing teeth with dental implants has become popular, but restoring anterior teeth with implant-supported restorations is a technique-sensitive task and poses challenges for dentists. With the progress of implant dentistry, the demand for optimal esthetics has become linked with the desire for faster, easier techniques that shorten treatment time and also satisfy patients. Immediate provisionalization of a single-tooth implant provides significant benefits compared with traditional delayed protocols, such as aiding the contouring of peri-implant soft tissue and enhancing patient comfort and satisfaction. This article describes a meticulous approach to a hopeless maxillary central incisor with root fracture. The defect in the extraction socket was reconstructed using autogenous bone harvested from the chin. Four months later, an implant was installed and immediately restored. After another healing period of 6 months, the peri-implant soft tissue had been shaped and matured according to the contours of the provisional restoration. The emergence profile was used to duplicate the definitive restoration. Peri-implant esthetics was achieved through socket augmentation and immediate provisionalization of the implant. This treatment modality attained predictable and maintainable outcomes, both functionally and esthetically.
Suominen, Sakari M A; Harju, Mika P; Hautamäki, Asta M E; Vesti, Eija T
To determine the effect of intraocular pressure (IOP) lowering with deep sclerectomy (DS) on visual acuity, macular structures, and anterior ocular dimensions during the early postoperative period. We prospectively analyzed 35 eyes of 35 patients scheduled for DS. Our focus with the measurements was on early postoperative changes in anterior ocular and macular structures related to IOP lowering during the first month after DS. In addition to a clinical ophthalmologic examination, our measurements included corneal topography, measurement of ocular dimensions with optical biometry, and examination of macular structure with optical coherence tomography. These measurements were repeated 1, 2, and 4 weeks postoperatively. Best-corrected visual acuity (BCVA) decreased 1 week postoperatively to 0.22 (0.20) LogMAR (p = 0.006). The BCVA then increased to its preoperative level, 0.17 (0.18) (p = 0.28), after 4 weeks. Axial length decreased from 24.12 (1.81) mm to 24.04 (1.81) (p<0.001) 4 weeks postoperatively. The steeper meridian of corneal curvature and average corneal power increased postoperatively; central corneal thickness was decreased. No significant change appeared in other measurements. We found changes in corneal curvature and ocular dimensions after DS. These changes were relatively small and do not completely explain the decrease in visual acuity postoperatively. Macular structures showed no changes.
Dakhilalian, Mansour; Rismanchian, Mansour; Fazel, Akbar; Basiri, Keyvan; Azadeh, Hamid; Mahmoodi, Maryam; Fayazi, Sara; Sadr-Eshkvari, Pooyan
Implant-supported overlay dentures (ISODs) have been widely accepted among patients using conventional removable complete dentures (CRCDs). The present study aimed to comparatively study conventional and ISODs in terms of function and coordination of masticatory muscles using electromyograms. Included were 10 patients with ISODs (each with 2 implants in the intercanine area). The mean wave range (MWR) and frequency (MWF) of masseter and temporalis were recorded with (ISOD) and without (CRCD) ball attachments while maximum clenching on cotton rolls (cotton roll clenching), maximum intercuspal clenching (clenching), and unilateral gum chewing (chewing) using electromyography. Data were analyzed in SPAW using t-paired for matched groups and independent-sample t tests for unmatched ones. The MWF differences were not statistically significant with or without attachments (P > .05). Without attachments in place, the MWF of both masseter and temporalis muscles significantly decreased when patients clenched on cotton rolls (P = .01 and .02, respectively) and when chewing unilaterally (both P = .01). With attachments present, the right and left temporalis muscles did not show identical mean wave ranges while chewing (P = .01). Without attachments, this disharmony was seen in the left and right masseter muscles (P = .03). The MWR of masseter was higher in men while chewing with attachments (P = .02). Without attachments, the MWR of temporalis was higher in women while cotton roll clenching (P = .03) and chewing (P = .02). These findings are seemingly in favor of improved masticatory function and coordination in edentulous patients with the application of ISODs.
A. Sumathi Felicita
Full Text Available ABSTRACT Objective: The aim of the present study was to clarify the biomechanics of en-masse retraction of the upper anterior teeth and attempt to quantify the different forces and moments generated using mini-implants and to calculate the amount of applied force optimal for en-masse intrusion and retraction using mini-implants. Methods: The optimum force required for en-masse intrusion and retraction can be calculated by using simple mathematical formulae. Depending on the position of the mini-implant and the relationship of the attachment to the center of resistance of the anterior segment, different clinical outcomes are encountered. Using certain mathematical formulae, accurate measurements of the magnitude of force and moment generated on the teeth can be calculated for each clinical outcome. Results: Optimum force for en-masse intrusion and retraction of maxillary anterior teeth is 212 grams per side. Force applied at an angle of 5o to 16o from the occlusal plane produce intrusive and retraction force components that are within the physiologic limit. Conclusion: Different clinical outcomes are encountered depending on the position of the mini-implant and the length of the attachment. It is possible to calculate the forces and moments generated for any given magnitude of applied force. The orthodontist can apply the basic biomechanical principles mentioned in this study to calculate the forces and moments for different hypothetical clinical scenarios.
Felicita, A Sumathi
The aim of the present study was to clarify the biomechanics of en-masse retraction of the upper anterior teeth and attempt to quantify the different forces and moments generated using mini-implants and to calculate the amount of applied force optimal for en-masse intrusion and retraction using mini-implants. The optimum force required for en-masse intrusion and retraction can be calculated by using simple mathematical formulae. Depending on the position of the mini-implant and the relationship of the attachment to the center of resistance of the anterior segment, different clinical outcomes are encountered. Using certain mathematical formulae, accurate measurements of the magnitude of force and moment generated on the teeth can be calculated for each clinical outcome. Optimum force for en-masse intrusion and retraction of maxillary anterior teeth is 212 grams per side. Force applied at an angle of 5o to 16o from the occlusal plane produce intrusive and retraction force components that are within the physiologic limit. Different clinical outcomes are encountered depending on the position of the mini-implant and the length of the attachment. It is possible to calculate the forces and moments generated for any given magnitude of applied force. The orthodontist can apply the basic biomechanical principles mentioned in this study to calculate the forces and moments for different hypothetical clinical scenarios.
Pieri, Francesco; Siroli, Lucia; Forlivesi, Caterina; Corinaldesi, Giuseppe
Fifty patients underwent single-tooth replacement in the maxillary and mandibular incisor area using two-piece 3.0-mm-diameter implants. Clinical and radiographic measurements of soft and hard tissue levels and esthetic parameters (pink esthetic score/white esthetic score [PES/WES]) were assessed at 3 years. No implant failed (success rate: 100%), and facial soft tissues and marginal bone levels remained stable throughout the study period. The mean total PES/WES was high (14.1 ± 1.75), and only one implant demonstrated an unfavorable esthetic outcome (PES/WES = 10). The use of 3.0-mm-diameter implants appears to be a viable treatment procedure in the medium term for single-tooth anterior restorations with limited dimensions.
Guarnieri, Renzo; Savio, Luca; Bermonds des Ambrois, Alessandro; Ippoliti, Stefano; Zuffetti, Francesco; Stefanelli, Luigi Vito; Di Carlo, Stefano; Pompa, Giorgio
The aim of this study was to evaluate the possible factors that influenced the periimplant soft tissue changes around single implants-abutments with laser-microtextured surface (LMS) in the esthetic zone. Thirty-nine units, formed by implant-abutment with LMS were studied. Variables possibly associated with the periimplant soft tissue changes were obtained from clinical measurements (plaque [present/absent], periimplant biotype [thin/thick], and probing depth); intrasurgical measurements (vertical height in millimeters of the keratinized gingiva in the vestibular part of the implant site vestibular keratinized gingiva [VKG], implant vestibular crestal exposition, vestibular crestal level, and vestibular bone width); cast models (implant position [buccal/palatal], implant abutments angle); periapical radiographs (distance from the contact point to the interproximal bone crest of the adjacent tooth [CP-BC], distance from the contact point to the implant platform [CP-P], distance from the contact point to the first bone to implant contact [CP-IB]); and digital clinical photographs. Fisher exact test was used to determine the influence of each factor on the papilla level and on the facial marginal mucosal level. The papillae level at the implant sites was significantly associated with the distance from the contact point to the alveolar bone crest, whereas no association was found with other variables. Periimplant biotype, differences in the VKG, CP-BC, and CP-IB were found associated with the different facial marginal mucosal level groups. This study showed that the papilla level at single-tooth implants-abutments with LMS in the anterior maxilla was mainly influenced by the interproximal bone crest level of the adjacent tooth, whereas the marginal mucosal level was affected by periimplant biotype, facial bone crest level, and crestal implant exposition.
Pereira, Ana Margarida Rei
Tese de mestrado, Medicina Dentária, Universidade de Lisboa, Faculdade de Medicina Dentária, 2016 Introdução: Implantes imediatos são colocados após a extracção dentária. As vantagens são a possível diminuição do tempo de tratamento, do número de cirurgias e da reabsorção óssea que, possivelmente, melhora a estética final. As desvantagens poderão ser a dificuldade em atingir a estabilidade primária e o risco aumentado de infeções e complicações. Objetivos: Responder à questão PICO: “Em pac...
Morimoto, Taichiro; Tsukiyama, Yoshihiro; Morimoto, Keizo; Koyano, Kiyoshi
The purpose of this cone beam computed tomography (CBCT) study was to describe the facial bone changes around single implants for immediate placement and provisionalization following tooth extraction in the maxillary anterior. The data between 2008 and 2013 were collected retrospectively. Superimposed facio-palatal cross-sectional CBCT images for the implants were derived from preoperative and postoperative radiographs via standardized CBCT processes. Horizontal and vertical facial measurements on the implants were identified at preoperative and approximately 1-year postoperative follow-ups. Correlation coefficient for those parameters was evaluated. A total of 12 single implants in 12 patients were included in this study. The mean loading period was 13.3 months (range 12-15 months). The median data of preoperative bone thickness 0.54 mm (A), preoperative vertical bone level 1.46 mm (B), postoperative bone thickness 1.77 mm (C), postoperative vertical bone level 1.08 mm (D), horizontal distance from outer surface of preoperative facial bone to implant surface 2.08 mm (E), horizontal gap distance 1.41 mm (E-A), horizontal bone resorption -0.26 mm (E-C), and vertical bone resorption -0.25 mm (B-D) were obtained. The data at the implant platform level (IPL) were selected for the horizontal measurements. Spearman's analysis demonstrated statistically significant correlations between B and D, C and E, E and E-A, and B and E-C (P Immediate placement and provisionalization of single implants procedure in the maxillary anterior showed excellent outcomes with the small facial bone alterations around the implants. Neither preoperative facial bone thickness nor horizontal gap distance influenced the amount of facial bone resorptions. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Mir Abolfazl Motiei
Full Text Available Abstract Background: Anterior interbody fusion of the cervical spine have become the gold standard for treating spinal diseases, hence the aim of this study was to compare long term follow up results in patients with cervical disk disease treated with anterior PEEK cage implantation and without it in anterior approach. Methods: Retrospectively 63 patients with known cervical discogenic disorders who went under surgery with and without cage implantation were enrolled. The neurological examination and neurologic function were assessed by using the Japanese Orthopedic Association (JOA scoring system and neurological cervical spine scale (NCSS before and 8 years after surgery in each patient and at the end all complications were recorded. Results: In the first group, there were 15 males and 14 females (mean age: 49±10 years and in the second group there were 27 male and 7 female (mean age: 47±9 years. The NCSS score was significantly different between two groups after surgery (p=0.035 but there was no significant difference before surgery (p=0.163. No statistical significance difference was also observed in JOA score and complications before and after procedure, but JOA post surgery score between two groups had significant difference (p=0.047 . Conclusion: In conclusion, present study showed that PEEK cage implantation is a highly useful alternative to the conventional treatment methods.
Santing, Hendrik J; Raghoebar, Gerry M; Vissink, Arjan; den Hartog, Laurens; Meijer, Henny J A
The purpose of this prospective study was to evaluate radiographic, clinical and aesthetic outcomes and patient satisfaction of cases treated with platform-switched single implant restorations in the aesthetic region of the maxilla. Furthermore, the influence of an augmentation procedure 3 months before implant placement and the type of restoration (screw-retained vs. cement-retained) was evaluated. Sixty patients with a missing anterior tooth in the maxilla were treated with a Straumann Bone Level Implant. Bone augmentation was performed in 29 patients at 3 months before implant placement. Implants were loaded after 3 months of submerged healing. Follow-up was conducted at 7 and 18 months after implant placement. Peri-implant mucosa and implant crown aesthetic outcomes were determined using the Implant Crown Aesthetic Index (ICAI) and the Pink Esthetic Score-White Esthetic Score (PES-WES). No implants were lost. At 18 months after implant placement, mean bone level change was -0.10 ± 0.27 mm and mean probing pocket depth was 2.57 mm. No differences were found between augmented and nonaugmented sites (P = 0.28). The ICAI indicated satisfactory mucosa and crown aesthetics in 67% and 75% of the cases, respectively, while the PES score was 14.4. ICAI mucosa (P = 0.004) and PES (P = 0.02) scores were significantly less favourable for augmented sites compared with nonaugmented sites. Patient satisfaction was high (8.9 ± 1.1 on VAS-score). From the present prospective, clinical study, it can be concluded that the Straumann Bone Level Implant shows an excellent survival rate, marginal bone stability and good clinical and aesthetic results. Bone augmentation before implant placement does not lead to more marginal bone loss. However, less favourable pink aesthetic outcomes were found in augmented sites compared with nonaugmented sites, while no differences were found between cement-retained and screw-retained restorations. © 2012 John Wiley & Sons A/S.
Avaliação da contaminação da câmara anterior na cirurgia de facoemulsificação com implante de lente intra-ocular Anterior chamber contamination in phacoemulsification surgery with intraocular lens implant
Cesar Nobuo Shiratori
Full Text Available Objetivo: Avaliar a existência de contaminação da câmara anterior durante a facectomia por facoemulsificação com implante de lente intra-ocular. Método: Foi realizado estudo prospectivo, avaliando-se 30 pacientes submetidos a facectomia por facoemulsificação com implante de lente intra-ocular, colhendo-se duas amostras de humor aquoso, uma obtida no início e outra no final da cirurgia. As amostras foram semeadas em meio de cultura para germes aeróbios, anaeróbios e fungos. Resultado: Todas as amostras avaliadas resultaram negativas. Conclusão: A contaminação da câmara anterior na cirurgia de facoemulsificação com implante de lente intra-ocular, usando os cuidados necessários, é infreqüente.Purpose: To evaluate the frequency of anterior chamber contamination during phacoemulsification surgery with intraocular lens implant. Method: A prospective study was done with 30 patients submitted to phacoemulsification surgery with intraocular lens implant. Two samples of the aqueous humor were removed from the anterior chamber, one at the beginning and another one at the end of the surgery and were inoculated in culture plates for anaerobic and aerobic bacteria and fungi. Results: Intraocular aspirates yielded negative cultures. Conclusion: The absence of microorganisms in the samples evaluated allowed us to conclude that contamination during the phacoemulsification surgery with lens implant is unusual.
Contaminação bacteriana da câmara anterior pós-facoemulsificação com implante de lente intra-ocular de polimetilmetacrilato ou silicone Bacterial anterior chamber contamination after phacoemulsification and polymethylmethacrylate or silicone intraocular lens implantation
Ricardo Antonio Pereira
Full Text Available OBJETIVO: Avaliar a contaminação bacteriana da câmara anterior, após facoemulsificação não complicada, com tamanhos diferentes de incisões e lentes intra-oculares. MÉTODOS: Foi realizado estudo prospectivo randomizado, de 80 olhos de 80 pacientes, submetidos à facoemulsificação sob anestesia tópica, distribuídos aleatoriamente em dois grupos iguais. No grupo A foram alocados os pacientes submetidos à cirurgia com incisão de 3,0 mm, lente intra-ocular dobrável de silicone implantadas com injetor. No grupo B os pacientes foram submetidos à cirurgia com incisão de 5,8 mm e implante de lente intra-ocular de polimetilmetacrilato de peça única, com pinça. Ao final de cada cirurgia, uma amostra do líquido da câmara anterior foi colhida e semeada em meios de cultura para bactérias. RESULTADOS: A cultura do líquido da câmara anterior foi positiva em 2,5% dos casos do grupo A e em 5,0% do grupo B. Não houve diferença estatisticamente significante entre os dois grupos (chi2 = 0, 380, p> 0,05. CONCLUSÃO: O implante de lente intra-ocular através de incisão menor, não resultou em menor contaminação da câmara anterior na cirurgia de facoemulsificação.PURPOSE: To evaluate bacterial anterior chamber contamination following uncomplicated phacoemulsification with differents sizes of incisions. METHODS: Prospective randomized study, 80 eyes, 80 patients divided into two groups, were submitted to phacoemulsification with topical anaesthesia. In group A, with 40 patients, surgery was perfomed with 3.0 mm incision and silicone intraocular lens implant with injector. In group B the surgery was done with 5.8 mm incision and polymethylmethacrylate intraocular lens implant with forceps. Anterior chamber aspirate was taken for culture upon completion of surgery in each case. RESULTS: Anterior chamber cultures were positive in 2.5% of the cases in group A, and 5.0% in group B (chi-square test = 0.380, p>0.05, frequencies of
Petsos, Hari; Trimpou, Georgia; Eickholz, Peter; Lauer, Hans-Christoph; Weigl, Paul
Evaluation of the influence of professional competence on esthetic predictability of implant-supported crowns in the anterior maxilla and identification of objective factors allowing predictable planning for esthetic results. Sixty patients with 82 implants in the esthetic zone were included in this study. Width of keratinized mucosa, biotype, recessions, and papilla index according to Jemt as well as radiological bone loss were assessed. Study casts and photographs were obtained. Each patient as well as people with different level of expertise (laypersons, students and dentists) rated the esthetic satisfaction after final restoration on a scale (1-10). Correlations between esthetic assessments and previously documented clinical parameters were tested. The study failed to show a significant relationship between the raters' level of dental expertise and their subjective esthetic evaluation. However, patients rated themselves much more favorable than the three evaluator groups did. A comparison of the clinical parameters with the esthetic evaluation revealed significantly more favorable ratings by the lay group in the presence of a wide attached gingiva (P = 0.021) than by the other groups and by the laypersons (P = 0.002), the dentists (P = 0.003), and students (P = 0.009) in the absence of recessions. The ratio of the implant crown length to the length of the contralateral crown had a negative effect on ratings for all three groups ([laypersons P esthetic predictability of implant-supported crowns in the anterior maxilla in laypersons' ratings. Furthermore, there is an association between the discrepancy of lengths of implant-supported single crowns to their contralateral natural teeth and esthetic satisfaction for all expertise levels. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Zembic, Anja; Philipp, Alexander Otto Hermann; Hämmerle, Christoph Hans Franz; Wohlwend, Arnold; Sailer, Irena
Clinical studies on zirconia abutments report very good survival rates and biological and technical results, but few have an observation period of more than 5 years. The aim of this study was to assess the long-term performance of customized zirconia implant abutments supporting all-ceramic crowns. Twenty-seven patients receiving 54 single implants were included (25 incisors, 14 canines, 15 premolars in both jaws). Yttria-stabilized zirconia abutments were screwed to the implants with a defined torque. All-ceramic crowns were adhesively cemented onto the abutments. The implants, abutments, and crowns were clinically and radiographically examined after 11 years of use. Modified United States Public Health Service (USPHS) criteria were used to assess technical outcomes: fracture of abutment/crown framework/veneering ceramic, loosening of abutment screw/crown, marginal adaptation, anatomical form, occlusal wear, and abutment fit. The biological parameters were pocket probing depth, plaque control record, bleeding on probing, papilla index, and gingival/mucosal recession at implants and neighboring natural teeth. The cumulative success rate of abutments and crowns was calculated by the Kaplan-Meier method. The results of the USPHS criteria were analyzed descriptively. Sixteen patients with 31 zirconia abutments were examined at 11.3 (±0.9) years after implantation. No abutment or crown was lost. The cumulative success rate was 96.3% for abutments and 90.7% for crowns. Two abutment screws loosened, and three crowns exhibited minor chipping. There were no biological complications. Customized zirconia single implant abutments exhibited excellent long-term outcomes in anterior and premolar regions. © 2014 Wiley Periodicals, Inc.
Noelken, Robert; Kunkel, Martin; Jung, Britta A; Wagner, Wilfried
The concept of scalloped implants to maintain the natural contour of the alveolar ridge has been a source of controversy for many years. This study examined the long-term clinical performance of the scalloped NobelPerfect implant in a one-stage procedure (immediate loading in the esthetic zone). In 20 patients, immediate prosthetic restorations were placed on 31 NobelPerfect implants in a private practice and followed for up to 78 months. Twenty-one implants were placed immediately after extraction, seven implants were placed after osseous consolidation of the extraction sockets, and three implants were placed secondary to extended alveolar ridge augmentation procedures. All implants were provisionalized on the day of implant placement and adjusted to clear all contacts in centric occlusion and during eccentric movements. Outcome variables were success rates, marginal bone levels, and pink esthetic score (PES) assessed per implant. One implant failed after 1.4 months. Five patients with six implants in total were scored in the 5-year follow-up as dropouts. Mean follow-up period of remaining 24 implants was 65 months (range, 55-78 months). Cumulative success rates according to the criteria specified by Smith and Zarb were 96.8%. Marginal bone levels averaged 1.1 mm above the first thread. Mean PES ratings were 10.5 (range, 3-13). Survival rates, marginal bone levels, and esthetic results suggest proof of principle for the preservation of the interproximal bony lamella with a scalloped implant design in long-term data. © 2012 Wiley Periodicals, Inc.
Akkas, Ismail; Toptas, Orcun; Akpinar, Yusuf Ziya; Ozan, Fatih
Dental implants have been used for a long time to achieve better prosthetic and health conditions in the mouth. With the increase in their usage, more complications have occurred, and methods of solving these problems have been developed. One complication is insertion of the implant in the wrong direction. The aim of this case report is to describe an osteotomy technique to reposition a malpositioned dental implant. A female patient, aged 38 years, and a male patient aged 48 years, were refer...
Pithon, Matheus Melo
This clinical case report presents the nonsurgical orthodontic treatment of a patient with skeletal Class II malocclusion, posterior crossbite, anterior open bite, accentuated dental discrepancies in both arches, and an odontoma. The proposed treatment involved maxillary expansion, extraction of atypical maxillary lateral incisors and mandibular first molars, and intrusion of maxillary teeth with the aid of mini-implants. The results obtained with these procedures included good tooth alignment, normal overbite and overjet, removal of the odontoma, and a harmonious smile. In complex cases, an accurate diagnosis is the key to a favorable outcome. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Omar Fawzi Abduljabbar
Full Text Available Background and objective: Orthodontic space opening is a common treatment for congenitally missing teeth. Dental implants are often used to replace the missing tooth to establish ideal esthetics without restoring the adjacent teeth. This study aimed to investigate the outcome of implants placed in orthodontically created bone. Methods: Fifty dental implants were used for rehabilitation of lost tooth/teeth in 30 patients after space creation using orthodontic treatment. Patients with congenital and traumatic missing tooth/teeth, who lost the space for accommodation of normal size crown, and patients with spacing were enrolled in the study. NiTi open coil spring was used for space creation. The patients were followed up clinically and radiographically (OPG. Results: Out of 50 implants, the success rate was 78% (39 implants. Eleven implants (22% failed to get osseointegration. Mean age of the patients was 26.33. Female patients constituted 63.33%, and male patients 36.67%. A new one replaced all the failed implants. Most of the failures were in the mandible. Conclusion: Orthodontic treatment can be used as a type of osteodistraction method for provision of an acceptable amount of bone for dental implants. The quality of the gained bone can be improved by offering sufficient time for healing.
Akkas, Ismail; Akpinar, Yusuf Ziya; Ozan, Fatih
Dental implants have been used for a long time to achieve better prosthetic and health conditions in the mouth. With the increase in their usage, more complications have occurred, and methods of solving these problems have been developed. One complication is insertion of the implant in the wrong direction. The aim of this case report is to describe an osteotomy technique to reposition a malpositioned dental implant. A female patient, aged 38 years, and a male patient aged 48 years, were referred complaining of the malpositioned osseointegrated implants, which had been placed in the region of the left maxillary first premolar and molar tooth, and in the region of the left maxillary lateral incisor. Due to severe buccal positioning of the implant fixtures, acceptable prosthetic treatment was not possible. Alveolar osteotomy procedure was used to reposition the implants. Satisfactory results were obtained by osteotomy for 18-month of follow up. We conclude that inadequately axially inclined implants can be successfully treated by alveolar osteotomy. The preservation of marginal gingiva permits obtaining better prosthetic results. To avoid the recession of attached gingiva, palatal approach technique may help the clinicians. PMID:26023650
Tettamanti, Sandro; Millen, Christopher; Gavric, Jelena; Buser, Daniel; Belser, Urs C; Brägger, Urs; Wittneben, Julia-Gabriela
A successful implant reconstruction with optimal esthetics consists of a visually pleasing prosthesis and complete and healthy surrounding soft tissue. In the current literature, numerous indices used to qualitatively assess esthetics have been described. However, studies comparing the indices and their reproducibility are scarce. The aim of this study was to compare three different esthetic indices for the evaluation of single implant-supported crowns. A total of 10 prosthodontists (P), 10 orthodontists (O), 10 general dentists (G), and 10 lay people (L) independently performed the same assessment using 30 photographs and corresponding casts with three different esthetic indices (Peri-Implant and Crown Index [PICI], Implant Crown Aesthetic Index [ICAI], "Pink Esthetic Score/White Esthetic Score [PES/WES]) and repeated the evaluations 4 weeks later. The PES/WES and the PICI showed significantly higher esthetic scores (pink, white, total) and clinical acceptance compared with the ICAI in all four groups and in both assessments. The highest intraobserver agreement was achieved using the PES/WES and the least with the ICAI. The mean Kappa per group ranged from 0.18 (group L with ICAI) to 0.63 (group G with PICI). In comparison with the ICAI, the PES/WES and PICI were more reproducible. Therefore, PES/WES and PICI seem to be more suitable as esthetic indices for single implant crowns. © 2015 Wiley Periodicals, Inc.
Freitas, Amilcar C; Bonfante, Estevam A; Rocha, Eduardo P; Silva, Nelson R F A; Marotta, Leonard; Coelho, Paulo G
The mechanical performance of cemented or screw-retained implant-supported crowns with an internal or external configuration is yet to be understood. This in vitro study evaluated the effect of screw-retained and cement-retained prostheses on internal and external implant-abutment connections. Thereby, the reliability and failure modes of crowns were investigated. Eighty-four implants (Emfils; Colosso Evolution system) were divided into four groups (n=21 each): screw-retained and internal connection (Si), screw-retained and external connection (Se), cement-retained and internal connection (Ci), and cement-retained and external connection (Ce). Ti-6Al-4V abutments were torqued (30 Ncm) to the implants, and maxillary central incisor metal crowns were torqued (30 Ncm) or cemented (Rely X Unicem; 3M-ESPE) and subjected to accelerated life-testing in water. Use-level probability Weibull curves and reliability for 50,000 cycles at 150 N were calculated. The β values for Si (1.72), Se (1.50), Ci (1.34), and Ce (1.77) groups indicated that fatigue/damage accumulation accelerated their failure. The Ci group presented the highest reliability, the Se group presented the lowest reliability, and Si and Ce groups presented intermediate reliability. Screw-retained restorations presented mainly abutment fracture. Cement-retained restorations resulted in failures of the screw in the Ce group, but implant/screw fracture in the Ci group. © 2011 Eur J Oral Sci.
Gomes, Filipe Manuel dos Santos Pedreira
Trabalho apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária A possibilidade de reabilitação oral com implantes dentários osteointegráveis, em pacientes total ou parcialmente desdentados, mostrou um avanço significativo nos últimos quarenta anos. Uma das propostas de reabilitação, bem documentadas e com taxas de sucesso quase similares à verificada em casos de colocação convencional de implantes, é a possibilidade de ...
Vivo dosimetry using TLD detectors in prostate seed implants of I-125: preliminary results; Dosimetria in vivo mediante detectores de TLD en implantes de prostata con semillas de I-125: resultados preliminares
Sanchez-Reyes, A.; Pedro, A.; Bassas, P.; Duch, M. A.; Cros, M.; Mane, S.
We present preliminary results of a new in vivo dosimetry technique that could allow to know immediately after implantation of the prostate if the dose distribution determined by the scheduler is similar to the actual dose measured with TLD detectors.
Full Text Available We present here the case of a 24-year-old male who experienced progressive keratoconus and vision loss which adversely affected his ability to carry out everyday tasks. This landed him in the Hashmanis Hospital for consultation. He had a preoperative best corrected visual acuity of 6/12. He underwent multiple Oculus Pentacam examinations, which showed progressive keratoconus. Corneal collagen cross-linking (CXL was performed to stabilize his cornea and, subsequently, an Artiflex anterior chamber iris-fixated phakic intraocular lens (ACIF-PIOL was implanted to alleviate his refractive errors. The patient achieved a postoperative uncorrected visual acuity of 6/12. This report shows that CXL combined with ACIF-PIOL can be safe and effective in those with progressive keratoconus.
Kazemi, S; Wirostko, W J; Sinha, S; Mieler, W F; Koenig, S B; Sheth, B P
To review our experience with combined pars plana lensectomy-vitrectomy and open-loop flexible anterior chamber intraocular lens (AC IOL) implantation for managing subluxated crystalline lenses. Retrospective review of 36 consecutive eyes (28 patients), all of which had subluxated crystalline lenses, managed by pars plana lensectomy-vitrectomy with insertion of an open-loop flexible AC IOL. The study was performed at the Medical College of Wisconsin, Milwaukee, over an 8-year period. An average preoperative visual acuity of 20/163 (range, 20/25 to hand motions) improved to 20/36 (range, 20/20 to 4/200) with surgery after a mean follow-up of 14 months (range, 1 to 59 months) (P IOL implantation appears to be an excellent technique for managing subluxated crystalline lenses. It is associated with a significant improvement in visual acuity (P subluxated lens through a limbal wound. Additionally, use of an AC IOL offers a simplified alternative to placement of a ciliary sulcus sutured posterior chamber intraocular lens (PC IOL).
Romanos, Georgios E; Malmstrom, Hans; Feng, Changyong; Ercoli, Carlo; Caton, Jack
Platform-switched implants have been demonstrated to maintain marginal bone-level stability after immediate loading. The present study evaluated crestal bone loss and soft tissue stability around ANKYLOS plus® implants (A-implants) and Certain® PREVAIL(TM) (B-implants). Patients were identified to receive three A- or three B-implants on each side of their mandibles, with randomization. All implants were loaded immediately after their insertion and splinted with a cemented provisional prosthesis. Final prostheses were delivered 3 months after implantation. Peri-implant crestal bone loss, gingival recession, and other soft tissue changes were evaluated throughout a 2-year follow-up. A total of one hundred seven implants were placed in 18 patients. Two of the group A-implants and one group B-implant failed. At the final 24-month assessment, bone loss of at least 2 mm (mesially or distally) was recorded at 5 of the 44 surviving A-implants (11%) and 33 of the 47 B-implants (70%), a success rate of 88.63% for the A- and 29.78% for the B-implants. Significant changes in the level of the crestal bone loss around immediately loaded platform-switched dental implants seem to be related to the platform shape and size, as well as the implant-abutment connection, when abutments are not removed. © 2013 Wiley Periodicals, Inc.
The distribution is determined of some sequences that measure how well a number is approximated by its mediants (or intermediate continued fraction convergents). The connection with a theorem of Fatou, as well as a new proof of this, is given.
Gao, Li-Jian; Chen, Ji-Lin; Chen, Jun; Yang, Yue-Jin; Gao, Run-Lin; Li, Jian-Jun; Qin, Xue-Wen; Qiao, Shu-Bin; Xu, Bo; Yao, Min; Liu, Hai-Bo; Wu, Yong-Jian; Yuan, Jin-Qing; Chen, Jue; You, Shi-Jie; Dai, Jun
Drug-eluting stents (DES) are superior to bare metal stents (BMS) for treating ostial left anterior descending artery (LAD) lesions, but DES is not suitable for all patients in real life practice. We hypothesize that cutting balloon angioplasty (CBA) followed by BMS (CBA + BMS) for treating ostial LAD lesions is an alternative strategy. In our study, 101 consecutive patients (51 with DES and 50 with CBA + BMS) with ostial LAD stenting were included for retrospective investigation between November 2003 and May 2005. The target vessel diameter was > or =3.0 mm. We compared the DES group with the CBA + BMS group, the rates of restenosis (10.3% versus 17.9%, p = 0.386), target lesion revascularization (TLR) (5.88% versus 10%, p = 0.487) and major adverse cardiac events (MACE) (7.84% versus 12%, p = 0.525) were similar at 6-8 months angiographic follow-up, but there were higher bleeding events in the DES group (p = 0.033). During a 2-year clinical follow-up, no myocardial infarction occurred in the 2 groups, the rates of TLR (7.84% versus 10%, p = 0.741) and MACE (9.8% versus 12%, p = 0.723) were also similar. The MACE-free survival rate was 90.2% versus 88 % (p = 0.723). The CBA + BMS combination has a good long-term clinical effect in the treatment of ostial LAD lesions; it might be an alternative strategy for patients with contraindication for DES implantation, or patients who cannot endure long-term dual antiplatelet medication, or in elderly patients.
Marín García, Fernando
El contraste de las diferentes alternativas terapéuticas en la regeneración ósea y el establecimiento de las indicaciones precisas para cada caso son una constante en la investigación, para obtener el mejor resultado y la menor morbilidad. Las técnicas de tunelización permiten un abordaje más seguro, pero ¿se pueden hacer injertos óseos mediante tunelización logrando un hueso con el que tener el mismo resultado que los implantes alojados en huesos indemnes? Se seleccionaron casos de déficit ó...
Calvo Guirado, José Luis; Sáez Yuguero, Rosario; Ferrer Pérez, Vicente; Moreno Pelluz, Alberto
Implant dentistry has evolved from a functional replacement of teeth to an aesthetically driven replacement of the natural tooth system. An immediate implant insertion after extraction may maintain the crestal bone and the interdental gingival soft tissue. With proper design, the implant gingival complex will heal to restore the correct gingival environment. In this prospective study, 18 Osseotite (3i, USA) implants were placed in 13 patients (8 women and 5 men with an average age of 32 years), using an immediate implant placement protocol and immediate loading by provisional crowns. Using the life table analysis method, the cumulative implant success rate was calculated at 100 per cent. A one-year interim report indicates that the implant developed and extended; functional osseous state show a predictable and reliable method after one year follow up period.
Complementary method of analyzing the quality of the implant I-125 seeds for prostate brachytherapy using ultrasound imaging post-implant; Metodo complementario de analisis de la calidad del implante de semillas de I-125 para braquiterapia de prostata mediante la adquisicion de imagenes ecograficas post-implante
Jimenez Dominguez, M.; Carrasco Herrera, M.; Baeza Trujillo, M.; Herrador Cordoba, M.
In this paper we propose a complementary method based on Longitudinal mode ultrasound images acquired the same day of surgery, at the end of the implant. This option will allow us to evaluate the dosimetry end of treatment with the patient in the same position he was planning and to the rectum and bladder just as full. This will permit the identification of bodies and the seeds of interest more easily and will have a reference with which to compare one month later, when the CT images can also detect whether there has been some migration.
Andonissamy, Leoney; Vidhya, N. Sri
Implant dentistry has provided a lot of surgical as well as prosthetic techniques for improving the success of the implants. The surgical technique commonly followed now prior to implant placement is bone grafting procedure. One of the commonest techniques is the use of autologous block graft harvested from mandibular chin region. However, interference in healing as well as excessive bone resorption due to the use of removable provisional prosthesis over the bone grafted region has been commo...
Effect of alpha lipoic acid co-administration on structural and immunohistochemical changes in subcutaneous tissue of anterior abdominal wall of adult male albino rat in response to polypropylene mesh implantation.
Mazroa, Shireen A; Asker, Samar A; Asker, Waleed; Abd Ellatif, Mohamed
Polypropylene mesh is commonly used in the treatment of abdominal hernia. Different approaches were addressed to improve their tissue integration and consequently reduce long-term complications. This study aimed to investigate the effect of alpha-lipoic acid (ALA) co-administration on structural and immunohistochemical (IHC) changes in the subcutaneous tissues of the anterior abdominal wall of the adult rat in response to polypropylene mesh implantation. Forty adult male albino rats were divided into: group I (control), group II (receiving ALA), group III (polypropylene mesh implantation) and group IV (mesh implantation + ALA co-administration). After 4 weeks, subcutaneous tissue samples were prepared for light microscopy and IHC study of CD34 as a marker for angiogenesis. In groups I and II rats, positive CD34 expression was demonstrated by IHC reaction, localized to endothelial cells lining small blood vessels. Group III showed an excess inflammatory reaction, deposition of both regular and irregularly arranged collagen fibres around mesh pores and few elastic fibres. CD34-positive was detected not only in cells lining small blood vessels but also in other cells scattered in the connective tissue indicating angiogenesis. In group IV, ALA co-administration resulted in less inflammatory reaction, regular collagen deposition, enhanced elastic fibres synthesis and a significant increase in CD34-positive cells and small blood vessels reflecting improved angiogenesis. ALA co-administration with polypropylene mesh implantation controlled the inflammatory reaction, helped regular collagen deposition, enhanced elastic fibres synthesis and improved angiogenesis in the subcutaneous tissue of anterior abdominal wall of adult albino rats, suggesting a possible role of ALA in optimizing mesh integration in subcutaneous tissue. © 2015 The Authors. International Journal of Experimental Pathology © 2015 International Journal of Experimental Pathology.
Paul, Stefan; Held, Ulrike
To assess the stability of the peri-implant bone, the peri-implant soft tissues and the esthetic success of immediately placed implants. In this retrospective study, scalloped-shaped implants were placed immediately and 1.5 mm supracrestally after single-tooth extraction. All implants were immediately restored with an implant-supported temporary crown. Clinical and radiographic parameters were assessed on the day of tooth extraction with subsequent implant placement and temporization, after 6 months at delivery of the final crown, and after 1, after 3, and up to 5 years after crown delivery. All 31 implants were clinically successful and in function during the observation period (mean 3.4 years). The peri-implant soft tissues were clinically healthy as indicated by a low mean plaque (below 0.5) and sulcus bleeding index (below 0.24) values. The distance between the implant shoulder and the first visible bone-to-implant contact (DIBrx) was measured at the mesial and distal aspects of each implant using periapical radiographs. Mean values for DIBrx of 1.73 ± 0.59 mm directly after implant placement and 2.25 ± 0.66 mm after the observation period demonstrated stable peri-implant bone levels. The mean distance from the implant shoulder to the gingival margin on the labial aspect (DIM vestibular) was 2.21 ± 1.09 mm directly after implant placement. Respective values at 1 year, at 3 years and at 5 years after crown delivery remained stable thus demonstrating little if any gingival recession. The assessed mean values for the pink (PES) and white (WES) esthetic score (0 = 0-33% score, 1 = 34-66% score, 2 = 67-100% score) were 8/4 directly after implant placement and 9/10 after 1.5-5.5 years of observation. After an observation time of 1.5-5.5 years all implants demonstrated very stable soft tissue levels with little if any recession on mesial, distal and labial aspects and an esthetic score that was reasonable directly after temporization and
Evaluation of the clinical and aesthetic outcomes of Straumann(®) Standard Plus implants supported single crowns placed in non-augmented healed sites in the anterior maxilla: a 5-8 years retrospective study.
Zhao, Xu; Qiao, Shi-Chong; Shi, Jun-Yu; Uemura, Naoya; Arai, Korenori; Lai, Hong-Chang
To evaluate the long-term aesthetic outcome of the single crowns supported by soft tissue level implants placed in healed sites in the anterior maxilla region via the pink aesthetic score (PES) and the white aesthetic score (WES). According to the inclusion criteria, patients who had received a single Straumann(®) Standard Plus implant in the anterior maxilla at the Shanghai 9th People's Hospital between 2005 and 2008 were invited for a re-examination based on a number of inclusion criteria and exclusion criteria. Clinical, radiographic and aesthetic outcomes (PES/WES) were assessed during their revisit at 5-8 years after crown placement. Forty-five patients were enrolled in the study. All 45 implants were successfully integrated and most of the implants did not show signs of peri-implant disease at the time of the assessment. The marginal bone resorption was 1.10 ± 0.92 mm. The mean total PES was 8.48 ± 2.62 at the baseline, 9.57 ± 2.37 at the 6-10 months revisit and 9.01 ± 2.45 at the 5-8 years follow-up. The scores of the mesial and distal papillae increased significantly between the baseline and 6-10 months follow-up, this improvement remained stable at the 5-8 years follow-up. The scores of soft tissue level, colour of the soft tissue, soft tissue texture and the alveolar process decreased significantly between the 6-10 months and 5-8 years revisits. The mean WES was 7.83 ± 1.60 at the baseline and 7.72 ± 1.43 at the 5-8 years revisit. There was no significant difference of the WES between the baseline and 5-8 years revisit. The possibility of spontaneous papillae regeneration after implant treatment and the long-term stability of the regenerated papillae were confirmed. However, recession of the facial soft tissue has been found. The incidence of the recession at thin biotype sites tended to be higher. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Esposito, Marco; Barausse, Carlo; Pistilli, Roberto; Jacotti, Michele; Grandi, Giovanni; Tuco, Lorenzo; Felice, Pietro
To compare the effectiveness of immediate post-extractive single implants with delayed implants, placed in preserved sockets after 4 months of healing. Implants that achieved an insertion torque of at least 35 Ncm were immediately non-occlusally loaded. Just after tooth extraction, and in the presence of less than 4 mm of vertical loss of the buccal bone in relation to the palatal wall, 106 patients requiring a single immediate post-extractive implant in the maxilla from second to second premolar were randomly allocated to immediate implant placement (immediate group; 54 patients) or to socket preservation using anorganic bovine bone covered by a resorbable collagen barrier (delayed group; 52 patients), according to a parallel group design at three different centres. Bone-to-implant gaps were to be filled with anorganic bovine bone, however this was not carried out in 17 patients (corresponding to 40% of those who should have been grafted). Four months after socket preservation, delayed implants were placed. Implants inserted with an insertion torque of at least 35 Ncm were immediately loaded with non-occluding provisional single crowns, then replaced after 4 months by definitive crowns. Patients were followed up to 1 year after loading. Outcome measures were implant failures, complications, aesthetics assessed using the pink esthetic score (PES), peri-implant marginal bone level changes and patient satisfaction recorded by blinded assessors. Nineteen (35%) implants were not immediately loaded in the immediate group versus 39 (75%) implants in the delayed placement group because an insertion torque superior to 35 Ncm could not be obtained. Six patients dropped out 4 months after loading from the delayed group versus none in the immediate group. Two implants failed in the immediate group (6%) versus none in the delayed group, with the difference showing no statistical significance (difference in proportions = 0.04; 95% CI: -0.03 to 0.11; P = 0.187). Eight minor
Tselios, Nikolaos; Parel, Stephen M; Jones, John D
A patient underwent immediate implant placement and immediate provisional restoration with nonocclusal loading in the right central incisor area. A provisional custom abutment and a cemented provisional restoration were fabricated. At the impression appointment, an implant level impression was made and the provisional abutment was scanned for fabrication of the definitive custom abutment. This clinical report describes how CAD/CAM technology can facilitate the definitive restoration of immediately placed and loaded implants by allowing the fabrication of the definitive abutment as an exact duplicate of the provisional abutment.
-pull headgear, chin cup, bite blocks, functional appliances, extractions, multi-loop edgewise arch wires and mini implant. The stability is the most important criterion in deciding the treatment method for anterior open bite malocclusion.
Andonissamy, Leoney; Vidhya, N Sri
Implant dentistry has provided a lot of surgical as well as prosthetic techniques for improving the success of the implants. The surgical technique commonly followed now prior to implant placement is bone grafting procedure. One of the commonest techniques is the use of autologous block graft harvested from mandibular chin region. However, interference in healing as well as excessive bone resorption due to the use of removable provisional prosthesis over the bone grafted region has been commonly observed/reported. Hence now-a-days, fixed provisional prosthesis is preferred over removable provisional prosthesis for the added advantages of superior aesthetics and patient acceptance. This article highlights a new technique of fabricating removable provisional prosthesis, which is superior in aesthetics and strength, consumes less chair time and exerts zero pressure onto the grafted site.
