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1.
Eur J Prosthodont Restor Dent ; 32(2): 234-242, 2024 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-38373222

RESUMEN

INTRODUCTION: Bulk-fill composites may simplify posterior restorations, saving time and reducing technical complexity. Post-operative sensitivity is a risk of posterior composites; bulk-fill composites could mitigate this. This single centre, double-blinded, parallel groups randomised controlled trial compared postoperative sensitivity following restoration of class II carious lesions with bulk-fill or conventional, layered composite. NULL HYPOTHESIS: there will be no difference in post-operative sensitivity between the two materials. METHODS: Participants requiring class II restoration of posterior teeth were randomised to bulk-fill (FU) (Coltene Fill-UpTM) or conventional, layered (BE) (Coltene Brilliant Everglow) composite. Allocation was concealed during cavity preparation. Only the operating dentist knew allocation. The outcome was 24 h post-operative sensitivity. RESULTS: 41 patients were randomised (20/group). Two patients from FU group were excluded from analysis (factors unrelated to intervention). There was no difference in postoperative sensitivity at 24 h nor any time point. Only participant age and baseline sensitivity scores significantly impacted post-operative sensitivity. One restoration debonded in FU group at 10 days, with no other adverse effects. No difference in time taken to place restorations was seen. CONCLUSIONS: Within the study's limitations, post-operative sensitivity after class II posterior restorations was no different in bulk-fill restorations compared with conventional, incrementally cured composite.


Asunto(s)
Resinas Compuestas , Restauración Dental Permanente , Sensibilidad de la Dentina , Humanos , Sensibilidad de la Dentina/etiología , Sensibilidad de la Dentina/prevención & control , Restauración Dental Permanente/métodos , Femenino , Masculino , Adulto , Método Doble Ciego , Persona de Mediana Edad , Complicaciones Posoperatorias , Caries Dental/terapia
2.
Scand J Trauma Resusc Emerg Med ; 31(1): 100, 2023 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-38093335

RESUMEN

INTRODUCTION: Survival from refractory out of hospital cardiac arrest (OHCA) without timely return of spontaneous circulation (ROSC) utilising conventional advanced cardiac life support (ACLS) therapies is dismal. CHEER3 was a safety and feasibility study of pre-hospital deployed extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) for refractory OHCA in metropolitan Australia. METHODS: This was a single jurisdiction, single-arm feasibility study. Physicians, with pre-existing ECMO expertise, responded to witnessed OHCA, age < 65 yrs, within 30 min driving-time, using an ECMO equipped rapid response vehicle. If pre-hospital ECPR was undertaken, patients were transported to hospital for investigations and therapies including emergent coronary catheterisation, and standard intensive care (ICU) therapy until either cardiac and neurological recovery or palliation occurred. Analyses were descriptive. RESULTS: From February 2020 to May 2023, over 117 days, the team responded to 709 "potential cardiac arrest" emergency calls. 358 were confirmed OHCA. Time from emergency call to scene arrival was 27 min (15-37 min). 10 patients fulfilled the pre-defined inclusion criteria and all were successfully cannulated on scene. Time from emergency call to ECMO initiation was 50 min (35-62 min). Time from decision to ECMO support was 16 min (11-26 min). CPR duration was 46 min (32-62 min). All 10 patients were transferred to hospital for investigations and therapy. 4 patients (40%) survived to hospital discharge neurologically intact (CPC 1/2). CONCLUSION: Pre-hospital ECPR was feasible, using an experienced ECMO team from a single-centre. Overall survival was promising in this highly selected group. Further prospective studies are now warranted.


Asunto(s)
Reanimación Cardiopulmonar , Paro Cardíaco Extrahospitalario , Humanos , Anciano , Estudios Prospectivos , Estudios de Factibilidad , Australia , Paro Cardíaco Extrahospitalario/terapia , Hospitales , Reperfusión , Estudios Retrospectivos
3.
Asian J Transfus Sci ; 17(2): 256-263, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38274958

RESUMEN

The International Society of Blood Transfusion (ISBT) 128 is an internationally endorsed, electronically readable labeling standard that provides a convenient and accurate means of identification, traceability, publication, and storage of information for blood and blood products. The authors' center recently registered with the International Council for Commonality in Blood Banking Automation (ICCBBA) and progressed to ISBT 128 labeling standard. This manuscript was written with the objective of sharing the authors' experience with respect to the implementation of ISBT 128 standards for whole blood donations and integration of ISBT 128 standards with Indian licensing regulations. The authors explore the process of implementation of ISBT 128 standards through a step-by-step journey that included facility registration with International Council for Commonality in Blood Banking Automation (ICCBBA), allotment of facility identification number, development of four-quadrant label for blood components, and integration of local regulatory requirements in the final "composite" label. Acknowledging the lack of any published report from India on ISBT 128 standards implementation, the authors wish to attempt help their peers in understanding and implementation of this global standard at their respective facilities.

4.
Br J Oral Maxillofac Surg ; 58(8): 1003-1007, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32474015

RESUMEN

Oral rehabilitation after treatment for head and neck cancer can be challenging. Implant-supported rehabilitation can considerably improve oral health-related quality of life, but there is a dearth of contemporary evidence of reported outcomes and trends in this cohort. In this study we retrospectively investigated the outcomes of 115 patients (376 dental implants) with a mean (range) follow up of 3.91(0.11-12.76) years. We considered survival of the implants, percentage of those used for prosthetic rehabilitation, time from diagnosis to placement and restoration, additional operations involving soft-tissue revision, and the effects of radiotherapy, chemotherapy, and reconstructive flaps on these outcomes. Implant survival was 97%. A total of 32% of patients had radiotherapy with a mean dose of 61Gy. A total of 94% of cases were restored with all the implants placed. Computed coefficients from a multinomial logistic regression model suggested that a trend towards radiotherapy, implant placement in the graft, and placement in the maxilla had a negative influence on success, but this was not significant (p>0.05). The placement of implants in a reconstructive flap was strongly associated with the need for soft tissue revision. The approach used (placement during primary cancer resection or after) significantly influenced the time to placement and restoration (p=0.016). These data suggest a local trend towards earlier placement of implants (during primary cancer resection) resulting in earlier restorative rehabilitation. Outcome data show that the survival of implants is comparable to that in non-oncological cases, and that radiotherapy and location of the implant have less influence on implant survival than previous studies have suggested.


Asunto(s)
Implantes Dentales , Calidad de Vida , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Maxilar/cirugía , Estudios Retrospectivos , Colgajos Quirúrgicos , Resultado del Tratamiento
5.
Br J Oral Maxillofac Surg ; 57(5): 442-448, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31010597

RESUMEN

Botulinum toxin injections are useful in patients with refractory sialorrhoea although the optimum treatment protocol and its efficacy over a long period of follow up are controversial. The aim of our prospective study was to examine the efficacy and complications of a protocol of repeated ultrasound-guided botulinum toxin injections of fixed doses at a tertiary children's hospital. A total of 79 procedures were done in 34 patients who were followed up for two years. The overall complication rate was 3%. The outcome measures considered included the Drooling Frequency Severity Scale (DFSS), visual analogue scale (VAS), and carers' assessments of the reduction in drooling. Our study highlighted two types on non-responders (primary and secondary) of which 3/34 required definitive surgical management. In summary, this study shows that a protocol of repeated injections of fixed doses of botulinum toxin A, while not beneficial in all cases, is a potentially valuable option for the safe and effective treatment of sialorrhoea in children.


Asunto(s)
Toxinas Botulínicas Tipo A/administración & dosificación , Fármacos Neuromusculares/administración & dosificación , Glándula Parótida , Sialorrea/tratamiento farmacológico , Glándula Submandibular , Toxinas Botulínicas Tipo A/uso terapéutico , Niño , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Inyecciones , Masculino , Fármacos Neuromusculares/uso terapéutico , Estudios Prospectivos , Sialorrea/etiología , Resultado del Tratamiento , Ultrasonografía Intervencional
6.
Eur J Prosthodont Restor Dent ; 26(4): 184-189, 2018 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-30398317

RESUMEN

Head and neck oncology patients are high risk for ingestion or aspiration of dental instruments during treatment, due to altered anatomy and sensation. This article describes a case report of accidental ingestion of an implant screwdriver during the prosthetic phase of oral rehabilitation of a 79 year old oncology patient. The management protocol is described which included referral to the medical Accident and Emergency department, where the object was safely removed from the stomach via endoscopy. A review of similar cases of ingestion/inhalation in the literature suggests implant screwdrivers should be retrieved as safe passage through the gastrointestinal system is not assured. Awareness of the medical history and risk factors should alert clinicians to be extra cautious, and preventative strategies should be implemented at all times. Preventative measures include ligation of instruments with floss/suture material, treatment in a more vertical position, and use of rubber dam where possible.