Doors, M.; Cruysberg, L.P.J.; Berendschot, T.T.; Brabander, J. De; Verbakel, F.; Webers, C.A.; Nuijts, R.M.
BACKGROUND: The repeatability and interchangeability of imaging devices measuring central corneal thickness (CCT) and anterior chamber depth (ACD) are important in the assessment of patients considering refractive surgery. The purpose of this study was to investigate the agreement of CCT and ACD
Oseointegración en implantes Bicon® cargados a los tres meses después de haber sido colocados mediante la técnica de elevación interna del seno maxilar en pacientes atendidos en la facultad de odontología de la universidad de Cartagena
Full Text Available ResumenObjetivo: El objetivo general de este estudio fue evaluar la oseointegración en implantes tipo Bicon® cargados a los tres meses de colocados, mediante la técnica de elevación interna de seno maxilar. Materiales y Métodos: Este estudio se establece como una investigación de tipo descriptivo, basado en una serie de casos clínicos tratados. En la recolección de la información se utilizó un instrumento en donde se registraron los datos personales de los pacientes, se realizó la toma de radiografías panorámicas iniciales y radiografías periapicales utilizadas para observar la neoformación ósea y medir el aumento del piso del seno maxilar. La información fue consignada y tabulada en tablas y gráficos de frecuencia. Resultados: De los implantes colocados ninguno presentó movilidad ni patologías perimplantares, el piso del seno maxilar se aumentó en promedio 2.6 mm y se presentó neoformación ósea adecuada a los tres meses, lo que permitió la carga de los implantes. Conclusiones: Se determinó que a los tres meses se logra una suficiente oseointegración con los implantes, que en conjunto con la elevación interna del piso del seno maxilar y el grado de neoformación ósea alcanzado dieron a los implantes las condiciones necesarias para poder cargar los mismos. Además, la ausencia total de lesiones perimplantarias señalan el cumplimiento estricto de las normas tecnoquirurgicas, evaluación e instrucción a los pacientes que se han estado manejando dentro del proceso de la colocación de los implantes Bicon®. (Duazary 2007; 2: 93 - 99AbstractObjective: The general objective of this investigation was to evaluate the oseointegration of Bicon® dental implants that have been charge after three month of put it with internal sinus lift in maxillary sinus Material and Methods: This investigation has been stablished as a descriptive study, support in clinic cases. In order to recollect the information, a format was used to
Slot, Jan; Raghoebar, Gerry M.; Vissink, Arjan; Meijer, Henny J. A.
Background: For maxillary overdenture therapy, treatment guidelines are missing. There is a need for longitudinal studies. Purpose: The purpose of this 1-year prospective case series study was to assess the treatment outcome of maxillary overdentures supported by six dental implants opposed by
Sagar S Padmawar
Conclusion: Stresses on the teeth are higher and distributed more evenly, when the point of force application is bilateral rather than a single source. Bilateral implants generate less stresses which are evenly distributed with minimum detrimental effect on the teeth during absolute intrusion.
Santing, Hendrik J.; Raghoebar, Gerry M.; Vissink, Arjan; den Hartog, Laurens; Meijer, Henny J. A.
Aim The purpose of this prospective study was to evaluate radiographic, clinical and aesthetic outcomes and patient satisfaction of cases treated with platform-switched single implant restorations in the aesthetic region of the maxilla. Furthermore, the influence of an augmentation procedure 3months
Hourfar, Jan; Kanavakis, Georgios; Bister, Dirk; Schätzle, Marc; Awad, Layla; Nienkemper, Manuel; Goldbecher, Christine; Ludwig, Björn
The aim of this retrospective investigation was to measure vertical bone thickness on the hard palate, determine areas with adequate bone for the insertion of orthodontic mini-implants (MIs), and provide clinical guidelines for identification of those areas. Pre-treatment records of 1007 patients were reviewed by a single examiner. A total of 125 records fulfilled the inclusion criteria and were further investigated. Bone measurements were performed on cone-beam computed tomography scans, at a 90° angle to the bone surface, on 28 predetermined and standardized points on the hard palate. Bone thickness at various areas was associated to clinically identifiable areas on the hard palate by means of pre-treatment plaster models. Bone thickness ranged between 1.51 and 13.86 mm (total thickness) and 0.33 and 1.65 mm (cortical bone thickness), respectively. Bone thickness was highest in the anterior palate and decreased significantly towards more posterior areas. Plaster model analysis revealed that bone thickness was highest at the level of the third palatal ruga. The areas on the anterior palate with adequate bone thickness for successful insertion of orthodontic MI correspond to the region of the third palatal ruga. These results provide stable and clinically identifiable landmarks for the insertion of palatal MIs. © The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: email@example.com.
Magne, Pascal; Paranhos, Maria Paula Gandolfi; Burnett, Luiz Henrique; Magne, Michel; Belser, Urs Christoph
This study assessed the fatigue resistance and failure mode of type III porcelain and composite resin veneers bonded to custom zirconia implant abutments. Twenty-four standardized zirconia implant abutments were fabricated. Using the CEREC 3 machine, type III veneers of standardized shape were milled in ceramic Vita Mark II or in composite resin Paradigm MZ100. The intaglio surfaces of the restorations were hydrofluoric acid etched and silanated (Mark II) or airborne-particle abraded and silanated (MZ100). The fitting surface of the abutments was airborne-particle abraded, cleaned, and inserted into a bone level implant (BLI RC SLActive 10 mm). All veneers (n=24) were adhesively luted with a zirconia primer (Z-Prime Plus), adhesive resin (Optibond FL) and a pre-heated light-curing composite resin (Filtek Z100). Cyclic isometric chewing (5 Hz) was simulated, starting with a load of 40 N, followed by stages of 80, 120, 160, 200, 240, and 280 N (20,000 cycles each). Samples were loaded until fracture or to a maximum of 140,000 cycles. Groups were compared using the life table survival analysis (Logrank test at P=.05). Mark II and MZ100 specimens fractured at an average load of 216 N and 229 N (survival rate of 17% and 8%), respectively, with no difference in survival probability (P=.18). Among the fractured samples, 40% of the failures were at the abutment level for Mark II and 27% were at the abutment level for MZ100. No exclusive adhesive failures were observed. Type III Mark II and Paradigm MZ100 veneers showed similar fatigue resistance when bonded to custom non-retentive zirconia implant abutments. The bond was strong enough to induce abutment fractures. MZ100 presented a higher percentage of "friendly" failures, i.e. maintaining the restoration-abutment adhesive interface and the abutment itself intact. © 2010 John Wiley & Sons A/S.
Preliminary simulation of implants breast through the accelerated partial irradiation technique: coverage rates and homogeneity; Simulacion previa de implates de mama mediante la tecnica de irradiacion parcial acelerada: indices de cubrimiento y homegeneidad
Moral Sanchez, S. C.; Paula Carranza, B. de; Erzibengoa, M.; Bragado Alvarez, L.; Guisasola Berasetegui, A.
In this work we present and evaluate the process of pre-simulation we have drawn up when it comes to treatments of accelerated partial irradiation of breast. Previous simulation that we will allow you to have greater control over the location of catheters with respect to the area to radiate. The goodness of this procedure is evaluated through representative quality indexes of the implant. (Author)
Huamaní Chávez, Alexis; Balarezo Razzeto, José Antonio; Matta Morales, Carlos; Ccahuana Vásquez, Vanessa
En el presente reporte se describen 03 casos clínicos de rehabilitación sobre implantes unitarios en el sector anterior: 01 sist. Lifecore-Renova (3,75 mm Ø, 13 mm. longitud, conexión interna), 02 del sist. Conexão (5 mm Ø x 13 mm. de longitud; 4,3 mm Ø x 15 mm. de longitud, conexión interna). En la etapa de provisionales, se realizó manejo de tejidos blandos a través de restauraciones atornilladas provisionales (6-8 meses). En la rehabilitación definitiva se rehabilitaron, mediante el uso de...
Alternativas a la elevación de seno maxilar: rehabilitación del sector posterior del maxilar atrófico mediante implantes pterigoideos Alternatives to maxillary sinus lift: posterior area of the atrophic maxilla rehabilitation by means pterigoideal implants
Full Text Available El primer y segundo molar son los dientes que se pierden más a menudo debido a la enfermedad periodontal y al exceso de fuerzas oclusales. A pesar de la frecuencia del edentulismo parcial del sector posterior raramente se ubican los implantes más allá de los premolares debido al aumento del índice de fallos. El escaso volumen óseo y la pobre mineralización del sector posterior del maxilar comprometen la viabilidad de las rehabilitaciones con implantes a largo plazo. Además, la cresta ósea a nivel del seno maxilar, en el maxilar atrófico, no suele permitir el anclaje de implantes de 10 mm. Se han propuesto varias técnicas para rehabilitar el sector posterior del maxilar atrófico: implantes cortos, extensiones protésicas, injerto sinusal, implante cigomático. El implante pterigoideo es otro de los posibles tratamientos para rehabilitar el sector posterior del maxilar atrófico. Anclado en el hueso cortical de la apófisis del esfenoides el implante pterigoideo evita la necesidad de injertar o utilizar extensiones protésicas. El objetivo de este artículo es analizar las indicaciones, la técnica, complicaciones y supervivencia del implante pterigoideo en el sector posterior del maxilar atrófico.The first and second molar are the teeth most commonly lost in the maxilla, mainly due to periodontal disease and excessive occlusal force. 1 Although partial edentulism of the posterior maxilla is common, implants are seldom placed distal to the premolars because failure rates in the posterior maxilla have historically been high. Poor volume and low density of bone are the worst conditions for long-term anchorage in the maxilla. 7 Moreover, bone under the maxillary sinus, in the atrophic maxilla, is usually insufficient to enable placement of 10 mm implants. Several techniques have been proposed to restore the atrophic posterior maxilla: short implants, prosthetic cantilevers, sinus bone graft, zigomatic fixtures. Pterygoid implants are
Mitra Karbasi Kheir
Conclusion: Great care is required when placing implants in proximity to mental foramen to avoid anterior loop injury. Because of the variations of anterior loop length in each patient, a fixed distance anterior to the mental foramen is not safe, and the anterior loop length should be determined for each individual. The use of CBCT provides accurate measurements of the length of anterior loop.
Eduardo Andrés Borie Echevarria
A reabilitação da região anterior com próteses sobre implantes é um procedimento complexo pela quantidade de fatores que devem ser controlados. Nos casos em que o paciente apresenta estruturas anatômicas ou deficiências ósseas na região da prémaxila, que impeçam o ideal posicionamento de todos os implantes possíveis, o clínico deverá escolher entre um planejamento com prótese em cantilever ou fixa convencional. O sucesso clínico de reabilitação com implantes está relacionado, principalmente, ...
Geckili, Onur; Bilhan, Hakan; Geckili, Esma; Cilingir, Altug; Mumcu, Emre; Bural, Canan
To analyze the prognostic factors that are associated with the success, survival, and failure rates of dental implants. Data including implant sizes, insertion time, implant location, and prosthetic treatment of 1656 implants have been collected, and the association of these factors with success, survival, and failure of implants was analyzed. The success rate was lower for short and maxillary implants. The failure rate of maxillary implants exceeded that of mandibular implants, and the failure rate of implants that were placed in the maxillary anterior region was significantly higher than other regions. The failure rates of implants that were placed 5 years ago or more were higher than those that were placed later. Anterior maxilla is more critical for implant loss than other sites. Implants in the anterior mandible show better success compared with other locations, and longer implants show better success rates. The learning curve of the clinician influences survival and success rates of dental implants.
... Medical Procedures Implants and Prosthetics Breast Implants Breast Implants Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Breast implants are medical devices that are implanted under the ...
Narimatsu, Akiko; Higuchi, Mutsuo; Shigeta, Akiko
Materials were 26 malignant anterior mediastinal tumors: 7 thymic carcinomas, 6 invasive thymomas, 7 malignant lymphomas (ML) and 6 malignant germ cell tumors (GCT). Egg shell calcification in the tumor was indicative of the invasive thymoma. Presence of conglomerated mass in the anterior mediastinum strongly suggested the diagnosis of ML. Although differentiation between thymic carcinoma and ML was difficult, punctate calcification and pleural implants were frequently found in the former. GCT showed no significant findings on CT. However, another clinical information was helpful to make correct diagnosis. CT guided biopsy is necessary to diagnose the malignant anterior mediastinal tumors. (author)
Narimatsu, Akiko; Higuchi, Mutsuo; Shigeta, Akiko (Tokyo Women' s Medical Coll. (Japan))
Materials were 26 malignant anterior mediastinal tumors: 7 thymic carcinomas, 6 invasive thymomas, 7 malignant lymphomas (ML) and 6 malignant germ cell tumors (GCT). Egg shell calcification in the tumor was indicative of the invasive thymoma. Presence of conglomerated mass in the anterior mediastinum strongly suggested the diagnosis of ML. Although differentiation between thymic carcinoma and ML was difficult, punctate calcification and pleural implants were frequently found in the former. GCT showed no significant findings on CT. However, another clinical information was helpful to make correct diagnosis. CT guided biopsy is necessary to diagnose the malignant anterior mediastinal tumors. (author).
Giselle Póvoa Gomes
Full Text Available In implants, maintenance is a decisive factor for obtaining success when implant supported overdentures and dentures are used. The present stud presents, a clinical case of a patient, a 70 year-old white man, with a completely edentulous mandibular alveolar ridge, severe bone resorption with presence of basal bone only, and absence of vestibule. Initially, treatment consisted of the placement of a mandibular overdenture, supported on three implants in the anterior inter-foramen region, as the left implant was transfixed in the basal bone of 2 to 3 millimeters. Eleven years later, another two implants were placed in the anterior area and an immediate load was performed up to the first molars, for the placement of an implant supported fixed. Throughout the entire treatment, meticulous maintenance was carried out, with follow-up for fourteen years, interrupted by the patient’s death. From the third month after the opening the three implants initially placed, the presence of keratinized mucosa, definition of the vestibule, maturation of the alveolar ridge and bone formation in the mento region were observed. It was concluded that good planning, allied to mastery of the technique and adequate maintenance were the prerequisites necessary for obtaining favorable results, success of the present case, and for the patient to have a better quality of life.
Conclusiones: En este estudio se presenta un protocolo establecido y se establece la necesidad de un diagnóstico detallado para planificar la rehabilitación mediante implantes dentales posterior a un trauma con un equipo multidisciplinario.
Iván Hernández López
Full Text Available OBJETIVO: Presentar un nuevo signo clínico como resultado del desprendimiento gigante del epitelio pigmentado posterior del iris en el curso de un síndrome tóxico del segmento anterior tras una cirugía de catarata. MÉTODOS: Presentamos un paciente intervenido de catarata mediante facoemulsificación con implante de lente intraocular de cámara posterior plegable, sin incidencias ni complicaciones transoperatorias. Se le realizó evaluación biomicroscópica en el posoperatorio inmediato diagnosticándosele un síndrome tóxico del segmento anterior asociado a un desprendimiento gigante del epitelio pigmentado posterior del iris. Se tomaron fotos durante la evolución del paciente para documentar este raro signo clínico. RESULTADOS: Al provocar la dilatación pupilar farmacológica nos encontramos con la retracción de todas las capas anteriores del iris, mostrando por debajo al epitelio pigmentado posterior del iris sinequiado al lente intraocular y tan extensamente desprendido que simulaba un segundo iris. No encontramos este hallazgo clínico reportado en la literatura revisada. Denominamos este signo como iris en sayuela. CONCLUSIONES: El desprendimiento del epitelio pigmentado posterior del iris constituye un hallazgo clínico que puede aparecer raramente asociado al síndrome tóxico del segmento anterior y cuando es muy extenso puede presentarse de forma insólita como el signo del iris en sayuela.OBJECTIVE: To present a new clinical sign as a result of a huge posterior pigmented epithelium detachment of the iris in the course of at toxic anterior segment syndrome after a successful cataract surgery. METHOD: A patient who had undergone a cataract surgery by phacoemulsification with posterior chamber foldable intraocular lens implantation, without any incidence or transoperative complication. He was evaluated through biomicroscopy in the immediate postoperative period where a huge posterior pigmented epithelium detachment of the iris
Narang, Sumit; Narang, Anu; Jain, Kapil; Bhatia, Vineet
The replacement of missing teeth with implant-borne restorations has become a treatment modality accepted by the scientific community for fully and partially edentulous patients. Recent reports have demonstrated the successful placement of dental implants into the fresh extraction socket in the anterior as well as in molar regions, which is made possible due to modification in implant surface. The present case report highlights the placement of three bicortical screw (BCS) implants into the f...
Narang, Sumit; Narang, Anu; Jain, Kapil; Bhatia, Vineet
The replacement of missing teeth with implant-borne restorations has become a treatment modality accepted by the scientific community for fully and partially edentulous patients. Recent reports have demonstrated the successful placement of dental implants into the fresh extraction socket in the anterior as well as in molar regions, which is made possible due to modification in implant surface. The present case report highlights the placement of three bicortical screw (BCS) implants into the fresh extraction sockets and one KOS implant in edentulous area with flapless technique. All the implants were immediately loaded and followed up for a period of 6 months.
Full Text Available The replacement of missing teeth with implant-borne restorations has become a treatment modality accepted by the scientific community for fully and partially edentulous patients. Recent reports have demonstrated the successful placement of dental implants into the fresh extraction socket in the anterior as well as in molar regions, which is made possible due to modification in implant surface. The present case report highlights the placement of three bicortical screw (BCS implants into the fresh extraction sockets and one KOS implant in edentulous area with flapless technique. All the implants were immediately loaded and followed up for a period of 6 months.
Full Text Available Successful treatment with the two-implant overdenture has been documented with multiple implant designs (e.g., hexagonal, Morse taper, internal connection and many implant systems. Clinicians may select implants for retention of the two-implant overdenture according to personal experience and preference with confidence that treatment success will not be determined by the selection made. This is due primarily to the anatomy and density of the bone in the anterior mandible. The aim of this case report is to demonstrate the concept of immediate functional loading in the mandible using unsplinted implants to support a locator attachment supported overdenture.
... the discussion with your doctor. Types of penile implants There are two main types of penile implants: ... might help reduce the risk of infection. Comparing implant types When choosing which type of penile implant ...
Immediate non-occlusal loading of immediate post-extractive versus delayed placement of single implants in preserved sockets of the anterior maxilla: 4-month post-loading results from a pragmatic multicentre randomised controlled trial.
Felice, Pietro; Soardi, Elisa; Piattelli, Maurizio; Pistilli, Roberto; Jacotti, Michele; Esposito, Marco
To compare the effectiveness of immediate post-extractive single implants with delayed implants placed in preserved sockets after 4 months of healing. Implants that achieved an insertion torque of at least 35 Ncm were immediately non-occlusally loaded. Just after tooth extraction and in the presence of a loss of the buccal plate bone less than 4 mm, compared to the palatal wall, 106 patients requiring a single immediate postextractive implant in the maxilla from second premolar to second premolar were randomly allocated to immediate implant placement (immediate group; 54 patients) or to socket preservation using anorganic bovine bone covered by a resorbable collagen barrier (delayed group; 52 patients) according to a parallel group design at three different centres. Bone-to-implant gaps were to be filled with anorganic bovine bone, however this was not done in 17 patients (corresponding to 40% of those who should have been grafted). Four months after socket preservation, delayed implants were placed. Implants placed with an insertion torque >35 Ncm were immediately loaded with non-occluding provisional single crowns, replaced, after 4 months, by definitive crowns. Outcome measures were implant failures, complications, aesthetics assessed using the pink esthetic score (PES), and patient satisfaction, recorded by blinded assessors. All patients were followed up to 4 months after loading. Nineteen (35%) implants were not immediately loaded in the immediate group versus 39 (75%) implants in the delayed placement group because an insertion torque >35 Ncm could not be obtained. No patient dropped out. Two implants failed in the immediate group (4%) versus none in the delayed group. More minor complications occurred in the immediate group (8) than the in the delayed group (1) and this was statistically significant (P = 0.032). At delivery of definitive crowns, 4 months after loading, aesthetics were scored as 12.8 and 12.6 in the immediate and delayed groups, respectively
Full Text Available The anterior horn cells control all voluntary movement. Motor activity, respiratory, speech, and swallowing functions are dependent upon signals from the anterior horn cells. Diseases that damage the anterior horn cells, therefore, have a profound impact. Symptoms of anterior horn cell loss (weakness, falling, choking lead patients to seek medical attention. In this article, anterior horn diseases were reviewed, diagnostic criteria and management were discussed in detail. [Archives Medical Review Journal 2016; 25(3.000: 269-303
Immediate non-occlusal loading of immediate post-extractive versus delayed placement of single implants in preserved sockets of the anterior maxilla: 1-year post-loading outcome of a randomised controlled trial.
Felice, Pietro; Pistilli, Roberto; Barausse, Carlo; Trullenque-Eriksson, Anna; Esposito, Marco
To compare the effectiveness of immediate post-extractive single implants with delayed implants placed in preserved sockets after 4 months of healing. Implants that achieved an insertion torque of at least 35 Ncm were immediately non-occlusally loaded. Just after tooth extraction, and in the presence of less than 4 mm of vertical loss of the buccal bone in relation to the palatal wall, 50 patients requiring a single immediate post-extractive implant in the maxilla from second to second premolar were randomly allocated for either immediate implant placement (immediate group; 25 patients) or for socket preservation using an algae-derived (phycogenic) bone substitute, covered by a resorbable collagen barrier (delayed group; 25 patients), according to a parallel group design in one centre. Bone-to-implant gaps were filled with an algae-derived bone substitute. Four months after socket preservation, delayed implants were placed. Implants inserted with an insertion torque of at least 35 Ncm were immediately loaded with non-occluding provisional single crowns, then replaced, after 4 months, by definitive crowns. Patients were followed up to 1 year after loading. Outcome measures were implant failures, complications, aesthetics assessed using the pink esthetic score (PES), peri-implant marginal bone level changes and patient satisfaction, recorded by blinded assessors. Nine (36%) implants were not immediately loaded in the immediate group versus 19 (76%) implants in the delayed placement group, because an insertion torque superior to 35 Ncm could not be obtained, the difference being statistically significant (difference = - 0.40, 95% CI: -0.652 to -0.148, P = 0.010). Two patients dropped out 4 months after loading in the delayed group versus none in the immediate group. Two implants failed in the immediate group (8%) versus none in the delayed group, with the difference showing no statistical significance (considering 25 and 23 patients, the difference in proportions was
Rachbauer, Franz; Kain, Michael S H; Leunig, Michael
The anterior approach is a safe, reliable, and feasible technique for total hip arthroplasty, permitting optimal soft tissue preservation. Since Hueter first described this interval, many surgeons have approached the hip anteriorly to perform a myriad of surgical procedures. The anterior approach allows optimal muscle preservation, and it is a truly internervous approach to the hip. An understanding of the evolution of the anterior approach to the hip will help the orthopedic community understand these advantages and why so many have used this approach in the treatment of hip pathology and for the implantation total hip arthroplasty.
Verhoeven, J. Willem; Cune, Marco S.; van Es, Robert J. J.
A 67-year-old woman was referred with a rapidly progressing swelling in the left canine region of the edentulous mandible. Nine months earlier, 2 permucosal implants had been placed in her atrophic anterior mandible. A few weeks after implant placement, an inoperable carcinoma of the lung had been
Full Text Available Temporary anchorage devices popularly called mini-implants or miniscrews are the latest addition to an orthodontist′s armamentarium. The following case report describes the treatment of a 16-year-old girl with a pleasant profile, moderate crowding and Angle′s Class II molar relationship. Maxillary molar distalization was planned and mini-implants were used to preserve the anterior anchorage. After 13 months of treatment, Class I molar and canine relation was achieved bilaterally and there was no anterior proclination. Thus, mini-implants provide a viable option to the clinician to carry out difficult tooth movements without any side effects.
Noro, Mahito; Zhu, Xin; Enomoto, Yoshinari; Oikawa, Yasuhiro; Tatsunami, Hiroyuki; Ishii, Rina; Toyoda, Yasutake; Asami, Masako; Sahara, Naohiko; Takagi, Takahito; Narabayashi, Yuriko; Hashimoto, Hikari; Ito, Naoshi; Kujime, Shingo; Sakai, Tsuyoshi; Nakamura, Keijirou; Sakata, Takao; Abe, Haruhiko; Sugi, Kaoru
To reduce myocardial damage caused by implantable cardioverter defibrillator (ICD) shock, the left axilla was studied as an alternative pulse generator implantation site, and compared with the traditional implantation site, the left anterior chest. Computer simulation was used to study the defibrillation conduction pattern and estimate the simulated defibrillation threshold (DFT) and myocardial damage when pulse generators were placed in the left axilla and left anterior chest, respectively; pulse generators were also newly implanted in the left axilla (n=30) and anterior chest (n=40) to compare the corresponding DFT. On simulation, when ICD generators were implanted in the left axilla, compared with the left anterior chest, the whole heart may be defibrillated with a lower defibrillation energy (left axilla 6.4 J vs. left anterior chest 12.0 J) and thus the proportion of cardiac myocardial damage may be reduced (2.1 vs. 4.2%). Clinically, ventricular fibrillation was successfully terminated with a defibrillation output ≤5 J in 86.7% (26/30) of the left axillary group, and in 27.5% (11/40) of the left anterior group (P<0.001). Clinically and theoretically, the left axilla was shown to be an improved ICD implantation site that may reduce DFT and lessen myocardial damage due to shock. Lower DFT also facilitates less myocardial damage, as a result of the lower shock required.
Chandrasekharan, Deepak; Balaji, S M
A gummy smile is probably one of the most common causes of an unaesthetic smile. Causes include overeruption of maxillary anterior teeth and maxillary vertical excess. Intrusion of maxillary anterior teeth with Orthodontics and Le forte I superior repositioning may form a part of the solution. Of late the use of micro implants have improved the smile esthetics of borderline surgical cases by allowing the Orthodontist to intrude teeth more than what was possible with conventional Orthodontics.
Full Text Available Congenital anterior tibiofemoral subluxation is an extremely rare disorder. All reported cases accompanied by other abnormalities and syndromes. A 16-year-old high school girl referred to us with bilateral anterior tibiofemoral subluxation as the knees were extended and reduced at more than 30 degrees flexion. Deformities were due to tightness of the iliotibial band and biceps femuris muscles and corrected by surgical release. Associated disorders included bilateral anterior shoulders dislocation, short metacarpals and metatarsals, and right calcaneuvalgus deformity.
Gabucio López, Pedro
Introducción: Las disfunciones de hombro son un problema de salud común en las sociedades occidentales. Algunos protocolos de tratamiento han sido desarrollados mediante ensayos clínicos con pacientes que presentan dolor de hombro. Sin embargo, no hay evidencias que sustenten que un protocolo es mejor que otros. El principal objetivo de este trabajo es presentar un caso clínico en el que mediante terapia manual y la prescripción de ejercicios físicos se consigue la resolución del ...
Van Weehaeghe, Manú; De Bruyn, Hugo; Vandeweghe, Stefan
An angulation of the implant connection could overcome the problems related to angulated abutments. This study compares conventional implants with angulated abutment to tilted implants with an angulated connection. Twenty patients were treated in the edentulous mandible. In the posterior jaw locations, one conventional tilted implant with angulated abutment and one angulated implant without abutment were placed. In the anterior jaw, two conventional implants were placed, one with and one without abutment. Implants were immediately loaded and 3 months later, the final bridge (PFM or monolithic zirconia) was placed. After a follow-up of 48 months, 17 patients were available for clinical examination. The mean overall marginal bone loss (MBL) was 1.26 mm. No significant differences in implant survival, MBL, periodontal indices, patients' satisfaction, or complications was found between implants restored on abutment or implant level, between the posteriorly located angulated implant nor angulated abutment, and between both anterior implants with or without abutment. The posterior implants demonstrated less MBL compared to the anterior implants (P implants restored with zirconia or PFM bridges (P = .294). Overall mean pocket depth was 2.83 mm. More plaque was found in the PFM group compared to the full-zirconia group, at the bridge (P = .042) and the implants (P = .029). There was no difference between both materials in pocket depth (P = .635) or bleeding (P = .821). One zirconia bridge fractured, two angulated abutment were replaced and four loose bridge screws connected to the angulated abutments had to be tightened. Patients were overall satisfied (4.74/5). An implant with angulated connection may results in a stronger connection but does not affect the marginal bone loss. No difference in MBL was seen between implants restored on abutment or implant level. Zirconia seems to reduce the amount of plaque. © 2017 Wiley Periodicals, Inc.
Khokhar, Sudarshan; Sharma, Reetika; Patil, Bharat; Sinha, Gautam; Nayak, Bhagabat; Kinkhabwala, Ravish Akhilkumar
To describe a safe technique for in-the-bag intraocular lens (IOL) implantation in pediatric cataract patients who undergo lens aspiration with primary posterior capsulorhexis and anterior vitrectomy. Sixty eyes of 45 consecutive patients with congenital/developmental cataract underwent lens aspiration with primary posterior continuous curvilinear capsulorhexis (PCCC) with anterior vitrectomy and in-the-bag IOL implantation using the described technique of IOL implantation using anterior capsule as support. All eyes had stable IOL at the end of surgery and none of the eyes had lens decentration/dislocation in posterior vitreous. Implantation of in-the-bag IOL is difficult in children who undergo primary PCCC with anterior vitrectomy. Our technique of implanting IOL by pushing it against the back surface of anterior capsule is a safe method and results in no complications related to faulty IOL implantation.
Changes in the abundance of cells in the anterior pituitary gland and the possible roles of luteinizing hormone, prolactin and progesterone in the control of delayed implantation in the straw-coloured fruit bat ( Eidolon helvum )
Tol, Johannes L.; van Dijk, C. Niek
The anterior ankle impingement syndrome is a clinical pain syndrome that is characterized by anterior ankle pain on (hyper) dorsiflexion. The plain radiographs often are negative in patients who have anteromedial impingement. An oblique view is recommended in these patients. Arthroscopic excision of
A cochlear implant is a small, complex electronic device that can help to provide a sense of sound. People who are ... of-hearing can get help from them. The implant consists of two parts. One part sits on ...
Goserelin implant is used in combination with radiation therapy and other medications to treat localized prostate cancer and is ... treatment of abnormal bleeding of the uterus. Goserelin implant is in a class of medications called gonadotropin- ...
Optimización de la superficie de implantes dentales de Ti c.p para la mejora y predictibilidad de la osteointegración mediante osteoconductividad. Caracterización físico-química y respuesta in vivo en cerdos “minipig”
Fernández Yagüe, Marc-Antoni
El éxito de la implantología dental se debe en gran medida a las excelentes propiedades que presentan ciertos materiales como el Ti c.p, como elevada resistencia a la corrosión y aceptación biológica. Sin embargo, es posible estimular el potencial natural biológico de regeneración ósea a través de factores de estructura superficial y biomecánicos. La consecución de la osteointegración de un implante no solo requiere de la ausencia de tejido fibroso alrededor del implante, sino tam...
... Palatal Island Advancement Flap was effective in bone graft coverage in premaxillary edentulous area. Conclusion: It can be used as an aid for bone graft coverage of premaxillary edentulous ridge, where the need for mucosa is small in width but long in length. Keywords: Anterior maxilla, bone graft, dental implant, ...
The application of endosseous implant therapy in conjugation with bone augmentation has tremendously improved the quality of reconstruction of maxilla and mandible over the last decade and has allowed for improved results. This clinical report describes the management of anterior mandibular continuity defect due to ...
Full Text Available Congenital anterior staphyloma entails grave visual prognosis. The majority of reported patients have undergone enucleation. We report a promising result of staphylectomy with implantation of a keratoprosthesis and a glaucoma drainage device in a seven-month-old child with a large, congenital anterior staphyloma.
intrusion has revolutionized orthodontic anchorage and biomechanics by making anchorage perfectly stable. This article addresses various conventional clinical intrusion mechanics and especially intrusion using mini-implants that have proven effective over the years for intrusion of maxillary anteriors.
Full Text Available An implant-supported crown or conventionally fixed partial denture is the most common treatment modality to replace a missing anterior tooth but a more conservative approach, with a fiber reinforced composite resin FPD, can be used to replace a missing anterior tooth in young patients or when the patient does not agree for an implant, or conventional FPD or RPD therapy. It is an esthetic, conservative single sitting chairside procedure which can be used as a definitive treatment alternative in certain clinical situations for esthetic and functional replacement of a missing anterior tooth. To achieve desirable results, putty matrix was used for proper positioning of the pontic during direct fabrication of FRCFPD.
... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...
Jung, Hyun Sub; Chung, Young Sun; Suh, Chee Jang; Won, Jong Jin
Two cases of congenital anterior urethral diverticular which have occurred in a 4 year old and one month old boy are presented. Etiology, diagnostic procedures, and its clinical results are briefly reviewed
... thighbone where the kneecap normally rests is too shallow. You have flat feet. Anterior knee pain is ... the principles of the Health on the Net Foundation (www.hon.ch). The information provided herein should ...
Hurley, I W; Brooks, A M; Reinehr, D P; Grant, G B; Gillies, W E
A series of 22 patients with crystals in the anterior segment of the eye was examined by specular microscopy. Of 10 patients with hypermature cataract and hyperrefringent bodies in the anterior chamber cholesterol crystals were identified in four patients and in six of the 10 in whom aspirate was obtained cholesterol crystals were demonstrated in three, two of these having shown crystals on specular microscopy. In 10 patients with intracorneal crystalline deposits, cholesterol crystals were f...
GALVIS, Virgilio; TELLO, Alejandro; M. RANGEL, Carlos
Anterior megalophthalmos is characterized by megalocornea associated with a very broad anterior chamber and ciliary ring elongation. It is also called X-linked megalocornea. It is accompanied by early development of cataracts, zonular anomalies, and, rarely, vitreoretinal disorders. Subluxation of a cataract can occur in cataract surgery because of zonular weakness. In addition, in most patients, standard intraocular lens (IOL) decentration is a risk because of the enlarged sulcus and capsular bag. These unique circumstances make cataract surgery challenging. To date, several approaches have been developed. Implantation of a retropupillary iris-claw aphakic intraocular lens may be a good option because it is easier than suturing the IOL and can have better and more stable anatomic and visual outcomes, compared to other techniques. PMID:27350950
Takahashi, Toshihito; Gonda, Tomoya; Maeda, Yoshinobu
Implant overdentures with attachments have been used in clinical practice and the effect of attachments on implant strain has been frequently reported. However, most studies have focused on mandibular overdentures; there are few reports on maxillary overdentures. The purpose of this study was to examine the influence of attachment type on implant strain in maxillary overdentures under various implant configurations. A maxillary edentulous model with implants and experimental overdentures were fabricated. Four strain gauges were attached to each implant, positioned in anterior, premolar, and molar areas. Three types of unsplinted attachments-ball, locator, and magnet-were set on the implants under various implant configurations. A vertical occlusal load of 98 N was applied through the mandibular complete denture, and implant strain was compared using the Kruskal-Wallis test. Ball attachments caused the greatest amount of strain, while magnet attachments caused the least amount under all conditions. For all attachments, two anterior implants caused significantly more strain than four implants (P magnet attachments are recommended to reduce implant stress. Using only two implants, especially two anterior implants, is not recommended regardless of attachment type.
Ahuja, Swati; Egbert, Nicholas; Jain, Vinay; Cagna, David
Implant-supported removable dental prostheses may be supported by a variety of splinted (bar and clip) attachment systems or nonsplinted abutment-based attachments (ball, magnets, and resilient stud attachments such as locators [Zest Anchors], ERA [Sterngold], and nonresilient-stud attachments such as ANKYLOS SynCone [Dentsply Implants]). Nonsplinted attachments are preferred as they are more economical, less technique sensitive, easier to clean, repair, and maintain than splinted (bar and clip) attachment systems, but they work favorably only when implants in the arch are placed parallel to each other. Often implants in the anterior maxilla have to be placed with a labial inclination (due to the proclination of the premaxilla), resulting in lack of parallelism between the anterior and posterior implants, making it challenging to fabricate a removable dental prostheses supported by nonsplinted attachments, and necessitating the use of angled abutments. Recently, a novel implant design with a 12° restorative platform angulation has been introduced by Southern Implants (Co-axis, Keystone Dental, Inc., Burlington, MA, USA). These new angulated implants aid in minimizing the divergence between the anterior and posterior maxillary implants without using angled abutments. The purpose of this article was to report a case utilizing the novel angulated implants (Co-axis, Keystone Dental, Inc., Burlington, MA, USA) in the premaxilla for fabrication of maxillary removable dental prostheses supported and retained by nonsplinted attachments.
Full Text Available Implant-supported removable dental prostheses may be supported by a variety of splinted (bar and clip attachment systems or nonsplinted abutment-based attachments (ball, magnets, and resilient stud attachments such as locators [Zest Anchors], ERA [Sterngold], and nonresilient-stud attachments such as ANKYLOS SynCone [Dentsply Implants]. Nonsplinted attachments are preferred as they are more economical, less technique sensitive, easier to clean, repair, and maintain than splinted (bar and clip attachment systems, but they work favorably only when implants in the arch are placed parallel to each other. Often implants in the anterior maxilla have to be placed with a labial inclination (due to the proclination of the premaxilla, resulting in lack of parallelism between the anterior and posterior implants, making it challenging to fabricate a removable dental prostheses supported by nonsplinted attachments, and necessitating the use of angled abutments. Recently, a novel implant design with a 12° restorative platform angulation has been introduced by Southern Implants (Co-axis, Keystone Dental, Inc., Burlington, MA, USA. These new angulated implants aid in minimizing the divergence between the anterior and posterior maxillary implants without using angled abutments. The purpose of this article was to report a case utilizing the novel angulated implants (Co-axis, Keystone Dental, Inc., Burlington, MA, USA in the premaxilla for fabrication of maxillary removable dental prostheses supported and retained by nonsplinted attachments.
Full Text Available AIM: To observe and discuss the clinical application and effect of anterior vitrectomy in phacoemulsification for the treatment of vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection.METHODS:Retrospective analysis of 28 cases(35 eyeswith cataract in whom vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification and intraocular lens implantation and anterior vitrectomy were performed was conducted. RESULTS:Anterior vitrectomy for timely and accurate treatment for vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification was satisfied. CONCLUSION: Anterior vitrectomy has good curative effect for vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification and is effective with less severe complications.
Altaba Rosas, Mar
El presente documento describe los procesos de diseño y desarrollo de un sistema que, a través de una aplicación móvil, sirve como dispositivo para el registro de la actividad cardíaca del paciente, mediante la obtención del electrocardiograma (ECG), y que permite detectar irregularidades para posteriormente, en caso que fuera necesario, poder enviar los datos adquiridos al profesional sanitario pertinente para que éste los analice. El sistema tiene dos componentes diferenciados, por un lado,...
Ormianer, Zeev; Piek, Dana; Livne, Shiri; Lavi, David; Zafrir, Gitit; Palti, Ady; Harel, Noga
To retrospectively evaluate the clinical outcome of tapered, multithreaded implants (Tapered Screw-Vent MTX; Zimmer Dental, Inc, Carlsbad, CA) with an emphasis on periimplant crestal bone status around those placed delayed and immediately in the posterior and anterior maxilla. Chart reviews were performed on 46 patients who had been treated with 173 implants replacing one or more missing and/or unsalvageable teeth in the maxilla. Implant placement and loading was either immediate or delayed. Marginal bone changes were calculated using standardized radiographs taken at implant placement and during annual follow-up. After a mean follow-up of 119 to 121 months, implant survival rate was 99%, and implant success rate was 97%. No discernable bone loss was evident in 85.5% of the surviving implants. Crestal bone loss was observed in 14.5% of all surviving implants: 38.5% of implants immediately loaded and 29.9% of implants with delayed loading. Twenty-one implants exhibited 1 mm of bone loss, 3 implants lost 2 mm, and 1 implant lost 3 mm. Low-density maxillary jawbone and more extensive bone remodeling required around implants immediately placed into extraction sockets were the probable causes of observed bone loss in this study. Implants exhibited excellent long-term outcomes with little or no bone loss.
Demitri, V; Polini, F; Robiony, M; Politi, M
Implant surgery in association with bone grafting is generally considered less predictive than primary implant surgery. Many reports have been published about implant rehabilitation with bone grafts in atrophic patients. Most of these papers showed a lower implant success rate than primary implantology. The aim of this study is to verify if it's possible to warrant similar results between the two types of implantology, if such procedures are performed following effective protocols and criteria. From 1995 to 1999, 43 severely atrophic edentulous patients were treated in our Clinic with 63 autologous bone grafts and delayed implantology; 45 patients were treated with traditional implantology. 284 fixtures were positioned. The success rate in grafted implantology versus traditional implantology was compared for every maxillary and mandibular region. Furthermore, success rate in implantology of the anterior maxilla versus the poster maxilla in grafted patients was compared. The statistical considerations were performed with c2 test (p<0.05). The statistical analysis evidenced not significative difference in the implant success rate between grafted and not grafted patients in the anterior (p=0.23) and in the posterior maxilla (p=0.35). There was not significative difference in the implant success rate between grafted and not grafted patients in the anterior mandible (p=0.54) and in the posterior mandible (p=0.54). There was not significative difference in the implant success rate between the anterior and posterior grafted maxilla (p=0.21). The results obtained show that if close surgical protocol is performed it is possible to obtain no prognostic difference between the two METHODS.
It most commonly occurs after phakic vitrectomy and scleral buckling for diabetic traction retinal detachment. It usually manifests with haemorrhage into the vitreous cavity or anterior hyaloid 3 to 12 weeks after vitrectomy and is the result of fibrovascular proliferation from the peripheral retina extending toward the equator of ...
Liu, Zhe; Sun, Chuan-Bin; Yao, Ke
Internal lenticonus is a very rare morphologic abnormality of crystalline lens which has been reported in only several cases in the literature. We herein reported the clinical characteristics and surgical findings of the anterior internal lenticonus accompanied by congenital nuclear cataract. Cataract extraction accompanied with intraocular lens implantation was uneventfully performed, and a good visual outcome was achieved in this case. Viral infection during embryonal and fetal period might account for the formation of the anterior internal lenticonus and congenital nuclear cataract in our case.
Full Text Available La epistaxis es un problema extremadamente común que en ocasiones requiere de taponamiento anterior. Usualmente se indican antibióticos de forma concomitante para la prevención de complicaciones infecciosas, aunque el rol de esta medida es controvertido. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos una revisión sistemática que incluye tres estudios primarios, ninguno de ellos controlado y aleatorizado. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que no está claro si los antibióticos profilácticos disminuyen las complicaciones infecciosas en pacientes con taponamiento nasal por epistaxis anterior porque la certeza de la evidencia es muy baja.
den Hartog, Laurens; Raghoebar, Gerry M.; Stellingsma, Kees; Meijer, Henny J. A.
The replacement of a single missing anterior tooth with an implant-supported crown Is a demanding therapy. This report describes a treatment in which an anterior maxillary implant was immediately restored with a provisional restoration. During the provisional phase, an optimal emergence profile was
Important changes in the near-surface physical properties of metals were obtained by high-fluence ion implantation. Recently there have been an increasing number of studies of the behavior of implanted species with the aim of understanding the detailed physical processes that occur in an implanted metal layer. A key aspect of these implantation metallurgy studies has been the ability to form uniquely controlled systems in the near-surface regions of metals that can be studied with accurate depth resolution. Metallurgical parameters that may be difficult or impossible to obtain by other means can be measured. Also, parameters that depend on the implantation process, due to the athermal introduction of atoms and defects can be determined. Thus the dual objective of implantation metallurgy is to obtain information to improve understanding of the microscopic aspects of metallurgy and to understand how to form controlled new metallurgical systems. Examples of parameters studied include implanted impurity location, diffusion, enhanced diffusion, solubility, precipitation, and dissolution. (auth)
... this page: //medlineplus.gov/ency/presentations/100230.htm Anterior cruciate ligament repair - Series—Normal anatomy To use the sharing ... to slide 5 out of 5 Overview The anterior cruciate ligament (ACL) is a ligament in the center of ...
Furuse, Adilson Yoshio; Herkrath, Fernando José; Franco, Eduardo Jacomino
Anterior diastemata may compromise the harmony of a patient's smile. Consideration of etiologic factors, previous gingival conditioning, and individual treatment planning are essential in the proper management of anterior diastemata. An integrated orthodontic-restorative approach may enhance...