Asunto(s)
Implantes Dentales , Cuerpos Extraños , Anciano , Implantes Dentales/efectos adversos , Instrumentos Dentales , Neoplasias de Cabeza y Cuello , Humanos , Dique de Goma
7.
Br Dent J ; 224(4): 247-254, 2018 02 23.
Artículo en Inglés | MEDLINE | ID: mdl-29472688

RESUMEN

Background Several guidelines have been published advocating the use of regenerative endodontic therapy (RET) in managing non-vital immature permanent teeth. It is unclear, however, how many UK paediatric dental specialists routinely use this technique and their opinion of its outcomes, and barriers to its use.Aim To assess the knowledge, experience and the opinion of UK based paediatric dental specialists/trainees (UKPDS/T) and practitioners working in the capacity of paediatric dental specialists on the use of RET.Design A cross-sectional study using a 22-item questionnaire was developed using the Bristol Online Survey tool and circulated electronically to members of the British Society of Paediatric Dentistry between August and November 2016.Results Ninety-eight UKPDS/T completed the survey. A quarter of respondents (N = 24, 24.5%) reported using RET. Reasons cited for not using RET included lack of: training (N = 48, 45%), materials (N = 28, 26%), evidence (N = 17, 16%) and suitable cases (N = 6, 6%). Different protocols in terms of disinfection, medicaments, scaffolds, and obturation material were identified.Conclusions This survey highlights a low uptake of RET by current UKPDS and trainees with several barriers identified. Deviations from the current RET guidelines were identified. Recommendations addressing the use of RET in light of the findings of this survey were made.


Asunto(s)
Odontólogos/estadística & datos numéricos , Pautas de la Práctica en Odontología/estadística & datos numéricos , Endodoncia Regenerativa/estadística & datos numéricos , Diente no Vital/cirugía , Niño , Estudios Transversales , Humanos , Encuestas y Cuestionarios , Reino Unido
8.
Br Dent J ; 222(5): 337-344, 2017 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-28281590

RESUMEN

Resin-based composite (RBC) materials are increasingly being used for the restoration of posterior teeth. The increasing demand for aesthetic, tooth-coloured restorations coupled with the patient's concerns regarding the use of mercury containing restorations, has driven a surge in the use of RBC materials. With the Minamata Convention in 2013 calling for the phase-out of dental amalgam and dental schools increasingly teaching techniques for RBC restorations in posterior teeth, it is likely that the dental profession's reliance upon RBC for the restoration of posterior teeth will only increase. In order to simplify and speed-up the placement of large posterior RBCs, manufacturers have produced a range of materials which can be placed in single or deeper increments, known as bulk-fill RBCs. Over a relatively short period of time many bulk-fill RBCs have been marketed quoting increment depths between 4-10 mm. The placement of these larger increments of RBC may reduce the time needed when placing posterior restorations and thereby reduce technique sensitivity. This article aims to review the properties and handling characteristics of the bulk-fill RBC materials currently available, while advising the optimal techniques of placement.


Asunto(s)
Resinas Compuestas , Restauración Dental Permanente , Restauración Dental Permanente/métodos , Humanos
9.
Br Dent J ; 218(2): 65-8, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25613260

RESUMEN

The incidence of head and neck cancer is on the rise. Most head and neck cancers are treated with surgery, radiotherapy, chemotherapy or a combination of these modalities. Patients undergoing radiotherapy can experience several unwanted oral side effects, which have both short and long term implications. Dental general practitioners should be aware of these implications and should liaise closely with the restorative consultants and the oncology team to establish the best oral care pathway. This two-part series is a review of the oral changes that occur during and after radiotherapy and the oral management of head and neck oncology before, during and after radiotherapy. This article deals with both immediate sequelae such as cellulitis, mucositis, dysphagia, dysguesia and weight loss as well as long term sequelae such as rampant caries, trismus, xerostomia and osteoradionecrosis. It also encompasses the importance and need for pre-radiotherapy assessment.


Asunto(s)
Atención Odontológica/métodos , Neoplasias de Cabeza y Cuello/radioterapia , Restauración Dental Permanente/métodos , Neoplasias de Cabeza y Cuello/complicaciones , Humanos , Enfermedades de la Boca/etiología , Enfermedades de la Boca/terapia , Traumatismos por Radiación/diagnóstico , Extracción Dental/métodos
10.
Br Dent J ; 218(2): 69-74, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25613261

RESUMEN

The incidence of head and neck cancer is on the rise. Radiation therapy is one of the major treatment modalities for the management of oral malignancies. As with any treatment modality, radiation therapy is associated with various complications. The second part of this series is a review of the oral changes that occur during and after radiotherapy and the oral management of head and neck oncology patients before, during and after radiotherapy. Dental practitioners will encounter patients who have been affected by cancer or who are current cancer patents. General dental practitioners (GDPs) have a vital and proactive role in supporting such patients. The aim of this article is to review the oral management of these patients during and after radiotherapy, and gives practical advice for GDPs and their teams in the long-term care of these patients.