Vidyadhar P. Mali
Full Text Available We studied the clinical presentation and management of four patients with anterior urethral valves; a rare cause of urethral obstruction in male children. One patient presented antenatally with oligohydramnios, bilateral hydronephrosis and bladder thickening suggestive of an infravesical obstruction. Two other patients presented postnatally at 1 and 2 years of age, respectively, with poor stream of urine since birth. The fourth patient presented at 9 years with frequency and dysuria. Diagnosis was established on either micturating cystourethrogram (MCU (in 2 or on cystoscopy (in 2. All patients had cystoscopic ablation of the valves. One patient developed a postablation stricture that was resected with an end-to-end urethroplasty. He had an associated bilateral vesicoureteric junction (VUJ obstruction for which a bilateral ureteric reimplantation was done at the same time. On long-term follow-up, all patients demonstrated a good stream of urine. The renal function is normal. Patients are continent and free of urinary infections. Anterior urethral valves are rare obstructive lesions in male children. The degree of obstruction is variable, and so they may present with mild micturition difficulty or severe obstruction with hydroureteronephrosis and renal impairment. Hence, it is important to evaluate the anterior urethra in any male child with suspected infravesical obstruction. The diagnosis is established by MCU or cystoscopy and the treatment is always surgical, either a transurethral ablation or an open resection. The long-term prognosis is good.
... made up of a microphone/receiver, a speech processor, and an antenna. This part of the implant ... ear. This sound is sent to a speech processor, which is most often connected to the microphone ...
Zembic, Anja; Tahmaseb, Ali; Jung, Ronald E; Wismeijer, Daniel
To assess implant survival rates and peri-implant bone loss of 2 titanium-zirconium implants supporting maxillary overdentures at 1 year of loading. Twenty maxillary edentulous patients (5 women and 15 men) being dissatisfied with their complete dentures were included. In total, 40 diameter-reduced titanium-zirconium implants were placed in the anterior maxilla. Local guided bone regeneration (GBR) was allowed if the treatment did not compromise implant stability. Following 3 to 5 months of healing, implant-supported overdentures were inserted on two ball anchors. Implants and overdentures were assessed at 1, 2, 4, and 8 weeks after implant insertion and 2, 4, and 12 months after insertion of overdentures (baseline). Standardized radiographs were taken at implant loading and 1 year. Implant survival rates and bone loss were the primary outcomes. Nineteen patients (1 dropout) with 38 implants were evaluated at a mean follow-up of 1.1 years (range 1.0-1.7 years). One implant failed resulting in an implant survival rate of 97.3%. There was a significant peri-implant bone loss of the implants at 1 year of function (mean, 0.7 mm, SD = 1.1 mm; median: 0.48 mm, IQR = 0.56 mm). There was a high 1-year implant survival rate for edentulous patients receiving 2 maxillary implants and ball anchors as overdenture support. However, several implants exhibited an increased amount of bone loss of more than 2 mm. Overdentures supported by 2 maxillary implants should thus be used with caution as minimally invasive treatment for specific patients encountering problems with their upper dentures until more long-term data is available. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Rinke, Sven; Lattke, Anja; Eickholz, Peter; Kramer, Katharina; Ziebolz, Dirk
This study aimed to determine the survival rate and prevalence of biologic and technical complications associated with single-tooth implants with all-ceramic abutments in the anterior region. A total of 33 patients were restored with 50 anterior implants and temporarily luted all-ceramic crowns on prefabricated zirconia abutments. All of the patients subsequently received annual supportive maintenance; 27 patients (18 women, 22-74 years) with 42 implants participated in the final maintenance visit and were included in the study (follow-up 78.1 ± 27.0 months). The time-dependent survival rate (Kaplan-Meier) and the frequency of prosthetic complications (abutment fracture [AF], screw loosening [SL], fracture of veneering ceramics [VF], retention loss [RL]) and biologic complications (peri-implantitis) were calculated to determine the success rates. No implant loss (implant-related survival rate 100%) but one abutment fracture occurred throughout the entire observation period; therefore, the survival rate of the superstructures (in situ criterion) was 97.6% (95% confidence interval [CI] 0.930- 1.000) after 7 years. Eleven restorations were affected by prosthetic complications: RL (n = 4), VF (n = 5), and SL (n = 2). Peri-implantitis was diagnosed for two implants (probing depth > 5 mm, bleeding on probing [BOP]/suppuration, and bone loss > 3 mm) (implant-related peri-implantitis rate 4.8%). No restoration required replacement due to complications. The success rate (event-free restoration) was 75.9% (95% CI 0.636- 0.882) after 7 years. Considering the calculated survival rate, the application of all-ceramic zirconia implant abutments in the anterior region can be recommended as a reliable therapy in private practice. Fractures of veneering ceramics were the most common prosthetic complication.
SPINELLI, D.; OTTRIA, L.; DE VICO, G.; BOLLERO, R.; BARLATTANI, A.; BOLLERO, P.
Implant surgery has been changing in different ways following improvements of computer technologies. Since its beginning, according to the original procedures of Branemårk system implants, guide-lines in implants-supported prosthetic rehabilitation have been founding on the placement of fixtures in a fairly upright position, after maxillary sinus floor elevation; while in the case of interforaminal rehabilitation, an upright distal implant may need to be placed anterior to the mental foramina...
Mouraret, S.; Hunter, D.J.; Bardet, C.; Brunski, J.B.; Bouchard, P.; Helms, J.A.
Many of our assumptions concerning oral implant osseointegration are extrapolated from experimental models studying skeletal tissue repair in long bones. This disconnect between clinical practice and experimental research hampers our understanding of bone formation around oral implants and how this process can be improved. We postulated that oral implant osseointegration would be fundamentally equivalent to implant osseointegration elsewhere in the body. Mice underwent implant placement in the edentulous ridge anterior to the first molar and peri-implant tissues were evaluated at various timepoints after surgery. Our hypothesis was disproven; oral implant osseointegration is substantially different from osseointegration in long bones. For example, in the maxilla peri-implant pre-osteoblasts are derived from cranial neural crest whereas in the tibia peri-implant osteoblasts are derived from mesoderm. In the maxilla, new osteoid arises from periostea of the maxillary bone but in the tibia the new osteoid arises from the marrow space. Cellular and molecular analyses indicate that osteoblast activity and mineralization proceeds from the surfaces of the native bone and osteoclastic activity is responsible for extensive remodeling of the new peri-implant bone. In addition to histologic features of implant osseointegration, molecular and cellular assays conducted in a murine model provide new insights into the sequelae of implant placement and the process by which bone is generated around implants. PMID:23886841
Moreno Hay, Isabel
En este estudio se propone analizar el efecto de la mordida abierta anterior en el patrón muscular del aparato estomatognático mediante pruebas electromiográficas estáticas y dinámicas; y cómo las relaciones oclusales que caracterizan a este tipo de maloclusiones determinan el funcionamiento del sistema neuromuscular y la aparición de un electromiograma característico. La descripción de las características electromiográficas de los sujetos con mordida abierta anterior contribuirían a un...
LLopis, Eva [Hospital de la Ribera, Alzira, Valencia (Spain) and Carretera de Corbera km 1, 46600 Alzira Valencia (Spain)]. E-mail: firstname.lastname@example.org; Padron, Mario [Clinica Cemtro, Ventisquero de la Condesa no. 42, 28035 Madrid (Spain)]. E-mail: email@example.com
Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries.
Seong, Wook-Jin; Kim, Uk-Kyu; Swift, James Q; Hodges, James S; Ko, Ching-Chang
There is confusion in the literature about how physical properties of bone vary between maxillary and mandibular regions and which physical properties affect initial implant stability. The purpose of this study was to determine correlations between physical properties of bone and initial implant stability, and to determine how physical properties and initial stability vary among regions of jawbone. Four pairs of edentulous maxillae and mandibles were retrieved from fresh human cadavers. Six implants per pair were placed in different anatomical regions (maxillary anterior, right and left maxillary posterior, mandibular anterior, right and left mandibular posterior). Immediately after surgery, initial implant stability was measured with a resonance frequency device and a tapping device. Implant surgeries and initial stability measurements were performed within 72 hours of death. Elastic modulus (EM) and hardness were measured using nano-indentation. Composite apparent density (cAD) was measured using Archimedes' principle. Bone-implant contact percentage and cortical bone thickness were recorded histomorphometrically. Mixed linear models and univariate-correlation analyses were used (alpha=.05). Generally, mandibular bone had higher initial implant stability and physical properties than maxillary bone. Initial implant stability was higher in the anterior region than in the posterior. EM was higher in the posterior region than in the anterior; the reverse was true for cAD. Of the properties evaluated, cAD had the highest correlation with initial implant stability (r=0.82). Both physical properties of bone and initial implant stability differed between regions of jawbone.
Dorecka, Mariola; Rokicki, Wojciech; Nita, Malgorzata; Krysik, Katarzyna; Nita, Ewa; Sikorska, Aleksandra; Romaniuk, Wanda
To evaluate long term results of phacoemulsification with PC IOL and capsular tension ring (CTR) implantation in lens subluxation. The study comprised of 134 patients--146 eyes with subluxated lens. In all cases phacoemulsification with PC IOL and CTR implantation was performed. No intaroperative complications has occured. Postoperative complications included: inflammation in the anterior chamber in 3 eyes (2.1%), retinal detachment in 2 eyes (1.4%). In all cases there was no PC IOL decentration. (1) CTR facilitates phacoemulsification with PC IOL implantation in lens subluxation. (2) Phacoemulsification of subluxated lens with PC IOL and CTR implantation seems to be safe and effective procedure.
Hong, Engene; Kraft, Michael C
Musculoskeletal complaints account for about 20% to 30% of all primary care office visits; of these visits, discomfort in the knee, shoulder, and back are the most prevalent musculoskeletal symptoms. Having pain or dysfunction in the front part of the knee is a common presentation and reason for a patient to see a health care provider. There are a number of pathophysiological etiologies to anterior knee pain. This article describes some of the common and less common causes, and includes sections on diagnosis and treatment for each condition as well as key points. Copyright © 2014 Elsevier Inc. All rights reserved.
Full Text Available The anterior cingulate cortex (ACC has a role in attention, analysis of sensory information, error recognition, problem solving, detection of novelty, behavior, emotions, social relations, cognitive control, and regulation of visceral functions. This area is active whenever the individual feels some emotions, solves a problem, or analyzes the pros and cons of an action (if it is a right decision. Analogous areas are also found in higher mammals, especially whales, and they contain spindle neurons that enable complex social interactions. Disturbance of ACC activity is found in dementias, schizophrenia, depression, the obsessive-compulsive syndrome, and other neuropsychiatric diseases.
Coen Pramono D
Full Text Available Three different dental implant placements according to surgical implant bed situations were observed in its bone integration 3 months after dental implant insertion. This observation was done on implant system which has plateau or fin system. Elf implants were placed in the upper jaw in two patients. In case one, two implants were inserted immediately after tooth extraction, and the other six implants were placed in the alveolar crest regions in delayed implantation or in which the teeth had been extracted over 6 months of period. In case two, three implants were inserted in the post trauma region in the anterior maxilla, which the labial plate had been lost and reconstructed with bone grafting procedure using a mixture of alloplastic and autogenous bones. The alveolar reconstruction was needed to be performed due to only thin alveolar crest width was left intact. All of those implants observed showed in good integration.
... To Health Topics / Implantable Cardioverter Defibrillators Implantable Cardioverter Defibrillators Also known as What Is an Implantable Cardioverter ... pacemakers and defibrillators. Comparison of an Implantable Cardioverter Defibrillator and a Pacemaker The image compares an ICD ...
Breast implants surgery; Mastectomy - breast reconstruction with implants; Breast cancer - breast reconstruction with implants ... to close the skin flaps. Breast reconstruction with implants is usually done in two stages, or surgeries. ...
Menéndez Collar, Manuel
Introducción: los cambios anatómicos producidos tras la pérdida dental, aún habiendo sido los pacientes portadores de prótesis completas removibles 35, hacen que el tratamiento quirúrgico mediante implantes dentales para rehabilitar pacientes que presentan reabsorciones avanzadas de los maxilares en sectores posteriores sea un desafío para todo clínico 13, 15. Actualmente se dispone de diferentes soluciones quirúrgicas y/o prostodóncicas para rehabilitar dientes ausentes mediante implantes...
Juan Diego Chavarría
Full Text Available La efectividad de la política monetaria bajo un esquema de metas de inflación como el propuesto por el Banco Central de Costa Rica se basa en buena medida en el correcto y oportuno pronóstico de la inflación a corto y mediano plazo con el fin de diseñar de mejor forma las acciones de política monetaria. Así, el propósito de este trabajo es desarrollar una herramienta complementaria para elaborar pronósticos de inflación mediante un enfoque bayesiano. Para lo anterior se propone la utilización de la metodología Bayesian Model Averaging y de Weighted Average Least Squares. Los modelos de proyección especificados permitirían ampliar y complementar el análisis que se realiza actualmente con el Modelo Macroeconómico de Proyección Trimestral (MMPT del Banco Central de Costa Rica. Como resultado esta investigación muestra que, para datos de periodicidad mensual y a horizontes de pronóstico de 1 a 12 meses, es posible encontrar proyecciones mediante un proceso bayesiano que poseen una mayor capacidad predictiva en relación con aquellas producidas por un modelo autorregresivo.
AlKharashi, Soliman A
Shrinkage and whitening of the anterior capsule opening - capsular contraction syndrome - is a well-known complication after continuous curvilinear capsulorrhexis. A 72-year-old women underwent continuous curvilinear capsulorrhexis, phacoemulsification, and implantation of posterior chamber intraocular lens with polymethylmethacrylate haptics. Four months postoperatively, the patient reported deterioration in visual acuity that was resulted due to complete occlusion of anterior capsular opening by fibrotic tissue. The fibrous membrane was excised surgically in capsulorrhexis fashion. (author)
Meijer, HJA; Starmans, FJM; Steen, WHA; Bosman, F
The design of dental superstructures influences the loading on dental implants and the deformation of the anterior interforaminal bone in an edentulous mandible. This deformation causes stress in the bone around the implants and may lead to bone resorption and loss of the implant. The stress
Boven, G. C.; Slot, J. W. A.; Raghoebar, G. M.; Vissink, A.; Meijer, H. J. A.
The aim of this study was to assess the 5-year treatment outcome of maxillary implant-retained overdentures opposed by natural antagonistic teeth. Fifty consecutive patients received maxillary overdentures supported by six dental implants. Implants were placed in the anterior region, if enough bone
De Brito, Ana Caroline Ramos; Nejaim, Yuri; De Freitas, Deborah Queiroz [Dept. of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Sao Paulo (Brazil); De Oliveira Santos, Christiano [Dept. of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Sao Paulo (Brazil)
The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.
Conclusiones: El tratamiento del sector posterior maxilar atrófico mediante reconstrucción tridimensional con autoinjerto óseo, elevación sinusal y abordaje por tunelización es una técnica que proporciona resultados predecibles y estables, permitiendo la rehabilitación con coronas sobre implantes dentales de dimensiones adecuadas.
Full Text Available Background: When an implant is exposed to oral cavity, its surface gets colonized by micro-organisms. The aim of this study is to comparatively assess the microbiological parameters in sulci around the teeth and the crowns supported by dental implants. Materials and Methods: In this prospective, cross-sectional study, 34 partially edentulous patients aged between 40 and 50 years with total 50 anterior maxillary single implants with cemented crowns (depth of sulci 0.05. Conclusion: The present study indicated that microflora in implant sulci is similar to the tooth sulci, when the depth of sulci is normal (<4 mm. As a result, implants′ susceptibility to inflammation is the same as teeth.
Dubreuil, J; Trevelo, A
Although the anterior guidance in complete dentures is not really a guide, the arrangement of the anterior maxillary and mandibular prosthetic teeth, defines a propulsive line called the virtual anterior guidance, a part from the cinematic criterias. The influence of this guide on cuspal movement is superior, in all mandibular points, to the influence of the condylar pathway. If this line is not respected, the practitioner may have to do excessive grindings during occlusal adjustments.
Furuse, Adilson Yoshio; Herkrath, Fernando José; Franco, Eduardo Jacomino
Anterior diastemata may compromise the harmony of a patient's smile. Consideration of etiologic factors, previous gingival conditioning, and individual treatment planning are essential in the proper management of anterior diastemata. An integrated orthodontic-restorative approach may enhance...... the aesthetic results when orthodontic therapy itself is not feasible. This article presents integrated orthodonticrestorative solutions of anterior diastemata, associated with the conditioning of the gingival tissue with composite resin, and discusses the most relevant aspects related to their etiology...
Radek, M; Radek, A; Zapałowicz, K; Maciejczak, A
Two cases with cervical discopathy and radiculopathy are presented. Discectomy and anterior interbody fusion with cage-plate PCB manufactured by French company Scient'x was performed. Authors present the shape of the implant and technical details of implantation. The paper discusses the advantages of the PCB which simplifies and shortens the operation procedure, minimizes the risk of traditional bone graft harvesting and provides immediate stabilization of the operated segment.
Behnaz, Ebadian; Ramin, Mosharraf; Abbasi, Samaneh; Pouya, Memar Ardestani; Mahmood, Farzin
Objective: The aim of this study was to investigate the influence of implant crown splinting and the use of angulated abutment on stress distribution in implant body and surrounding bone by three-dimensional finite element analysis. Materials and Methods: For this study, three models with two implants at the site of mandibular right second premolar and first molar were designed (1): Both implants, parallel to adjacent teeth, with straight abutments (2): Anterior implant with 15 mesial angulations and posterior implant were placed parallel to adjacent tooth, (3): Both implants with 15 mesial angulations and parallel to each other with 15° angulated abutments. Restorations were modeled in two shapes (splinted and nonsplinted). Loading in tripod manner as each point 50 N and totally 300 N was applied. Stress distribution in relation to splinting or nonsplinting restorations and angulations was done with ABAQUS6.13. Results: Splinting the restorations in all situations, led to lower stresses in all implant bodies, cortical bone and spongy bone except for the spongy bone around angulated first molar. Angulated implant in nonsplinted restoration cause lower stresses in implant body and bone but in splinted models more stresses were seen in implant body in comparison with straight abutment (model 2). Stresses in nonsplinted and splinted restorations in cortical bone of angulated molar region were more than what was observed in straight molar implant (model 3). Conclusion: Implant restorations splinting lead to a better distribution of stresses in implant bodies and bone in comparison with nonsplinted restorations, especially when the load is applied off center to implant body. Angulations of implant can reduce stresses when the application of the load is in the same direction as the implant angulation. PMID:26430356
Rakesh V. Somanathan
Full Text Available Dental implants have been considered to be a successful treatment modality. Recently, achieving a good osseointegration is not the ultimate goal for the restorative dentist. Successful implant treatment demands the best gingival esthetic success along with stability and function of the implant. This study was performed to obtain answers to some controversial points pertaining to esthetics and function of implants in maxilla. Immediate flapless implantation into the extraction sockets in maxillary anterior zone is an emerging treatment option in dentistry- the esthetic success of which was in debate for long. The proposed study compared the esthetic success of immediate flapless implants (ILA, to immediate implants with the need for flap (ILB and, delayed implants (DSL in single tooth restorations, in the anterior region of the maxilla. The other aim of the study was to find out if any relation exists between the interproximal crestal bone height and papilla height. Analysis was done irrespective of treatment procedure in the same study group using periodontal sounding and radiographs to find out the relation. From the study involving 106 participants, including 21 ILA, 22 ILB and 63 DSL cases, we received highest papillary index score of 2.6 average from group ILA, followed by ILB and DSL, after 3 months of prosthetic loading. From the periodontal sounding and radiographic study it was evident that, when the distance between the base of the contact point of crowns and height of interproximal bone was less than 5, the papilla was present 100 % of the time, but when the distance increased to 6 and more than 7 mm, the papilla was present only 46.5 and 24 percentage of the time respectively.
Altman, Gregory (Inventor); Kaplan, David (Inventor); Vunjak-Novakovic, Gordana (Inventor); Martin, Ivan (Inventor)
The present invention provides a method for producing an anterior cruciate ligament ex vivo. The method comprises seeding pluripotent stem cells in a three dimensional matrix, anchoring the seeded matrix by attachment to two anchors, and culturing the cells within the matrix under conditions appropriate for cell growth and regeneration, while subjecting the matrix to one or more mechanical forces via movement of one or both of the attached anchors. Bone marrow stromal cells are preferably used as the pluripotent cells in the method. Suitable matrix materials are materials to which cells can adhere, such as a gel made from collagen type I. Suitable anchor materials are materials to which the matrix can attach, such as Goinopra coral and also demineralized bone. Optimally, the mechanical forces to which the matrix is subjected mimic mechanical stimuli experienced by an anterior cruciate ligament in vivo. This is accomplished by delivering the appropriate combination of tension, compression, torsion, and shear, to the matrix. The bioengineered ligament which is produced by this method is characterized by a cellular orientation and/or matrix crimp pattern in the direction of the applied mechanical forces, and also by the production of collagen type I, collagen type III, and fibronectin proteins along the axis of mechanical load produced by the mechanical forces. Optimally, the ligament produced has fiber bundles which are arranged into a helical organization. The method for producing an anterior cruciate ligament can be adapted to produce a wide range of tissue types ex vivo by adapting the anchor size and attachment sites to reflect the size of the specific type of tissue to be produced, and also adapting the specific combination of forces applied, to mimic the mechanical stimuli experienced in vivo by the specific type of tissue to be produced. The methods of the present invention can be further modified to incorporate other stimuli experienced in vivo by the
... For young children who are deaf or severely hard-of-hearing, using a cochlear implant while they are young exposes them to sounds during an optimal period to develop speech and language skills. Research has shown that when these children receive ...
Dalesandro, Nicole; Stiles, Jean; Miller, Margaret
A 13-year-old female spayed domestic shorthair cat was presented initially for a change in the appearance of the left eye. On initial examination, a small penetrating wound was suspected as the cause for a corneal scar, an anterior cortical incipient cataract and mild iritis. The cat was not re-presented until 1 year later at which time ocular pain was marked. Severe anterior uveitis and glaucoma were diagnosed and the eye enucleated. Histopathology documented intralenticular coccoid bacteria and septic lens implantation syndrome. © 2011 American College of Veterinary Ophthalmologists.
Fehring, Thomas K; Odum, Susan M; Hughes, Josh; Springer, Bryan D; Beaver, Walter B
Claims that there are dramatic differences in anterior condylar anatomy between the sexes have led to the design of total knee implants with thinner anterior condyles specifically for use in women. We had observed, in our patients, differences in anterior condylar anatomy that appeared to be highly variable and dependent on the size, height, and ethnicity of the patient as well as his or her sex. Because of this observed variability, we sought to determine if differences in anterior condylar anatomy between the sexes actually exist. Two hundred and twelve randomly selected magnetic resonance images (112 of men and 100 of women) were evaluated. The anterior condyle was defined as the area of bone anterior to the anterior femoral cortex, 10 mm above the joint line. The medial and lateral heights of the anterior condyles were measured in millimeters directly from magnetic resonance imaging data obtained in two planes. The so-called aspect ratio was calculated to determine whether patient size had an effect on the size of the anterior condyles. On the basis of the numbers available, there was no significant difference (p = 0.16) between the sexes with regard to lateral condylar height. The average difference was only 0.5 mm. There was a significant difference (p = 0.001) between men and women with regard to medial condylar height. However, the average difference was only 1.1 mm. While the difference between the sexes with regard to anterior condylar height was nominal, the measurements were highly variable regardless of sex. On the basis of the numbers available, there were no significant differences between men and women with regard to the condylar aspect ratios. The difference in anterior condylar anatomy is mentioned as one of three reasons for the need for a so-called gender-specific knee implant. The aspect ratio reported here, which is a surrogate for patient size, seems to negate any difference in anterior condylar anatomy based on sex. We have shown that
Nüssler, Emil Karl; Greisen, Susanne; Kesmodel, Ulrik Schiøler
Abstract INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare patient reported outcomes and complications after repair of recurrent anterior vaginal wall prolapse in routine health care settings using standard anterior colporrhaphy or non-absorbable mesh. METHODS: The study is based...... doctors and patients. Patient reported outcomes were evaluated 2 months and 12 months after the operation. RESULTS: After 12 months, the odds ratio (OR) of patient reported cure was 2.90 (1.34-6.31) after mesh implants compared with anterior colporrhaphy. Both patient- and doctor-reported complications...
Inbarajan, Athiban; Banu, Fathima; TV, Padmanabhan; Kumar, Anand; Seenivasan, Madhan
A 49-year-old patient reported for immediate replacement of missing maxillary anterior teeth with implant-retained prosthesis. Elevation of flap alters the mucosal level, causes discomfort, and delays the restorative procedure. To maintain the esthetics, flapless surgery was planned. Since placement of an implant is pre-planned in a predetermined site, fabrication of the prostheses before commencement of the surgery, especially when replacing the teeth in the anterior region, could be a viabl...
Serra-Pastor, Blanca; Roig-Vanaclocha, Ana; Román-Rodriguez, Juan-Luis; Fons-Font, Antonio
Introduction: Implant-supported prostheses have to overcome a major difficulty presented by the morphology and esthetics of peri-implant tissues in the anterior sector. Diverse therapeutic techniques are used for managing the mucosa adjacent to the implant and the most noteworthy is immediate/deferred fixed provisionalization. Objectives: In vitro testing of strength and deformation of implant prosthetic abutments made from different materials (Titanium/PEEK/methacrylate). Material and Methods: Forty Sweden&Martina® implant prosthetic abutments (n=40) were divided into five groups: Group MP: methacrylate provisional abutments with machined titanium base; Group PP: Poly ether ether ketone (PEEK) provisional abutments; Group TP: titanium provisional abutments; Group TAD: titanium anti-rotational definitive abutments; Group TRD: titanium rotational definitive abutments. Their mechanical behavior under static loading was analyzed. Samples were examined under a microscope to determine the type of fracture produced. Results and Conclusions: Definitive anti-rotational titanium abutments and definitive rotational titanium abutments achieved the best mean compression strength, while PEEK resin provisional abutments obtained the lowest. The group that showed the greatest elastic deformation was the group of titanium provisional abutments. Key words:Immediate loading, immediate provisionalization, implant prosthetic abutment, definitive implant prosthetic abutment. PMID:25129253
Full Text Available Implant placement in maxillary anterior region has most aesthetic challenges in implant dentistry because tooth loss lead to bone resorption and collapse of gingival architecture, which lead to aesthetic compromise and inadequate bone for implant placement. Immediate implant placement into fresh extraction socket reduces the treatment time, cost, preserved the gingival aesthetic and increases the comfort of the patient. This article describes the procedure for immediate implant placement in fresh extraction socket and early loading of implant with zirconia crown. Clinical and radiographic examination revealed width and length of the tooth for selecting implant size and design. Cement retained zirconia crown was used for early loading. Implant was successfully loaded and was functional during 36 months follow up period. Immediate placement and early loading of dental implant provides advantages like fewer surgical procedures, shorter treatment time, and improved aesthetic and psychological confidence.
Pablo David Flint Kuran
Full Text Available Introducción La luxación recidivante de hombro es una patología frecuente en pacientes jóvenes, laboralmente activos. Existen numerosas técnicas quirúrgicas para la inestabilidad glenohumeral. La técnica de Bristow, discutida por no ser anatómica y por sus complicaciones, continúa vigente debido al bajo índice de reluxaciones. Los objetivos fueron determinar el índice de recidiva, alteraciones funcionales e índice de consolidación del injerto. Materiales y Métodos Se evaluaron 24 pacientes del sexo masculino, de entre 19 y 40 años, operados por luxación anterior recidivante de hombro según la técnica de Bristow, entre enero de 2003 y agosto de 2011. Se evaluó la tasa de reluxación, la función articular según el puntaje de Constant y el posicionamiento del injerto con respecto a la superficie articular con tomografía y radiografías para evaluar la consolidación del injerto. Se registraron las complicaciones quirúrgicas. Resultados Todos los pacientes eran hombres, con rango de edad de 19 a 40 años. La causa fue traumática en 24 pacientes. Dieciséis pacientes presentaron más de 3 episodios de luxación prequirúrgicos. Según la escala de Constant, 21 obtuvieron entre 96 y 100 puntos, y los restantes, entre 90 y 95 puntos. No hubo nuevos episodios de luxaciones. La tomografía mostró la consolidación en todos los casos. Un paciente tuvo una imagen osteolítica alrededor del tornillo, sin compromiso funcional del hombro. Conclusión La técnica de Bristow para tratar la luxación anterior recidivante de hombro provocó un bajo índice de complicaciones, con resultados funcionales entre excelentes y buenos. No hubo episodios de reluxación y se logró la consolidación del injerto óseo en todos los casos.
Full Text Available We report on a patient who was referred for port implantation with a two-chamber pacemaker aggregate on the right and total occlusion of the central veins on the left side. Venous access for port implantation was performed via left side puncture of the horizontal segment of the anterior jugular vein system (AJVS and insertion of the port catheter using a crossover technique from the left to the right venous system via the jugular venous arch (JVA. The clinical significance of the AJVS and the JVA for central venous access and port implantation is emphasised and the corresponding literature is reviewed.
Ozan, Oguz; Ramoglu, Serhat
Implant-supported overdentures with self-aligning attachment systems are preferred to improve the stability and retention of complete dentures. The positioning of the implant attachments is a very important aspect of two-implant overdentures in obtaining better stress distribution. Therefore, the objective of this study was to compare two different attachment systems in a two-implant overdenture by evaluating the stress distributions in peri-implant bone and stresses on the attachments with positioning at different height levels using the 3D FEA method. Six models with ball attachments and 6 models with locator attachments-totaling 12 models (including 2 controls)-with the left implant positioned unilaterally at different height levels were subjected to 3 loading conditions (anterior, right posterior, and left posterior). Data for Von Misses stresses were produced numerically, color coded, and compared among the models for attachments and peri-implant cortical bone. The configurations in which implants presented 3 mm height differences in the bone level showed the most successful results in the peri-implant bone. When stresses on the attachments were compared, greater stress values were obtained from the ball attachments. As a conclusion, the configurations with a considerable (3 mm) height difference between quadrants of the mandible in the anterior segment showed the most successful results in the peri-implant bone. On the contrary, peak stress values around the implant observed from the models with less (1 mm) bone height difference may require leveling of the bone during surgery. However, these findings should be corroborated with clinical studies.
Gulati, Manisha; Garg, Meenu; Pathak, Chetan
The choice of implant length is an essential factor in deciding the survival rates of these implants and the overall success of the prosthesis. Placing an implant in the posterior part of the maxilla and mandible has always been very critical due to poor bone quality and quantity. Long implants can be placed in association with complex surgical procedures such as sinus lift and bone augmentation. These techniques are associated with higher cost, increased treatment time and greater morbidity. Hence, there is need for a less invasive treatment option in areas of poor bone quantity and quality. Data related to survival rates of short implants, their design and prosthetic considerations has been compiled and structured in this manuscript with emphasis on the indications, advantages of short implants and critical biomechanical factors to be taken into consideration when choosing to place them. Studies have shown that comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Short implants can be considered as an effective treatment alternative in resorbed ridges. Short implants can be considered as a viable treatment option in atrophic ridge cases in order to avoid complex surgical procedures required to place long implants. With improvement in the implant surface geometry and surface texture, there is an increase in the bone implant contact area which provides a good primary stability during osseo-integration. PMID:27790598
Jain, Neha; Gulati, Manisha; Garg, Meenu; Pathak, Chetan
The choice of implant length is an essential factor in deciding the survival rates of these implants and the overall success of the prosthesis. Placing an implant in the posterior part of the maxilla and mandible has always been very critical due to poor bone quality and quantity. Long implants can be placed in association with complex surgical procedures such as sinus lift and bone augmentation. These techniques are associated with higher cost, increased treatment time and greater morbidity. Hence, there is need for a less invasive treatment option in areas of poor bone quantity and quality. Data related to survival rates of short implants, their design and prosthetic considerations has been compiled and structured in this manuscript with emphasis on the indications, advantages of short implants and critical biomechanical factors to be taken into consideration when choosing to place them. Studies have shown that comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Short implants can be considered as an effective treatment alternative in resorbed ridges. Short implants can be considered as a viable treatment option in atrophic ridge cases in order to avoid complex surgical procedures required to place long implants. With improvement in the implant surface geometry and surface texture, there is an increase in the bone implant contact area which provides a good primary stability during osseo-integration.
Full Text Available Vitreous loss is a dreaded complication of cataract surgery, especially so with IOL implant which then may have to be abandoned. Thirty three cases of IOL implants, either anterior chamber or posterior chamber, after vitreous loss done in the past 3 years were studied. Of these, 18 (55% had a final visual acuity of 6/18 or better and none was worse than 6/60. The postoperative complications and findings and a review of literature are discussed.
Kohal, Ralf J; Weng, Dietmar; Bächle, Maria; Strub, Jörg R
Zirconia might be an alternative material to titanium for dental implant fabrication. The aim of the present study was to investigate the histological behavior (osseointegration) of loaded zirconia implants in an animal model and to compare it with the behavior of titanium implants. Five months after extraction of the upper anterior teeth, 12 custom-made titanium implants (control group) and 12 custom-made zirconia implants (test group) were inserted in the extraction sites in six monkeys. Before insertion, the titanium implant surfaces were sandblasted with Al2O3 and subsequently acid-etched. The zirconia implants were only sandblasted. Six months following implant insertion, impressions were taken for the fabrication of single crowns. A further 3 months later, nonprecious metal crowns were inserted. Five months after insertion of the crowns, the implants with the surrounding hard and soft tissues were harvested, histologically prepared, and evaluated under the light microscope regarding the peri-implant soft tissue dimensions and mineralized bone-to-implant contact. No implant was lost during the investigational period. The mean height of the soft peri-implant tissue cuff was 5 mm around the titanium implants and 4.5 mm around the zirconia implants. No statistically significant differences were found in the extent of the different soft tissue compartments. The mean mineralized bone-to-implant contact after 9 months of healing and 5 months of loading amounted to 72.9% (SD: 14%) for the titanium implants and to 67.4% (SD: 17%) for the zirconia implants. There was no statistically significant difference between the different implant materials. Within the limits of this animal experiment, it can be concluded that the custom-made zirconia implants osseointegrated to the same extent as custom-made titanium control implants and show the same peri-implant soft tissue dimensions.
Full Text Available Anterior chamber aspirate cultures were done for 66 patients who underwent either an uncomplicated intracapsular cataract extraction, extracapsular cataract extraction with posterior-chamber intraocular lens implantation, or phacoemulsification with posterior-chamber intraocular lens implantation. The aspirate was obtained at the time of wound closure. The aspirates were immediately transferred to the microbiology laboratory where one drop of the aspirate was placed on a glass slide for gram stain, and the remainder was unequally divided and inoculated into blood agar, chocolate agar and thioglycolate broth. The cultures were incubated at 37° C with 5% CO2 and held for 5 days. Of 66 patients 4 (6%, had smear-positive anterior chamber aspirates. None of the aspirates showed any growth on any of the 3 culture media used. None of the eyes in the study developed endophthalmitis. This study concludes that there is no contamination of the anterior chamber by viable bacteria after cataract surgery, irrespective of the mode of intervention.
Slater, Gordon L; Sayres, Stephanie C; O’Malley, Martin J
Ankle arthrodesis is a common procedure that resolves many conditions of the foot and ankle; however, complications following this procedure are often reported and vary depending on the fixation technique. Various techniques have been described in the attempt to achieve ankle arthrodesis and there is much debate as to the efficiency of each one. This study aims to evaluate the efficiency of anterior plating in ankle arthrodesis using customised and Synthes TomoFix plates. We present the outcomes of 28 ankle arthrodeses between 2005 and 2012, specifically examining rate of union, patient-reported outcomes scores, and complications. All 28 patients achieved radiographic union at an average of 36 wk; the majority of patients (92.86%) at or before 16 wk, the exceptions being two patients with Charcot joints who were noted to have bony union at a three year review. Patient-reported outcomes scores significantly increased (P plate offers added compression and provides a rigid fixation for arthrodesis stabilization. PMID:24649408
Full Text Available AIM: To analyze the clinical efficacy of phakic posterior chamber implantable contact lens(ICLimplantation on high myopia patients. METHODS: Thirty-four patients(68 eyeswho checked and diagnosed as high myopia in our hospital from June 2014 to June 2015 were selected as the clinical research subjects, and all the patients were given phakic posterior chamber intraocular lens implantation treatment. The diopter, visual acuity recovery, central anterior chamber depth, corneal endothelial cell count, and intraocular pressure after treatment were observed. RESULTS: The equivalent spherical refraction, central anterior chamber depth, uncorrected visual acuity and best corrected visual acuity recovery at 1, 3 and 6mo, 1 and 2a after treatment were better than those before treatment, and the differences were statistically significant(PP>0.05. There were no significant differences in uncorrected visual acuity, best corrected visual acuity, equivalent spherical refraction and central anterior chamber depth at 1, 3mo and 1 and 2a after treatment(P>0.05. CONCLUSION: The application of phakic posterior chamber intraocular lens implantation for the treatment of high myopia patients can improve the equivalent spherical refraction and central anterior chamber depth, improve uncorrected visual acuity, meanwhile, it has less effect on the patient's intraocular pressure and corneal endometrial cells, the effect maintenance and safety is better which meet their expectations.
Liu, Catherine Y; Vemuri, Swapna; Tao, Jeremiah P
To describe a small incision technique for the removal of a nylon foil orbital wall implant. The authors retrospectively reviewed the charts of 9 patients who underwent a minimally invasive anterior orbitotomy for nylon foil explantation. Indications for removal and surgical technique, including size of orbitotomy incision and extent of orbital dissection, were recorded. Motility, globe position, strabismus pre- and post procedure, and complications were also assessed. Photographs, videos, and postoperative imaging were included, when available. The indications for removal were adjacent sinusitis (4 cases), undesirable implant position (3), orbital abscess (1), and adjacent orbital emphysema (1). The removal technique was associated with no changes in motility, globe position, or strabismus postprocedure. The average incision size was 1.1 cm, and the procedure was rapid, usually seconds once the anterior aspect of the implant was exposed and grasped with a hemostat. The dissection in all cases was to the anterior aspect of the implant without a need for deep orbital manipulation. The authors demonstrate through video that the implant folds to exit through a small incision. No adverse events were noted. Nasal endoscopy and radiography demonstrated a fibrous capsule that maintained orbital structure and support. Thin nylon foil implant can be explanted safely and efficiently through a very small incision. The orbit maintains structure and configuration postexplantation in this series.
Conclusion: The prevalence of the mandibular lingual foramen seems to be nearly universal in the Saudi population. Surgeons looking to place implants in the mandibular anterior region should take cognizance of this fact in order to minimize the chance of complications.
Franken, K. A.; van Delft, J. L.; Dubbelman, T. M.; de Wolff-Rouendaal, D.; Oosterhuis, J. A.; Star, W. M.; Marijnissen, H. P.
The effects of Hematoporphyrin Derivative Photoradiation Therapy (HpD-PRT) on Greene's amelanotic melanoma implanted into the anterior chamber of rabbits have been examined by biomicroscopy, fluorescein angiography and histopathology. The tumors were irradiated 24 hours after injection of HpD when
Cruysberg, L.P.J.; Doors, M.; Berendschot, T.T.; Brabander, J. De; Webers, C.A.; Nuijts, R.M.
PURPOSE: To elucidate the physiological characteristics of eyes implanted with iris-fixated anterior chamber phakic intraocular lenses (pIOLs), which are increasingly being used for the correction of higher myopic and hyperopic refractive errors. METHODS: In a case series of 20 patients (39 eyes),
Underlying ion-beam modification of surfaces is the more basic subject of particle-surface interaction. The ideas can be grouped into forward and backward features, i.e. those affecting the interior of the target and those leading to particle expulsion. Forward effects include the stopping of the incident particles and the deposition of energy, both governed by integral equations which are easily set up but difficult to solve. Closely related is recoil implantation where emphasis is placed not on the stopping of the incident particles but on their interaction with target atoms with resulting implantation of these atoms. Backward effects, all of which are denoted as sputtering, are in general either of collisional, thermal, electronic, or exfoliational origin. (Auth.)
Full Text Available Purpose. Evaluation of the short implant (8 mm in height long-term prognosis and of the implant site influence on the prognosis. Methods. A longitudinal study was carried out on 121 patients (57 males and 64 females consecutively treated with 257 implants. 108 implants were short. Results. Four (3.6% short implants supporting fixed partial prostheses failed. Similarly, three standard implants supporting fixed partial prostheses and one supporting single-crown prosthesis failed. Mean marginal bone loss (MBL and probing depth (PD of short and standard implants were statistically comparable (P>.05. The 20-year cumulative survival rates of short and standard implants were 92.3 and 95.9%, respectively. The cumulative success rates were 78.3 and 81.4%. The survival rates of short implants in posterior and anterior regions were comparable: 95 and 96.4%, respectively. The difference between survival rates was not significant (P>.05. Conclusions. The high reliability of short implants in supporting fixed prostheses was confirmed. Short and standard implants long-term prognoses were not significantly different. The prognosis of short implants in posterior regions was comparable to that of in anterior regions. Nevertheless, a larger sample is required to confirm this trend.
Lops, Diego; Bressan, Eriberto; Pisoni, Gianluca; Cea, Niccolò; Corazza, Boris; Romeo, Eugenio
Purpose. Evaluation of the short implant (8 mm in height) long-term prognosis and of the implant site influence on the prognosis. Methods. A longitudinal study was carried out on 121 patients (57 males and 64 females) consecutively treated with 257 implants. 108 implants were short. Results. Four (3.6%) short implants supporting fixed partial prostheses failed. Similarly, three standard implants supporting fixed partial prostheses and one supporting single-crown prosthesis failed. Mean marginal bone loss (MBL) and probing depth (PD) of short and standard implants were statistically comparable (P > .05). The 20-year cumulative survival rates of short and standard implants were 92.3 and 95.9%, respectively. The cumulative success rates were 78.3 and 81.4%. The survival rates of short implants in posterior and anterior regions were comparable: 95 and 96.4%, respectively. The difference between survival rates was not significant (P > .05). Conclusions. The high reliability of short implants in supporting fixed prostheses was confirmed. Short and standard implants long-term prognoses were not significantly different. The prognosis of short implants in posterior regions was comparable to that of in anterior regions. Nevertheless, a larger sample is required to confirm this trend. PMID:22829823
Jensen, Charlotte; Meijer, Henny J A; Raghoebar, Gerry M; Kerdijk, Wouter; Cune, Marco S
PURPOSE: The purpose of this retrospective study was to assess performance, together with biological and technical complications, of implant-supported removable partial dentures (ISRPD) in mandibular Kennedy class I situations with implants placed in the anterior or posterior position. METHODS: 23
Jensen, Charlotte; Meijer, Henny J. A.; Raghoebar, Gerry M.; Kerdijk, Wouter; Cune, Marco S.
Purpose: The purpose of this retrospective study was to assess performance, together with biological and technical complications, of implant-supported removable partial dentures (ISRPD) in mandibular Kennedy class I situations with implants placed in the anterior or posterior position. Methods: 23
den Hartog, Laurens; Meijer, Henny J. A.; Stegenga, Boudewijn; Tymstra, Nynke; Vissink, Arjan; Raghoebar, Gerry M.
Objectives: To compare single implants in the aesthetic zone with different neck designs for marginal bone-level changes and clinical outcome measures. Materials and methods: Ninety-three patients with a missing anterior tooth in the maxilla were randomly assigned to be treated with an implant with
Swart, Louwrens C; Dreyer, Wynand P; van Zyl, Paul P; Blignaut, Renette J
This prospective study was undertaken to evaluate the 10-year implant survival rate as well as bone remodeling for immediately loaded anterior mandibular implants. Patients with nonrestorable anterior mandibular teeth were enrolled. All mandibular teeth were extracted, and five rough-surfaced (titanium plasma spray) one-piece implants were placed, evenly spread between the mental foramina. All implants were immediately loaded with a provisional prosthesis. A definitive prosthesis was . Eight patients received 40 implants, 30 in extraction sockets and 10 in healed sites. All but two implants that did not achieve primary stability (35 Ncm) were immediately loaded. The progress of seven patients was evaluated after 10 years. The mean age at implant placement was 60 years, and the length of follow-up varied between 10.3 and 11.47 years. The results showed a 100% implant retention rate; however, clinically observed bone loss around two central implants led to consideration for future surgical intervention or removal. Average bone loss was < 1 mm, and little difference was noted between implants placed in healed sites and those placed in extraction sockets. Technical problems with the prostheses were confined to two patients; one patient had seven fractures and the other had one. Rough-surfaced implants placed in extraction sockets between the mental foramina and immediately loaded can be successful in the long term. Because only is recommended that this site be avoided when immediately loaded implants are to be used in the anterior mandible.