Asunto(s)
Atención Odontológica/métodos , Neoplasias de Cabeza y Cuello/radioterapia , Neoplasias de Cabeza y Cuello/complicaciones , Humanos , Enfermedades de la Boca/etiología , Enfermedades de la Boca/terapia , Odontología Preventiva , Traumatismos por Radiación/etiología , Trismo/etiología , Trismo/terapia , Xerostomía/etiología , Xerostomía/terapia
11.
Br J Radiol ; 87(1044): 20130571, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25247346

RESUMEN

The objective of this review is to perform a systematic review of ultrasound-guided fine-needle aspiration (FNA) services for head and neck lesions with assessment of inadequacy rates and related variables such as the presence of immediate cytological assessment. A computer-based systematic search of articles in English language was performed using MEDLINE (1950 to date) from National Health Service evidence healthcare database and PubMed. Full texts of all relevant articles were obtained and scrutinized independently by two authors according to the stated inclusion and exclusion criteria. The primary search identified 932 articles, but only 78 met all the study criteria. The overall inadequacy rate was 9.3%, 16 studies had on-site evaluation by a cytopathologist/specialist clinician with a rate of 6.0%. In seven studies, a cytotechnician was available to either assess the sample or prepare the slides with an average inadequacy rate of 11.4%. In 1 study, the assessment was unclear, but the inadequacy rate for the remaining 54 studies, without immediate assessment, was 10.3%. The rate for the cytopathologist/specialist clinicians was significantly different to no on-site assessment but this was not found for assessment by cytotechnicians. The review suggests that the best results are obtained with a cytopathologist-led FNA service, where the pathologist reviews the specimen immediately, in relation to the clinical context, thereby deciding on adequacy and need for further biopsies. A systematic review looking at ultrasound-guided FNA of head and neck lesions has not been published previously.


Asunto(s)
Biopsia con Aguja Fina/métodos , Neoplasias de Cabeza y Cuello/patología , Biopsia Guiada por Imagen/métodos , Técnicas Citológicas , Humanos , Reproducibilidad de los Resultados
12.
Br Dent J ; 217(6): E11, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25257015

RESUMEN

BACKGROUND: Gold alloy has long been used in dentistry for the fabrication of cast restorations due to its material and clinical properties and known excellent longevity over long-term follow-up. The cost of gold has increased dramatically in recent years (by 450% in the past ten years). The use of base metal alloys as an alternative would lead to a considerable cost saving: a cobalt chromium alloy is around 98% cheaper than gold alloy at the time of writing. NHS regulations state which alloys are permissible for use in cast restorations in dentistry, and certain 'non-precious gold' alloys should not be used. MATERIALS AND METHODS: A prospective audit was carried out in our unit into the standard of cast restorations in cobalt-chromium alloy. The standard set before the audit was established by a prior audit of gold alloy restorations with measures of clinical and technical factors. RESULTS: Base-metal alloy restorations were considerably cheaper; but were of a poorer clinical standard than gold-alloy and required more frequent adjustment and remake (17% compared to 5%).


Asunto(s)
Auditoría Odontológica , Restauración Dental Permanente , Metales , Materiales Biocompatibles , Medicina Estatal , Reino Unido
13.
J Perinatol ; 33(10): 806-10, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23788368

RESUMEN

OBJECTIVE: To compare asthma history and pulmonary function in adolescents born prematurely with very low birth weight with and without antenatal steroid exposure. STUDY DESIGN: We studied 188 fourteen-year olds (94 exposed, 84 male). We used parent report to ascertain asthma and asthma-related symptoms and spirometry to assess pulmonary function. Steroid-exposed and -unexposed groups were compared using Mann-Whitney U-tests (continuous variables), χ(2) analysis (categorical variables) and logistic regression (multivariate analyses). RESULT: The steroid-exposed group had greater prevalence of larger airway obstruction (35% vs 21%), and steroid-exposed adolescents with birth weights <1000 g had 4.5-fold higher odds of larger airway obstruction. Wheezing in the past 12 months was two times as prevalent in steroid-exposed adolescents with birth weights between 1000 and 1500 g. CONCLUSION: Antenatal steroid exposure does not provide long-term benefits for pulmonary outcomes in adolescents born prematurely with very low birth weight in the era of surfactant therapy.