Mayra Rodríguez Hernández
Full Text Available Se define una estrategia para la prevención en Cuba de la distrofia muscular de Duchenne (DMD, una de las enfermedades hereditarias letales más frecuentes, y se evalúan la factibilidad de su aplicación y los problemas que pudieran dificultar su implantación al nivel nacional. La estrategia se basa fundamentalmente en la necesidad de detectar las familias afectadas, la definición de las mujeres portadoras o en riesgo de serlo y el estudio molecular de los miembros de interés con anterioridad al ofrecimiento de los servicios de diagnóstico prenatal mediante análisis directo -detección de deleciones en el gen DMD mediante reacción en cadena de la polimerasa (PCR o análisis indirecto- empleo de los marcadores denominados polimorfismos en la longitud de los fragmentos de restricción (RFLPs en análisis de ligamento. Se concluye en que la aplicación de esta estrategia es factible y conveniente, pues permite ofrecer el diagnóstico prenatal al 75 % de las mujeres portadoras. Su eficiencia en la prevención del nacimiento de nuevos enfermos DMD se demuestra en 2 diagnósticos prenatales realizados, uno de los cuales detectó un embarazo afectado que fue interrumpido por solicitud de los padres.A strategy is defined for the prevention in Cuba of the Duchenne's muscular dystrophy (DMD, one of the most frequent lethal hereditary diseases, and the feasibility of its application, and the troubles that might difficult its implantation at a national level, are evaluated. This strategy is mainly based on the need of detecting the affected families, the definition of the carrier women, or the women at risk of being carriers, and the molecular study of the members of interest with anteriority to the offering of prenatal diagnosis services by direct analysis -detection of DMD gen deletions by (PCR polymerase chain reaction, or indirect analysis-, use of the markers called polymorphisms in the length of the restriction fragments (RFLPs in ligament
Guex-Crosier, Yan; Durig, Jacques
To evaluate the pattern of anterior segment indocyanine green (ICG) angiography in episcleritis and scleritis. Prospective comparative (paired-eye) observational case series. Twenty subjects presenting clinical diseases compatible with episcleritis or scleritis. Anterior segment ICG angiography was performed according to a standard protocol in subjects presenting either episcleritis or scleritis. Photographs of the anterior segment were taken in the early phase (up to 3 minutes after dye injection), intermediate phase (10-12 minutes) and late phase (30-45 minutes). The inflamed zones were compared with the same regions of the controlateral eye. The amount of protein ICG exudation was scored by a masked observer as follows: zero for no exudation, one for slight exudation, two for moderate exudation, and three for severe exudation. Evaluation of dye leakage, which reflects protein exudation, with anterior segment ICG angiography in episcleritis and scleritis. Twenty subjects with a mean age of 43 +/- 15 years (7 male, 13 female) were enrolled in the study. Thirteen subjects had anterior scleritis (7 nodular, 5 diffuse, and 1 scleromalacia perforans), and 7 subjects had episcleritis. Only 1 out of 7 subjects with episcleritis showed a slight ICG leakage (a score of one), whereas all subjects with scleritis had ICG leakage scores of one or more (P = 0.0005, Fisher exact test). ICG angiography of the anterior segment of the eye is a good clinical test to differentiate episcleritis from scleritis.
Nettemu Sunil Kumar
Full Text Available The anterior maxilla presents a challenging milieu interior for ideal placement of implants because of the compromised bone quality. With the advent of intraoral bone harvesting and augmentation techniques, immediate implant placement into fresh extraction sockets have become more predictable. Immediate implant placement has numerous advantages compared to the delayed procedure including superior esthetic and functional outcomes, maintenance of soft and hard tissue integrity and increased patient compliance. This case report exhibits immediate implant placement in the maxillary esthetic zone by combining a minimal invasive autogenous block bone graft harvest technique for ensuring successful osseointegration of the implant at the extraction site.
Rammelsberg, Peter; Lorenzo-Bermejo, Justo; Kappel, Stefanie
single crowns (P = 0.08). Other factors, for example location (anterior/posterior, maxilla/mandible), age, sex, or implant placement combined with bone augmentation, had no significant effect on the incidence of implant-related complications (P values ranging between 0.16 and 0.94). The type of support has a small but significant effect on implant prognosis. For detailed analysis of the effects of loading by different types of prosthetic restoration, larger sample sizes are required. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Garrick, James G.
This article presents a pragmatic approach to the definition, diagnosis, and management of anterior knee pain. Symptoms and treatment are described. Emphasis is on active involvement of the patient in the rehabilitation exercise program. (IAH)
Zurlo, J.V.; Towers, J.D.; Golla, S.
Objective. To develop a new method of magnetic resonance arthrography (MRA) of the knee using an anterior approach analogous to the portals used for knee arthroscopy.Design. An anterior approach to the knee joint was devised mimicking anterior portals used for knee arthroscopy. Seven patients scheduled for routine knee MRA were placed in a decubitus position and under fluoroscopic guidance a needle was advanced from a position adjacent to the patellar tendon into the knee joint. After confirmation of the needle tip location, a dilute gadolinium solution was injected.Results and conclusion. All the arthrograms were technically successful. The anterior approach to knee MRA has greater technical ease than the traditional approach with little patient discomfort. (orig.)
Full Text Available People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss. In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.
Full Text Available People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss . In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.
Takahashi, Toshihito; Gonda, Tomoya; Tomita, Akiko; Maeda, Yoshinobu
Palateless maxillary implant overdentures are often used for patients experiencing problems with a full-palate denture. However, palateless overdentures are reported to be a risk factor for implant complications. The purpose of this study was to examine the strain on implants beneath palateless overdentures with unsplinted attachments under various implant distributions. A maxillary edentulous model with implants and an experimental palateless overdenture were fabricated. Four strain gauges were attached to each implant, positioned in the anterior, premolar, and molar areas. Three types of unsplinted attachments (ball, locator, and magnet) were set on the implants under various implant distributions. A vertical occlusal load of 98 N was applied through the mandibular complete denture, and the bending strain on the implants was compared using the Kruskal-Wallis test (P = .05). When comparing the strain among different attachments, those using a magnet attachment were the smallest and those using a ball attachment were the greatest, and this difference was significant in most situations (P implant distributions, the strain on a four-implant distribution was significantly smaller than that on a two-implant distribution in most situations (P implants recorded the smallest strain. The strain on implants using a locator attachment tended to be midway between those using ball and magnet attachments, regardless of the implant distribution. In most implant distributions, magnet attachments decrease the strain on implants more than ball and locator attachments. The most favorable unsplinted attachments for use beneath palateless overdentures to decrease the implant strain are magnet attachments and four implants placed in the premolar and molar areas.
Siadat, Hakimeh; Alikhasi, Marzieh; Beyabanaki, Elaheh
Dental implants have become a popular treatment modality for replacing missing teeth. In this regard, the importance of restoring patients with function during the implant healing period has grown in recent decades. Esthetic concerns, especially in the anterior region of the maxilla, should also be considered until the definitive restoration is delivered. Another indication for such restorations is maintenance of the space required for esthetic and functional definitive restorations in cases where the implant site is surrounded by natural teeth. Numerous articles have described different types of interim prostheses and their fabrication techniques. This article aims to briefly discuss all types of implant-related interim prostheses by different classification including provisional timing (before implant placement, after implant placement in unloading and loading periods), materials, and techniques used for making the restorations, the type of interim prosthesis retention, and definitive restoration. Furthermore, the abutment torque for such restorations and methods for transferring the soft tissue from interim to definitive prostheses are addressed. © 2015 by the American College of Prosthodontists.
Mimche, Sylive; Ahn, Dukju; Kiani, Mehdi; Elahi, Hassan; Murray, Kyle; Easley, Kirk; Sokoloff, Alan; Ghovanloo, Maysam
The Tongue Drive System (TDS) is a new wearable assistive technology (AT), developed to translate voluntary tongue movements to user-defined computer commands by tracking the position of a titanium-encased magnetic tracer (Ti-Mag) implanted into the tongue. TDS application, however, is constrained by limited information on biological consequence and safety of device implantation into the tongue body. Here we implant a stainless-steel pellet in the rat tongue and assay pellet migration, tongue lick function, and tongue histology to test the safety and biocompatibility of unanchored tongue implants. Water consumption, weight and lick behavior were measured before and for >24days after implantation of a stainless-steel spherical pellet (0.5mm) into the anterior tongue body of twelve adult male rats. X-rays were obtained weekly to assess pellet migration. Pellet location and tissue reaction to implantation were determined by post-mortem dissection and histology of the anterior tongue. By dissection pellets were distributed across the transverse plane of the tongue. Measures of water consumption, weight, and lick behavior were unchanged by implantation except for a decrease in consumption immediately post-implantation in some animals. By X-ray, there was no migration of the implant, a finding supported by pellet encapsulation demonstrated histologically. Measures of lick behavior were minimally impacted by implantation. A smooth spherical stainless-steel implant in the anterior tongue of the rat does not migrate, is encapsulated and does not substantially impact lick behavior. These findings support the implantation of small tracers in the anterior tongue in humans for operating wearable assistive technologies. Copyright © 2016 Elsevier Ltd. All rights reserved.
Neergaard-Richardt, Tobias; Väkiparta, Teemu
This study investigated the immediate implant placement in the maxillary aesthetic zone without flap elevation or enhancement of the hard tissue component with filler or membrane material. The aim of this paper is to study treatment outcome for immediate implant placement in fresh extraction socket in the maxillary anterior region regarding marginal bone level. This retrospective cross-sectional study includes data on 41 patients, total of 54 implants (n = 54), treated for immediate placed im...
The introduction of mini-implants has broadened the range of tooth movements possible by fixed appliance therapy alone. The limits of fixed orthodontic treatment have become more a matter of facial appearance than anchorage. Many complex cases which would previously have required surgery or functional appliances can now be treated with fixed appliance therapy using mini-implants. A mutilated dentition case where mini-implants were used to provide anchorage for intrusion of molars and retraction of anterior teeth is reported here to illustrate this point.
Full Text Available The introduction of mini-implants has broadened the range of tooth movements possible by fixed appliance therapy alone. The limits of fixed orthodontic treatment have become more a matter of facial appearance than anchorage. Many complex cases which would previously have required surgery or functional appliances can now be treated with fixed appliance therapy using mini-implants. A mutilated dentition case where mini-implants were used to provide anchorage for intrusion of molars and retraction of anterior teeth is reported here to illustrate this point.
Seira Ibáñez, Juana
En este proyecto se propone la técnica de la adsorción mediante la utilización de polímeros naturales para eliminar el boro de residuos industriales, puesto que estos residuos presentan una gran problemática medioambiental. El polímero elegido para realizar la adsorción en este estudio es el alginato. Para poder trabajar en estado sólido se transforma el alginato de sodio, que es soluble en agua, en gel mediante la fabricación de las perlas de alginato de calcio. (Se utiliza...
Gil, Mindy S; Ishikawa-Nagai, Shigemi; Elani, Hawazin W; Da Silva, John D; Kim, David M; Tarnow, Dennis; Schulze-Späte, Ulrike; Bittner, Nurit
The purpose of this prospective, randomized, controlled, multicenter clinical study was to analyze the optical effects of an anodized pink colored implant shoulder/abutment system in the peri-implant mucosa of immediately placed dental implants. Forty subjects with a restoratively hopeless tooth in the maxillary esthetic zone, were recruited and randomized to receive either a pink-neck implant, or a conventional gray implant. All patients received an immediate implant and immediate provisional and two identical CAD/CAM titanium abutments with different surface colors: pink and gray, and one zirconia all-ceramic crown. The color of the peri-implant mucosa was measured using a dental spectrophotometer and analyzed using CIELAB color system. The overall color difference between the peri-implant mucosa with a pink abutment and a gray abutment was ΔE = 4.22. Patients with gray implants presented a color change of ΔE = 3.86-4.17 with this abutment change, while patients with pink implants had a color change of ΔE = 3.84-4.69. The peri-implant mucosa with a pink abutment was significantly more red when compared with a gray abutment (P ≤ .01). When a pink abutment was used, there is a significant color change of the peri-implant mucosa that is above the detectable color threshold. Esthetic outcomes are important for the success of implant treatment of maxillary anterior implants. The phenomenon of the gray color of a dental implant and abutment shining through the peri-implant mucosa has been documented in the literature. The objective of this study was to assess the optical effect of an anodized pink-neck implant and a pink abutment on the color of peri-implant mucosa. This study demonstrates that using pink-neck implant and a pink abutment would contribute positively to the overall esthetic outcome for an anterior implant. © 2017 Wiley Periodicals, Inc.
Full Text Available Because of the minimal soft tissue injury, the laparoscopic-assisted internal fixation is a promising technique in fixing the pelvic anterior ring fracture. The aim of this study was to investigate the biomechanical performance of the laparoscopic-assisted plate by the finite element method. Four kinds of implants were investigated, that is, the laparoscopic-assisted plate (LAP, the percutaneous anterior pelvic bridge (PAPB, the transramus intraosseous screw (TIS, and the open reduction (OR. The stability of the implants was investigated under three loading cases, showing that when the LAP was used, the stress at the fracture site was smaller than that at other parts, while for other implants, the high stress was always around the fracture site. In conclusion, the LAP demonstrated a good biomechanical performance in fixing the pelvic anterior ring fracture and is a promising technique in clinical applications.
Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard
Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...
Cervantes Haro, María Noelia
La rehabilitación oral con implantes dentales, es una vía de tratamiento desde hace mas de dos décadas. Una de las principales preocupaciones del clínico es saber en qué momento del tratamiento se puede conectar el implante al pilar protésico para la rehabilitación. Por ello se ha estudiado el coeficiente de estabilidad de los implantes en diferentes momentos de la cicatrización mediante el Osstell Mentor. Para ello se han colocado 83 implantes de diferentes longitudes, diámetros y casas come...
Calvo, M P; Muller, E; Garg, A K
Histologic and histomorphometric studies in both animals and humans have shown that more rapid and greater bone-to-implant contact can be achieved with implants that incorporate certain surface characteristics compared with the original machined-surface implants. Such findings are significant because various implant designs may allow the fixtures to sufficiently resist functional loading sooner than originally thought. The case report presented here indicates that immediate loading of hexed titanium screw-type implants in the anterior mandible can lead to successful osseointegration and clinical outcome. The number of implants placed, their distribution, and the type of rigid connection are critical considerations for immediate loading. A bone height that can accommodate dental implants > or = 10 mm long is recommended. Biomechanically, the implants to be immediately loaded must be stable and resistant to macromovement to ensure good osseointegration.
Allahbakhshi, Hanif; Vafaee, Fariborz; Lotfazar, Mehrdad; Ahangary, Ahmad Hasan; Khoshhal, Masoumeh; Fotovat, Farnoush
Background. Delayed loading is one of the concerns in implant patients. Immediate loading can solve the problem and make patients more satisfied. The present study aimed to compare the removal torque of maxi implants under different loading (immediate and delayed) patterns. Methods. This split-mouth experimental study included 2 dogs. Impressions were made and then all the premolars were extracted under general anesthesia. After a three-month healing period, 3 implants were inserted in each quadrant (a total of 12 implants). Anterior and posterior implants (the case group) were splinted by an acrylic temporary bridge in order to make the middle implants (the control group) off the occlusion. The dogs were sacrificed after 6 weeks and bone blocks were submitted for removal torque test. Data were analyzed with ANOVA (Pimmediate loading does not reduce the reverse torque values of maxi implants. This supports the advantages of immediate loading for maxi implants.
Allahbakhshi, Hanif; Vafaee, Fariborz; Lotfazar, Mehrdad; Ahangary, Ahmad Hasan; Khoshhal, Masoumeh; Fotovat, Farnoush
Background. Delayed loading is one of the concerns in implant patients. Immediate loading can solve the problem and make patients more satisfied. The present study aimed to compare the removal torque of maxi implants under different loading (immediate and delayed) patterns. Methods. This split-mouth experimental study included 2 dogs. Impressions were made and then all the premolars were extracted under general anesthesia. After a three-month healing period, 3 implants were inserted in each quadrant (a total of 12 implants). Anterior and posterior implants (the case group) were splinted by an acrylic temporary bridge in order to make the middle implants (the control group) off the occlusion. The dogs were sacrificed after 6 weeks and bone blocks were submitted for removal torque test. Data were analyzed with ANOVA (Pimmediate loading does not reduce the reverse torque values of maxi implants. This supports the advantages of immediate loading for maxi implants. PMID:28748047
Takahashi, Toshihito; Gonda, Tomoya; Maeda, Yoshinobu
The aim of this study was to examine the deformation modality of palateless maxillary implant overdentures using isolated attachments under various implant configurations. A maxillary edentulous model with implants inserted in the anterior, premolar, and molar areas was fabricated, and three types of unsplinted attachments-ball, locator, and magnet-were set on the implants distributed in various configurations. Experimental palateless dentures were fabricated, and two strain gauges were attached at the anterior midline of the labial and palatal sides. A vertical occlusal load of 98 N was applied, and the shear strains of dentures were measured. The measurements of strains were compared with the Kruskal-Wallis test (P = .05). The strains of the labial side were much larger than those of the palatal side except for those using the ball attachment. The strains using the magnet attachment on anterior implants were significantly larger than those using other attachments (P implants were significantly smaller than those using premolar or molar implants (P attachments and implant distribution. However, when using molar implants, there was no significant difference among the three attachments.
Full Text Available The effect of inter-implant distance on retention and resistance of implant-tissue-supported overdentures is lacking in the literature. An in vitro study was performed to evaluate this effect for mandibular implant-tissue-supported overdentures retained by two ball attachments.An acrylic cast of an edentulous mandible was fabricated. Three pairs of implants were symmetrically placed at both sides of the midline. The inter-implant distance was 10, 25, and 35 millimeters in positions A, B and C, respectively. A framework simulating the overdenture was fabricated on the cast. Six attachment housings were placed within the overdenture. For each sample, two ball abutments were screwed onto the implant pairs and two pink nylon inserts were seated in their respective attachment housings. The samples were tested in three groups of 15 (A, B, and C. The testing machine applied tensile dislodging forces and peak loads were measured in three directions: vertical, oblique, and anterior-posterior. A one-way ANOVA followed by Tukey's HSD was used to determine groups that were significantly different. Tests were carried out at 0.05 level of significance.Peak loads for the anterior-posteriorly directed dislodging forces were significantly the highest for group C (P0.05.Inter-implant distance did not affect the vertical retention and oblique resistance of mandibular implant-tissue-supported overdentures; however, it affected anterior-posterior resistance.
Full Text Available ABSTRACT We present the case of a 31-year-old patient with toxic anterior segment syndrome (TASS that developed after undergoing deep anterior lamellar keratoplasty (DALK. She had keratoconus, and despite wearing hard contact lenses for many years in the left eye, her vision had deteriorated; therefore, DALK was performed on this eye. The preoperative visual acuity (VA was finger counting at 3 m. Routine DALK was performed using the "big-bubble" technique. The corneal entry incision was hydrated at the end of the surgery, which was terminated by air injection into the anterior chamber. On postoperative day 1, VA was at the level of hand movements, and the cornea was edematous. Topical high-dose dexamethasone and oral steroids were initiated considering the diagnosis of TASS. Subsequently, the patient's VA increased, and the corneal edema decreased. We believe that the use of re-sterilized cannulas may have been the likely cause of TASS. Although DALK can be performed without interfering with the anterior chamber, one should keep in mind that TASS may occur in response to the solution used to hydrate the incision site and the air injected into the anterior chamber.
de Leeuw, P.A.J.; Golanó, P.; Clavero, J.A.; van Dijk, C.N.
Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly
Guo, Qunfeng; Zhang, Mei; Wang, Liang; Lu, Xuhua; Ni, Bin
To analyze the diagnosis and management of deep surgical site infection (SSI) with implant involved after anterior decompression and fusion for cervical spondylotic radiculopathy/myelopathy (CSR/CSM). Data of the patients who underwent anterior cervical decompression and fusion with plate fixation due to CSR/CSM were retrospectively reviewed. Cases with postoperative deep SSI with implant involved were identified and analyzed. A total of 1287 patients were finally included. Five patients (0.4%) were found to be with deep SSI. Bone fusion was not obtained when SSI was confirmed in each patient. Three cases were cured using one or two debridement and postoperative antibiotic therapy. Two cases with delayed diagnosis needed anterior implants removal, interbody fusion with autologous iliac bone and posterior lateral mass screw fixation at the first/second debridement. One of the two patients developed esophagus perforation after a second debridement and experienced one-month open drainage. All of the patients were cured without relapse of infection. For early deep SSI after anterior cervical decompression and fusion, surgical debridement was effective to eradicate infection. But for cases with delayed diagnosis, anterior debridement with prophylactic implant removal and posterior reconstruction was an ideal option. Esophagus perforation complicated with multiple debridements should be paid attention to and avoided. Copyright © 2015. Published by Elsevier B.V.
Full Text Available Aims and Objectives : To assess the efficacy of flapless implant surgery on soft-tissue profile and to compare the clinical outcomes of flapless implant therapy on immediate loading (IL implants to delayed loading (DL implants. Materials and Methods : The study sample consisted of 20 patients who were partially edentulous in the anterior maxillary region. They were divided into two groups. In group I (IL 10 implants were placed and immediately provisionalized and restored with a metal ceramic crown on the 14th day. In group II (DL 10 implants were placed and loaded after 4 months. Single-piece implants were used for the IL group and two-piece implants were used for the DL group. All soft tissue parameters i.e., modified plaque index (mPI, modified bleeding index (mBI, papillary index (PPI, marginal level of soft tissue (ML and width of keratinized mucosa (WKM were recorded at baseline, Day 60, Day 120 and Day 180. Results: The success rate in group I was found to be 80%, which was lower than the success rate in group II which was found to be 90%. On comparison, there is no statistically significant difference in success rate between the two study groups. There was no statistically significant difference between the groups over time in parameters like mPI, mBI, ML and WKM. The mean PPI score in group II showed a significant increase from when compared to group I. Conclusion: The results of this study indicated that flapless implant surgery using either immediately loading implants or DL implants, demonstrate enhancement of implant esthetics.
Korge, Andreas; Siepe, Christoph J; Heider, Franziska; Mayer, H Michael
Dynamic intervertebral support of the cervical spine via an anterolateral approach using a modular artificial disk prosthesis with end-plate fixation by central keel fixation. Cervical median or mediolateral disk herniations, symptomatic cervical disk disease (SCDD) with anterior osseous, ligamentous and/or discogenic narrowing of the spinal canal. Cervical fractures, tumors, osteoporosis, arthrogenic neck pain, severe facet degeneration, increased segmental instability, ossification of posterior longitudinal ligament (OPLL), severe osteopenia, acute and chronic systemic, spinal or local infections, systemic and metabolic diseases, known implant allergy, pregnancy, severe adiposity (body mass index > 36 kg/m2), reduced patient compliance, alcohol abuse, drug abuse and dependency. Exposure of the anterior cervical spine using the minimally invasive anterolateral approach. Intervertebral fixation of retainer screws. Intervertebral diskectomy. Segmental distraction with vertebral body retainer and vertebral distractor. Removal of end-plate cartilage. Microscopically assisted decompression of spinal canal. Insertion of trial implant to determine appropriate implant size, height and position. After biplanar image intensifier control, drilling for keel preparation using drill guide and drill bit, keel-cut cleaner to remove bone material from the keel cut, radiologic control of depth of the keel cut using the corresponding position gauge. Implantation of original implant under lateral image intensifier control. Removal of implant inserter. Functional postoperative care and mobilization without external support, brace not used routinely, soft brace possible for 14 days due to postoperative pain syndromes. Implantation of 100 cervical Prodisc-C disk prostheses in 78 patients (average age 48 years) at a single center. Clinical and radiologic follow-up 24 months postoperatively. Significant improvement based on visual analog scale and Neck Disability Index. Radiologic
Cooper, Lyndon F; Reside, Glenn J; Raes, Filiep; Garriga, Joan Soliva; Tarrida, Luis Giner; Wiltfang, Jörg; Kern, Matthias; De Bruyn, Hugo
This 5-year prospective multicenter study compared implant survival and success, peri-implant health and soft tissue responses, crestal bone level stability, and complication rates following immediate loading of single OsseoSpeed implants placed in anterior maxillary healed ridges or extraction sockets. Individuals requiring anterior tooth replacement with single implants were treated and immediately provisionalized. Definitive all-ceramic crowns were placed at 12 weeks. Implant survival, bone levels, soft tissue levels, and peri-implant health were monitored for 5 years. One hundred thirteen patients received implants in fresh sockets (55) and healed ridges (58). After 5 years, 45 and 49 patients remained for evaluation, respectively. During the first year, three implants failed in the extraction socket group (94.6% survival) and one implant failed in the healed ridge group (98.3% survival); this difference was not significant. No further implant failures were recorded. After 5 years, the interproximal crestal bone levels were located a mean of 0.43 ± 0.63 mm and 0.38 ± 0.62 mm from the reference points of implants in sockets and healed ridges (not a significant difference). In both groups, papillae increased over time and peri-implant mucosal zenith positions were stable from the time of definitive crown placement in sockets and healed ridges. Compared to flap surgery for implants in healed ridges, flapless surgery resulted in increased peri-implant mucosal tissue dimension (average, 0.78 ± 1.34 mm vs 0.19 ± 0.79 mm). After 5 years, the bone and soft tissue parameters that characterize implant success and contribute to dental implant esthetics were similar following the immediate provisionalization of implants in sockets and healed ridges. The overall tissue responses and reported implant survival support the immediate provisionalization of dental implants in situations involving healed ridges and, under ideal circumstances, extraction sockets.
Full Text Available En los trabajos sobre implantes mamarios, la principal preocupación de muchos autores en el postoperatorio alejado es la eventual formación de una cápsula. Otros cambios importantes, son las modificaciones en la posición del implante en relación con la glándula y su cobertura y las alteraciones de la glándula generadas por fenómenos habituales que ocurren a través de la vida de la mujer. Hemos generado conductas en el planteamiento quirúrgico que tienen por objeto atenuar o retrasar estos fenómenos. Creemos haberlo logrado mediante la aplicación de un zócalo de apoyo del implante, produciendo al mismo tiempo una firme interfase entre el plano dermocelular y la prótesis. Este plano subfascial para el polo inferior actúa como estante que da firmeza y estabilidad al neosurco.On many presentations about long term results in mammary implants, the main concern of the authors is capsule formation. We have also observed important changes in the position of the implant in relation to the glandular and other overlying tissues, as well as changes characteristic to the gland in the different ages of women. We have applied conducts on our surgical planning aiming to diminish or delay this facts. We believe this has been achieved with the creation of a plinth to sustain the implant, generating in this way a firm interphase between the dermocellular plane and the implant. This subfascial plane acts as a shelf giving firmness and stability to the new inframmamary fold.
Blaylock, W K; Moore, C A; Linberg, J V
The ethmoid air cell labyrinth lies adjacent to the medial orbital wall, extending even beyond the sutures of the ethmoid bone. Its anatomic relationship to the lacrimal sac fossa is important in lacrimal surgery. We evaluated computed tomographic scans of 190 orbits with normal ethmoid anatomy to define the anatomic relationship of anterior ethmoid air cells to the lacrimal sac fossa. In 93% of the orbits, the cells extended anterior to the posterior lacrimal crest, with 40% entering the frontal process of the maxilla. This anatomic relationship may be used to facilitate the osteotomy during dacryocystorhinostomy. During a 10-year period (310 cases), one of us routinely entered the anterior ethmoid air cells to initiate the osteotomy during dacryocystorhinostomy. This technique has helped to avoid lacerations of the nasal mucosa.
Ana Luiza Biancardi
Full Text Available Relato de caso de um paciente de 18 anos com sindrome de Alport apresentando perda visual progressiva. A biomicroscopia revelou lenticone anterior bilateral. O paciente realizou tomografia de córnea e segmento anterior com o sistema Scheimpflug (Pentacam e aberrometria e topografia corneana (i-Trace. O paciente foi submetido à facoemulsificação com implante de lente intraocular peça única hidrofóbica (Acrysof® SN60AT. As imagens de Scheimpflug documentaram o lenticone anterior. A aberrometria total mostrou acentuado astigmatismo miópico com acentuada aberração esférica negativa, havendo grande impacto das aberrações de alta ordem (HOA na conversão da letra E de Snellen. O mapa de integração da aberrometria do olho todo com a topografia corneana mostrou maior semelhança das aberrrações totais com as aberrações intraoculares do que com as aberrações da superfície anterior da córnea. Após a cirurgia, o paciente apresentou acuidade visual corrigida igual a 20/20 em ambos os olhos, as imagens de Scheimpflug revelaram lentes intraoculares tópicas e os mapas diferenciais revelaram resolução da miopia e redução das aberrações da alta ordem (total e interna. Os exames de imagem foram úteis para demonstrar o impacto do lenticone anterior na qualidade visual e a resolução das aberrações ópticas após a cirurgia.
Misch, Craig M
This article presents a clinical technique for immediate implant loading in the completely edentulous mandible. The protocol recommends the placement of 4 to 5 root-form implants in the anterior mandible between the mental foramina. Upon insertion the implants must have favorable primary stability. Abutments are added to the implants and the patient's lower denture is converted into an immediate load provisional fixed prosthesis. The denture conversion technique has been shown to provide predictable results for immediate implant loading in the edentulous mandible. The final prosthesis is fabricated upon integration of the implants in 3 months. The denture conversion technique offers several advantages because it may be used with most commercially available implant systems and it incorporates conventional implant components. Guidelines for patient selection, presurgical preparation, implant surgery, prosthesis fabrication, and postoperative care are reviewed.
Nekhoroshev, M. V.; Ryabov, K. N.; Avdeev, E. V.
Custom individual implants for the reconstruction of craniofacial defects have gained importance due to better qualitative characteristics over their generic counterparts – plates, which should be bent according to patient needs. The Additive Manufacturing of individual implants allows reducing cost and improving quality of implants. In this paper, the authors describe design of zygomatic implant models based on computed tomography (CT) data. The fabrication of the implants will be carried out with 3D printing by selective laser melting machine SLM 280HL.
Coen Pramono D
Full Text Available The high success rate of immediate implant placement both in the anterior and posterior regions were reported by many authors, therefore applying this techniques can be considered as a safe surgical procedure and minimizing the dental office visit for patient satisfaction. This paper reports the outcome of immediate placement of implants following extraction of anterior maxillary teeth. Combination technique of immediate and submerge implant placements including bone grafting procedure were used. Four implants with TiUnite surface type were placed immediately in two patients with the short-term result indicated that this technique may serve as a simple and safe procedure for immediate implant placement. It was concluded that immediate implant placement technique combined with TiUnite implant surface was successful in treating region directly after tooth extraction therefore this technique can be use as an alternative surgical method for dental implant rehabilitation.
Raikar, Sonal; Talukdar, Pratim; Kumari, Sarala; Panda, Sangram Kumar; Oommen, Vinni Mary; Prasad, Arvind
Dental implants have emerged as new treatment modality for the majority of patients and are expected to play a significant role in oral rehabilitation in the future. The present study was conducted to assess various factors affecting the survival rate of dental implants. The present retrospective study was conducted in the Department of Prosthodontics. In this study, 5200 patients with dental implants which were placed during June 2008-April 2015 were included. Exclusion criteria were patients with hormonal imbalance, patients with chronic infectious disease, patients receiving immunosuppressive therapy, pregnant women, drug and alcohol addicts, and patients with severe periodontal diseases. Parameters such as name, age, gender, length of implant, diameter of implant, location of implant, and bone quality were recorded. Data were tabulated and statistically evaluated with IBM SPSS Statistics for Windows, Version 20.0., IBM Corp., Armonk, NY, USA. Out of 5200 patients, 2800 were males and 2400 females. Maximum implants failures (55) were seen in age group above 60 years of age (males - 550, females -700). Age group implants. Age group 41-60 years (males - 1500, females - 1150) showed 45 failed implants. The difference was nonsignificant ( P = 0.21). Maximum implant failure was seen in implants with length >11.5 mm (40/700) followed by implants with implants failure (30/1000) was seen in implants with diameter implants with diameter >4.5 mm (16/1600) and implants with diameter 3.75-4.5 mm (50/2600). The Chi-square test showed significant results ( P implants failure, maxillary posterior revealed 2.2%, maxillary anterior showed 2.1%, and mandibular anterior showed 1% failure rate; this difference was significant ( P implant failure, Type II showed 1.95%, Type III showed 3%, and Type IV revealed 0.8% failure rate; this difference was significant ( P implant, diameter of implant, bone quality, and region of implant are factors determining the survival rate of implants
Muller, Bart; Duerr, Eric R. H.; van Dijk, C. Niek; Fu, Freddie H.
To measure and compare the amount of anterior tibial subluxation (ATS) after anatomic ACL reconstruction for both acute and chronic ACL-deficient patients. Fifty-two patients were clinically and radiographically evaluated after primary, unilateral, anatomic ACL reconstruction. Post-operative true
Kuehlewein, Laura; Kitiratschky, Veronique; Gosheva, Mariya; Edwards, Thomas L; MacLaren, Robert E; Groppe, Markus; Kusnyerik, Akos; Soare, Cristina; Jackson, Timothy L; Sun, Chen-Hsin; Chee, Caroline; Sachs, Helmut; Stingl, Krunoslav; Wilhelm, Barbara; Gekeler, Florian; Bartz-Schmidt, Karl Ulrich; Zrenner, Eberhart; Stingl, Katarina
The aim of this study was to assess changes in retinal structure and thickness after subretinal implantation of the Retina Implant Alpha IMS (Retina Implant AG, Reutlingen, Germany). Spectral-domain optical coherence tomography (SD-OCT) imaging was performed to assess the structure and thickness of the retina anterior to the microphotodiode array preoperatively, within 6 weeks and 6 months ± 1 month after implantation. Thickness measurements were performed using the distance tool of the built-in software. Three thickness measurements were performed in each of the four quadrants of the retina on the microchip within 6 weeks and 6 months ± 1 month after implantation. The mean ± standard deviation change in retinal thickness from within 6 weeks to 6 months ± 1 month after implantation in all four quadrants combined was 24 μm ± 68 μm. None of the tested variables (location, time, or their interaction) had a statistically significant effect on the mean retinal thickness (P = .961, P = .131, and P = .182, respectively; n = 19). The authors report on qualitative and quantitative findings in retinal structure in 27 patients after subretinal implantation of the Retina Implant Alpha IMS using OCT technology. No significant changes of retinal thickness could be observed in a period of 6 months after surgery. With more patients receiving subretinal implants and with advanced OCT technology, the data set will be extended to study possible changes in retinal structure in finer detail. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:993-999.]. Copyright 2017, SLACK Incorporated.
Mundt, Torsten; Schwahn, Christian; Biffar, Reiner; Heinemann, Friedhelm
To evaluate changes in marginal bone levels around maxillary and mandibular mini-implants stabilizing complete dentures and to explore possible risk factors associated with bone loss. All eligible patients from nine private dental practices were invited to participate. Panoramic radiographs were obtained postoperatively and at the follow-up examination. The changes in bone level were estimated with linear mixed models that included the factors sex, age, jaw, region (anterior versus posterior), smoking habits, and loading concept. Of the 180 invited patients, 133 participated in the follow-up (response rate: 73.9%). Of 336 mini-implants in 54 maxillas and 402 mini-implants in 95 mandibles, 15 maxillary implants and 11 mandibular implants were lost after insertion, and 4 mandibular implants fractured. Radiographic evaluations in 11 participants were not possible. The mean marginal bone loss at the remaining 634 mini-implants in 122 patients was 0.8 mm in the maxilla and 0.5 mm in the mandible over a mean observation time of 2.2 ± 1.0 years. This difference in univariate estimation lost significance after adjusting for the other variables. Implants in former smokers showed more bone loss than implants in participants who had never smoked. Implants that were loaded 3 to 4 months after placement (delayed loading) showed more marginal bone loss than immediately loaded implants. No statistically significant differences were found between men and women, different age groups, or anterior and posterior implants. Mean marginal bone loss around mini-implants used to stabilize complete dentures was insignificantly higher in the maxilla than in the mandible after a mean observation period of 2.3 years. These values are comparable with marginal bone loss around standard-diameter implants. A previous smoking habit and delayed loading after implant placement with a low insertion torque were shown to be possible risk factors for bone loss.
Closs, Luciane Quadrado; Reston, Eduardo Galia; Vargas, Ivana Ardenghi; de Figueiredo, Jose Antonio Poli
This case report refers to an 11-year-old boy with avulsion of the upper left central and lateral incisors. The teeth were replanted after 4 h, splinted with a semi-rigid splint for 12 days, and then endodontically treated. Severe progressive root resorption was seen after 2 years and the teeth were extracted. The boy had a normal occlusion with spacing in both jaws and slight protrusion of the anterior teeth. The treatment objectives were to close some of the spaces by mesial movement of the buccal segments in the upper jaw to minimize bone loss for a future single osseointegrated implant. Fixed appliance in combination with a removable plate was used for the mesial movements, levelling, and alignment of the upper jaw. Fixed appliance in the lower jaw and Class II traction were used for the final adjustment of the occlusion. A good occlusion with coincident upper and lower midlines and up-righted anterior teeth were achieved. A Maryland bridge was performed as a temporary solution for a future osseointegrated implant.
Yurdagüven, Haktan; Say, Esra Can; Güler, Nurhan
The loss of anterior teeth due to trauma requires immediate attention for function and esthetics. While implant- supported or conventional fixed prostheses may be the treatments of choice for adults, relatively noninvasive and reversible provisional procedures for tooth replacement are necessary for adolescents. In recent years, developments in fiber and composite technology offer a conservative treatment approach to restore the anterior edentulous space as a fixed provisional tooth replacement. This case report presents the chairside procedures of anterior tooth replacement in an adolescent using the avulsed tooth crowns as pontics which were bonded to teeth on either side of the edentulous space and reinforced with a preimpregnated fiber.
Bidra, Avinash S; Almas, Khalid
Mini implants are commonly used in orthodontics and for interim prosthodontic treatment, but evidence for their use in definitive prosthodontic treatment is not clear. This systematic review evaluated the mini-implant literature to analyze short-term (1 to 5 years), medium-term (5 to 10 years), and long-term (beyond 10 years) survival rates when used for definitive prosthodontic treatment. An electronic search of the English language literature for articles published between January 1974 and May 2012 was performed by using PubMed and Cochrane databases with predetermined inclusion criteria. Key terms included in the search were mini dental implants, narrow diameter implants, reduced diameter implants, small diameter implants, transitional implants, interim implants, and provisional implants. After a systematic filtering process, the selected articles were subjected to a detailed review, and the data collected were used to calculate the 1-year interval survival rate (ISR) and the cumulative survival rate (CSR). The electronic database search yielded 1807 titles. By scrutinizing the titles and abstracts with inclusion and exclusion criteria, the researchers identified 9 studies of mini implants for definitive prosthodontic treatment. Of the studies identified, 1 was a randomized controlled trial, 2 were prospective studies, and 6 were retrospective studies. The majority of mini implants were placed by using a flapless surgical technique in the mandibular anterior region to support an overdenture. The 1st year ISR was 94.7% and the CSR over a 9-year period, primarily attributed to data from 1 study, was 92.2%. Most implants were immediately loaded and almost all implant failures occurred during the first year after implant placement. For short-term survival, the first year ISR of 94.7% of mini dental implants appears encouraging, but the true 1-year survival rate is unknown, as the minimum follow-up period reported for several implants was less than a year
Guler, Ahmet Umut; Sumer, Mahmut; Duran, Ibrahim; Sandikci, Elif Ozen; Telcioglu, Nazife Tuba
The most important prerequisite for the success of an osseointegrated dental implant is achievement and maintenance of implant stability. The aim of the study was to measure the 208 Straumann dental implant stability quotient (ISQ) values during the osseointegration period and determine the factors that affect implant stability. A total of 164 of the implants inserted were standard surface, and 44 of them were SLActive surface. To determine implant stability as ISQ values, measurements were performed at the stage of implant placement and healing periods by the Osstell mentor. The ISQ value ranges showed a significant increase during the healing period. Except for the initial measurement, the posterior maxilla had the lowest ISQ values, and there was no significant difference among anterior mandible, posterior mandible, and anterior maxilla (P .05). The second measurement was significantly higher in men compared with women (P < .05). The second measurement was significantly higher than the others at 4.8 mm, and for the final measurement, there were no significant differences between 4.8 and 4.1 mm, which were higher than 3.3 mm (P < .05). When comparing sandblasted, large-grit, acid-etched (SLA) and SLActive surface implants, there were no significant differences for insertion measurements, but for second measurements, SLActive was significantly higher (P = 0), and for the final measurement, there was no significant difference. It appears that repeated ISQ measurements of a specific implant have some diagnostic benefit, and the factors that affect implant stability during the healing period are presented.
Di, Ping; Lin, Ye; Li, Jian-Hui; Luo, Jia; Qiu, Li-xin; Chen, Bo; Cui, Hong-yan
To evaluate the outcome and special characteristics of immediate implant rehabilitation using the All-on-Four treatment concept in completely or potentially completely edentulous Chinese patients. A convenience sample consisted of 69 consecutive patients (37 men, 32 women; mean age: 56.7 years) treated with immediate implant placement and full-arch prosthodontic provisional prostheses between April 2008 and December 2011. Of 344 implants (192 mandibular, 152 maxillary), 240 implants were placed in fresh extraction sites. The remaining 104 implants were placed in healed sites. Implants were immediately loaded with a fixed full-arch provisional prosthesis. Implant survival rate, marginal bone loss, abutment selection, complications, and subjective patient responses were recorded during follow-up. Implant survival rate was 96.2% at 33.7 months of mean follow-up (range: 12 to 56 months). A statistically significantly higher implant survival rate was found in the mandible (99.0% vs 92.8%) (P .05). Peri-implant marginal bone loss around upright implants and tilted implants was 0.7 ± 0.2 mm and 0.8 ± 0.4 mm, respectively. All patients reported satisfactory treatment outcomes. The modified All-on-Four treatment concept provides predictably favorable outcomes in completely or potentially completely edentulous patients and is well suited to the sociodemographic needs of Chinese patients. Exploratory use of a surgical guide was limited because of mouth opening, and more angulated abutments were needed in anterior upright implants of the maxilla.
Skie, M C; Ebraheim, N A; Woldenberg, L; Randall, K
The authors retrospectively reviewed 33 cases of fracture involving the anterior colliculus of the medial malleolus to examine clinical results of operative treatment for these fractures. Although this injury appears innocuous, it can be difficult to obtain stable fixation of the fragment intraoperatively, and painful nonunion can result. A simple reduction maneuver and method of tension band fixation are described.
Full Text Available Single teeth replaced by implants in the aesthetic zone are one of the most challenging situations faced by a clinician. Recent studies have encouraged a progressive shortening of the healing period for single-tooth implants with immediate implantation and immediate loading being proposed for the aesthetic zone in the maxilla. The present report describes three cases with single tooth replacement in the anterior maxillary region by implant therapy with flapless technique followed by immediate provisionalization of the implant with all-ceramic crown. The patients exhibited no clinical or radiologic complications 1 year after loading. Implant placement and immediate loading of single tooth can provide an attractive treatment option in the aesthetic zone. Careful assessment must be made of mucosal and bone volumes in relation to implant placement for optimum aesthetic outcome.
ulcer formation. On the other side, it is not clear what was the grade and morphology of the lens opacity, especially if it is known that visual acuity in right – healthy eye is 6/12 with presence of immature senile cataract. Retained IOFB is a risk factor for prolonged postoperative inflammation and endophthalmitis after cataract surgery. Therefore, surgical intervention including cataract extraction, foreign body removal with possible toric intraocular lens implantation could be therapy of choice for this patient. For these reasons, we would kindly ask the authors to present the data regarding the uncorrected visual acuity, required spherical and cylindrical correction, keratometry and refractometry readings, intraocular pressure values, grade and morphology of the lens opacification, state of the iridocorneal angle, possible changes in the vitreous, retina and optic nerve head. Without this information’s it would be difficult to hypothesize that the IOFB in the anterior chamber was completely inactive forthe past twenty years and it did not produce any adverse effect in patient’s eye. These findings will significantly contribute to the papers scientific value and contribution. Overall we agree with Surekha et al. that IOFBs can be variable in presentation and outcome. There is still signiﬁcant controversy in the management of IOFBs, particularly the timing and method of surgery.
Silvio Tucci Jr.
Full Text Available Objetivo: apresentar os aspectos clínicos, diagnósticos e terapêuticos de pacientes portadores de válvula da uretra anterior. Descrição: em dois neonatos, o diagnóstico presuntivo de patologia obstrutiva do trato urinário foi sugerido pela ultra-sonografia realizada no período pré-natal, confirmando-se o diagnóstico de válvula de uretra anterior pela avaliação pós-natal. Os pacientes foram submetidos a tratamento cirúrgico paliativo, com vesicostomia temporária e, posteriormente, definitivo, pela fulguração endoscópica das válvulas. Ambos evoluíram com função renal normal. Comentários: a válvula da uretra anterior é anomalia rara que deve ser considerada em meninos com quadro radiológico pré-natal sugestivo de obstrução infravesical, secundariamente à hipótese mais comum de válvula da uretra posterior. Ressaltamos a utilização da vesicostomia como derivação urinária temporária nestes casos, prevenindo potenciais complicações pela manipulação da uretra do recém-nascido.Objective: to discuss clinical signs, diagnostic tools and therapeutics of anterior urethral valves, an obstructive anomaly of the urinary system in males. Description: signs of urinary tract obstruction were identified on pre-natal ultrasound in two male fetuses and the diagnosis of anterior urethral valves was made through post-natal evaluation. As an initial treatment, vesicostomy was performed in both patients. Later, the valves were fulgurated using an endoscopic procedure. During the follow-up period both patients presented normal renal function. Comments: anterior urethral valves are a rare form of urethral anomaly that must be ruled out in boys with pre-natal ultrasound indicating infravesical obstruction. Vesicostomy used as an initial treatment rather than transurethral fulguration may prevent potential complications that can occur due to the small size of the neonatal urethra.
Lang-Hua, Bich Hue; Lang, Niklaus P; Lo, Edward C M; McGrath, Colman P J
To determine attitudes of general dental practitioners in a community where provision dental implants is a well-known treatment modality; and to identify variations in the attitudes with respect to dentists' factors, training factors and implant provision factors. A questionnaire survey to a random sample of registered dentists In Hong Kong was performed. Attitudes towards implant dentistry with respect to (i) perceived superiority of implant therapy, (ii) perceived outcomes of dental implant therapy, (iii) perceived complications & maintenance issues and (iv) placement issues were ascertained. In addition, information was collected on dentists' factors, training factors and implant provision factors. Variations in attitudes towards implant dentistry were explored in bivariate and regression analyses. Among eligible practitioners (n = 246), the response rate was 46.3%. Dentists perceived implants to be superior to conventional prostheses for the replacement of a single missing posterior tooth (80%, 67) and likewise, for the replacement of a single missing anterior tooth (67%, 67), P < 0.05. Variations in attitudes with respect to attitudes exists with respect to dentists' factors (years in practice [P < 0.05]), place of graduation (P < 0.05); implant trainings factors ("hand-on" training [P < 0.05]); number of days of training (P < 0.05) and implant experience factors (Number of patients treated [P < 0.05]) and number of implants placed (P < 0.05). In a community where provision of dental implants is widespread among its General Dental Practitioners (GDPs), their attitudes are not wholly in line with evidence-based knowledge. Variations in their attitudes existed with respect to dentist factors, training and experience issues. © 2012 John Wiley & Sons A/S.
Lindeboom, Jerome A.; Frenken, Joost W.; Dubois, Leander; Frank, Michael; Abbink, Ingmar; Kroon, Frans H.
PURPOSE: The aim of this prospective randomized study was to evaluate the clinical outcome of immediately loaded solid plasma sprayed (TPS) BioComp (BioComp Industries BV, Vught, The Netherlands) implants versus immediate provisionalized but non-loaded BioComp implants in the anterior and premolar
Petersen, Wolf; Rembitzki, Ingo Volker; Brüggemann, Gerd-Peter; Ellermann, Andree; Best, Raymond; Koppenburg, Andreas Gösele-; Liebau, Christian
Anterior knee pain is one of the most common causes of persistent problems after implantation of a total knee replacement. It can occur in patients with or without patellar resurfacing. As a result of the surgical procedure itself many changes can occur which may affect the delicate interplay of the joint partners in the patello-femoral joint. Functional causes of anterior knee pain can be distinguished from mechanical causes. The functional causes concern disorders of inter- and intramuscular coordination, which can be attributed to preoperative osteoarthritis. Research about anterior knee pain has shown that not only the thigh muscles but also the hip and trunk stabilising muscles may be responsible for the development of a dynamic valgus malalignment. Dynamic valgus may be a causative factor for patellar maltracking. The mechanical causes of patello-femoral problems after knee replacement can be distinguished according to whether they increase instability in the joint, increase joint pressure or whether they affect the muscular lever arms. These causes include offset errors, oversizing, rotational errors of femoral or tibial component, instability, maltracking and chondrolysis, patella baja and aseptic loosening. In these cases, reoperation or revision is often necessary.
Joshi, Rajesh S
Cotton is commonly used during ophthalmic surgical procedure. Cotton fibers may get attracted to the instruments due to electrostatic forces and become adhered to the surface. With the introduction of these instruments during the surgical procedure cotton fiber may get entry into the eye. In the literature they have been infrequently reported due to insignificant effect on the ocular structures. We present a case of recurrent iridocyclitis due to cotton fiber in the anterior chamber. Patient was relived of his symptoms after removal. A 78-year-old male presented with pain, redness and blurring of right eye vision since last six months. The patient had undergone phacoemulsification with implantation of hydrophilic intraocular lens (IOL) six years earlier. Postoperative follow up was uneventful from his records till last 6 months. Slit-lamp examination revealed a cotton fiber in the anterior chamber touching the endothelium. Keratic precipitates were seen on the endothelium. Removal of the cotton fiber resulted in subsidence of inflammation. We recommend use of plastic eye and trolley drapes, lint free instrument wipes and use of needle cap to support the globe during creation of side port while performing phacoemulsification instead of cotton buds to avoid entry of cotton fiber into the anterior chamber. © NEPjOPH.
Durán Montoro, Alberto
Este trabajo propone una solución a la pérdida de privacidad de las imágenes JPEG mediante la inclusión de políticas de privacidad. Posteriormente se genera una petición de acceso a la imagen y un autorizador determina si se tienen o no privilegios para visualizar el contenido de la imagen.
Full Text Available Single tooth replacement with a dental implant has become an increasingly favored treatment option in the anterior maxilla; however, bone resorption following maxillary anterior tooth extraction is very common and often compromises gingival tissue for the implant restoration. Achieving predictable peri-implant esthetics requires a proper understanding and preservation of the osseous and gingival tissue surrounding the failing tooth. Therefore, the key to maintaining the interproximal papillae is to preserve the osseous support with minimally invasive extraction. An immediate implant insertion after tooth extraction may maintain the crest bone and the interdental papillae, thus achieving peri-implant esthetics. This article describes the detailed treatment planning and meticulous techniques in immediate implant placement that reduce treatment time and maintain functional as well as esthetic results through a 6-year follow-up.
Ferrara, Alberto; Galli, Carlo; Mauro, Giovanni; Macaluso, Guido Maria
The timing of implant placement and loading following tooth extraction has recently undergone substantial reconsideration. The authors tested a protocol of immediate loading of single implants placed at the time of tooth extraction in a consecutive case series. Thirty-three patients received a single implant-supported crown to replace a maxillary anterior tooth at the time of extraction. Regular recalls were planned for the following 4 years. One implant did not integrate, and another became unstable secondary to facial trauma. Overall patient satisfaction and clinical and radiographic parameters were good.
Kinsel, Richard P; Liss, Mindy
The purpose of this retrospective study was to evaluate the effects of implant dimensions, surface treatment, location in the dental arch, numbers of supporting implant abutments, surgical technique, and generally recognized risk factors on the survival of a series of single-stage Straumann dental implants placed into edentulous arches using an immediate loading protocol. Each patient received between 4 and 18 implants in one or both dental arches. Periapical radiographs were obtained over a 2- to 10-year follow-up period to evaluate crestal bone loss following insertion of the definitive metal-ceramic fixed prostheses. Univariate tests for failure rates as a function of age ( or = 60 years), gender, smoking, bone grafting, dental arch, surface type, anterior versus posterior, number of implants per arch, and surgical technique were made using Fisher exact tests. The Cochran-Armitage test for trend was used to evaluate the presence of a linear trend in failure rates regarding implant length and implant diameter. Logistic regression modeling was used to determine which, if any, of the aforementioned factors would predict patient and implant failure. A significance criterion of P = .05 was utilized. Data were collected for 344 single-stage implants placed into 56 edentulous arches (39 maxillae and 17 mandibles) of 43 patients and immediately loaded with a 1-piece provisional fixed prosthesis. A total of 16 implants failed to successfully integrate, for a survival rate of 95.3%. Increased rates of failure were associated with reduced implant length, placement in the posterior region of the jaw, increased implant diameter, and surface treatment. Implant length emerged as the sole significant predictor of implant failure. In this retrospective analysis of 56 consecutively treated edentulous arches with multiple single-stage dental implants loaded immediately, reduced implant length was the sole significant predictor of failure.
Tran, Ton; Chen, Bernard K; Wu, Xinhua; Pun, Chung Lun
Repair of peri-prosthetic proximal tibia fractures is very challenging in patients with a total knee replacement or arthroplasty. The tibial component of the knee implant severely restricts the fixation points of the tibial implant to repair peri-prosthetic fractures. A novel implant has been designed with an extended flange over the anterior of tibial condyle to provide additional points of fixation, overcoming limitations of existing generic locking plates used for proximal tibia fractures. Furthermore, the screws fixed through the extended flange provide additional support to prevent the problem of subsidence of tibial component of knee implant. The design methodology involved extraction of bone data from CT scans into a flexible CAD format, implant design and structural evaluation and optimisation using FEM as well as prototype development and manufacture by selective laser melting 3D printing technology with Ti6Al4 V powder. A prototype tibia implant was developed based on a patient-specific bone structure, which was regenerated from the CT images of patient's tibia. The design is described in detail and being applied to fit up to 80% of patients, for both left and right sides based on the average dimensions and shape of the bone structure from a wide range of CT images. A novel tibial implant has been developed to repair peri-prosthetic proximal tibia fractures which overcomes significant constraints from the tibial component of existing knee implant. Copyright © 2018 Elsevier Ltd. All rights reserved.
Lee, Albert Ming Hsien; Poon, Choy Yoke
The primary aim was to investigate whether ridge preservation done at extraction will preserve at least 6 mm of alveolar ridge width in the anterior maxillary zone and obviate the need for secondary bone augmentation during implant insertion. Sixty patients with single implants placed in the anterior maxillary zone were classified in two groups. In the test group, 40 patients underwent ridge preservation at the time of tooth extraction, while the remaining 20 patients in the control group did not. Preimplant CBCT was evaluated to investigate if at least 6 mm of alveolar ridge width existed before implant insertion. The records were studied to investigate if secondary bone augmentation was done during implantation. The mean patient age was 48.4 years. In the test group, mean healing time before implant placement was 5.0 ± 3.7 months (2 to 22 months); in the control groups, 13.0 + 12.7 months (1.2 to 38 months). In the test group, 82.5% of the subjects had a preimplant alveolar ridge width measuring at least 6 mm. In comparison, only 35% of the subjects in the control group had a preimplant alveolar ridge width measuring at least 6 mm. The odds of having at least 6 mm preimplant alveolar ridge width was significantly higher than the control group (p preservation material. There was no significant difference in the alveolar ridge width between these two materials (p = 1) CONCLUSION: Ridge preservation was effective in providing a sufficient ridge width in the anterior maxilla at the time of implantation and reduced the need for further bone augmentation. The results of this study give the clinician insight into whether ridge preservation is required during extraction in the anterior maxilla in preparation for an implant restoration. (J Esthet Restor Dent 29:137-145, 2017). © 2016 Wiley Periodicals, Inc.
J.M. Cervilla Lozano
Full Text Available La lipoestructura mamaria ofrece nuevas alternativas de tratamiento en la cirugía estética de aumento mamario, cumpliendo en algunos casos las expectativas esperadas y en otros no. Analizamos este hecho en 4 tipos de aplicación de lipoestructura mamaria que hemos venido realizando en los últimos años, centrándonos en un aspecto importante de esta cirugía que es el relleno del polo superior de la mama. Los tipos de aplicación empleados son: aumento mamario simple mediante lipoestructura en comparación con implantes; pexia más lipoestructura frente a pexia más implantes mamarios; reconstrucción de mama tuberosa mediante lipoestructura o implantes y finalmente, relleno periprotésico mediante lipoestructura en mamas sometidas a cirugía de aumento mamario con implantes. En definitiva, podríamos resumir este trabajo en una frase diciendo que la lipoestructura mamaria, a nuestro juicio, no sirve si lo que prima es conseguir el relleno del polo superior de la mama, siendo en este caso de elección la colocación de implantes mamarios. No obstante, en alguno de los casos señalados no solo es una alternativa, sino que obtiene resultados superiores a los logrados sólamente con implantes.The mammary structural fat graft offers news treatment options in breast augmentation cosmetic surgery, but it sometimes meets expectations and sometimes doesn´t. We analyze 4 different types of lipostructure mammary applications that we have been using in the last years, focused in an important aspect of this surgery as it´s the filling of the upper mammary pole. These applications are: mammary augmentation by simple structural fat compared with the use of mammary implants; structural fat graft and mastopexy versus implants and mastopexy; tuberous breast reconstruction using structural fat graft or implants and finally, periprosthetic filling in breast augmentation with mammary implants using structural fat graft. In short, we could summarize this paper
Afify, Ahmed; Haney, Stephan
With careful restorative planning and surgical placement, dental implants can be used to support and retain a wide range of esthetic prostheses. When implant planning or surgical executions are less than ideal, however, the resulting restorative space can be a significant obstacle to successful treatment. The aim of this article is to describe the use of a customized anterior bar to support a partial overdenture prosthesis for a youthful patient with a high smile line and a limited restorative space of 6 mm. Details of the treatment and an illustration of the customized design are also presented. © 2018 by the American College of Prosthodontists.
... differ in material and consistency, however. Saline breast implants Saline implants are filled with sterile salt water. ... of any age for breast reconstruction. Silicone breast implants Silicone implants are pre-filled with silicone gel — ...
Stöver, T; Lenarz, T
Cochlear implants (CI) represent the "gold standard" for the treatment of congenitally deaf children and postlingually deafened adults. Thus, cochlear implantation is a success story of new bionic prosthesis development. Owing to routine application of cochlear implants in adults but also in very young children (below the age of one), high demands are placed on the implants. This is especially true for biocompatibility aspects of surface materials of implant parts which are in contact with the human body. In addition, there are various mechanical requirements which certain components of the implants must fulfil, such as flexibility of the electrode array and mechanical resistance of the implant housing. Due to the close contact of the implant to the middle ear mucosa and because the electrode array is positioned in the perilymphatic space via cochleostomy, there is a potential risk of bacterial transferral along the electrode array into the cochlea. Various requirements that have to be fulfilled by cochlear implants, such as biocompatibility, electrode micromechanics, and although a very high level of technical standards has been carried out there is still demand for the improvement of implants as well as of the materials used for manufacturing, ultimately leading to increased implant performance. General considerations of material aspects related to cochlear implants as well as potential future perspectives of implant development will be discussed.
Full Text Available Context : Pediatric cataract surgery is traditionally done with the aid of high-molecular-weight viscoelastics which are expensive. It needs to be determined if low-cost substitutes are just as successful. Aims : The study aims to determine the success rates for anterior and posterior capsulorrhexis and intraocular lens (IOL implantation in the bag for pediatric cataract surgery performed with the aid of a low-molecular-weight viscoelastic. Settings and Design : Nonrandomized observational study. Materials and Methods: Children less than 6 years of age who underwent cataract surgery with IOL implantation in the period May 2008-May 2009 were included. The surgeries were done by pediatric ophthalmology fellows. A standard procedure of anterior capsulorrhexis, lens aspiration with primary posterior capsulorrhexis, anterior vitrectomy, and IOL implantation was followed. Three parameters were studied: successful completion of anterior and posterior capsulorrhexis and IOL implantation in the bag. Results: 33 eyes of 28 children were studied. The success rate for completion was 66.7% and 88.2 % for anterior and posterior capsulorrhexis, respectively. IOL implantation in the bag was successful in 87.9%. Conclusions: 2% hydroxypropylmethylcellulose is a viable low-cost alternative to more expensive options similar to high-molecular-weight viscoelastics. This is of great relevance to hospitals in developing countries.
... this page: //medlineplus.gov/ency/patientinstructions/000681.htm Anterior cruciate ligament (ACL) injury - aftercare To use the sharing features ... that connects a bone to another bone. The anterior cruciate ligament (ACL) is located inside your knee joint and ...
Klakeel, Merrine; Thompson, Justin; Srinivasan, Rajashree; McDonald, Frank
A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery. We present the cases of two 13-year-old boys with anterior spinal cord syndrome, along with a review of the anatomy and vasculature of the spinal cord and an explanation of how a lesion in the cord corresponds to anterior spinal cord syndrome.
... a tube was inserted, and get a new contraceptive implant on schedule or switch to another method ... STDs. Possible Side Effects Young women who get contraceptive implants might notice such side effects as: irregular ...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Anterior poliomyelitis. 3... Specific Diseases § 3.379 Anterior poliomyelitis. If the first manifestations of acute anterior poliomyelitis present themselves in a veteran within 35 days of termination of active military service, it is...
P. Galarza Estebaranz; F.J. Díaz Prada; J.J. López Castro; V. Pérez Fontal
Introducción: El objetivo del presente estudio era mostrar los resultados clínicos del tratamiento con una rehabilitación fija mediante implantes dentales en pacientes edéntulos totales. Métodos: Veinte pacientes fueron tratados con 248 implantes Galimplant® de conexión externa y con superficie arenada y grabada para la rehabilitación fija. Los implantes fueron cargados después de un periodo de cicatrización de 2 meses. El seguimiento clínico fue al menos de 24 meses. Resultados: 145 implante...
Kankane Vivek Kumar
Full Text Available Epidermoid cysts are benign slow growing more often extra-axial tumors that insinuate between brain structures, we present the clinical, imaging, and pathological findings in 35 years old female patients with atypical epidermoid cysts which was situated anterior, middle & posterior cranial fossa. NCCT head revealed hypodense lesion over right temporal and perisylvian region with extension in prepontine cistern with mass effect & midline shift and MRI findings revealed a non-enhancing heterogeneous signal intensity cystic lesion in right frontal & temporal region extending into prepontine cistern with restricted diffusion. Patient was detoriated in night of same day of admission, emergency Fronto-temporal craniotomy with anterior peterousectomy and subtotal resection was done. The histological examination confirms the epidermoid cyst. The timing of ectodermal tissue sequestration during fetal development may account for the occurrence of atypical epidermoid cysts.
Lo Monaco, A; Santilli, D; Trotta, F
Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondyloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the "activity" of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.
Couto, Cristóbal; Frick, Mercedes M; LaMattina, Kara; Schlaen, Ariel; Khoury, Marina; Lopez, Matilde María; Hurtado, Erika; Espada, Graciela
To describe the visual prognosis and remission rate of chronic anterior uveitis in pediatric patients. A retrospective case series of children with chronic anterior uveitis treated in the University of Buenos Aires. Juvenile idiopathic arthritis was defined according to the International League of Associations for Rheumatology criteria. Uveitis remission was defined according to SUN criteria. There were 35 pediatric patients (61 eyes), mean age of uveitis onset was 7.69 ± 3 years, 60% were females and 74% had bilateral disease, median follow-up was 60 months (range: 12-192 months). JIA was more frequent in females (80.95 vs 21.43; pgood Received 30 August 2015; revised 6 March 2016; accepted 14 March 2016; published online 18 May 2016.
A review is given of the field of Moessbauer spectroscopy of ion-implanted sources. After an introduction to the various aspects of the ion-implantation method, the following topics are treated: final site selection of implanted impurities; trapping of defects at implanted ions; on-line implantation; implantation in metals, semiconductors and insulators. (Auth.)
Implantable Electronic Medical Devices provides a thorough review of the application of implantable devices, illustrating the techniques currently being used together with overviews of the latest commercially available medical devices. This book provides an overview of the design of medical devices and is a reference on existing medical devices. The book groups devices with similar functionality into distinct chapters, looking at the latest design ideas and techniques in each area, including retinal implants, glucose biosensors, cochlear implants, pacemakers, electrical stimulation t
Cochlear implant is a small, surgically implanted complex electronic device that can help to provide a sense of sound to a person with severe to profound sensorineural hearing loss. This type of hearing loss, typically involves damage to hair cells in the cochlea, as a result sound cannot reach the auditory nerve which usually receives information from hair cells. A cochlear implant skips the damaged hair cells and to stimulate the auditory nerve directly. An implant does not rest...
Bielemann, Amália Machado; Marcello-Machado, Raissa Micaella; Manzolli Leite, Fabio Renato
concentrations increased gradually over time, showing the highest concentrations at the 12th week (p implants failed at different periods. Conclusion While the clinical measurements presented differences between the evaluation periods, these were not indicative of early dental implant......Objectives The aim of this study is to improve the understanding of interleukin mechanisms during osseointegration to enhance the monitoring of implant failure and success. Clinical parameters, implant stability, and cytokine levels in peri-implant crevicular fluid (PICF) during early bone healing...... after implant placement were investigated. Material and methods Sixty narrow implants were placed in mandible anterior region of 30 edentulous patients (67.23 ± 7.66 years). Bone type, insertion torque, and primary stability were registered during surgery. Clinical measurements of peri-implant health...
Nitin Agarwal, MD
Full Text Available Conservative therapy is often the first-line treatment for many symptoms of various disease processes, including pain. Nevertheless, if pharmacological or medical management fails for those patients with severe and chronic pain, a surgical strategy may be a reasonable option. First performed for psychiatric disorders, cingulotomy now has been recognized as a viable option for the management of pain. The authors review the literature on anterior cingulotomy for intractable pain to provide guidelines for management and expected outcomes.
Aronen, J G
Anterior shoulder dislocations, primary and recurrent, are among the most disabling injuries to the shoulder that can plague the athlete. The diagnosis is easily made by the following: the physical appearance of the shoulder; loss of capability by the athlete to internally and externally rotate the shoulder with the elbow at his side; by evaluating the mechanism of injury; and x-rays. Anterior shoulder dislocations should be reduced as soon as possible after diagnosis, to minimise the stretching effect on the neurovascular structures while the humeral head is dislocated. The reduction is not done to allow the athlete to return immediately to sport. Use of a simple traction method in the first 10 to 15 minutes following the injury will result in a successful reduction in the vast majority of dislocations. Reduction of the humeral head can be confirmed by the athlete regaining the capability to internally and externally rotate his shoulder with his elbow at his side. Following reduction, the athlete should begin a treatment regimen which includes a restrengthening programme emphasising the muscles of internal rotation and adduction plus rigid restrictions of activities until the goals of the rehabilitation programme are satisfied. The author's experience with this treatment regimen with athletes at the United States Naval Academy, has shown a decrease of the recurrence rate of primary anterior shoulder dislocations to 25% versus the 80% recurrence rate we have become familiar with from studies done which did not stress specific rehabilitation programmes. The athlete should also be instructed in a self-performed traction method for reduction should a redislocation occur, to minimise the stretching effect on the neurovascular structures and allow relief from discomfort. Surgery for primary and recurrent anterior dislocations should only be considered when the athlete fails to achieve the desired goals after participating in a specific, progressive, adequate
F. Trotta; D. Santilli; A. Lo Monaco
Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as er...
Jennings, John D; Iorio, Justin; Kleiner, Matthew T; Gaughan, John P; Star, Andrew M
The goal of this retrospective review was to determine whether fluoroscopic guidance improves acetabular cup abduction and anteversion alignment during anterior total hip arthroplasty. The authors retrospectively reviewed 199 patients (fluoroscopy group, 98; nonfluoroscopy group, 101) who underwent anterior total hip arthroplasty at a single center with and without C-arm fluoroscopy guidance. Included in the study were patients of any age who underwent primary anterior approach total hip arthroplasty performed by a single surgeon, with 6-month postoperative anteroposterior pelvis radiographs. Acetabular cup abduction and anteversion angles were measured and compared between groups. Mean acetabular cup abduction and anteversion angles were 43.4° (range, 26.0°-57.4°) and 23.1° (range, 17°-28°), respectively, in the fluoroscopy group. Mean abduction and anteversion angles were 45.9° (range, 29.7°-61.3°) and 23.1° (range, 17°-28°), respectively, after anterior total hip arthroplasty without the use of C-arm guidance (nonfluoroscopy group). The use of fluoroscopy was associated with a statistically significant difference in cup abduction (P=.002) but no statistically significant difference in anteversion angles. In the fluoroscopy group, 80% of implants were within the combined safe zone compared with 63% in the nonfluoroscopy group. A significantly higher percentage of both acetabular cup abduction angles and combined anteversion and abduction angles were in the safe zone in the fluoroscopy group. Fluoroscopy is not required for proper anteversion placement of acetabular components, but it may increase ideal safe zone placement of components. Copyright 2015, SLACK Incorporated.
Takahashi, Toshihito; Gonda, Tomoya; Maeda, Yoshinobu
This study examined the effects of attachments on strain in maxillary implant overdentures supported by two or four implants. A maxillary edentulous model with implants inserted into anterior, premolar, and molar areas was fabricated, and three types of unsplinted attachments-ball, locator, and magnet-were set on the implants distributed under various conditions. Maxillary experimental dentures were fabricated, and two strain gauges were attached at the anterior midline on the labial and palatal sides. A vertical occlusal load of 98 N was applied and shear strain of the dentures was measured. On both sides, magnet attachments resulted in the lowest shear strain, while ball attachments resulted in the highest shear strain under most conditions. However, differences in shear strain among the three attachment types were not significant when supported by four implants, especially molar implants. Shear strain of the maxillary implant overdenture was lowest when using magnet attachments. Magnet attachments mounted on four implants are recommended to prevent denture complications when using maxillary implant overdentures.
Pasqualini, M E; Lauritano, D; Rossi, F; Dal Carlo, L; Shulman, M; Meynardi, F; Colombo, D; Manenti, P; Comola, G; Zampetti, P
The authors present an implant prosthesis procedure that uses screws on one-piece implants connected with a titanium pin at their abutment level and one supporter titanium bar in order to guarantee immediate stabilization. These can be implanted and fitted with customized temporary crowns in a single surgical procedure, restoring function and aesthetics and consenting recovery of the bone deficit with reduced healing times and limited patient discomfort. One-piece wide-diameter titanium screw implants with thread measurements of 2.1 and 2.6 mm (smaller diameter) up to diameter of 4.5 mm with one abutment of 2.0 and 2.5 mm respectively, were positioned and splinted by intraoral welding. One-piece titanium implants were used together with a pin (needle) titanium implant as supporting structure to achieve deep stabilization. The Scialom-like pin has a diameter of 1.2 mm and it is long enough to reach deep cortical bone that is bicorticalism. The One-piece implant is tightly connected to the needle implant by means of Mondani intra-oral welding technique. In severely atrophic anterior maxilla, the use of this method allows the immediate loading of a fixed resin prosthesis soon after surgery. These implants yielded satisfactory functional and aesthetic outcome in bone-deficient upper anterior sectors, without invasive regenerative procedures. The low invasiveness of this approach also consents rapid healing, reduced biological burden and greater patient benefit.
Hinds, Kenneth F
Providing an accurate soft-tissue transfer for anterior implants is not a new concept; however, it is currently an especially relevant one. There are numerous documented cases in which residual excess cement with cement-retained implant restorations was a contributing cause in periimplantitis. In 2012, Wadhwani et al reported the importance of placing the crown abutment margins supragingivally for ease of cement removal as a possible solution to address this important issue. Therefore, if placement of the crown abutment margin location is imperative, making an impression that reproduces the soft tissue is equally critical. In 1997, this author introduced the "custom impression coping" to achieve such an accurate transfer. Given the wide use of intraoral digital impressions in 2014, this discussion describes how to fabricate a "custom scan body" using that technology to replicate the transition zone in the virtual environment.
Full Text Available "nBackground and Aim: Soft tissue condition around dental implant is an essential part for long term healthy and esthetic outcome. The aim of this study was to compare soft tissue dimensions between implant supported single tooth replacement and the contra-lateral natural tooth. "nMaterials and Methods: This retrospective study was performed on dentate patients treated with anterior single tooth implant at least 1 year ago. Of twenty eight, fourteen patients had been treated with one stasge method and others with two stage method. Biologic width (BW, papilla index (PI, and mucosal thickness (MT were evaluated around implants and contra-lateral teeth clinically and compared with each other. The Wilcoxon test, Mann-Whitney test, and Student pair t-test were used to assess the differences between one stasge and two stage implants, and implant and tooth groups. "nResults: The mean BW around one stasge implants, two stage implants, and contra-lateral teeth were 1.42±0.48 mm, 1.67±0.48 mm, and 1.47±0.60 mm, respectively. The mean PI adjacent to one stasge implants, Two stage implants, and contra-lateral teeth were 2.50±0.52, 2.53±0.55, and 2.72±0.47, correspondingly. The mean MT around one stasge implants, two stage implants, and contra-lateral teeth were 3.10±0.48, 3.09±0.75, and 2.57±0.88, respectively. There was no statistically significant difference among one stasge implants, two stage implants, and contra-lateral teeth with regard to measured variables. "nConclusion: Based on the results of this investigation, in standard condition, it seems that there is no noticeable difference in indicators of; biologic width, papilla index, and mucosal thickness around one stasge implants, two stage implants, and contra-lateral teeth.
Enkling, Norbert; Nicolay, Claudia; Utz, Karl-Heinz; Jöhren, Peter; Wahl, Gerhard; Mericske-Stern, Regina
The purpose of this randomized split-mouth clinical trial was to determine the active tactile sensibility between single-tooth implants and opposing natural teeth and to compare it with the tactile sensibility of pairs of natural teeth on the contralateral side in the same mouth (intraindividual comparison). The hypothesis was that the active tactile sensibilities of the implant side and control side are equivalent. Sixty two subjects (n=36 from Bonn, n=26 from Bern) with single-tooth implants (22 anterior and 40 posterior dental implants) were asked to bite on narrow copper foil strips varying in thickness (5-200 microm) and to decide whether or not they were able to identify a foreign body between their teeth. Active tactile sensibility was defined as the 50% threshold of correct answers estimated by means of the Weibull distribution. The results obtained for the interocclusal perception sensibility differed between subjects far more than they differed between natural teeth and implants in the same individual [implant/natural tooth: 16.7+/-11.3 microm (0.6-53.1 microm); natural tooth/natural tooth: 14.3+/-10.6 microm (0.5-68.2 microm)]. The intraindividual differences only amounted to a mean value of 2.4+/-9.4 microm (-15.1 to 27.5 microm). The result of our statistical calculations showed that the active tactile sensibility of single-tooth implants, both in the anterior and posterior region of the mouth, in combination with a natural opposing tooth is similar to that of pairs of opposing natural teeth (double t-test, equivalence margin: +/-8 microm, P80%). Hence, the implants could be integrated in the stomatognathic control circuit.
Full Text Available This case report describes the esthetic and functional rehabilitation of a female patient in her mid forties having Class II Div 1 malocclusion, anterior open bite and multiple missing molars, with orthodontics and implant prosthodontics. The patient had bilaterally missing upper first and third molars and lower first and second molars. Orthodontic treatment using skeletal anchorage was performed to retract and align the upper anteriors and correct the open bite. In the upper arch, first molar spaces were closed and no prosthesis was needed. In the lower arch, the anteriors and premolars were aligned and implants were placed bilaterally to replace the missing molars and provide proper occlusion with the upper posteriors. Significant improvement in the occlusion, smile and facial esthetics was achieved. This article highlights the importance of an interdisciplinary team approach for providing optimum treatment to many adult patients.
E. Velasco Ortega; L. Monsalve Guil; N. Matos Garrido; A. Jiménez Guerra; A. García Méndez; R. Medel Soteras; I. Ortiz García; A. España López
Introducción: La implantología oral representa en la actualidad, una modalidad terapéutica odontológica en los pacientes con pérdida dental total y parcial. El estudio muestra la evaluación de los pacientes tratados mediante carga precoz de implantes de titanio con conexión interna y superficie arenada y grabada. Métodos: 39 pacientes con pérdidas dentales fueron tratados con implantes con conexión interna y superficie arenada y grabada Frontier GMI®. Los implantes fueron cargados funcionalme...
Full Text Available Introduction: The survival of an implant system is affected by the choice of antirotational design, which can include an external or internal hex. Implant success also is affected by the maintenance of the crestal bone around implants. The aim of present study was to evaluate the crestal bone loss and clinical parameters related to bone loss in patients loaded with an external or internal hex 3i implant (3i Implant Innovation, Palm Beach Gardens, FL, USA. The evaluations were performed one year after loading. Materials and Methods: A total of 39 implants (23 external hex, 16 internal hex were placed randomly in 23 patients (10 male, 13 female by a submerged approach. None of patients had compromised conditions or parafunctional habits. At placement and at one year after loading, periapical radiographs were taken via the parallel method from the implant sites. Results: Crestal bone loss was -0.712±0.831 mm in implants with an internal hex connection and -0.139±0.505 mm in implants with an external hex connection (P≤0.05. No correlation was found between crestal bone loss and parameters such as age, gender, jaw, implant location (anterior, premolar, or molar, implant diameter, or implant length. Conclusions: Crestal bone loss was greater in patients with internal hex 3i implants than in those with external implants. Similar results in other clinical factors were found between the groups.
Sanjay M Mallya
Full Text Available Dental implants are a popular modality for permanent tooth replacement. The key to successful implant placement, its subsequent osseointegration and the final prosthetic rehabilitation is proper preoperative assessment. Diagnostic imaging plays an important role in the pre- and post-surgical evaluation process. Imaging is used to evaluate suitability of implant sites, aid in selection of appropriate implants, and finally evaluate implant placement and osseointegration. This article reviews the role of diagnostic imaging in the various phases and the advantages and limitations of the numerous imaging modalities.
Full Text Available The aim of the present study was to assess the presence and course of the anterior loop in the mental foramen region according to age and gender, using cone beam computed tomography (CBCT. Both the right and left sides were retrospectively studied in 141 patients (n = 282. Axial, sagittal, cross-sectional and panoramic images were evaluated and three-dimensional images were reconstructed and evaluated as necessary. The morphology, course and length of the anterior loop were measured. The reliability and reproducibility were assessed based on the intraclass correlation coefficient (ICC and the coefficient of variation. An anterior loop was found in about 86% of the scans. The mean anterior loop proximal edge was 3.15 mm and the mean distance between the buccal border of the anterior loop and buccal alveolar wall was 2.24 mm. The mean volume of the mandibular canal was 1140 mm3 and the mean volume of the anterior loop was 90 mm3. Statistically significant difference was found in male patients in terms of the canal and anterior loop volume (p < 0.05. A high prevalence of anterior loop was detected by CBCT imaging, with predominance in female patients. Clinicians should be careful during implant or bone surgery procedures to avoid possible complications, with special emphasis on patient age, using this imaging modality that involves use of less radiation.
Kulkova, Julia; Moritz, Niko; Suokas, Esa O; Strandberg, Niko; Leino, Kari A; Laitio, Timo T; Aro, Hannu T
Bioresorbable suture anchors and interference screws have certain benefits over equivalent titanium-alloy implants. However, there is a need for compositional improvement of currently used bioresorbable implants. We hypothesized that implants made of poly(l-lactide-co-glycolide) (PLGA) compounded with nanostructured particles of beta-tricalcium phosphate (β-TCP) would induce stronger osteointegration than implants made of PLGA compounded with microsized β-TCP particles. The experimental nanostructured self-reinforced PLGA (85L:15G)/β-TCP composite was made by high-energy ball-milling. Self-reinforced microsized PLGA (95L:5G)/β-TCP composite was prepared by melt-compounding. The composites were characterized by gas chromatography, Ubbelohde viscometry, scanning electron microscopy, laser diffractometry, and standard mechanical tests. Four groups of implants were prepared for the controlled laboratory study employing a minipig animal model. Implants in the first two groups were prepared from nanostructured and microsized PLGA/β-TCP composites respectively. Microroughened titanium-alloy (Ti6Al4V) implants served as positive intra-animal control, and pure PLGA implants as negative control. Cone-shaped implants were inserted in a random order unilaterally in the anterior cortex of the femoral shaft. Eight weeks after surgery, the mechanical strength of osteointegration of the implants was measured by a push-out test. The quality of new bone surrounding the implant was assessed by microcomputed tomography and histology. Implants made of nanostructured PLGA/β-TCP composite did not show improved mechanical osteointegration compared with the implants made of microsized PLGA/β-TCP composite. In the intra-animal comparison, the push-out force of two PLGA/β-TCP composites was 35-60% of that obtained with Ti6Al4V implants. The implant materials did not result in distinct differences in quality of new bone surrounding the implant. Copyright © 2014 Elsevier Ltd. All
ALEIXANDRE TUDO, BERNARDO
La tecnología forma parte de la sociedad actual y de la vida cotidiana de las personas. Los últimos avances tecnológicos han simplificado nuestra vida y han provocado muchos cambios en las diversas áreas de la sociedad. Una de estas áreas es sin duda la automatización de la vivienda. Los nuevos aparatos electrónicos nos permiten tener acceso a las comunicaciones en cualquier lugar y a cualquier hora. La entrada de internet móvil en el mercado mediante los Smartphone y su ráp...
Holst, Stefan; Geiselhoeringer, Hans; Wichmann, Manfred; Holst, Alexandra Ioana
The osseointegration or fibrous encapsulation of immediately loaded dental implants depends largely on the extent of implant micromovement. The impact of acrylic resin or metal-reinforced acrylic resin provisional restorations on this movement is currently unknown. The purpose of this study was to isolate and measure the effect of provisional restoration type on the vertical displacement of adjacent implants under load at 2 locations. Vertical loads ranging from 10-200 N were applied to polymethyl methacrylate resin (n=56) or metal-reinforced acrylic resin provisional restorations (n=56) supported by 4 implants inserted into homogenous artificial bone in a "u-shaped" alignment. Provisional restorations were first loaded in the anterior segment where the provisional restoration was supported by a mesial and distal implant, followed by loading on an extension 8 mm distal to the last implant. Vertical displacement of the 2 implants nearest the load application was measured and recorded using an optical image correlation technique based on photogrammetric principles. Data were subjected to a nonparametric multivariate analysis (generalized Wilcoxon test) and a Mann-Whitney test with a 2-tailed P value (alpha=.05). There was no significant difference in the vertical implant displacement of the 2 provisional restoration groups when they were loaded in the anterior segment. However, when loads were applied to the distal cantilever, metal reinforcement resulted in less vertical displacement of the next-to-last implant. The mean vertical displacement of the next-to-last implant when supporting an acrylic resin provisional restoration increased from 20 microm +/-3 microm (pooled loads of 10-50 N) to 130 microm +/-21 microm (pooled loads of 160-200 N), while the vertical displacement of the implant when retaining a metal-reinforced acrylic resin provisional restoration increased from 10 microm +/-2 microm to 69 microm +/-13 microm under the same loads (Pprovisional
Dandekeri, Shilpa Sudesh; Dandekeri, Savita
One of the most challenging and complex treatment modality is replacement of single anterior tooth. This can be overcome by different treatment options such as implant-supported restorations as well as conventional porcelain-fused-to-metal and resin-bonded fixed partial dentures. Drifting of teeth into the edentulous area may reduce the available pontic space; whereas a diastema existing before an extraction may result in excessive mesiodistal dimension to the pontic space. Loop connector fixed partial denture (FPD) may be the simplest and best solution to maintain the diastema and provide optimum restoration of aesthetics. This article describes the procedure for the fabrication of a loop connector FPD to restore an excessively wide anterior edentulous space in a patient with existing spacing between the maxillary anterior teeth.
Full Text Available Purpose: To present a unique case of a 58-year-old female with toxic anterior segment syndrome (TASS, following a triple procedure: Descemet’s stripping automated endothelial keratoplasty (DSAEK, phacoemulsification and posterior chamber intraocular lens implantation. Methods: The patient was treated with topical dexamethasone sodium phosphate 0.1% and topical atropine sulfate 1%. Due to a slow improvement in her clinical status, oral prednisone 1 mg/kg/day was added. Results: The anterior chamber reaction improved gradually, with tapering down of topical and oral treatment, until a complete resolution of the anterior chamber reaction was observed. Conclusions: Taking into account the estimated volume of DSAEK triple procedures performed worldwide, we would expect an annual incidence of several TASS cases, following triple DSAEK procedures. However, we were unable to find any such previous reports in the literature. This fact raises questions regarding the cause of reduced TASS incidence following triple DSAEK procedures.
To maximize esthetics in anterior implant restorations, the initial step in treatment planning should be determining the prosthesis's esthetic integration with the patient's smile in keeping with the patient's anatomical limitations. This article examines the role of the abutment in supporting both esthetics and technical success. Included are discussions regarding cemented versus screw-retained restorations, material selection for anterior tooth replacement, and design parameters.
Yazici, Gozde; Sari, Sezin Yuce; Yedekci, Fazli Yagiz; Yucekul, Altug; Birgi, Sumerya Duru; Demirkiran, Gokhan; Gultekin, Melis; Hurmuz, Pervin; Yazici, Muharrem; Ozyigit, Gokhan; Cengiz, Mustafa
The effects of spinal implants on dose distribution have been studied for conformal treatment plans. However, the dosimetric impact of spinal implants in stereotactic body radiotherapy (SBRT) treatments has not been studied in spatial orientation. In this study we evaluated the effect of spinal implants placed in sawbone vertebra models implanted as in vivo instrumentations. Four different spinal implant reconstruction techniques were performed using the standard sawbone lumbar vertebrae model; 1. L2-L4 posterior instrumentation without anterior column reconstruction (PI); 2. L2-L4 anterior instrumentation, L3 corpectomy, and anterior column reconstruction with a titanium cage (AIAC); 3. L2-L4 posterior instrumentation, L3 corpectomy, and anterior column reconstruction with a titanium cage (PIAC); 4. L2-L4 anterior instrumentation, L3 corpectomy, and anterior column reconstruction with chest tubes filled with bone cement (AIABc). The target was defined as the spinous process and lamina of the lumbar (L) 3 vertebra. A thermoluminescent dosimeter (TLD, LiF:Mg,Ti) was located on the measurement point anterior to the spinal cord. The prescription dose was 8 Gy and the treatment was administered in a single fraction using a CyberKnife® (Accuray Inc., Sunnyvale, CA, USA). We performed two different treatment plans. In Plan A beam interaction with the rod was not limited. In plan B the rod was considered a structure of avoidance, and interaction between the rod and beam was prevented. TLD measurements were compared with the point dose calculated by the treatment planning system (TPS). In plan A, the difference between TLD measurement and the dose calculated by the TPS was 1.7 %, 2.8 %, and 2.7 % for the sawbone with no implant, PI, and PIAC models, respectively. For the AIAC model the TLD dose was 13.8 % higher than the TPS dose; the difference was 18.6 % for the AIABc model. In plan B for the AIAC and AIABc models, TLD measurement was 2.5 % and 0.9 % higher than the
Takeshita, Shin; Kanazawa, Manabu; Minakuchi, Shunsuke
This study aimed to investigate the influence of different overdenture attachment systems on the stress generated in peri-implant bone during overdenture dislodgement and loading. Two implants were placed in the canine regions on an acrylic edentulous mandibular model. Four strain gauges were attached to the resin surface adjacent to the left implant. Bar, ball, and magnetic attachments were examined. Three experimental overdentures were fabricated, and the denture parts of the attachment systems were incorporated into the mucosal surface. Retentive forces and strains generated in peri-implant bone during three types of dislodgement (vertical, anterior and posterior) and loading (left first molar region, right first molar region and mid-anterior region) were measured. The bar attachment showed the highest retentive force and reduced strain on posterior dislodgement. The ball attachment demonstrated the largest strain on loading at molar regions. The magnetic attachment showed the smallest retentive force and little strain.
Jensen, Charlotte; Meijer, Henny J A; Raghoebar, Gerry M; Kerdijk, Wouter; Cune, Marco S
The purpose of this retrospective study was to assess performance, together with biological and technical complications, of implant-supported removable partial dentures (ISRPD) in mandibular Kennedy class I situations with implants placed in the anterior or posterior position. 23 subjects with two endosseous implants to support a bilateral-free-ending mandibular removable denture were examined. Eight subjects had implants in the premolar (anterior) region and 15 subjects implants in the molar (posterior) region. Biological and technical complications were recorded from the patients' medical record. Patients filled out a validated questionnaire regarding their appreciation of oral health related quality of life (OHIP-NL49) and a VAS score on overall satisfaction. Over a mean follow-up period of 8 years (median 8 years, range 3-16 years) the cumulative implant survival rate was 91.7% (SE 0.05). Mean peri-implant bone loss was 0.9mm (SD 1.0mm). Scores for bleeding on probing, plaque and mucosal health were generally low, but significantly worse for posteriorly placed implants. Significantly more biological complications occurred in the posterior group (X 2 (1)=3.9; p=0.048). In 65% of the cases no technical complications were registered. Mean overall OHIP score was 16.1 (SD 18.4) and patients were highly satisfied (VAS: 8.4; SD 2.1). Within the limitations of this retrospective study, in case of a Kennedy class I situation in the mandible, an ISRPD is a viable treatment option with a high implant survival rate and satisfied patients after a maximum of 16 years. Technical and biological complications should be anticipated. Anteriorly placed implants performed slightly better. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Full Text Available Ocular involvement with Gnathostoma spinigerum occurs years after the initial infection that is acquired by ingestion of poorly cooked, pickled seafood or water contaminated with third stage larvae. Here we report a case of gnathostomiasis of the left eye of a 32-year-old lady hailing from Meghalaya, India. Her vision had deteriorated to hand movement. Slit lamp examination revealed a live, actively motile worm in the anterior chamber, which was extracted by supra temporal limbal incision and visual acuity was restored.
Donk, Roland D; Verhagen, Wim I M; Hosman, Allard J F; Verbeek, Andre; Bartels, Ronald H M A
A prospective cohort of 142 patients underwent either anterior cervical discectomy alone, anterior cervical discectomy with fusion by cage stand-alone, or anterior cervical discectomy with arthroplasty. We then followed up on their condition for a mean of 9.1±1.9 years (5.6-12.2 y) later. We aimed to evaluate the annual rate of clinically symptomatic adjacent segment disease (ASD) and to analyze predictive factors. Until recent, ASD has been predominantly evaluated radiologically. It is not known whether all patients had complaints. A frequent cited annual rate of ASD is 2.9%, but a growing number of studies report a lower annual rate. Furthermore, maintaining motion to prevent ASD is one reason for implanting a cervical disk prosthesis. However, the results of studies contradict one another. Participants took part in a randomized controlled trial that ended prematurely because of the publication of evidence that did not justify continuation of the trial. The patients were randomly allocated to 3 groups, each of which received one of the abovementioned treatments. We defined symptomatic ASD as signs and symptoms caused by degeneration of an intervertebral disk adjacent to a level of previous anterior cervical disk surgery. At the last follow-up, we were able to ascertain whether clinically symptomatic ASD was present in any of the participants. The overall annual rate of symptomatic ASD was 0.7%. We found no statistically significant correlations between any of the investigated factors and symptomatic ASD except for the surgical method used. Symptomatic ASD was seen less often in anterior cervical discectomy solely or anterior cervical discectomy with arthroplasty than in anterior cervical discectomy with fusion by plate fixation. The annual rate of symptomatic ASD after an anterior cervical discectomy procedure was estimated to be 0.7%. This seems to be related to the procedure, although firm conclusions cannot be drawn. Level 2-prospective cohort.
Full Text Available Tube implants or glaucoma drainage devices have become an important method of intraocular pressure reduction when treating complex cases of traumatic glaucoma. However, it is not uncommon to have complications associated with tube implants. The optimal treatment of patients who have undergone glaucoma implant surgery complicated by vitreous incarceration is uncertain. If vitreous is present or is able to prolapse into anterior chamber, as in aphakic or pseudophakic patient without an intact posterior capsule, a concurrent anterior vitrectomy is usually performed. In such cases, pars plana vitrectomy has been found to be more effective in several studies. However, there are no set guidelines for management of such a case in a phakic eye and the management can be more challenging especially when there is no obvious deficiency in posterior capsule, zonular dialysis, or loose vitreous gel in the anterior chamber prior to or during tube implantation. We describe a case of 14-year-old phakic patient with traumatic glaucoma without vitreous gel in anterior chamber whose tube implant became occluded by vitreous resulting in increased intra ocular pressure. This is the first documented report of vitreous incarceration in a phakic patient and its successful management.
Chu, Stephen J; Salama, Maurice A; Garber, David A; Salama, Henry; Sarnachiaro, Guido O; Sarnachiaro, Evangelina; Gotta, Sergio Luis; Reynolds, Mark A; Saito, Hanae; Tarnow, Dennis P
This article presents the results of evaluating the changes in peri-implant soft tissue dimensions associated with immediate implant placement into anterior postextraction sockets for four treatment groups: no BGPR (no bone graft, no provisional restoration), PR (no bone graft, provisional restoration), BG (bone graft, no provisional restoration), and BGPR (bone graft, provisional restoration). The vertical distance of the peri-implant soft tissue was greater for grafted sites than for nongrafted ones (2.72 mm vs 2.29 mm, P provisional restorations compared to sites without them (2.81 mm vs 2.37 mm, P provisional restoration.
Takeshita, Kenji; Vandeweghe, Stefan; Vervack, Valentin; Sumi, Takashi; De Bruyn, Hugo; Jimbo, Ryo
This study evaluated the clinical outcomes of immediately loaded maxillary anterior single implants placed in fresh extraction sockets. A patient cohort that was treated 1.5 years earlier was recalled, and 18 patients (6 men, 12 women) with 21 implants were included. Clinical photographs and periapical radiographs were taken at follow-up and baseline to determine the bone loss and change in esthetics. No marginal bone loss was detected at follow-up (mean bone level ± standard deviation = 0.32 ± 0.82 mm). Immediate implant placement and loading resulted in predictable clinical and esthetic outcomes, with soft and hard tissue levels remaining stable over time.
Kim, Yongsoo; Leem, Dae Ho
Without a proper intervention, a crushed alveolar process fracture can cause significant dimensional changes on affected hard and soft tissue that lead to difficult circumstances for post traumatic bone augmentation and dental implant placement. We present herein the cases of immediate guided bone regeneration (GBR) for the maxillary anterior alveolar process with comminuted fracture. Shortly after the hospital visit, guided bone regeneration was conducted for three patients using only xenograft material and bone fragments from traumatic site, without an additional donor site. Resorbable collagen membrane was used on the bone graft site, and titanium mesh was also used if significant bone loss were expected. Radiographic evaluation 6 months after GBR confirmed that all three cases had sufficiently preserved alveolar bone which is clinically required for implant placement. Dental implant installation was carried out for two patients and no specific findings were noted in follow-up after the placement. In this method, additional operation sites for bone collection are not necessary and the number of surgical steps before implant placement can be reduced. Furthermore, this immediate intervention can effectively minimize the alveolar ridge shrinkage of anterior maxilla after injury. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Jae Jun Lee
Full Text Available A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
NAVES, Marina de Melo; HORBYLON, Bruna Zacharias; GOMES, Camila de Freitas; MENEZES, Helder Henrique Machado de; BATAGLION, César; MAGALHÃES, Denildo de
The esthetics and functional integrity of the periodontal tissue may be compromised by dental loss. Immediate implants became a viable option to maintain the periodontal architecture because of their anatomic compatibility with the dental socket and the possibility of eliminating local contamination. This article describes the procedure of immediate implant placement in the anterior maxilla replacing teeth with chronic periapical lesions, which were condemned due to endodontic lesions persist...
Bilhan, Hakan; Geckili, Onur; Mumcu, Emre
Purpose The anterior region is a challenge for most clinicians to achieve optimal esthetics with dental implants. The provisional crown is a key factor in the success of obtaining pink esthetics around restorations with single implants, by soft tissue and inter-proximal papilla shaping. Provisional abutments bring additional costs and make the treatment more expensive. Since one of the aims of the clinician is to reduce costs and find more economic ways to raise patient satisfaction, this pap...
Full Text Available Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the “activity” of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.
Esquivel-Miranda, Miguel; De la O Ríos, Elier; Vargas-Valenciano, Emmanuelle; Moreno-Medina, Eva
Schwannomas are nerve sheath tumours that originate in Schwann cells. They are usually solitary and sporadic and manifest on peripheral, spinal or cranial nerves. Intracranial schwannomas tend to manifest on the eighth cranial nerve, particularly in patients with neurofibromatosis type2. Anterior skull-base schwannomas represent less than 1% of all intracranial schwannomas. They are more frequent in young people and are typically benign. These tumours represent a diagnostic challenge due to their rarity and difficult differential diagnosis, and numerous theories have been postulated concerning their origin and development. In this article, we present the case of a 13-year-old male with a single anterior cranial-base tumour not associated with neurofibromatosis who presented with headache, papilloedema, eye pain and loss of visual acuity. Complete resection of the tumour was performed, which was histopathologically diagnosed as a schwannoma. The patient made a complete clinical recovery with abatement of all symptoms. We conducted a review of the literature and found 66 cases worldwide with this diagnosis. We describe the most relevant epidemiological and clinical characteristics of this kind of tumour and its relation with the recently discovered and similar olfactory schwannoma. Copyright © 2017 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.
Ferrus, Jorge; Cecchinato, Denis; Pjetursson, E Bjarni; Lang, Niklaus P; Sanz, Mariano; Lindhe, Jan
To identify factors that may influence ridge alterations occurring at the buccal aspect of the extraction site following immediate implant placement. In 93 subjects, single-tooth implants were placed immediately into extraction sockets in the maxilla (tooth locations 15-25). A series of measurements describing the extraction site were made immediately after implant installation and at re-entry, 16 weeks later. The implant sites were stratified according to four factors: (i) implant location (anterior/posterior), (ii) cause of tooth extraction (periodontitis/non-periodontitis), (iii) thickness of the buccal bone walls ( 1 mm) and (iv) the dimension of the horizontal buccal gap ( 1 mm). (i) The location where the implant was placed (anterior/posterior) as well as (ii) the thickness of the buccal bone crest and (iii) the size of the horizontal buccal gap significantly influenced the amount of hard tissue alteration that occurred during a 4-month period of healing. At implant sites in the premolar segment, the fill of the horizontal gap was more pronounced than in the incisor-canine segment, while the vertical crest reduction was significantly smaller. Furthermore, at sites where the buccal bone wall was thick (>1 mm) and where the horizontal gap was large (>1 mm), the degree of gap fill was substantial. The thickness of the buccal bone wall as well as the dimension of the horizontal gap influenced the hard tissue alterations that occur following immediate implant placement into extraction sockets.
Full Text Available Propósito: El presente artículo es un estudio prospectivo de las tasas de éxito implantaria y de las complicaciones mecánicas y biológicas en el tratamiento rehabilitador implanto-asistido del sector posterior de la maxila, mediante provisionalización inmediata. Material y Método: El estudio clínico observó a 21 sujetos desdentados parciales unitarios del sector posterior maxilar, con reborde cicatrizado y antagonista dentario natural, por un período de 6 meses, en los que se insertaron implantes cónicos roscados de conexión interna, con tratamiento de superficie, temporizados inmediatamente después de insertados en el hueso maxilar, mediante la confección de una corona de resina acrílica sobre un pilar temporal de titanio atornillada directa al implante, dejados sin contactos dentarios durante la máxima intercuspidación (MIC y movimientos excéntricos mandibulares. Todas las restauraciones fueron observadas durante un período de 6 meses, evaluando tasa de éxito implantario, complicaciones biológicas y mecánicas. Resultados: Se insertaron 25 implantes en 21 pacientes, obteniéndose un valor promedio de inserción de torque quirúrgico de 45.6 Nt. Durante el período de observación clínico se presentó un 100% de éxito de sobrevida implantario, no se detectaron complicaciones biológicas, pero sí se presentaron complicaciones mecánicas por fractura de una cúspide vestibular de una restauración provisional acrílica y dos aflojamientos de tornillos. Conclusiones: La temporización unitaria mediante provisorio atornillado es un protocolo predecible y confiable que permite el proceso de oseointegración y la coexistencia en salud de tejido periimplantario y su sistema protésico.Purpose: This article is a prospective study of implant success rates and of mechanical and biological complications in the assisted-implant rehabilitation treatment of the posterior maxilla by immediate temporization. Material and Methods: The
Ventura Marco, M.
Full Text Available Los modelos media-varianza de selección de cartera, y en general los basados en el binomio rentabilidad-riesgo, parten de un capital inicial cierto. La consideración de la aversión al riesgo en los mismos es indirecta y siempre referida al valor final de la cartera, así que por lo general lo que se determina en los mismos es la proporción de la inversión total o riqueza inicial que se destina a cada activo considerado. Sin embargo, en muchas situaciones reales la aversión al riesgo debe considerarse ya en el momento de invertir, por lo que la determinación de la cuantía a invertir, coste o dotación inicial forma parte del problema, considerando que será mayor, dentro de unas cotas, si existe la probabilidad de obtener mayor rentabilidad aún soportando mayor riesgo. El problema se presenta mediante un modelo simple, pero general en su planteamiento, en el que además de la composición de la cartera queda determinada la cantidad a invertir. La idea es que el inversor establece dos capitales, uno como mínimo y otro como máximo, que está dispuesto a invertir y se utiliza la optimización por escenarios para decidir qué cantidad, entre las dos anteriores, le conviene invertir según sus expectativas.
Kim, Y-K; Park, J-Y; Kim, S-G; Kim, J-S; Kim, J-D
Objectives The purpose of this study was to determine the accuracy and effectiveness of digital panoramic radiographs for pre-operative assessment of dental implants. Methods We selected 86 patients (221 implants) and calculated the length of the planned implant based on the distance between a selection of critical anatomical structures and the alveolar crest using the scaling tools provided in the digital panoramic system. We analysed the magnification rate and the difference between the actual inserted implant length and planned implant length according to the location of the implant placement and the clarity of anatomical structures seen in the panoramic radiographs. Results There was no significant difference between the planned implant length and actual inserted implant length (P > 0.05). The magnification rate of the width and length of the inserted implants, seen in the digital panoramic radiographs, was 127.28 ± 13.47% and 128.22 ± 4.17%, respectively. The magnification rate of the implant width was largest in the mandibular anterior part and there was a significant difference in the magnification rate of the length of implants between the maxilla and the mandible (P panoramic radiographs is low, the magnification rate of the width of the inserted implants is significantly higher (P panoramic radiography can be considered a simple, readily available and considerably accurate pre-operative assessment tool in the vertical dimension for dental implant therapy. PMID:21239569
Anitua, Eduardo; Piñas, Laura; Alkhraisat, Mohammad Hamdan
There is a paucity of studies examining long-term outcomes of immediate loading of dental implants immediately placed into infected sites. This study aims to evaluate long-term outcomes of immediate loading of postextraction implants placed in infected sites. Patients were selected if they had postextraction implants in the anterior maxilla that were inserted in the period from December 2006 to June 2015 and immediately loaded. Information collected about patients included: 1) demographic data; 2) implant details; 3) soft tissue stability; and 4) prosthodontics data. Marginal bone loss (BL) and implant and prosthesis survival rates were calculated. Thirty patients (mean age: 56 years) had 43 implants immediately inserted into infected sites and immediately loaded. Implants were inserted at torque ≥35 Ncm. Mean follow-up time was 6 years (range: 1 to 8 years), and 65% of implants had a follow-up time >5 years. No implant failure occurred, and implant success rate was 93%. Proximal BL was 1.42 mm (range: 0.21 to 5.61 mm). Three prosthetic complications (all fracture of veneer material) occurred. Immediate loading of implants inserted into fresh and infected extraction sockets is not a risk factor for implant survival. However, stability of peri-implant soft and hard tissues indicates the need to take measures that minimize loss.
Kroeplin, Birgit S; Strub, Joerg R
The aim of this study was to describe the didactic and clinical undergraduate implant dentistry program of the Albert-Ludwigs University, Freiburg, Germany, with emphasis on the clinical implant experience. A detailed description of the implant curriculum at Albert-Ludwigs University is given with documented exemplary cases and additional flow charts. All students participate in 28 hours of lectures and approximately 64 hours of seminars with hands-on courses and gain clinical experience. All undergraduate students are eligible to place and restore oral implants. Emphasis is placed on prosthetic-driven planning of implant positions, three-dimensional imaging, and computer-guided implant placement. Implant restorations performed by undergraduate students comprise single crowns and small multiunit fixed dental prostheses in partially edentulous posterior maxillae and anterior or posterior mandibles, implant-retained overdentures (snap attachment) in edentulous patients, and telescopic fixed-removable dental prostheses on remaining teeth and strategically placed additional implants. Over the past 2.5 years, 51 patients were treated with 97 dental implants placed by students in the undergraduate program. Seventy-one restorations were inserted: 60.6% single crowns, 7% fixed dental protheses, 21.1% overdentures, and 11.3% telescopic fixed-removable dental prostheses. The implant survival rate was 98.9%. Because survival rates for dental implants placed and restored by students are comparable to those of experienced dentists, oral implant dentistry should be implemented as part of the undergraduate dental curriculum.
Choi, Yong-Geun; Eckert, Steven E; Kang, Kyung Lhi; Shin, Sang-Wan; Kim, Young-Kyun
To examine the disparity of single-crown implant failure with a similar loss of the splinted prosthesis in differing anatomical locations while controlling for other demographic and clinical variables that may confound the relationship between prosthesis types and implant loss. A multicenter retrospective cohort study was designed to include patients treated with dental implants from 2003 to 2014. The variables included age, sex, systemic disease, bone graft, implant placement date, position of dental implant, length of dental implant, diameter of dental implant, loading time, type of prosthesis, type of opposing occlusion, latest check date, and survival or loss of the dental implant. The demographic and clinical variables' influence on the survival of dental implants was estimated by the Kaplan-Meier method. The position and diameter were adjusted for the accurate estimation of the relationship between the prosthesis type and survival of the dental implant with the Cox proportional hazard method. A total of 1,151 dental implants from 403 patients were ascertained. After adjusting for the confounding effect of position and diameter, single-crown prostheses were 38.1 (95% CI: 15.1-118) times more likely to be lost than the connected-type prostheses. For single-crown implants, the waiting time for osseointegration before loading was the highest for the maxillary molar position and the lowest for the mandibular molar position (P < .0001), while the most frequent implant loss occurred in the maxillary anterior area, and the second frequent area was the maxillary molar position; the lowest occurrence of implant loss was for the mandibular molar position. This disparity was statistically significant (P = .0271). Despite the high survival rates of endosseous implants as a whole, since the variation of implant loss was observed among the different anatomical positions for single-crown implants, special attention has to be given to the maxillary anterior and maxillary
Tabatabaei, S A; Rajabi, M B; Tabatabaei, S M; Soleimani, M; Rahimi, F; Yaseri, M
PurposeTo determine the proper time for traumatic cataract surgery after open globe injuries.SettingFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.DesignRandomized clinical trial.Patients and methodsIn a randomized clinical trial, 30 eyes with traumatic cataract after open globe injury with IOL implantation underwent early (in the first week after the trauma) and 30 eyes underwent late cataract surgery (from the first to second month after the trauma). We excluded patients who were under 12-year-old. All patients were visited at 1 week, 4 weeks, 12 weeks, and 6 months after surgery. In each visit, patients were examined regarding visual acuity, intraocular pressure (IOP), anterior chamber inflammation, IOL position, and posterior synechiae. In addition, posterior segment evaluation and fundoscopy were performed. Intraoperative complication including posterior capsular rupture, anterior vitrectomy, and zonulysis as well as the site of IOL implantation were documented and post-operative complications including raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were listed.ResultsBest-corrected visual acuity 6 months after surgery was not different between the two groups. Also in early cataract surgery group, the rate of posterior capsular rupture was not significantly higher than the late surgery group (P=0.069). On the other hand, zonulysis was significantly higher in the late procedure group (P=0.039). Other complications including anterior vitrectomy, raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were not different in the two groups.ConclusionsEarly and late traumatic cataract surgery and IOL implantation after open globe injuries, have no significant difference regarding the post-surgical BCVA and prominent intraoperative and post-operative complications.
Almeida, Erika O; Rocha, Eduardo P; Freitas Júnior, Amilcar C; Anchieta, Rodolfo B; Poveda, Ronald; Gupta, Nikhil; Coelho, Paulo G
This study compared the biomechanical behavior of tilted long implant and vertical short implants to support fixed prosthesis in an atrophic maxilla. The maxilla model was built based on a tomographic image of the patient. Implant models were based on micro-computer tomography imaging of implants. The different configurations considered were M4S, four vertical anterior implants; M4T, two mesial vertical implants and two distal tilted (45°) implants in the anterior region of the maxilla; and M6S, four vertical anterior implants and two vertical posterior implants. Numerical simulation was carried out under bilateral 150 N loads applied in the cantilever region in axial (L1) and oblique (45°) (L2) direction. Bone was analyzed using the maximum and minimum principal stress (σmax and σmin ), and von Mises stress (σvM ) assessments. Implants were analyzed using the σvM . The higher σmax was observed at: M4T, followed by M6S/L1, M6S/L2, M4S/L2, and M4S/L1 and the higher σvM : M4T/L1, M4T/L2 and M4S/L2, M6S/L2, M4S/L1, and M6S/L1. The presence of distal tilted (all-on-four) and distal short implants (all-on-six) resulted in higher stresses in both situations in the maxillary bone in comparison to the presence of vertical implants (all-on-four). © 2013 Wiley Periodicals, Inc.
Pfeifer, Kyle [Mallinckrodt Institute of Radiology, Department of Radiology, St. Louis, MO (United States); Leslie, Michael [Yale School of Medicine, Department of Orthopedics and Rehabilitation, New Haven, CT (United States); Menn, Kirsten; Haims, Andrew [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States)
Anterior hip dislocations are rare orthopedic emergencies resulting from high-energy trauma and have unique imaging characteristics on radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Imaging findings on CT and MRI allow for the prompt recognition and classification of anterior hip dislocations, which guides patient management and reduces complications. The purpose of this article is to review imaging findings of anterior hip dislocations, specifically focusing on CT and MRI. (orig.)
Pfeifer, Kyle; Leslie, Michael; Menn, Kirsten; Haims, Andrew
Anterior hip dislocations are rare orthopedic emergencies resulting from high-energy trauma and have unique imaging characteristics on radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Imaging findings on CT and MRI allow for the prompt recognition and classification of anterior hip dislocations, which guides patient management and reduces complications. The purpose of this article is to review imaging findings of anterior hip dislocations, specifically focusing on CT and MRI. (orig.)
Hayashi, Hisami; Fischer, Hans
The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding.
Daugaard, Henrik; Søballe, Kjeld; Bechtold, Joan E
The goal of osseointegration of orthopedic and dental implants is the rapid achievement of a mechanically stable and long lasting fixation between living bone and the implant surface. In total joint replacements of cementless designs, coatings of calcium phosphates were introduced as a means...... of improving the fixation of implants. Of these, hydroxyapatite (HA) is the most widely used and most extensively investigated. HA is highly osseoconductive, and the positive effect is well documented in both basic and long-term clinical research [1–6]. This chapter describes experimental and clinical studies...... evaluating bone-implant fixation with HA coatings....
Downey, DF; Jones, KS; Ryding, G
Ion implantation technology has made a major contribution to the dramatic advances in integrated circuit technology since the early 1970's. The ever-present need for accurate models in ion implanted species will become absolutely vital in the future due to shrinking feature sizes. Successful wide application of ion implantation, as well as exploitation of newly identified opportunities, will require the development of comprehensive implant models. The 141 papers (including 24 invited papers) in this volume address the most recent developments in this field. New structures and possible approach
Eldibany, Riham; Rodriguez, Joaquin G.
This report describes a treatment modification for a patient presented with severely resorbed bilateral edentulous posterior mandible and mobility of the anterior teeth. There was less than 8 mm of bone between the crest of the alveolar ridge and the mandibular canal as revealed by radiographic examination. A modified technique for inferior alveolar nerve lateralization (IANL) in conjunction with ridge expansion was performed using threaded bone expanders, which allowed for better primary stability and placing longer implants. A total of four postextraction implants were in the anterior region of the mandible. The mandible received a total of nine one-piece implants to allow for immediate nonfunctional loading. The definitive ceramometallic prosthesis was delivered 3 months postoperatively. The 10 years clinical and radiographic assessment showed minimal bone resorption around osseointegrated implants. One-piece implants showed great success rate and minimal bone resorption following the modified technique of IANL and immediate implantation. PMID:24624258
Eldibany, Riham; Rodriguez, Joaquin G
This report describes a treatment modification for a patient presented with severely resorbed bilateral edentulous posterior mandible and mobility of the anterior teeth. There was less than 8 mm of bone between the crest of the alveolar ridge and the mandibular canal as revealed by radiographic examination. A modified technique for inferior alveolar nerve lateralization (IANL) in conjunction with ridge expansion was performed using threaded bone expanders, which allowed for better primary stability and placing longer implants. A total of four postextraction implants were in the anterior region of the mandible. The mandible received a total of nine one-piece implants to allow for immediate nonfunctional loading. The definitive ceramometallic prosthesis was delivered 3 months postoperatively. The 10 years clinical and radiographic assessment showed minimal bone resorption around osseointegrated implants. One-piece implants showed great success rate and minimal bone resorption following the modified technique of IANL and immediate implantation.
Full Text Available Purpose: To study the efficacy and safety of 0.1% Trypan Blue dye to stain the anterior capsule for capsulorhexis in mature and hypermature cataracts. Methods: This preliminary study included 25 eyes of 25 patients with a unilateral mature or hypermature cataract, including one case of traumatic mature cataract. In all these cases 0.2ml of 0.1% trypan blue dye was used to stain the anterior capsule. The efficacy and safety of the dye was evaluated on the basis of intraoperative and postoperative observations. Results: In all 25 eyes the capsulorhexis was completed. There was peripheral extension of the capsulorhexis in the eye with traumatic cataract and the stained edge of the anterior capsule helped identification and redirection of the capsulorhexis. Successful phacoemulsification with intraocular lens implantation was performed in all eyes. Adverse reactions related to the dye such as raised intraocular pressure, anterior chamber inflammation and endothelial damage were not observed in the immediate postoperative period or at the end of mean follow-up of 3 months. Conclusion: Trypan blue dye staining of the anterior capsule appears to be a very useful and safe technique that simplifies capsulorhexis in mature and hypermature cataracts.
Samim, Mohammad; Smitaman, Edward; Lawrence, David; Moukaddam, Hicham
Anterior knee pain is the most common knee complaint. It may be due to a variety of soft tissue or osseous abnormalities. Knowledge of the radiologic appearance of the abnormalities allows more accurate diagnosis of the cause of the pain including chondral abnormalities, patellar instability and dislocation, femoral trochlear dysplasia, abnormal patellar location, bipartite patella, various tendinopathies, bursal inflammation, traction apophysitis in pediatric and adolescent patients, and miscellaneous diseases including mediopatellar plica syndrome and Hoffa's disease. Radiographs are often obtained to exclude acute osseous abnormalities, such as fractures. Magnetic resonance (MR) imaging offers superior soft tissue contrast resolution and allows for more accurate evaluation of the underlying etiology and therefore may improve treatment and possible surgical planning.
Garc??a Guaza, Eduardo
Esta aplicaci??n pr??ctica basada en la evidencia cient??fica se ha llevado a cabo mediante la revisi??n bibliogr??fica de numerosos art??culos en diferentes bases cient??ficas. El objetivo de este trabajo es establecer un programa de recuperaci??n de una ruptura total del ligamento cruzado anterior de una rodilla tras una reparaci??n quir??rgica, que se ha planificado durante un periodo de aproximadamente siete meses teniendo en cuenta las diferencias existentes en la disponib...
Silvia EstellÃ©s MartÃnez
Full Text Available Resumen: Este trabajo presenta el modelado de un quadrotor como un sistema multicuerpo llevado a cabo mediante el software Vehicle- Sim, en el que los diferentes componentes del sistema son descritos mediante una estructura paterno-filial seÃ±alando las restricciones fÃsicas entre ellos. Los modelos estructural y aerodinÃ¡mico han sido desarrollados mediante este software, ampliamente utilizado en la simulaciÃ³n del comportamiento dinÃ¡mico de vehÃculos.Sobre el modelo resultante se he desarrollado un algoritmo de control basado en la metodologia PVA con la finalidad de obtener un seguimiento de trayectoria mediante acciones de control suaves. Empleando la metodologÃa convencional de control PVA no es posible estabilizar el vehÃculo en todos los rangos de posicionamiento lateral (y y longitudinal (x. En este artÃculo los autores muestran como esta limitaciÃ³n en el diseÃ±o de una estrategia de control PVA convencional es solventada con una modificaciÃ³n consistente en sustituir los parÃ¡metros constantes del PVA clÃ¡sico por funciones dependientes del desplazamiento.El sistema de control es implementado para adecuarse a los requerimientos de las actuaciones y se diseÃ±a sobre la plataforma de simulaciÃ³n multidominio Simulink. Con la finalidad de obtener una importante mejora en la respuesta de posicionamiento, se im- plementa un generador de trayectorias continuas.Una vez que el modelo es desarrollado y el sistema de control implementado, los autores presentan el modelo matemÃ¡tico y los resultados de las simulaciones realizadas. Ãstas validan el empleo tanto de la metodologÃa de control PVA aplicada, como de la alimentaciÃ³n de trayectorias predefinidas, no sÃ³lo para la posiciÃ³n, sino tambiÃ©n para la velocidad y aceleraciÃ³n. Abstract: In this work the authors present the modelling of a quadrotor as a multibody system carried out with the software VehicleSim, in which the different
Sonda, Ildo; Basso, Luciano Silveira
We present a case of fenestrated anterior cerebral artery associated to duplicated anterior communicating artery found duringa routine dissection of the brain in a male human body. Fenestrations of the A1 segment of the anterior cerebral artery are rare,especially if associated to a duplicated anterior communicating artery. To our knowledge, this is the second reported case in theliterature. We also present a brief review of the surgical importance of this anomaly
Pirris, Stephen M; Nottmeier, Eric W
Three dimensional (3D) image guidance has been used to improve the safety of complex spine surgeries, but its use has been limited in anterior cervical spine approaches. Twenty-two patients underwent complex anterior cervical spine surgeries in which 3D image guidance provided intraoperative assistance with the dissection, decompression and implant placement. One of two paired systems, the BrainLAB (BrainLAB, Westchester, Illinois) system, or Stealth (Medtronic Inc., Littleton, Massachusetts) system was used for 3D image guidance in this study. Image guidance was able to reliably locate pertinent anatomical structures in complex anterior cervical spine surgery involving re-exploration, dissection around vertebral arteries or deformity correction. No complications occurred, and no patients required a revision anterior surgery. This technical note describes the setup and technique for the use of cone beam computed tomography (cbCT)-based, 3D image guidance in subaxial anterior cervical surgery. The authors have found this technique to be a useful adjunct in revision anterior cervical procedures, as well as anterior cervical procedures involving corpectomy or tumor removal. Copyright © 2014 John Wiley & Sons, Ltd.
Linna Marcela Neme Ardila
Full Text Available Las mezclas asfálticas son el material más utilizado en la fabricación de pavimentos y los ensayos que permiten caracterizarlas son costosos y demorados. Por esta razón, mediante esta investigación se planteó establecer la viabilidad del uso del ensayo Fénix en mezclas asfálticas colombianas con granulometrías del Instituto de Desarrollo Urbano (IDU y del Instituto Nacional de Vías (INVIAS con diferentes características. El estudio inició con la fabricación de probetas Fénix con diferentes materiales (Agregados, asfaltos, asfaltita, pavimento asfalto reciclado (RAP, cal, cemento y su ejecución a 15 °C, una velocidad de 1 mm/min y la medición de los parámetros del ensayo. De los resultados obtenidos de resistencia a tracción, índice de rigidez a tracción e índice de energía, área elástica y área de fluencia, se estableció que el ensayo Fénix es un procedimiento eficaz, eficiente, económico, rápido y sencillo para determinar las propiedades mecánicas y dinámicas de las mezclas asfálticas estudiadas, especialmente mediante el análisis de los parámetros de las curvas carga-desplazamiento, irrelevantemente de la mezcla asfáltica fabricada.
Kang, Moo Sung; Kim, Kyung Hyun; Park, Jeong Yoon; Kuh, Sung Uk; Chin, Dong Kyu; Jin, Byung Ho; Kim, Keun Su; Cho, Yong Eun
To describe our experience in treating esophageal and pharyngeal perforation after anterior cervical spine surgery. Six patients with esophageal injury and one patient with pharyngeal injury after anterior cervical spinal surgery, managed at our department between 2000 and 2015, were analyzed retrospectively. During the study period, 7 patients (6 male and 1 female; mean age, 45 years) presented with esophageal perforation. The original anterior cervical spinal surgery was performed due to trauma in 2 patients and because of a degenerative cervical disorder in 5. Early esophageal perforation was diagnosed in 2 patients, and delayed esophageal injury due to chronic irritation with the cervical implants was noted in 5. Three of the five delayed perforation cases were related to cervical instrument displacement. Two patients showed no definite signs of infection, whereas 5 patients had various symptoms, including fever, neck pain, odynophagia, neck swelling, and upper extremity weakness. Two patients with a large defect underwent surgical repair and three with minimal perforation due to chronic irritation from the implants underwent instrument removal without direct repair of defect. Two asymptomatic patients received no intervention. Six patients with infection completely recovered from esophageal injury after treatment for a mean duration of 5.2 weeks (range, 4-8 weeks). One patient died because of postoperative pneumonia and sepsis after implant removal. Esophageal and pharyngeal injury after cervical spinal surgery may occur either directly due to spinal trauma and vigorous intraoperative retraction or due to chronic irritation with cervical implants. In cases of perforation associated with infection, various surgical modalities, including primary closure and reinforcement with a flap, could be considered depending on factors such as esophageal defect size, infection severity, and timing of recognition of injury. Copyright © 2017 Elsevier Inc. All rights reserved.
Brunetto, Priscilla S.; Fromm, Katharina M.
Body-foreign materials are used more and more frequently in our lives: joint implants (hips, knees, fingers, etc.), catheters, pacemakers, dental and aesthetic implants, etc. The increasing numbers of patients requiring such implants also raises the absolute numbers of implant-related infections. Thus, it is known that body-foreign materials are prone to bacterial adhesion and subsequent biofilm formation, either via bacterial debris on implant materials, infections during implantation or, la...
Bamashmus, Mahfouth A; Al-Salahim, Seddique A; Tarish, Nabil A; Saleh, Mahmoud F; Mahmoud, Hatem A; Elanwar, Mohamed F; Awadalla, Mohamed A
To evaluate the vitreoretinal complications in myopes after Visian implantable collamer lenses (ICL) implantation. This is a retrospective, observational, non-comparative clinical study that evaluated 617 consecutive myopes who underwent ICL implantation at the Department of Refractive Surgery, Yemen Magrabi Hospital, Sana'a, Yemen between July 2006 and May 2010. Follow up ranged from 6 months to 40 months. Preoperative and postoperative patient evaluation included manifest and cycloplegic refractions, uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), slit-lamp biomicroscopy, intraocular pressure and dilated retinal examination. Investigations included corneal topography, central corneal thickness, anterior chamber depth and white to white diameter. Retinal diseases and complications were recorded and analyzed preoperatively and postoperatively. Preoperatively, 61 (9.9%) eyes had posterior segment pathology requiring prophylactic laser photocoagulation. One eye developed spontaneous rhegmatogenous retinal detachment (RRD), one eye developed traumatic retinal detachment and two eyes required laser treatment postoperatively. The overall retinal detachment rate post-ICL was 0.32%. Posterior segment complications are rare after ICL implantation but dilated vitreoretinal assessment is important before and after the procedure. Patients with suspicious retinal lesions need a comprehensive vitreoretinal evaluation by a retinal specialist. If a patient develops floaters or blurry vision he/she requires further assessment by a vitreoretinal specialist.
Full Text Available Toxic anterior segment syndrome (TASS is an acute sterile postoperative anterior segment inflammation that may occur after anterior segment surgery. I report herein a case that developed mild TASS in one eye after bilateral uneventful cataract surgery, which was masked during early postoperative period under steroid eye drop and mimicking delayed onset TASS after switching to weaker steroid eye drop.
Full Text Available Dennis Flanagan1,2 1Department of Dental Medicine, Implantology LUdeS Foundation, Ricasoli, Malta; 2Private Practice, Willimantic, CT, USA Abstract: Dental implants are placed endosseously, and the bone is the ultimate bearer of the occlusal load. Patients are not uniform in the maximum bite force they can generate. The occlusal biting load in the posterior jaw is usually about three times of that found in the anterior. It is possible for supporting implants to be overloaded by the patients’ biting force, resulting in bone loss and failure of the fixture. Bite force measurement may be an important parameter when planning dental implant treatment. Some patients can generate extreme biting loads that may cause a luxation of the fixture and subsequent loss of osseointegration. A patient with low biting force may be able to have a successful long-term outcome even with poor anatomical bone qualities. Patients with a high bite force capability may have an increased risk for late component fracture or implant failure. There is no correlation of any bite force value that would indicate any overload of a given implant in a given osseous site. Nonetheless, after bite force measurement, a qualitative judgement may be made by the clinician for the selection of an implant diameter and length and prosthetic design. Keywords: occlusal load, newtons, oral function, force, sensor, software
Masaki, Chihiro; Nakamoto, Tetsuji; Mukaibo, Taro; Kondo, Yusuke; Hosokawa, Ryuji
In dental implant treatment, ridge preservation and immediate or early implant placement are recommended to minimize bone resorption after tooth extraction and achieve esthetic outcomes. However, there is no consensus concerning the efficacy of this surgical method. There is also no consensus on the efficacy of bone and soft tissue grafts and surgical methods for alveolar ridge reconstruction. This paper reports ridge alteration in the anterior maxilla after tooth extraction, and summarizes the efficacy of various ridge preservation methods and immediate or early implant placement as alveolar ridge preservation methods to minimize bone resorption after tooth extraction. The advantages and complications of alveolar ridge reconstruction methods, and the efficacy and surgical method of soft tissue graft are reviewed. The anterior maxilla is in the esthetic zone, and the thickness of the bone on the labial side around the natural tooth is less than 1mm in many cases. Therefore, it is impossible to prevent bone resorption completely, even if ridge preservation and immediate or early implant placement are performed after tooth extraction. It is necessary to obtain stable and long-term esthetics by combining connective tissue and free gingival grafts, in addition to hard tissue augmentation. It is important to consider the burden and level of satisfaction of patients, such as in terms of donor site morbidity in hard and soft tissue grafting, and to pay attention to appropriate indications to avoid overtreatment. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Bagherpour, Reza; Mirfazaelian, Ali; Mangoli, Amir A; Alikhasi, Marzieh
This clinical report describes the rehabilitation of a patient with a compromised temporal bone anatomy caused by resection of bone due to squamous cell carcinoma of external auditory canal. Tumor resection was followed by placement of three implants. The implants were intentionally malpositioned in the anterior-posterior plane due to the lack of temporal bone. Prosthodontic treatment included customized implant bar-supported auricular prosthesis.
Petsch, Matthias; Spies, Benedikt; Kohal, Ralf-Joachim
Improvements in implant design, placement protocols, and sequences for reconstruction in the anterior region have enabled clinicians to provide their patients with esthetically acceptable results. Yet from a clinical standpoint, the predictable preservation of the peri-implant soft tissue remains challenging and tissue grafting is often necessary to compensate for ridge contour changes in postextraction sites. In animal and clinical studies, the socket shield technique has shown its potential to prevent resorption of buccal tissues. This 24-month follow-up case report presents a 47-year-old patient with a failing maxillary incisor replaced with an immediately placed single implant in conjunction with the socket shield technique.
Hjørting-Hansen, E; Helbo, M; Aaboe, M
The principle of guided tissue regeneration was applied in an attempt to generate bone to cover a subperiosteal implant. Titanium frame works, casted on individual impressions of the anterior surface of the tibia of 4 Copenhagen White rabbits, were stabilized to the tibia by microscrews, and half...... of them were covered by an expanded polytetrafluoroethylene augmentation membrane. The observation period was 12 weeks. Guided bone regeneration partly covering the implants was seen at all experimental sides; on the control sides the implants were mainly embedded in fibrous tissue. Studies...
Review of carbon implants developed by NASA discussed four different types of implants and subsequent improvements. Improvements could be of specific interest to rehabilitation centers and similar organizations.
Yileika Elías García
Full Text Available Objetivo: caracterizar el comportamiento del cálculo de la lente intraocular mediante biometría ultrasónica. Métodos: se realizó un estudio descriptivo y prospectivo, con un grupo de pacientes atendidos por el Servicio de Catarata del Centro Oftalmológico «Enrique Cabrera», que recibieron tratamiento quirúrgico por catarata con implante de lente intraocular, mediante técnica de Blumenthal. La muestra se conformó con 160 ojos y se estudiaron las variables: sorpresa refractiva, edad, longitud axial y promedio queratométrico según resultado refractivo, poder dióptrico de la lente y componente esférico según edad. Resultados: como resultados más sobresalientes, se obtuvo que el 78,7 % no presentó error en el cálculo de la lente, la mayoría de los pacientes tenían 60 años y más, predominó el rango de longitud axial entre 22 y 24,4 (67,5 %, el promedio queratométrico de 43 a 44,99 (64,3 %, el poder dióptrico del lente de + 20 a + 23 dioptrías (48,2 % y el componente esférico entre 0,00 y +/-1,00 dioptrías (78,8%. Conclusiones: se considera que la biometría ultrasónica resulta adecuada para el cálculo correcto del lente.
Resultados clínicos e radiológicos en serie de artrodesis cervical anterior con caja de fusión intersomática y placa Resultados clínicos e radiológicos em série de artrodese cervical anterior com dispositivo de fusão intersomática e placa Clinical and radiologica outcomes in series of anterior cervical fusion with intersomatic cage and plate
Lyonel Beaulieu Lalanne
Full Text Available OBJETIVOS: Analizar los resultados clínicos e radiológicos de una serie de pacientes sometidos a artrodesis cervical anterior con caja de fusión intersomática (CAGE y placa. MÉTODOS: Análisis retrospectivo de serie de pacientes sometidos a artrodesis cervical anterior con caja de fusión intersomática y placa entre los años 2004 y 2009. Revisión de fichas clínicas y radiografías, registro de edad, sexo, diagnósticos, nivel operado, complicaciones, evolución clínica y radiológica. Técnica quirúrgica de Smith-Robinson. Las cajas de fusión intersomática fueron llenadas con sustitutos de huesos. Deambulación 12 horas después de la cirugía, alta a las 48 horas, collar cervical intermitente por 2 semanas. Evaluación clínica mediante criterios de Odom. Seguimiento 17 a 78 meses. RESULTADOS: Diagnósticos: Hernia del núcleo pulposo (HNP cervical, 44 (71%, mielopatía, 11 (17,7%, fracturas, 7 (11,3%. Nivel 1: 44 (71%, Nivel 2: 15 (24,2%, Nivel 3: (4,8%. El nivel C5-C6 incluyó 92% de los casos. Alivio del dolor radicular: 60 (97%. Recuperación del déficit neurológico: 59 (95,2%. Alivio de la mielopatía: 8/11 pacientes (73%. Alivio del dolor cervical: 56 (90%. Resultados clínicos: 91,9% excelentes y buenos. Complicaciones (12,9%: 4 disfagias transitorias (6,5%, 1 disfagia permanente (1,6%, 2 disfonías transitorias (3,3%, 1 subcidencia con aflojamiento del implante y fractura asintomática de placa (1,6%. No hubo pseudoartrosis. CONCLUSIONES: Esta serie presenta buenos resultados clínicos, com alivio del dolor y recuperación neurológica comparables con los hallazgos en la literatura. El uso de la caja de fusión intersomática evita complicaciones de la zona dadora y, cuando es asociado a placa cervical anterior permite fijación intersomática inmediata, dando soporte estructural adecuado, con buenos resultados y sin complicaciones a largo plazo.OBJETIVOS: Analisar os resultados clínicos e radiológicos de uma série de
Escribano Castro, Ane
Análisis de caucho reciclado de manera hiperelástica mediante métodos de ajuste de Mínimos Cuadrados con programa MATLAB y Curve fitting mediante ANSYS. Para la parte viscoelástica se usa Algoritmo de Optimicación con MATLAB. Comprobación de resultados y fiabilidad.
... Dentists about How Often They Floss Their Teeth Oral Hygiene Habits and Hypertension Risk Alcohol Consumption and Gum ... peri-implant disease include previous periodontal disease diagnosis, poor ... tooth. With a proper oral health routine, your dental implant can last a ...
Limitation of this study is that we tried to give a broader overview related to implant surface treatments. It does not give any conclusion regarding the best biocompatible implant surface treatment investigated till date. Unfortunately, the eventually selected studies were too heterogeneous for inference of data.
The graphitization and the change to amorphous state of diamond surface layer by ion implantation and its characteristics are reported. In the diamond surface, into which more than 10 16 ions/cm 2 was implanted, the diamond crystals are broken, and the structure changes to other carbon structure such as amorphous state or graphite. Accompanying this change of structure, the electric conductivity of the implanted layer shows two discontinuous values due to high resistance and low resistance. This control of structure can be done by the temperature of the base during the ion implantation into diamond. Also it is referred to that by the base temperature during implantation, the mutual change of the structure between amorphous state and graphite can be controlled. The change of the electric resistance and the optical characteristics by the ion implantation into diamond surface, the structural analysis by Raman spectroscopy, and the control of the structure of the implanted layer by the base temperature during implantation are reported. (K.I.)
Daugaard, Henrik; Søballe, Kjeld; Bechtold, Joan E
The goal of osseointegration of orthopedic and dental implants is the rapid achievement of a mechanically stable and long lasting fixation between living bone and the implant surface. In total joint replacements of cementless designs, coatings of calcium phosphates were introduced as a means...
The Dynamic Ion Implantation Technique consists of ion implantation of a film during the film-deposition process. This technique was investigated theoretically and experimentally with ions whose incident energy is of the order of a few times 100 keV. It was found to be a viable alternative low-temperature method for the preparation of thick zirconium nitride films (∼1 μm) with good mechanical properties. Theoretical modeling of the processes involved during dynamic ion implantation lead to analytical expressions for the ions' depth-profile distributions. Numerical evaluations of these equations indicated that the depth distributions of dynamically implanted ions are in general more uniform than those predicted by the model for ions implanted by more conventional techniques. Mechanical properties of stoichiometric RF sputter-deposited zirconium nitride films post implanted with krypton and rubidium ions were investigated. Scratch-adhesion critical load and Vickers microhardness of samples implanted with doses varying from 1 x 10 15 to 5 x 10 16 ions/cm 2 and energies ranging from 300 to 500 keV were studied. In general, best mechanical properties were observed for 300- keV krypton implantations
V R Roopesh Kumar
Full Text Available Giant anterior communicating artery aneurysmsarerare. Apatient presented with visual dysfunction, gait ataxia and urinary incontinence. MRI showed a giant suprasellar mass.At surgery, the lesion was identified as being an aneurysm arising from the anterior communicating artery.The difficulty in preoperative diagnosis and relevant literature are reviewed.
Full Text Available Latar Belakang. Remodeling tulang alveolar berguna untuk memperbaiki kehilangan struktur jaringan pendukung gigi yang hebat pada reimplantasi dan transplantasi gigi anterior, supaya gigi anterior yang terlepas dari soketnya paska trauma dapat di implantasi. Bahan cangkok tulang untuk remodeling tulang alveolar yang digunakan berjenis demineralized freeze-dried bone allograft (DFDBA. Tujuan Penulisan Laporan Kasus. Melaporkan keberhasilan menanam gigi tetap ditempatnya dengan teknik remodeling tulang dengan penambahan DFDBA agar struktur jaringan pendukung gigi yang hilang kembali normal. Penatalaksanaan. Pasien paska trauma, dalam keadaan tidak sadar selama 7 hari di ruang rawat intensif dan dirawat selama 7 hari di bangsal. Pasien mengalami trauma dan kehilangan tulang penyangga gigi yang hebat, pada gigi anterior bawah. Tiga gigi anterior mengalami kegoyahan 4° dan dua gigi hilang. Hilangnya dua gigi mengakibatkan area edentulous besar, sehingga perlu di lakukan transplantasi satu gigi. Untuk memperkecil edentulous dilakukan penambahan lebar mahkota gigi menggunakan composite light curing. Setelah pencabutan gigi, semua gigi yang akan di implant dilakukan perawatan saluran akar gigi dan disterilkan. Flap operasi dilakukan untuk menata serpihan tulang dan menilai besarnya trauma, daerah luka dibersihkan dengan lIarutan salin. Splinting semua gigi yang akan di implant menggunakan arch bar dan kawat. Penambahan bahan cangkok tulang DFDBA pada daerah operasi. Menjahit daerah operasi ke korona gigi dan ditutup pack. Setelah 6 bulan operasi dua gigi tidak men gal ami kegoyahan, dua gigi lain mengalami kegoyahan 2°, 12 bulan tiga gigi tidak mengalami kegoyahan dan hanya satu gigi transplantasi yang mengalami kegoyahan 1°. Re-entry operasi dilakukan untuk remodeling tulang bertambah baik. Setelah 6 bulan paska re-entry operasi, gigi yang di transplantasi tidak mengalami kegoyahan. Sehingga splint dapat dilepas. Kesimpulan. Remodeling tulang pada
Full Text Available Dislocation of the hip joint in adults is usually caused by high-energy trauma such as road traffic accidents or falls from heights. Posterior dislocation is observed in most cases. However, atraumatic anterior dislocation of the hip joint is extremely rare. We present a case of atraumatic anterior dislocation of the hip joint that was induced by an activity of daily living. The possible causes of this dislocation were anterior capsule insufficiency due to developmental dysplasia of the hip, posterior pelvic tilt following thoracolumbar kyphosis due to vertebral fracture, and acetabular anterior coverage changes by postural factor. Acetabular anterior coverage changes in the sagittal plane were measured using a tomosynthesis imaging system. This system was useful for elucidation of the dislocation mechanism in the present case.
Floré, Vincent; Vandenberk, Bert; Belmans, Ann; Garweg, Christophe; Ector, Joris; Willems, Rik
A new end point called ICD-resistant mortality was evaluated to assess the clinical efficacy of ICD implantations. In 302 ICD patients with ischaemic cardiomyopathy, we investigated which clinical parameters predicted useful ICD implantations using cumulative incidence competing risk analysis. Implantation was deemed clinically useful when the ICD provided appropriate therapy and the patient survived implantation by 1 year and the first shock by 30 days. ICD-resistant mortality (ICDRM) was defined as death within 30 days after the first shock, within 1 year of implantation or without previous appropriate ICD therapy. After 5 years, ICDRM occurred in 23% of implantations, while 36% were clinically useful. After multivariable analysis, ICDRM was associated with LVEF <35% (HR: 2.63; p = .005), beta-blocker dose <50% (HR: 2.0; p = .01) and anterior or diffuse infarct location (HR: 3.61; p = .001 and HR: 2.89; p = .02). Useful ICD implantations were associated with beta-blocker dose <50% (HR: 1.64; p = .02) and non-anterior infarct location (HR: 3.22 vs anterior and 1.59 vs diffuse; combined p<.001). Five years after implantation, an ICD could be classified as useful in 1 out of 3, while ICDRM occurred in one out of four patients. At 10 years, up to 80% of implantations could be categorized. Lower LVEF was related with significantly higher incidence of ICDRM. Anterior infarcts were associated with more ICDRM and less useful implantations than non-anterior infarcts. Future risk stratification for ICD should focus more on the discrimination between arrhythmic risk, probably preventable by ICDs and ICD-resistant mortality risk.
Full Text Available Partial knee replacement (PKR results in fast recovery and good knee mechanics and is ideal to treat medial knee osteoarthritis. Cementless PKR depends on bone growing into the implant surface for long-term fixation. Implant loosening may occur due to high tensile strain resulted from large mechanical loads during rehab exercises. The purpose of this study is to investigate whether external fixations such as superior screw and frontal flange could reduce the tensile strain at the implant-bone interface. Three medial PKRs were designed. The first PKR had no external fixations. A superior screw and a frontal flange were then added to the first PKR to form the second and third PKR designs, respectively. Finite element analysis was performed to examine the tensile strain at the implant-bone interface during weight-bearing exercises. The PKR with no external fixations exhibited high tensile strain at the anterior implant-bone interface. Both the screwed and flanged PKRs effectively reduced the tensile strain at the anterior implant-bone interface. Furthermore, the flanged PKR resulted in a more uniform reduction of the tensile strain than the screwed PKR. In conclusion, external fixations are necessary to alleviate tensile strain at the implant-bone interface during knee rehab exercises.
Amir Alireza Rasouli Ghahroudi
Full Text Available Objectives: Anterior maxilla, known as the esthetic zone, plays an important role in facial and smile esthetics. This study assessed the frequency of implant treatments in the esthetic zone of patients presenting to Dental Implant Department of Tehran University during 2002-2012.Materials and Methods: This descriptive study was conducted on dental records of patients receiving implant treatment during 2002-2012. Patient records were retrieved from the archives and patient demographics, implant characteristics, failure rate, prevalence of complications and implant systems were collected. The data were reported as frequency and percentage.Results: Of a total of 2,381 implants placed in the mentioned time period, 492 (20.8% had been placed in the anterior maxilla and 531 (22.3% had been placed in the anterior mandible from canine to canine. Timing of implant placement was immediate in 12.0%, early in 0.5% and late in 87.4%. Survival rate was 99.1%. Rate of failure was 0.8%. Failure rate was 0.4% in the maxillary and 1.1% in the mandibular canine to canine region. Complications were reported in 10.1% of patients. Rate of complications was 18.3% in the maxillary canine to canine, 8.9% in the mandibular canine to canine, 18.1% in the maxillary first premolar to first premolar and 9.5% in the mandibular first premolar to first premolar. The frequency of bone grafts placed in these areas was 17.6%, 33.9%, 13.6%, 32.1% and 14.3%, respectively.Conclusion: Of implants placed in our center, around 20% were in the anterior maxilla, and delayed implant placement was the most commonly adopted technique.
Clemmensen, Tor Skibsted; Mølgaard, Henning; Andersen, Niels Frost; Baerentzen, Steen; Poulsen, Steen Hvitfeldt
Patients with cardiac amyloidosis are at increased AV-block and syncope risk. Therefore, a prophylactic pacemaker is often implanted. However, this case illustrates that other mechanisms should be ruled out prior to pacemaker implantation. The patient studied had mitral valve thickening without increased left ventricular outflow track (LVOT) velocity. However, bicycle exercise-stress test with simultaneous echocardiography revealed a stepwise decrease in blood pressure, a substantial increase in the LVOT velocity, and severe systolic anterior motion of the mitral valve. The patients' symptoms were likely explained by these findings. Therefore, a comprehensive clinical evaluation is warranted prior to pacemaker implantation in cardiac amyloidosis patients.
Tor Skibsted Clemmensen
Full Text Available Patients with cardiac amyloidosis are at increased AV-block and syncope risk. Therefore, a prophylactic pacemaker is often implanted. However, this case illustrates that other mechanisms should be ruled out prior to pacemaker implantation. The patient studied had mitral valve thickening without increased left ventricular outflow track (LVOT velocity. However, bicycle exercise-stress test with simultaneous echocardiography revealed a stepwise decrease in blood pressure, a substantial increase in the LVOT velocity, and severe systolic anterior motion of the mitral valve. The patients’ symptoms were likely explained by these findings. Therefore, a comprehensive clinical evaluation is warranted prior to pacemaker implantation in cardiac amyloidosis patients.
van Brakel, Ralph; Noordmans, Herke Jan; Frenken, Joost; de Roode, Rowland; de Wit, Gerard C.; Cune, Marco S.
Objectives: To determine the difference in light reflection of oral mucosa covering titanium (Ti) or zirconia (ZrO2) abutments as it relates to the thickness of the covering mucosa. Material and methods: Fifteen anterior implants (Astra Osseo speed (R)) in 11 patients were fitted with a Ti or a ZrO2
Anmar M. Abdul-Rahman
Full Text Available Purpose: To report a case of inadvertent bleb formation presenting 18 months after pars plana M3 Molteno implant tube obstruction in a patient with mixed mechanism glaucoma. Materials and Methods: An 84-year-old Caucasian male with mixed mechanism glaucoma underwent slit-lamp examination, gonioscopy, colour anterior segment photography and anterior segment optical coherence tomography (AS-OCT. Results: An inadvertent bleb developed 18 months after pars plana implant tube re-positioning with a 6/0 Vicryl tie ligature. The bleb was located in the area anterior to the implant plate; it was characterised by a thin, transparent, avascular and multi-cystic wall, with a visible stoma at the posterior edge of the bleb. The bleb was functioning as demonstrated by an intraocular pressure of 6 mm Hg at presentation and a punctate fluorescein uptake pattern of the bleb wall. The bleb over the plate of the Molteno implant was non-functioning, likely secondary to tube obstruction by vitreous in the early postoperative period. AS-OCT showed a tract from the anterior chamber commencing at an entry wound through a corneal tunnel to the posterior stoma at the base of the inadvertent bleb. Conclusions: We hypothesise that the pathophysiologic factors resulting in an inadvertent bleb are a result of a combination of apoptosis, late-onset wound dehiscence and internal gaping of a centrally placed corneal wound. In addition, aqueous hydrodynamic factors may play a role.
Conclusions and importance: This is the first report of a rare occurrence of intraocular and extraocular hemorrhage associated following spontaneous release of ligature of a non-valved glaucoma drainage implant. The presumed mechanism was sudden shallowing of the anterior chamber resulting in the tube irritating uveal vasculature. We do not have an explanation for the extraocular blood.
Jung, Ronald E; Heitz-Mayfield, Lisa; Schwarz, Frank
Working Group 2 at the 2nd Consensus Meeting of the Osteology Foundation had a focus on the influence of vertical implant placement on papilla height at single implants adjacent to teeth and on the inter-implant mucosa fill at two adjacent implants in the anterior maxilla. Two systematic reviews were prepared in advance of the consensus meeting. Due to the heterogeneity among the studies with regard to study design, study population, method of assessment, meta-analyses were not possible. Consensus statements, clinical recommendations, and implications for future research were based on structured group discussions until consensus was reached among the entire expert group. The systematic review about single-tooth implants included a total of 12 studies demonstrating that the vertical distance from the crestal bone level to the base of the interproximal contact point varied considerably from 2 mm up to 11 mm, and a partial or complete papilla fill was reached in 56.5% to 100% of the cases. For the systematic review regarding two adjacent implants, only four studies reported on horizontal inter-implant distances which ranged between 2.0 and 4.0 mm. More than half of the papilla presence was indicated in 21% to 88.5% of the cases. It was concluded that for single-tooth implants, the papilla height between an implant and a tooth is predominantly dependent on the clinical attachment level of the tooth. In cases with two adjacent implants, it was concluded that it is not possible to define the optimal horizontal distance between two adjacent implants restored with fixed dental prosthess. © 2018 The Authors. Clinical Oral Implants Research Published by John Wiley & Sons Ltd.
A. Jiménez Guerra; L. Monsalve Guil; I. Ortiz García; A. España López; J.J. Segura Egea; E. Velasco Ortega
Introducción: El objetivo del presente estudio era mostrar los resultados de la elevación del seno maxilar con biomateriales en el tratamiento con implantes del maxilar posterior. Métodos: 70 pacientes edéntulos parciales fueron tratados con 181 implantes Galimplant® con superficie arenada y grabada con ácidos para la rehabilitación del maxilar posterior mediante la técnica de elevación de seno y relleno con betafosfato tricálcico (Osteoblast®). Los implantes fueron cargados después de un per...
Chang Kyu Lee
Full Text Available The overall objective of this study is to evaluate the long term results of interpositional connective tissue graft and horizontal and vertical bone augmentation in recessed area of interproximal papilla. Atrophic ridges rebuilt through GBR procedures. For this study, 2 major alterations are made in the surgical technique describes. First, the horizontal and vertical bone augmentation graft is obtained from autograft like ascending ramus or allograft with or without platelet-rich plasma and barrier membrane. Second, connective tissue for interpositional grafting is obtained from hard palate. This interpositioning graft would be success by use of pouch technique or envelope flap technique. From 1998, among over than 120 patients of implant treated. for this study, regardless of 1-staged or 2-staged surgery or type of implant surface treated, 60 implants of 18 patients which has a dissatisfaction on anterior region, food impaction on posterior region subjectively, or has a black-triangle on anterior and flattened inter-implant spaces clinically was selected. Differences of success rate between inter-dental and inter-implants depend on blood supply and distance between implants. Autografts, PRP and anorganic bovine bone Bio-Oss have been successfully employed for isolated augmentation area. It is essential to make the CT graft neovascularize to a recipient site, overcorrection of graft, immobilization of graft and tension-free suture. Based on annual measurements of gross texture, pocket probing depth, attachment level, and width of keratinized mucosa, this 5-year study indicates that interpositional CT graft when used in conjunction with appropriate bone augmentation technique, can become successfully esthetics and yield predictable maintenance results.
Ayako Okada, MD
Full Text Available The incidence of cardiovascular implantable electronic device infection is increasing. We report a case of and successful device removal in a 79-year-old man with implantable cardioverter-defibrillator infection. Right phrenic nerve paralysis was evident on chest radiography. The lead was in front of the anterior scalene muscle, close to the left phrenic nerve. Therefore, extraction carried a risk of bilateral phrenic nerve paralysis. The lead was successfully extracted from the right internal jugular vein by using the snare technique. No complications occurred, and the extraction was successful.
Wright, Rick W.; Haas, Amanda K.; Anderson, Joy; Calabrese, Gary; Cavanaugh, John; Hewett, Timothy E.; Lorring, Dawn; McKenzie, Christopher; Preston, Emily; Williams, Glenn; Amendola, Annunziato
Context: Anterior cruciate ligament (ACL) reconstruction rehabilitation has evolved over the past 20 years. This evolution has been driven by a variety of level 1 and level 2 studies. Evidence Acquisition: The MOON Group is a collection of orthopaedic surgeons who have developed a prospective longitudinal cohort of the ACL reconstruction patients. To standardize the management of these patients, we developed, in conjunction with our physical therapy committee, an evidence-based rehabilitation guideline. Study Design: Clinical review. Level of Evidence: Level 2. Results: This review was based on 2 systematic reviews of level 1 and level 2 studies. Recently, the guideline was updated by a new review. Continuous passive motion did not improve ultimate motion. Early weightbearing decreases patellofemoral pain. Postoperative rehabilitative bracing did not improve swelling, pain range of motion, or safety. Open chain quadriceps activity can begin at 6 weeks. Conclusion: High-level evidence exists to determine appropriate ACL rehabilitation guidelines. Utilizing this protocol follows the best available evidence. PMID:26131301
Knoernschild, Kent L
The authors used MEDLINE, EMBASE, and CENTRAL (Cochrane Central Register of Controlled Trials) databases to locate studies for this systematic review (SR). For studies to be eligible for this SR, all had to evaluate single-implant restorations with a follow-up of at least 1 year after implant loading. A total of 19 prospective studies met inclusion and exclusion criteria. Fifteen studies provided implant survival data (499 patient/509 implants), whereas 5 studies provided radiographic marginal bone height data (52 patients/52 implants). The analysis included studies with patients with single anterior or premolar, maxillary or mandibular edentulous sites bounded by anterior and posterior neighboring teeth. Meta-analyses of prospective trials (randomized-controlled trials, clinical trials, cohort studies, case series) reported loaded implant survival with one-year or more than one-year follow-up. Meta-analysis of prospective trials reporting marginal bone loss with one-year follow-up was also reported. The key interventions were the timing of implant placement following extraction and the timing of implant loading after implant placement. Comparisons following greater than one-year follow-up were made between implants with immediate placement with immediate loading, immediate/early placement with conventional loading, conventional placement with immediate/early loading, or conventional placement with conventional loading. The main outcome was implant survival. Radiographically determined peri-implant bone level change was also reported. Meta-analyses were completed using studies that reported one-year implant survival data (15 studies) and more than one-year implant survival data (11 studies). One-year marginal bone level data were analyzed for implants treated conventionally (5 studies). For survival and marginal bone levels, weighted rates and random effects models were used to calculate overall effects of the included studies. For greater than one-year follow
Wanivenhaus, A. [Medizinische Universitaet, Universitaetsklinik fuer Orthopaedie, Wien (Austria)
Increasingly, implants in the region of hand joints and the wrist represent an alternative for the treatment of post-traumatic, inflamed, or degenerative joint damage. The diversity of hand functions also results in varied solutions, which are effective in their stability, mobility, and distraction. Different materials are necessary for this, and they require subtile radiological control. The native X-ray represents the substantial method to observe migration of the implants. Each interface between titanium, ceramic, zirconium, pyrocarbon, and silicon to the bone has to be assessed differently in order to obtain a relevant statement. The finger joints and to a limited extent the wrist represent the artificial joints with limited alternative therapy. Other implants in the hand should only be applied after strict indication and patient compliance, as arthrodesis and resection arthroplasty have shown very good long-term results. (orig.) [German] Implantate im Bereich der Gelenke der Hand und des Handgelenks stellen zunehmend Alternativen bei der Versorgung posttraumatischer, entzuendlicher oder degenerativer Gelenkschaeden dar. Die Vielfalt der Handfunktionen fuehrt auch zu unterschiedlichen Loesungen, die durch Stabilitaet, Mobilitaet und Distraktion wirksam werden. Dafuer sind unterschiedliche Materialien erforderlich, die eine subtile radiologische Kontrolle erfordern. Das Nativroentgen stellt das wesentlichste Verfahren zur Verlaufsbeobachtung von Implantaten dar. Das Interface zwischen Titan, Keramik, Zirkonium, Pyrokarbon und Silikon zum Knochen muss unterschiedlich bewertet werden, um relevante Aussagen treffen zu koennen. Die Fingergelenke und in begrenztem Ausmass auch das Handgelenk stellen Kunstgelenke mit geringen Alternativtherapiemoeglichkeiten dar. Die uebrigen Implantate der Hand sollten nur bei strenger Indikationsstellung und hoher Patientencompliance Anwendung finden, da Arthrodese oder Resektionsarthroplastik gute Langzeitresultate aufweisen. (orig.)
Tomsia, Antoni P; Lee, Janice S; Wegst, Ulrike G K; Saiz, Eduardo
With the advent of nanotechnology, an opportunity exists for the engineering of new dental implant materials. Metallic dental implants have been successfully used for decades, but they have shortcomings related to osseointegration and mechanical properties that do not match those of bone. Absent the development of an entirely new class of materials, faster osseointegration of currently available dental implants can be accomplished by various surface modifications. To date, there is no consensus regarding the preferred method(s) of implant surface modification, and further development will be required before the ideal implant surface can be created, let alone become available for clinical use. Current approaches can generally be categorized into three areas: ceramic coatings, surface functionalization, and patterning on the micro- to nanoscale. The distinctions among these are imprecise, as some or all of these approaches can be combined to improve in vivo implant performance. These surface improvements have resulted in durable implants with a high percentage of success and long-term function. Nanotechnology has provided another set of opportunities for the manipulation of implant surfaces in its capacity to mimic the surface topography formed by extracellular matrix components of natural tissue. The possibilities introduced by nanotechnology now permit the tailoring of implant chemistry and structure with an unprecedented degree of control. For the first time, tools are available that can be used to manipulate the physicochemical environment and monitor key cellular events at the molecular level. These new tools and capabilities will result in faster bone formation, reduced healing time, and rapid recovery to function.
Spinelli, D; Ottria, L; DE Vico, G; Bollero, R; Barlattani, A; Bollero, P
Implant surgery has been changing in different ways following improvements of computer technologies. Since its beginning, according to the original procedures of Branemårk system implants, guide-lines in implants-supported prosthetic rehabilitation have been founding on the placement of fixtures in a fairly upright position, after maxillary sinus floor elevation; while in the case of interforaminal rehabilitation, an upright distal implant may need to be placed anterior to the mental foramina without nerve damage (although the consequence would have been bilateral cantilevers to provide good chewing capacity). Some authors have proposed engaging the molar/tuberosity area: Bahat and Venturelli demonstrated these areas reliable and predictable alternative to distal cantilever prostheses or sinus elevation procedures. In recent years, the immediate loading of tilted implants with a provisional restoration has been proposed for the treatment of the atrophic maxilla. Tilted posterior implants in either arches could avoid (cantilever length) and provide to a better load distribution. Further studies have showed excellent outcomes for both tilted and axial implants; indeed this protocol allows to use longer implants, improve bone anchorage and avoid bone grafting procedures. Malò at al., in a retrospective clinical study, showed important results using two posterior tilted implants and two anterior non-tilted ones in the so-called All-on-four technique (Nobel Biocare, Göteborg, Sweden). Instead of the great loss of bone (amount and quality) in long-term edentuly the clinically documented computer-guided implantology software is able, through posterior tilted implants, to improve load distribution. Many authors have reported reduced surgical invasion (sinus grafting surgery is needless), shorter treatment time, lower cost, natural aesthetic profiles and functional bite.
Cho, Bong Hae
To compare the bone height of implant sites measured using panoramic radiography and spiral CT. The available bone height was determined for 263 maxillary and mandibular implant sites in 59 patients. Distortion was calculated using the metal bar for the panoramic radiographs. Significant differences in mean bone height between the two imaging modalities were found in maxillary and mandibular anterior regions (p<0.05). The mean difference in bone height recorded by the two techniques was smallest in the maxillary and mandibular molar areas (0.8 mm), and greatest in the mandibular anterior region (1.3 mm). With the exception of the mandibular anterior region, ninety percent of all the sites showed measurement differences within 2 mm. A safety margin of 2 to 3 mm is called for when utilizing panoramic radiography, otherwise additional imaging modality such as computed tomography is necessary to obtain accurate measurements.
Ochiai, Kent T; Ozawa, Shogo; Caputo, Angelo A; Nishimura, Russell D
There is some question about whether implant abutment selection affects the transfer of load between connected implants and natural teeth. The purpose of this study was to compare stress transfer patterns with either 1 or 2 posterior implants connected to a single anteriorly located simulated natural tooth with either 1 or 2 segmented and nonsegmented implant abutments under relevant functional loads by use of the photoelastic stress analysis technique. A model of a human left mandible, edentulous posterior to the first premolar, with two 3.75-mm x 13-mm screw-type implants embedded within the edentulous area, was fabricated from photoelastic materials. The implants were in the first and second molar positions. Two fixed partial denture prosthetic restorations were fabricated with either segmented conical abutments or nonsegmented UCLA abutments. Vertical occlusal loads were applied at fixed locations on the restorations. The photoelastic stress fringes that developed in the supporting mandible were monitored visually and recorded photographically. The stress intensity (number of fringes), stress concentrations (closeness of fringes), and their locations were subjectively compared. Loading on the restoration over the simulated tooth generated apical stresses of similar intensity (fringe order) at the tooth and the first molar implant for both abutment types. Low-level stress was transferred to the second molar implant. Loading directed on the implant-supported region of the restoration demonstrated low transfer of stress to the simulated tooth. Nonvertical stress transfer with slightly higher intensity was observed for the nonsegmented abutment. Within the limitations of this simulation study, stress distribution and intensity for the 2 implant conditions was similar for segmented and nonsegmented abutment designs. Magnitude of stresses observed for both abutment designs was similar for the single implant condition. Vertical loading produced more nonaxial stresses
Romanos, George E; Toh, Chooi Gait; Siar, Chong Huat; Swaminathan, Dasan
Immediately loaded splinted implants can become osseointegrated when they are placed in the anterior part of the mandible. The concept of immediate loading has not been well examined in the posterior mandible. The aim of this study was to evaluate the hard tissue reactions around immediately loaded implants placed in the posterior mandible in the monkey model. Six adult M. fascicularis monkeys were used in this study. Thirty-six Ankylos implants (Degussa Dental, Hanau-Wolfgang, Germany) were placed after extraction of the second premolar, first, and second molar teeth and complete healing of the sockets. Control (C) group implants were placed and, after osseointegration, were loaded for 1 month using temporary acrylic resin prostheses and later for 2 months using splinted metal crowns. In the contralateral region of the mandible, test (T) group implants were placed and loaded immediately with the same sequence as carried out for the C implants. After sacrifice of the animals, specimens were examined histologically and evaluated histomorphometrically. All implants were osseointegrated. Compact, cortical bone in contact with the implant surface without any gaps or connective tissue formation was demonstrated. Histomorphometric findings of the bone-implant-contacts showed no significant differences between the T and C group implants. Peri-implant mineralized bone areas presented statistically significant differences and showed a higher density of bone between the threads of immediately loaded implants (P < .05). Immediately loaded splinted implants in the posterior mandible can become osseointegrated with a hard tissue peri-implant response similar to that of delayed loaded implants. Moreover, immediate loading seems to increase the ossification of the alveolar bone around endosseous implants.
Dol, Aleksandr V.; Ivanov, Dmitriy V.
Modern dentistry can not exist without dental implantation. This work is devoted to study of the "bone-implant" system and to optimization of dental prostheses installation. Modern non-invasive methods such as MRI an 3D-scanning as well as numerical calculations and 3D-prototyping allow to optimize all of stages of dental prosthetics. An integrated approach to the planning of implant surgery can significantly reduce the risk of complications in the first few days after treatment, and throughout the period of operation of the prosthesis.
Al-Ekrish, Asma'a Abdurrahman
The article presents an overview of the goal of imaging at each stage of implant therapy and the usefulness and limitations of multidetector computed tomography (MDCT) in achieving those goals. Various MDCT protocols of use in implant imaging also are presented, with an emphasis on dose reduction and the use of iterative reconstruction techniques. Also discussed are options for viewing and analysis of CT images, issues related to appropriate image reformatting and interpretation, interactive treatment planning, and transfer of information from the images to the surgical field during implant surgery using surgical guides and CT-guided navigation systems. Copyright © 2017 Elsevier Inc. All rights reserved.
Hwang, Sungsoon; Lim, Dong Hui; Lee, Soomin; Choi, Daye Diana; Chung, Eui-Sang; Chung, Tae-Young
To report the long-term results of temporary piggyback IOL implantation in congenital cataract and to compare the clinical outcomes of temporary piggyback IOL with those of single IOL implantation. This is a retrospective, comparative, interventional study. The medical records of all consecutive patients who underwent cataract extraction and single or temporary piggyback IOL implantation within the first 3 years of life from 1999 to 2013 at Samsung Medical Center were reviewed. Twenty-eight eyes from 18 patients underwent single IOL implantation (monopseudophakia group), and 32 eyes of 20 patients underwent temporary piggyback IOL implantation in congenital cataract surgery (polypseudophakia group). The mean age at initial cataract surgery was 15.8 months in the monopseudophakia group and 11.1 months in the polypseudophakia group (P = 0.144). The average follow-up duration was 133 months in the monopseudophakia group and 120 months in the polypseudophakia group (P = 0.391). The best-corrected visual acuity at the last visit was 0.36 logMAR in the monopseudophakia group and 0.55 logMAR in the polypseudophakia group (P = 0.044). Four (14%) and 14 (44%) reoperations for complications within the anterior segment were performed in the monopseudophakia group and polypseudophakia group, respectively (P = 0.042). Four cases (14.3%) in the monopseudophakia group and 13 cases (40.6%) in the polypseudophakia group had a glaucoma-related adverse event (P = 0.086). Compared with primary single IOL implantation in congenital cataract, temporary piggyback IOL implantation produced worse visual acuity, higher reoperation rate, and higher risk of secondary glaucoma. Temporary piggyback IOL implantation does not have benefit in congenital cataract.
Brekke, Anders Falk
, DK-5000 Odense C, Denmark ABSTRACT (1795 anslag) Background: Excessive anterior pelvic tilt has been linked to pain and dysfunction of the hip and pelvic region. Conservative treatment (e.g. manual therapy and physical training) is suggested in correcting the tilt and eventually related symptoms....... However, the effectiveness in reducing excessive anterior pelvic tilt in adults is unknown. Purpose: To systematically review studies investigating the effectiveness of conservative treatment in reducing anterior pelvic tilt in adults and evaluate the quality of evidence. Materials and methods: MEDLINE...
Jafri Malim Abdullah
To determine the suitability of amniotic membrane an bovine bone xenografts for the use in spinal surgery and anterior cranial for a generations. Fifteen patients with anterior cranial fossa defects and spinal bone fractures received bovine bone xenografts and 10 patients with meningomyeloceles received amniotic membranes (produced by the Malaysian National Tissue Bank) were analysed retrospectively. Clinical criterias like fever, signs of inflammation, breakdown of graft implant, non specific reaction to the nervous tissue were analysed haematological and radiologically. All patients who received the bovine grafts and amniotic membranes did not show any evidence of inflammation or fever. There were no graft implant breakdowns. There was no radiological or clinical evidence of specific or non specific reaction to the nervous tissue after 12-36 months followup Amniotic membranes and bovine xenografts may be used in the healing and reconstruction of spinal and cranial defects. Despite no evidence of rejection and infection after 36 months, a long term followup is still needed
Full Text Available Background: Space closure by en masse intrusion and retraction in orthodontics is of particular interest. Aim: The aim of this study was to evaluate the stress distribution and displacement of maxillary anterior teeth. Materials and Methods: Four different finite element models of maxillary arch were constructed to understand the nature of stresses and displacement patterns of anterior teeth during en masse intrusion and retraction on force application with different combinations of mini-implants and retraction hooks. Results: In this study, tensile stresses were seen in the cervical region and various movements of teeth such as lingual crown tipping, bodily movement, lingual root tipping, intrusion, and extrusion were observed. Conclusion: Nature of stresses changes from tensile to compressive from cervical area to apical area. Various tooth displacements suggest that different combinations of mini-implants and retraction hooks affect the direction of the tooth movement.
Full Text Available AIM: To observe the changes of anterior and posterior corneal curvature and anterior chamber depth after small incision lenticule extraction(SMILEfor low and high myopic astigmatism. METHODS: Sixty-three cases(88 eyesundergone SMILE in our hospital were included. The patients were divided into two groups based on astigmatism degree: the Group A: -2.00D to -4.00D astigmatism, the Group B: -0.25D to -1.00D astigmatism. Patients were examined at 1wk, 1 and 3mo after operations. Visual acuity, intraocular pressure, refraction, corneal curvature and anterior chamber depth were recorded. The change of anterior and posterior corneal curvature and anterior chamber depth was compared. Spearman correlation analysis and independent t test were used for statistical analysis. RESULTS: Surgery was done well in all patients without complications. No statistically significant difference was found between the two groups in posterior corneal curvature and anterior chamber depth preoperatively, postoperatively 7d,1 and 3mo(P>0.05. One week postoperatively, the anterior corneal curvature was statistically significant from that of preoperative in both groups(PP>0.05. CONCLUSION: No significant change of anterior and posterior corneal curvature and anterior chamber depth was found after SMILE for correcting low and high myopic astigmatism. One week after SMILE the anterior corneal curvature become stable.
Full Text Available An implant-supported restoration offers a predictable treatment for tooth replacement. Reported success rates for dental implants are high. Nevertheless, failures that mandate immediate implant removal do occur. The consequences of implant removal jeopardize the clinician's efforts to accomplish satisfactory function and esthetics. For the patient, this usually involves further cost and additional procedures. The aim of this paper is to describe different methods and treatment modalities to deal with dental implant failure. The main topics for discussion include identifying the failing implant, implants replacing failed implants at the exact site, and the use of other restorative options.When an implant fails, a tailor made treatment plan should be provided to each patient according to all relevant variables. Patients should be informed regarding all possible treatment modalities following implant failure and give their consent to the most appropriate treatment option for them.
Full Text Available El artículo sostiene que las exigencias técnicas del muestreo para la vigilancia epidemiológica, exigen una revisión profunda de importantes conceptos de la Teoría de la Salud. En particular, es necesario hacer énfasis en las condiciones de vida, y, más específicamente, en los ambientes o contextos en que se desarrollan los procesos reproductivos de la vida social. Pero ambos campos temáticos exigen potenciar el acceso a datos más ricos que los que aportan las fuentes tradicionales. Este enfoque de la "vigilancia epidemiológica" exige una revisión de los tipos de muestras, y esto implica revisar las interpretaciones dominantes sobre los fundamentos lógicos de las inferencias a partir de muestras. Se torna necesario dejar atrás las muestras estadísticas (aún las estratificadas y promover procedimientos del tipo de los "sitios centinelas". Esta técnica, aplicada originariamente en sociedades con sistemas estadísticos deficitarios, puede desarrollarse para constituirse en un complemento substancial del monitoreo de condiciones de vida incluso en sociedades con buenos sistemas de información. El artículo propone transformar el concepto de "sitio centinela" incorporandole el requisito de la "representatividad cualitativa" mediante muestreos finalísticos sustentados en tipologías previas de las unidades espacio-poblacionales.
Full Text Available El artículo sostiene que las exigencias técnicas del muestreo para la vigilancia epidemiológica, exigen una revisión profunda de importantes conceptos de la Teoría de la Salud. En particular, es necesario hacer énfasis en las condiciones de vida, y, más específicamente, en los ambientes o contextos en que se desarrollan los procesos reproductivos de la vida social. Pero ambos campos temáticos exigen potenciar el acceso a datos más ricos que los que aportan las fuentes tradicionales. Este enfoque de la "vigilancia epidemiológica" exige una revisión de los tipos de muestras, y esto implica revisar las interpretaciones dominantes sobre los fundamentos lógicos de las inferencias a partir de muestras. Se torna necesario dejar atrás las muestras estadísticas (aún las estratificadas y promover procedimientos del tipo de los "sitios centinelas". Esta técnica, aplicada originariamente en sociedades con sistemas estadísticos deficitarios, puede desarrollarse para constituirse en un complemento substancial del monitoreo de condiciones de vida incluso en sociedades con buenos sistemas de información. El artículo propone transformar el concepto de "sitio centinela" incorporandole el requisito de la "representatividad cualitativa" mediante muestreos finalísticos sustentados en tipologías previas de las unidades espacio-poblacionales.
Wilde, Jeffrey; Bedi, Asheesh; Altchek, David W.
Context: Reconstruction of the anterior cruciate ligament (ACL) is one of the most common surgical procedures, with more than 200,000 ACL tears occurring annually. Although primary ACL reconstruction is a successful operation, success rates still range from 75% to 97%. Consequently, several thousand revision ACL reconstructions are performed annually and are unfortunately associated with inferior clinical outcomes when compared with primary reconstructions. Evidence Acquisition: Data were obtained from peer-reviewed literature through a search of the PubMed database (1988-2013) as well as from textbook chapters and surgical technique papers. Study Design: Clinical review. Level of Evidence: Level 4. Results: The clinical outcomes after revision ACL reconstruction are largely based on level IV case series. Much of the existing literature is heterogenous with regard to patient populations, primary and revision surgical techniques, concomitant ligamentous injuries, and additional procedures performed at the time of the revision, which limits generalizability. Nevertheless, there is a general consensus that the outcomes for revision ACL reconstruction are inferior to primary reconstruction. Conclusion: Excellent results can be achieved with regard to graft stability, return to play, and functional knee instability but are generally inferior to primary ACL reconstruction. A staged approach with autograft reconstruction is recommended in any circumstance in which a single-stage approach results in suboptimal graft selection, tunnel position, graft fixation, or biological milieu for tendon-bone healing. Strength-of-Recommendation Taxonomy (SORT): Good results may still be achieved with regard to graft stability, return to play, and functional knee instability, but results are generally inferior to primary ACL reconstruction: Level B. PMID:25364483
Pinholt, Else M
and the patients were followed between 20 and 67 months post implantation. The bone graft was transplanted to add bony volume in the maxillary sinus, the anterior floor of the nose and/or the alveolar ridge. After a healing period of 4(1/2) months, dental implants were inserted and left for healing for 8 months......-treated ITI implants has a significant higher survival rate than machine-surfaced Brånemark implants in autogenous grafted maxillary bone.......The development of new characteristics concerning implant surface makes it interesting to clinically compare different implant systems in the bone-grafted maxilla. The aim of this evaluation was to compare clinical data of a two-staged procedure on the augmented extremely atrophic maxilla using...
Muller, Bart; Duerr, Eric R H; van Dijk, C Niek; Fu, Freddie H
To measure and compare the amount of anterior tibial subluxation (ATS) after anatomic ACL reconstruction for both acute and chronic ACL-deficient patients. Fifty-two patients were clinically and radiographically evaluated after primary, unilateral, anatomic ACL reconstruction. Post-operative true lateral radiographs were obtained of both knees with the patient in supine position and knees in full passive extension with heels on a standardized bolster. ATS was measured on the radiographs by two independent and blinded observers. ATS was calculated as the side-to-side difference in tibial position relative to the femur. An independent t test was used to compare ATS between those undergoing anatomic reconstruction for an acute versus chronic ACL injury. Chronic ACL deficiency was defined as more than 12 weeks from injury to surgery. Patients averaged 26.4 ± 11.5 years (mean ± SD) of age, 43.6 % were female, and 48.1 % suffered an injury of the left knee. There were 30 and 22 patients in the acute and chronic groups, respectively. The median duration from injury to reconstruction for the acute group was 5 versus 31 weeks for the chronic group. After anatomic ACL reconstruction, the mean ATS was 1.0 ± 2.1 mm. There was no statistical difference in ATS between the acute and chronic groups (1.2 ± 2.0 vs. 0.6 ± 2.3 mm, n.s.). Assessment of inter-tester reliability for radiographic evaluation of ATS revealed an excellent intraclass correlation coefficient of 0.894. Anatomic ACL reconstruction reduces ATS with a mean difference of 1.0 mm from the healthy contralateral limb. This study did not find a statistical difference in ATS between patients after anatomic ACL reconstruction in the acute or chronic phase. These observations suggest that anatomic ACL reconstruction, performed in either the acute or the chronic phase, approaches the normal AP relationship of the tibiofemoral joint. IV.
Full Text Available Se hace un estudio de la interacción de promastigotes de Leishmania donovani con células de exudado peritoneal de ratón (c e p mediante la influencia de la quimotripsina. La adhesión de los promastigotes a las c e p fue terminal y marginal, y en observaciones hechas a partir de los 10 minutos de enfrentamiento, esta adhesión fue nula hasta los 30 minutos en el grupo tratado, y sólo a las das horas hubo un pequeño incremento (2.4% con respecto al control. Se observa marcada disminución en todos los parámetro medidos, tales como enlace, penetración, multiplicación intracelular, división de formas flageladas, en el grupo tratado. La quimotripsina favorece la formación de formas intermedias flageladas, heciendose el parásito piriforme y esférico, apareciendo una forma aberrante de extremo anterior cilindrico que semeja a una forma coanoflagelada. Se sospecha que la enzima reduce efectivamente fragmentos proteicos o péptidos, los cuales pueden haber sido tan pequeños como para esconder a otros ligandos relacionados con la adhesión macrófago-parásito.
Full Text Available Introduction: Progressive loading protocol is a high-demanding procedure suggested to increase the quality of bone when the implant is inserted in D3 or D4-typed bone. The purpose of this study was to present a case report regarding simultaneously progressive and immediately loading implants in the anterior position of the maxilla. Case report: One patient whose implants in the anterior maxilla (in site of teeth #7, #9, #11 had questionable to poor prognosis who was treated immediate and delayed progressive loading protocol and was followed up for 2 years. Discussion: Although the number of studies in this field is limited, it can be concluded that the progressive loading protocol can predictably enhance the treatment success in immediate-loaded implants with poor prognosis and when inserted in low quality bone such as the present case.
Ben G. L. Vanneste
Full Text Available ABSTRACT Introduction: A rectum balloon implant (RBI is a new device to spare rectal structures during prostate cancer radiotherapy. The theoretical advantages of a RBI are to reduce the high radiation dose to the anterior rectum wall, the possibility of a post-implant correction, and their predetermined shape with consequent predictable position. Objective: To describe, step-by-step, our mini-invasive technique for hands-free transperineal implantation of a RBI before start of radiotherapy treatment. Materials and Methods: We provide step-by-step instructions for optimization of the transperineal implantation procedure performed by urologists and/or radiation oncologists experienced with prostate brachytherapy and the use of the real-time bi-plane transrectal ultrasonography (TRUS probe. A RBI was performed in 15 patients with localised prostate cancer. Perioperative side-effects were reported. Results: We provide ‘tips and tricks’ for optimizing the procedure and proper positioning of the RBI. Please watch the animation, see video in https://vimeo.com/205852376/789df4fae4. The side-effects included mild discomfort to slight pain at the perineal region in 8 out of 15 patients. Seven patients (47% had no complaints at all. Two patients developed redness of the skin, where prompt antibiotic regimen was started with no further sequelae. One patient revealed a temporary urine retention, which resolved in a few hours following conservative treatment. Further no perioperative complications occurred. Conclusion: This paper describes in detail the implantation procedure for an RBI. It is a feasible, safe and very well-tolerated procedure.
Ion implantation is a nonequilibrium process. It is possible to implant materials with impurities to concentration levels which exceed the solid solubilities. The return of the system to thermodynamic equilibrium is often accomplished by precipitation of the implanted species or a compound involving atoms of both the host and the implanted species. This may involve long time scales when taking place at room temperature or it may take place during the implantation
Simonian, Krikor; Frydman, Alon; Verdugo, Fernando; Roges, Rafael; Kar, Kian
Implants are a predictable and effective method for replacing missing teeth. Some clinicians have advocated extraction and replacement of compromised but treatable teeth on the assumption that implants will outperform endodontically and/or periodontally treated teeth. However, evidence shows that conventional therapy is as effective as implant treatment. With data on implants developing complications long term and a lack of predictable treatment for peri-implantitis, retaining and restoring the natural dentition should be the first choice when possible.
Hong, Do Gia Khang; Oh, Ji-hyeon
Dental implants are a common treatment for the loss of teeth. This paper summarizes current knowledge on implant surfaces, immediate loading versus conventional loading, short implants, sinus lifting, and custom implants using three-dimensional printing. Most of the implant surface modifications showed good osseointegration results. Regarding biomolecular coatings, which have been recently developed and studied, good results were observed in animal experiments. Immediate loading had similar c...
Baulot, E; Trouilloud, P; Ragois, P; Giroux, E A; Grammont, P M
. Peroperative radiologic control ascertained the good position of the implant. At the end of the procedure a chest tube was placed through the lower trocar site and the lung re-expanded. A post operative CT Scan controlled good position of the graft and complete lung expansion. Contra-indications for VATS are previous surgical procedures or empyema causing extensive pleural adhesions. Procedures not appropriate for VATS approach are some that require anterior instrumentation for stabilisation, burst fracture, or fracture with posterior wall involved. The planned procedure was accomplished in all but one patient who required conversion to an open procedure because of segmental artery bleeding. Mean operative time was 1 h 45 mm, and mean estimated blood loss was 650 cc. There was no complication from CO2 insufflation neither postoperative complication. With an average of 2 years follow up, anterior grafting is as good as an open technique, radiologic evaluation according to Uchida (1990) showed good incorporation of each block without any radiolucent line or displacement. According to literature this technique was performed safely in 10 cases, especially without any respiratory complications and chronic pain (impairement of pulmonary function, re-expansion failure, incisional complications, rib fractures, chronic pain and malfunction of the chest wall, limitation of shoulder girdle motion) which are considered to be the main disadvantage of traditional thoracotomy. Many authors previously used VATS for multi level thoracic discectomy for correction of spinal deformities (Mack 1995), spinal reconstructive surgery (Mac Afee 1995) or removal of protrude thoracic disc (Rosenthal 1994). This original technique demonstrates that thoracoscopy for anterior thoracic surgery is better for the patients, reducing surgical trauma of the chest wall and to the lung parenchyma (in term of post operative comfort, sh
Ramsey, Dan K; Wretenberg, Per F; Lamontagne, Mario; Németh, Gunnar
Examine the neuromuscular response to functional knee bracing relative to anterior tibial translations in vivo. During randomised brace conditions, electromyographic data with simultaneous skeletal tibiofemoral kinematics were recorded from four anterior cruciate ligament deficient subjects to investigate the effect of the DonJoy Legend functional brace during activity. Knee braces do not increase knee stability but may influence afferent inputs from proprioception and therefore one might expect changes in muscle firing patterns, amplitude and timing. Hoffman bone pins affixed with markers were implanted into the tibia and femur for kinematic measurement. The EMG data from the rectus femoris, semitendinosus, biceps femoris, and lateral head of the gastrocnemius were integrated for each subject in three separate time periods: 250 ms preceding footstrike and two consecutive 125 ms time intervals following footstrike. With brace, semitendinosus activity significantly decreased 17% prior to footstrike whereas bicep femoris significantly decreased 44% during A2, (P<0.05). Rectus femoris activity significantly increased 21% in A2 (P<0.05). No consistent reductions in anterior translations were evident. Our preliminary findings, based on a limited number of subjects, indicate joint stability may result from proprioceptive feedback rather than the mechanical stabilising effect of the brace. Despite a significant increase in rectus femoris activity upon landing, only one subject demonstrated an increase in anterior tibial drawer. Studies have shown functional braces do not mechanically stabilise the anterior cruciate ligament deficient knee. Perhaps bracing alters proprioceptive feedback. It has been shown that bracing the anterior cruciate ligament deficient knee may affect hamstring and quadriceps activity. Our findings stresses the importance of functional knee bracing combined with proprioceptive and muscular coordination training in order to increase joint stability.
Rachala, Madhukar Reddy; Harikrishnan, Pandurangan
Anterior open bite is often caused by a downward rotation of the mandible and/or by excessive eruption of the posterior teeth. In such cases, it is difficult to establish absolute anchorage for molar intrusion by traditional orthodontic mechanics. This is a case report of successful treatment of a severe anterior open bite using miniscrew anchorage. A female patient of 20 yrs presented with symmetrical frontal facial appearance, increased anterior facial height, convex profile and incompetent lips. Dentally, she had lost both mandibular first molars due to caries and both maxillary first molars were extruded. She had class II canine relationship, 5 mm overjet, 5 mm anterior open bite, 3 mm mandibular midline diastema and a spacing of 2 mm in the maxillary arch. The treatment objectives were to correct the anterior open bite and establish ideal overjet and overbite and to restore the mandibular first molars with fixed prosthesis. Titanium miniscrews (1.3 mm diameter and 9 mm length) were implanted bilaterally in the maxillary arch between the second premolar and the first molar, and an intrusion force was applied with NiTi closed coil springs for 8 months. After molar intrusion, the same screws were used for en masse retraction of the entire dentition (third molars were extracted) for 4 months. The results showed that, after an active treatment of 20 months, the maxillary molars were intruded about 4 mm each and good occlusion was achieved. In conclusion, the miniscrews were very useful in the non-surgical management of adult anterior open bite cases.
Fissell, William H; Roy, Shuvo
The confluence of an increasing prevalence of end-stage renal disease (ESRD), clinical trial data suggestive of benefit from quotidian dialysis, and ongoing cost/benefit reanalysis of healthcare spending have stimulated interest in technological improvements in provision of ESRD care. For the last decade, our group has focused on enabling technologies that would permit a paradigm shift in dialysis care similar to that brought by implantable defibrillators to arrhythmia management. Two significant barriers to wearable or implantable dialysis persist: package size of the dialyzer and water requirements for preparation of dialysate. Decades of independent research into highly efficient membranes and cell-based bioreactors culminated in a team effort to develop an implantable version of the University of Michigan Renal Assist Device. In this review, the rationale for the design of the implantable artificial kidney is described.
Majidzadeh Bafar, Vahid
Wireless Cortical Implantable Systems examines the design for data acquisition and transmission in cortical implants. The first part of the book covers existing system-level cortical implants, as well as future devices. The authors discuss the major constraints in terms of microelectronic integration. The second part of the book focuses on system-level as well as circuit and system level solutions to the development of ultra low-power and low-noise microelectronics for cortical implants. Existing solutions are presented and novel methods and solutions proposed. The third part of the book focuses on the usage of digital impulse radio ultra wide-band transmission as an efficient method to transmit cortically neural recorded data at high data-rate to the outside world. Original architectural and circuit and system solutions are discussed.
... Orthopaedic Surgeons Information about Soft Tissue Imaging and Metal Ion Testing Information for All Health Care Professionals who Provide Treatment to Patients with a Metal-on-Metal Hip Implant Metal-on-Metal Hip ...
del Río Highsmith, J; López Lozano, J F
In the present article deals with a number of general considerations in the realization of prostheses over endosseous implants. The different principles to study in the construction of a fixed protesic rehabilitation implanto-supported are analyzed.
... What you can expect Breast reconstruction begins with placement of a breast implant or tissue expander, either at the time of your mastectomy surgery (immediate reconstruction) or during a later procedure (delayed reconstruction). ...
Fournier, Eric; Devaney, Robert; Palmer, Matthew; Kramer, Joshua; El Khaja, Ragheb; Fonte, Matthew
The demand for hip and knee replacement surgery is substantial and growing. Unfortunately, most joint replacement surgeries will fail within 10-25 years, thereby requiring an arduous, painful, and expensive revision surgery. To address this issue, a novel orthopedic implant coating material ("eXalt") has been developed. eXalt is comprised of super elastic nitinol wire that is knit into a three-dimensional spacer fabric structure. eXalt expands in vivo to conform to the implantation site and is porous to allow for bone ingrowth. The safety and efficacy of eXalt were evaluated through structural analysis, mechanical testing, and a rabbit implantation model. The results demonstrate that eXalt meets or exceeds the performance of current coating technologies with reduced micromotion, improved osseointegration, and stronger implant fixation in vivo.
... them or to undergo additional reconstructive surgery. Photo courtesy of Walter Peters, Ph.D., M.D., F. ... placement of silicone gel-filled breast implants. Photo courtesy of Walter Peters, Ph.D., M.D., F. ...
Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne
Studies of complications following reconstructive surgery with implants among women with breast cancer are needed. As the, to our knowledge, first prospective long-term study we evaluated the occurrence of complications following delayed breast reconstruction separately for one- and two......-stage procedures. From the Danish Registry for Plastic Surgery of the Breast, which has prospectively registered data for women undergoing breast implantations since 1999, we identified 559 women without a history of radiation therapy undergoing 592 delayed breast reconstructions following breast cancer during...... of reoperation was significantly higher following the one-stage procedure. For both procedures, the majority of reoperations were due to asymmetry or displacement of the implant. In conclusion, non-radiated one- and two-stage delayed breast implant reconstructions are associated with substantial risks...
J. Pato Mourelo; A. Jiménez Guerra; L. Monsalve Guil; J.J. Segura Egea; E. Velasco Ortega
Introducción. El objetivo del presente caso clínico era mostrar los resultados del tratamiento con implantes dentales mediante regeneración ósea guiada. Caso clínico. Un varón de 32 años es valorado para tratamiento implantológico del incisivo central superior derecho perdido. El plan de tratamiento comprende la eliminación de un quiste periapical residual, inserción de forma sumergida de un implante unitario con nanosuperficie Galimplant® y regeneración ósea guiada con membrana de colágeno r...
Full text: Over the past two decades, thousands of particle accelerators have been used to implant foreign atoms like boron, phosphorus and arsenic into silicon crystal wafers to produce special embedded layers for manufacturing semiconductor devices. Depending on the device required, the atomic species, the depth of implant and doping levels are the main parameters for the implantation process; the selection and parameter control is totally automated. The depth of the implant, usually less than 1 micron, is determined by the ion energy, which can be varied between 2 and 600 keV. The ion beam is extracted from a Freeman or Bernas type ion source and accelerated to 60 keV before mass analysis. For higher beam energies postacceleration is applied up to 200 keV and even higher energies can be achieved by mass selecting multiplycharged ions, but with a corresponding reduction in beam output. Depending on the device to be manufactured, doping levels can range from 10 10 to 10 15 atoms/cm 2 and are controlled by implanter beam currents in the range up to 30mA; continuous process monitoring ensures uniformity across the wafer of better than 1 % . As semiconductor devices get smaller, additional sophistication is required in the design of the implanter. The silicon wafers charge electrically during implantation and this charge must be dissipated continuously to reduce the electrical stress in the device and avoid destructive electrical breakdown. Electron flood guns produce low energy electrons (below 10 electronvolts) to neutralize positive charge buildup and implanter design must ensure minimum contamination by other isotopic species and ensure low internal sputter rates. The pace of technology in the semiconductor industry is such that implanters are being built now for 256 Megabit circuits but which are only likely to be widely available five years from now. Several specialist companies manufacture implanter systems, each costing around US$5 million, depending on the
Niki, Yasuo; Hakozaki, Akihiro; Iwamoto, Wataru; Kanagawa, Hiroya; Matsumoto, Hideo; Toyama, Yoshiaki; Suda, Yasunori
The purpose of this study was to evaluate the prevalence of anterior knee pain in anatomic double-bundle anterior cruciate ligament (ACL) reconstruction and to identify critical factors affecting postoperative anterior knee pain development. Subjects comprised 171 patients (171 knees) who underwent anatomic double-bundle ACL reconstruction with a follow-up period of ≥2 years. The procedure used bone-patellar tendon-bone plus gracilis tendon (BTB-G) in 56 knees, semitendinosus tendon (ST) in 71 knees, and ST-G in 44 knees. Clinical results and prevalence and severity of anterior knee pain were assessed at 3 months and 2 years postoperatively. Clinical variables influencing anterior knee pain development at each postoperative period were subjected to univariate analysis, followed by logistic regression analysis to identify risk factors for anterior knee pain. Overall prevalences of anterior knee pain at 3 months and 2 years postoperatively were 42.0 and 11.1%, respectively. Use of BTB-G graft represented the highest prevalence of anterior knee pain between the 3 different grafts (P = 0.001); however, this statistical significance disappeared at 2 years postoperatively. Prevalence of postoperative extension deficit was significantly higher in anterior knee pain-positive cohort than in anterior knee pain-negative cohort at 3 months postoperatively. Level of quadriceps strength was significantly lower, and Lysholm score was significantly worse in anterior knee pain-positive cohort than in anterior knee pain-negative cohort at 2 years postoperatively. According to logistic regression analysis, knee extension deficit was a predisposing factor for the development of anterior knee pain at 3 months postoperatively (odds ratio, 2.76; P = 0.004); however, there was no significant predisposing factor for anterior knee pain at 2 years postoperatively. Knee extension deficit was an important predisposing factor for postoperative anterior knee pain in the early
Full Text Available Presentamos una serie de pacientes con mastectomía a las que hemos realizado reconstrucción mamaria con infiltraciones de grasa (lipoinfiltrado enriquecida con plasma rico en plaquetas (PRP como único procedimiento, o como paso previo a la colocación de un implante mamario. El objetivo de este trabajo es presentar una alternativa a la reconstrucción mamaria con colgajos libres o pediculados en mamas sometidas a radioterapia; también, una revisión detallada de los pasos a seguir para la realización de este procedimiento, que van desde la extracción de sangre para la posterior obtención del PRP, hasta la técnica de infiltración de grasa enriquecida con dichos factores en la mama intervenida. Con esta técnica de enriquecimiento de la grasa hemos logrado mejores resultados y mayor permanencia de los injertos grasos. Evaluando los postoperatorios de las pacientes sometidas a este procedimiento, hemos observado que se necesitan de 2 a 3 tiempos de lipoinfiltrado para obtener buena cobertura y mejoría de la calidad de piel como paso previo a la colocación del implante en este tipo de pacientes.
Nguyen, Anh H.; Bartlett, Erica L.; Kania, Katarzyna; Bae, Sang Mo
Augmentation rhinoplasty among Asian patients is often performed to improve the height of the nasal dorsum. As the use of autogenous tissues poses certain limitations, alloplastic materials are a viable alternative with a long history of use in Asia. The superiority of one implant prosthesis over another for augmentation rhinoplasty is a matter of debate, with each material representing varying strengths and weaknesses, indications for use, and precautions to consider in nasal implant placeme...
This is a report of the study of the implantation of heavy ions at medium keV-energies into electrically conducting mono-elemental solids, at ion doses too small to cause significant loss of the implanted ions by resputtering. The study has been undertaken to investigate the possibility of accurate portioning of matter in submicrogram quantities, with some specific applications in mind. The problem is extensively investigated both on a theoretical level and in practice. A mathematical model is developed for calculating the loss of implanted ions by resputtering as a function of the implanted ion dose and the sputtering yield. Numerical data are produced therefrom which permit a good order-of-magnitude estimate of the loss for any ion/solid combination in which the ions are heavier than the solid atoms, and for any ion energy from 10 to 300 keV. The implanted ion dose is measured by integration of the ion beam current, and equipment and techniques are described which make possible the accurate integration of an ion current in an electromagnetic isotope separator. The methods are applied to two sample cases, one being a stable isotope, the other a radioisotope. In both cases independent methods are used to show that the implantation is indeed quantitative, as predicted. At the same time the sample cases are used to demonstrate two possible applications for quantitative ion implantation, viz. firstly for the manufacture of calibration standards for instrumental micromethods of elemental trace analysis in metals, and secondly for the determination of the half-lives of long-lived radioisotopes by a specific activity method. It is concluded that the present study has advanced quantitative ion implantation to the state where it can be successfully applied to the solution of problems in other fields
Ion implantation is a widely used technique with a literature that covers semiconductor production, surface treatments of steels, corrosion resistance, catalysis and integrated optics. This brief introduction outlines advantages of the technique, some aspects of the underlying physics and examples of current applications. Ion implantation is already an essential part of semiconductor technology while in many other areas it is still in an early stage of development. The future scope of the subject is discussed. (author)
Gallo, Robert A.; DeMeo, Patrick J.; Kolman, Brett H.; Daffner, Richard H.; Sciulli, Robert L.; Roberts, Catherine C.
Ruptures of the tibialis anterior tendon are rare. We present the clinical histories and MRI findings of three recent male patients with tibialis anterior tendon rupture aged 58-67 years, all of whom presented with pain over the dorsum of the ankle. Two of the three patients presented with complete rupture showing discontinuity of the tendon, thickening of the retracted portion of the tendon, and excess fluid in the tendon sheath. One patient demonstrated a partial tear showing an attenuated tendon with increased surrounding fluid. Although rupture of the tibialis anterior tendon is a rarely reported entity, MRI is a useful modality in the definitive detection and characterization of tibialis anterior tendon ruptures. (orig.)
Yamanishi, Yasufumi; Yamaguchi, Satoshi; Imazato, Satoshi; Nakano, Tamaki; Yatani, Hirofumi
Occlusal overloading causes peri-implant bone resorption. Previous studies examined stress distribution in alveolar bone around commercial implants using three-dimensional (3D) finite element analysis. However, the commercial implants contained some different designs. The purpose of this study is to reveal the effect of the target design on peri-implant bone stress and abutment micromovement. Six 3D implant models were created for different implant-abutment joints: 1) internal joint model (IM); 2) external joint model (EM); 3) straight abutment (SA) shape; 4) tapered abutment (TA) shapes; 5) platform switching (PS) in the IM; and 6) modified TA neck design (reverse conical neck [RN]). A static load of 100 N was applied to the basal ridge surface of the abutment at a 45-degree oblique angle to the long axis of the implant. Both stress distribution in peri-implant bone and abutment micromovement in the SA and TA models were analyzed. Compressive stress concentrated on labial cortical bone and tensile stress on the palatal side in the EM and on the labial side in the IM. There was no difference in maximum principal stress distribution for SA and TA models. Tensile stress concentration was not apparent on labial cortical bone in the PS model (versus IM). Maximum principal stress concentrated more on peri-implant bone in the RN than in the TA model. The TA model exhibited less abutment micromovement than the SA model. This study reveals the effects of the design of specific components on peri-implant bone stress and abutment displacement after implant-supported single restoration in the anterior maxilla.
Nguyen, Anh H; Bartlett, Erica L; Kania, Katarzyna; Bae, Sang Mo
Augmentation rhinoplasty among Asian patients is often performed to improve the height of the nasal dorsum. As the use of autogenous tissues poses certain limitations, alloplastic materials are a viable alternative with a long history of use in Asia. The superiority of one implant prosthesis over another for augmentation rhinoplasty is a matter of debate, with each material representing varying strengths and weaknesses, indications for use, and precautions to consider in nasal implant placement. An implant prosthesis should be used on a case-by-case basis. Augmentation rhinoplasty requires the consideration of specific anatomical preoperative factors, including the external nose, nasal length, nasofrontal angle, humps, and facial proportions. It is equally important to consider several operative guidelines to appropriately shape implants to minimize the occurrence of adverse effects and postoperative complications. The most common postoperative complications include infection, nasal height change, movement of implant prosthesis, and silicone implant protrusion. In addition, the surgeon should consider the current standards of Asian beauty aesthetics to better understand the patient's desired outcome.
Stöver, Timo; Lenarz, Thomas
The cochlear implant (CI) represents, for almost 25 years now, the gold standard in the treatment of children born deaf and for postlingually deafened adults. These devices thus constitute the greatest success story in the field of ‘neurobionic’ prostheses. Their (now routine) fitting in adults, and especially in young children and even babies, places exacting demands on these implants, particularly with regard to the biocompatibility of a CI’s surface components. Furthermore, certain parts of the implant face considerable mechanical challenges, such as the need for the electrode array to be flexible and resistant to breakage, and for the implant casing to be able to withstand external forces. As these implants are in the immediate vicinity of the middle-ear mucosa and of the junction to the perilymph of the cochlea, the risk exists – at least in principle – that bacteria may spread along the electrode array into the cochlea. The wide-ranging requirements made of the CI in terms of biocompatibility and the electrode mechanism mean that there is still further scope – despite the fact that CIs are already technically highly sophisticated – for ongoing improvements to the properties of these implants and their constituent materials, thus enhancing the effectiveness of these devices. This paper will therefore discuss fundamental material aspects of CIs as well as the potential for their future development. PMID:22073103
Conrad, J.R.; Forest, C.
The authors' technique allows the ion implantation to be performed directly within the ion source at higher currents without ion beam extraction and transport. The potential benefits include greatly increased production rates (factors of 10-1000) and the ability to implant non-planar targets without rastering or shadowing. The technique eliminates the ion extractor grid set, beam raster equipment, drift space and target manipulator equipment. The target to be implanted is placed directly within the plasma source and is biased to a large negative potential so that plasma ions gain energy as they accelerate through the potential drop across the sheath that forms at the plasma boundary. Because the sheath surrounds the target on all sides, all surfaces of the target are implanted without the necessity to raster the beam or to rotate the target. The authors have succeeded in implanting nitrogen ions in a silicon target to the depths and concentrations required for surface treatment of materials like stainless steel and titanium alloys. They have performed ESCA measurements of the penetration depth profile of a silicon target that was biased to 30 kV in a nitrogen discharge plasma. Nitrogen ions were implanted to a depth of 700A at a peak concentration of 30% atomic. The measured profile is quite similar to a previously obtained profile in titanium targets with conventional techniques
Full Text Available Sam Rowlands,1,2 Stephen Searle3 1Centre of Postgraduate Medical Research and Education, School of Health and Social Care, Bournemouth University, Bournemouth, United Kingdom; 2Dorset HealthCare, Bournemouth, United Kingdom; 3Sexual Health Services, Chesterfield, United KingdomAbstract: Progestin-only contraceptive implants are a highly cost-effective form of long-acting reversible contraception. They are the most effective reversible contraceptives and are of a similar effectiveness to sterilization. Pregnancies are rare in women using this method of contraception, and those that do occur must be fully investigated, with an ultrasound scan of the arm and serum etonogestrel level if the implant cannot be located. There are very few contraindications to use of implants, and they have an excellent safety profile. Both acceptability and continuation with the method are high. Noncontraceptive benefits include improvements in dysmenorrhea, ovulatory pain, and endometriosis. Problematic bleeding is a relatively common adverse effect that must be covered in preinsertion information-giving and supported adequately if it occurs. Recognized training for both insertion and removal should be undertaken. Care needs to be taken at both insertion and removal to avoid neurovascular injury. Implants should always be palpable; if they are not, noninsertion should be assumed until disproven. Etonogestrel implants are now radiopaque, which aids localization. Anticipated difficult removals should be performed by specially trained experts. Keywords: contraceptive, subdermal implant, etonogestrel, levonorgestrel, progestin-only, long-acting reversible contraception
Sunil Kumar Mishra
Full Text Available Purpose: Anodized implants with moderately rough surface were introduced around 2000. Whether these implants enhanced biologic effect to improve the environment for better osseointegration was unclear. The purpose of this article was to review the literature available on anodized surface in terms of their clinical success rate and bone response in patients till now. Materials and Methods: A broad electronic search of MEDLINE and PubMed databases was performed. A focus was made on peer-reviewed dental journals. Only articles related to anodized implants were included. Both animal and human studies were included. Results: The initial search of articles resulted in 581 articles on anodized implants. The initial screening of titles and abstracts resulted in 112 full-text papers; 40 animal studies, 16 studies on cell adhesion and bacterial adhesion onto anodized surfaced implants, and 47 human studies were included. Nine studies, which do not fulfill the inclusion criteria, were excluded. Conclusions: The long-term studies on anodized surface implants do favor the surface, but in most of the studies, anodized surface is compared with that of machined surface, but not with other surfaces commercially available. Anodized surface in terms of clinical success rate in cases of compromised bone and immediately extracted sockets has shown favorable success.
Al-Hashedi, Ashwaq Ali; Taiyeb Ali, Tara Bai; Yunus, Norsiah
Short implants have been advocated as a treatment option in many clinical situations where the use of conventional implants is limited. This review outlines the effectiveness and clinical outcomes of using short implants as a valid treatment option in the rehabilitation of edentulous atrophic alveolar ridges. Initially, an electronic search was performed on the following databases: Medline, PubMed, Embase, Cochrane Database of Systematic Reviews, and DARE using key words from January 1990 until May 2012. An additional hand search was included for the relevant articles in the following journals: International Journal of Oral and Maxillofacial Implants, Clinical Oral Implants Research, Journal of Clinical Periodontology, International Journal of Periodontics, Journal of Periodontology, and Clinical Implant Dentistry and Related Research. Any relevant papers from the journals' references were hand searched. Articles were included if they provided detailed data on implant length, reported survival rates, mentioned measures for implant failure, were in the English language, involved human subjects, and researched implants inserted in healed atrophic ridges with a follow-up period of at least 1 year after implant-prosthesis loading. Short implants demonstrated a high rate of success in the replacement of missing teeth in especially atrophic alveolar ridges. The advanced technology and improvement of the implant surfaces have encouraged the success of short implants to a comparable level to that of standard implants. However, further randomized controlled clinical trials and prospective studies with longer follow-up periods are needed.
Lamas Lara, César; CD, Docente del Área de Operatoria Dental y Endodoncia de la Facultad de Odontología de la UNMSM.; Angulo de la Vega, Giselle; CD, Alumna de la Especialidad de Rehabilitación Oral de la Facultad de Odontología de la UNMSM.
The anterior sector problems are very common in our professional practice and became vital importance to make a suitable rehabilitation in these cases; we can not do a good rehabilitation if we do not know the basic characteristics, both aesthetic and functional. Today the composites are a valid alternative for the restoration of the anterior sector, since they offer to us a conservative and aesthetic possibility, but independently of the material to use we have to based on certain rules or p...
Brekke, Anders Falk
quality by two reviewers using Cochrane Collaboration’s tool for assessing risk of bias in RCT’s and the ROBINS-I tool (Risk Of Bias In Non-randomized Studies - of interventions). Data was synthesized qualitatively. The GRADE approach was used to determine the overall quality of the evidence. PROSPERO...... treatment may reduce anterior pelvis tilt and reduce symptoms in relation to faulty posture. Keywords: pelvis, anterior tilt, anteversion, posture...
Jivraj, Saj; Reshad, Mamaly; Chee, Winston W L
The predictability of dental implants using the traditional branemark protocol has been well documented. Since its inception, this protocol has been progressively challenged to decrease treatment time, minimize the number of surgical procedures, and maximize esthetic outcomes. Today, in specific clinical situations, implants may be placed and immediately loaded with provisional restorations. Immediate loading in the edentulous mandible has been well documented. There are also good data to show that immediate loading of the edentulous maxilla is also feasible if bone quality is suitable. The focus now has shifted toward immediate loading of implants placed in the esthetic zone. Clinicians have recognized that the challenge of providing anterior tooth replacements is in preserving the hard and soft tissue components that exist around natural teeth. The advantages of immediate restoration are obvious; however, the application of immediate or early load may pose an increased risk of implant failure in single-tooth situations. The prerequisites for achieving and maintaining acceptable results are not fully known. This review examines some of the literature concerning the reliability of early or immediate loading of implants placed in the esthetic zone.
Gragnaniello, Cristian; Seex, Kevin A; Eisermann, Lukas G; Claydon, Matthew H; Malham, Gregory M
The authors report on 2 cases of anterior dislocation of the Maverick lumbar disc prosthesis, both occurring in the early postoperative period. These cases developed after experience with more than 50 uneventful cases and were therefore thought to be unrelated to the surgeon's learning curve. No similar complications have been previously reported. The anterior Maverick device has a ball-and-socket design made of cobalt-chromium-molybdenum metal plates covered with hydroxyapatite. The superior and inferior endplates have keels to resist translation forces. The patient in Case 1 was a 52-year-old man with severe L4-5 discogenic pain; and in Case 2, a 42-year-old woman with disabling L4-5 and L5-S1 discogenic back pain. Both patients were without medical comorbidities and were nonsmokers with no risk factors for osteoporosis. Both had undergone uneventful retroperitoneal approaches performed by a vascular access surgeon. Computed tomography studies on postoperative Day 2 confirmed excellent prosthesis placement. Initial recoveries were uneventful. Two weeks postoperatively, after stretching (extension or hyperextension) in bed at home, each patient suffered the sudden onset of severe abdominal pain with anterior dislocation of the Maverick prosthesis. The patients were returned to the operating room and underwent surgery performed by the same spinal and vascular surgeons. Removal of the Maverick prosthesis and anterior interbody fusion with a separate cage and plate were performed. Both patients had recovered well with good clinical and radiological recovery at the 6- and 12-month follow-ups. Possible causes of the anterior dislocation of the Maverick prosthesis include the following: 1) surgeon error: In both cases the keel cuts were neat, and early postoperative CT confirmed good placement of the prosthesis; 2) equipment problem: The keel cuts may have been too large because the cutters were worn, which led to an inadequate press fit of the implants; 3) prosthesis
Ketan K Vakil
Full Text Available The orthodontic correction of deep overbite can be achieved with several mechanisms that will result in true intrusion of anterior teeth, extrusion of posterior teeth, or a combination of both. For the orthodontic correction of bimaxillary dentoalveolar protrusion with deep bite, there are several treatment modalities like segmented arch approach, retraction and intrusion utility arches, temporary anchorage devices. Though not a novel therapeutic concept, the use of miniscrew implants to obtain absolute anchorage has recently become very popular in clinical orthodontic approaches. To allow the use of sliding mechanics for bodily retraction with intrusion of anterior teeth, we devised a soldered power arm (SPA on standard molar tube. It is simple, stable, precise and effective in cases where anterior teeth need to be simultaneously retracted and intruded. A power arm can be readily fabricated from 20 gauge stainless steel wire and soldered on the molar buccal tube so as to avoid any distortion or loosening of power arm from molar tube during the course of the treatment. The SPA works efficiently with the molar being stabilized in all three planes of space. The resultant force vector is directed more apically toward the center of resistance of the anchor unit, which resulted in the treatment outcome of retraction and intrusion of the anterior teeth and correction of the deep bite.
Full Text Available A 14-year-old girl reported with severely proclined maxillary anterior teeth with fractured and discolored right maxillary central incisor with questionable prognosis. Autotransplantation of premolar to replace central incisor was considered a risky option as patient was 14-year-old with presence of advanced root development of premolar. The immediate placement of the prosthetic implant was also not possible because of patient′s age. Therefore, it was decided to use the space obtained by extracting questionable maxillary right central incisor for orthodontic purpose and also sacrificing the healthy premolar is invariably an excessive biological cost for a modest functional and aesthetic gain. Hence, the treatment plan for this case includes extraction of right maxillary central incisor and left maxillary first premolar, movement of right maxillary lateral incisor mesially, achieving normal axial inclination of maxillary anteriors with normal overjet and overbite. Mandibular arch was treated nonextraction due to congenitally missing central incisors with presence of normally inclined lower anteriors thereby maintaining Angles class I occlusion. Tipping, usually, seen in Begg mechanotherapy was used for our advantage to correct severely proclined maxillary anteriors with simultaneous bite opening mechanics. Case was completed in 19 months and posttreatment records including photographs, radiographs and study models were made. Begg wrap around the retainer was placed in the maxillary arch allowing natural settling of occlusion.
LUIS R. IZQUIERDO
Full Text Available Este trabajo compara dos técnicas de modelado de sistemas complejos: la simulación basada en agentes y la dinámica de sistemas. Esta comparación se lleva a cabo dentro del marco general del proceso de modelado científico. Los autores concluyen que la principal diferencia entre las dos metodologías se encuentra en el proceso de abstracción que cada una de ellas realiza para construir el modelo formal a partir del sistema complejo observado. Esta diferencia inicial se extiende a las restantes etapas del proceso de modelado científico. Finalmente, se indican los principales factores y las propiedades generales de un sistema complejo que hacen que una u otra técnica sea más relevante, aunque los autores destacan que, en la mayoría de los casos, modelizar un mismo sistema mediante las dos técnicas es la solución idónea.
López Asunción, Samuel
En este Proyecto Fin de Carrera se ha desarrollado un sistema de acceso inalámbrico seguro a un dispositivo médico implantable, en nuestro caso un marcapasos, mediante un protocolo de acceso Heart-To-Heart. El objetivo es diseñar un sistema capaz de extraer datos de un paciente o reprogramar su dispositivo implantado con un control suficientemente estricto para evitar accesos no autorizados, pero lo suficientemente permisivo cuando ocurran situaciones de emergencia médica. El sistema dispondr...
Restoy, Andrés; Pizarro, Víctor L.; Ordóñez, Vanesa; Lara, Juan; Doussinague, Beatriz R.; Domínguez-Mompell, José Luis
Objetivos: En defectos maxilares con importante componente vertical, es necesaria la reconstrucción del proceso alveolar previamente a la rehabilitación con implantes para evitar una longitud desproporcionada de las coronas protésicas. En este artículo se revisa el tratamiento del maxilar posterior atrófico mediante elevación de seno y técnica de reconstrucción alveolar tridimensional simultánea con autoinjerto óseo. Se utilizó como vía de abordaje un túnel mucoso subperióstico a través de un...
Zhao, Wei-Jie; Hosseini, Mandana; Zhou, Wen-Juan; Xiao, Ting
Restorations of 98 implant-supported single crowns in anterior maxillary area were divided into 5 groups: zirconia abutment, titanium abutment, and gold/gold hue abutment with zirconia coping, respectively, and titanium abutment with metal coping as well as gold/gold hue abutment with metal coping. A reflectance spectrophotometer was used to evaluate the color difference between the implant crowns and contralateral/neighboring teeth, as well as the color difference between the peri-implant soft tissue and the natural marginal mucosa. The mucosal discoloration score was used for subjective evaluation of the esthetic outcome of soft tissue around implant-supported single crowns in the anterior zone, and the crown color match score was used for subjective evaluation of the esthetic outcome of implant-supported restoration. ANOVA analysis was used to compare the differences among groups and Spearman correlation was used to test the relationships. A gold/gold hue abutment with zirconia coping was the best choice for an esthetic crown and the all-ceramic combination was the best for peri-implant soft tissue. Significant correlation was found between the spectrophotometric color difference of peri-implant soft tissue and mucosal discoloration score, while no significant correlation was found between the total spectrophotometric color difference of implant crown and crown color match score. PMID:29349075
Full Text Available Restorations of 98 implant-supported single crowns in anterior maxillary area were divided into 5 groups: zirconia abutment, titanium abutment, and gold/gold hue abutment with zirconia coping, respectively, and titanium abutment with metal coping as well as gold/gold hue abutment with metal coping. A reflectance spectrophotometer was used to evaluate the color difference between the implant crowns and contralateral/neighboring teeth, as well as the color difference between the peri-implant soft tissue and the natural marginal mucosa. The mucosal discoloration score was used for subjective evaluation of the esthetic outcome of soft tissue around implant-supported single crowns in the anterior zone, and the crown color match score was used for subjective evaluation of the esthetic outcome of implant-supported restoration. ANOVA analysis was used to compare the differences among groups and Spearman correlation was used to test the relationships. A gold/gold hue abutment with zirconia coping was the best choice for an esthetic crown and the all-ceramic combination was the best for peri-implant soft tissue. Significant correlation was found between the spectrophotometric color difference of peri-implant soft tissue and mucosal discoloration score, while no significant correlation was found between the total spectrophotometric color difference of implant crown and crown color match score.
Mohan, C S Anand; Harinath, P; Cholan, Priyanka K; Kumar, D Lokesh
One piece mini implants are viable and predictable options to conventional implants in areas of deficit bone width. These can be placed without complex surgical augmentation procedures and are cost effective. Four mini implants were placed in a 40 year old female patient replacing her mobile mandibular anterior teeth. Provisional restoration was given after 2 weeks followed by individual ceramic crowns after 6 months. 5 year follow-up showed aesthetic soft tissue contours and successful osseointegration. One piece mini implants are viable treatment option in the aesthetic management of partial edentulism especially in the mandibular anterior region. How to cite the article: Mohan CS, Harinath P, Cholan PK, Kumar DL . Predictable aesthetic outcome with immediate placement and early loading of one piece mini implant - A 5 year follow-up case report. J Int Oral Health 2014;6(2):132-5.
Karikari, Isaac O; Jain, Deeptee; Owens, Timothy Ryan; Gottfried, Oren; Hodges, Tiffany R; Nimjee, Shahid M; Bagley, Carlos A
Systematic review. To provide a systematic review of published literature on the impact of subsidence on clinical outcomes and radiographic fusion rates after anterior cervical discectomy and fusion with plates or without plates. Subsidence of interbody implants is common after anterior cervical spine fusions. The impact of subsidence on fusion rates and clinical outcomes is unknown. Systematic literature review on published articles on anterior cervical discectomy and fusion, which objectively measured graft subsidence, radiographic fusion rates, and clinical outcomes between April 1966 and December 2010. A total of 35 articles that measured subsidence and provided fusion rates and/or clinical outcomes were selected for inclusion. The mean subsidence rate ranged from 19.3% to 42.5%. The rate of subsidence based on the type of implant ranged from 22.8% to 35.9%. The incidence of subsidence was not impacted by the type of implant (P=0.98). The overall fusion rate of the combined studies was 92.8% and was not impacted by subsidence irrespective of subsidence definition or the measurement technique used (P=0.19). Clinical outcomes were evaluated in 27 of 35 studies with all studies reporting an improvement in patient outcomes postoperatively. Subsidence irrespective of the measurement technique or definition does not appear to have an impact on successful fusion and/or clinical outcomes. A validated definition and standard measurement technique for subsidence is needed to determine the actual incidence of subsidence and its impact on radiographic and clinical outcomes.
Su, Chih-Ying; Alswiahb, Jamil N; Hwang, Chung-Feng; Hsu, Cheng-Ming; Wu, Pei-Yin; Huang, Hsun-Hsien
The conventional method for preventing web formation after anterior glottic web surgery is keel insertion. However, this presents risks of airway compromise and granulation tissue formation, which could necessitate tracheotomy in addition to a secondary procedure for keel removal. We introduce a novel, 1-stage endoscopic laser anterior commissurotomy for preventing anterior glottic web re-formation. Twenty patients with glottic webs involving the anterior commissure were studied. The lesions were removed by transoral carbon dioxide laser microsurgery. In all patients, the anterior glottic web was vaporized along with the inner perichondrium of the thyroid cartilage over the anterior commissure area, creating a raw vertical break "alley" between the anterior vocal folds that measured between 0.3 and 0.5 cm in width and between 0.8 and 2 cm in length. The preoperative and postoperative vocal folds and voice quality were evaluated by videostrobolaryngoscopy and voice recordings. All 20 patients had anterior glottic webs ranging from 11% to 64% of the length from the anterior commissure to the vocal process. None of the patients developed restenosis at the anterior commissure of a severity similar to that of the initial lesion during follow-up (mean, 13 months; range, 3 to 44 months).All patients except 1 reported satisfaction with their voice improvement. Outcome analysis revealed that partial re-formation of the web was noted in 4 patients. One-stage, endoscopic laser anterior commissurotomy was effective and relatively safe for removing glottic webs, for preventing anterior glottic web re-formation, and for improving vocal fold performance among our patients.
Liebmann, J M; Ritch, R
New imaging technologies are revolutionizing the understanding and treatment of a wide variety of ocular disorders. Confocal scanning laser ophthalmoscopy, ultrasound biomicroscopy, confocal scanning laser polarimetry, color doppler imaging of blood flow, and optical coherence tomography are providing important information regarding disease pathophysiology, diagnosis, progression, and treatment. High frequency (50 MHz), high resolution ultrasound biomicroscopy of the anterior segment was obtained in a wide variety of disorders of the anterior segment. Tissue resolution is approximately 50 microns and the penetration depth is 5 mm. Ultrasound biomicroscopy is capable of imaging the comea, iris, anterior chamber, anterior chamber angle, posterior chamber, and ciliary body with great detail. The structures surrounding the posterior chamber, previously hidden from clinical observation, can be imaged and their normal anatomic relationships assessed. The various forms of angle closure glaucoma, such as pupillary block and plateau iris configuration, can be differentiated. The concave iris found in pigment dispersion and its response to treatment can be assessed. Visualization of anterior segment anatomy in eyes with opaque media is possible. Ultrasound biomicroscopy assists in the management of eyes with disorders of the anterior segment. Future applications of this technology will yield important information regarding accommodation, normal ocular physiology and disease pathophysiology.
Fontaine, N; Hemar, P; Schultz, P; Charpiot, A; Debry, C
BAHA implants have been shown to be effective in certain forms of conductive hearing loss, but the presence of the titanium abutment is responsible for sometimes severe skin reactions. The objective of this study was to compare two operative techniques: skin flap, and full-thickness skin graft. Between January 2004 and January 2011, 72 patients were treated by BAHA implant and 32 of these patients (total of 41 implants) were included in the study. Two surgical techniques were used: full-thickness skin graft (n=21) and skin flap (n=20). Four types of skin complications were observed: necrosis, inflammation/infection, hypertrophic scar, and fixture loss due to inadequate osseointegration. Complications requiring surgical revision were observed in 20% of cases with the skin flap method and 38% of cases with the skin graft technique, with no significant difference between the two groups (P=0.31). The skin graft technique appears to be associated with a higher rate of major complications. The most common complication is hypertrophic scar. The apparently high complication rate in this series can be explained by a selection bias (exclusion of a large number of complication-free patients). Copyright © 2013. Published by Elsevier Masson SAS.
Papadopoulos, Moschos A
Orthodontic treatment of patients with Class II malocclusion who show poor compliance with conventional treatment modalities such as extraoral headgear, functional orthopedic appliances, or conventional fixed appliances with intermaxillary elastics, can be challenging. Noncompliance approaches can be used, but they often pose anchorage problems. This article describes the orthodontic treatment of a girl, aged 11.5 years, with a Class II malocclusion, a deep bite, and increased overjet. Initially, an intraoral miniscrew implant supported distalization system (MISDS) was used to distalize the maxillary first molars. Temporary stationary anchorage was provided by 2 miniscrew implants that were placed paramedian in the anterior region of the palate. After distalization, the system was modified slightly by a chair-side procedure and then used to provide the desired stationary anchorage for subsequent anterior tooth retraction in conjunction with conventional full fixed orthodontic appliances. After 18 months of treatment, a Class I molar relationship was achieved, and the deep bite, overjet, posterior intercuspation, and facial esthetics were improved. Biomechanical considerations, clinical efficacy, and the advantages and potential complications of MISDS treatment are discussed. This case report illustrates the use of MISDS to distalize the maxillary molars and retract the anterior teeth, providing noncompliance, nonextraction, and efficient approach for the orthodontic treatment of patients with Class II malocclusion, which is initially invisible.