Asunto(s)
Asma/epidemiología , Madurez de los Órganos Fetales/efectos de los fármacos , Glucocorticoides/farmacología , Recién Nacido de muy Bajo Peso , Pulmón/embriología , Efectos Tardíos de la Exposición Prenatal/fisiopatología , Adolescente , Asma/etiología , Estudios de Cohortes , Femenino , Glucocorticoides/uso terapéutico , Humanos , Recien Nacido Prematuro , Pulmón/efectos de los fármacos , Pulmón/fisiopatología , Análisis Multivariante , Embarazo , Pruebas de Función Respiratoria
14.
Philos Trans R Soc Lond B Biol Sci ; 367(1608): 3444-54, 2012 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-23148271

RESUMEN

Photosystem II (PSII) mutants are useful experimental tools to trap potential intermediates involved in the assembly of the oxygen-evolving PSII complex. Here, we focus on the subunit composition of the RC47 assembly complex that accumulates in a psbC null mutant of the cyanobacterium Synechocystis sp. PCC 6803 unable to make the CP43 apopolypeptide. By using native gel electrophoresis, we showed that RC47 is heterogeneous and mainly found as a monomer of 220 kDa. RC47 complexes co-purify with small Cab-like proteins (ScpC and/or ScpD) and with Psb28 and its homologue Psb28-2. Analysis of isolated His-tagged RC47 indicated the presence of D1, D2, the CP47 apopolypeptide, plus nine of the 13 low-molecular-mass (LMM) subunits found in the PSII holoenzyme, including PsbL, PsbM and PsbT, which lie at the interface between the two momomers in the dimeric holoenzyme. Not detected were the LMM subunits (PsbK, PsbZ, Psb30 and PsbJ) located in the vicinity of CP43 in the holoenzyme. The photochemical activity of isolated RC47-His complexes, including the rate of reduction of P680(+), was similar to that of PSII complexes lacking the Mn(4)CaO(5) cluster. The implications of our results for the assembly and repair of PSII in vivo are discussed.


Asunto(s)
Proteínas Bacterianas/metabolismo , Genes Bacterianos , Complejos de Proteína Captadores de Luz/metabolismo , Complejo de Proteína del Fotosistema II/metabolismo , Synechocystis/metabolismo , Proteínas Bacterianas/genética , Proteínas Bacterianas/aislamiento & purificación , Transporte de Electrón , Electroforesis en Gel de Poliacrilamida , Eliminación de Gen , Holoenzimas/genética , Holoenzimas/metabolismo , Complejos de Proteína Captadores de Luz/genética , Complejos de Proteína Captadores de Luz/aislamiento & purificación , Proteínas de la Membrana/genética , Proteínas de la Membrana/metabolismo , Peso Molecular , Oxidación-Reducción , Oxígeno/metabolismo , Procesos Fotoquímicos , Complejo de Proteína del Fotosistema II/genética , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Unión Proteica , Mapeo de Interacción de Proteínas , Estabilidad Proteica , Transporte de Proteínas , Synechocystis/genética , Tilacoides/metabolismo
15.
Br Dent J ; 211(7): 315-9, 2011 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-21979345

RESUMEN

This paper is the second in a three part series looking at the aetiology and management of gingival recession. Part one discussed the aetiology and non-surgical management and this part aims to discuss the use of pedicle soft tissue grafts in the treatment of gingival recession. This article also considers the factors affecting the outcome of surgical procedures used to treat localised recession defects. The third paper in this series will consider the use of free soft tissue grafts and guided tissue regeneration.


Asunto(s)
Recesión Gingival/cirugía , Gingivoplastia/métodos , Colgajos Quirúrgicos , Contraindicaciones , Humanos , Higiene Bucal , Factores de Riesgo , Fumar , Resultado del Tratamiento
16.
Br Dent J ; 211(8): 353-8, 2011 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-22015511

RESUMEN

This paper is the third in a three part series looking at the aetiology and management of gingival recession. Part 1 in this series discussed the aetiology of gingival recession and the non-surgical management. Part 2 discussed in detail the factors affecting the outcome of periodontal surgery and the use of pedicle flaps. This paper aims to discuss the surgical options available to correct localised recession defects using free grafts and guided tissue regeneration.


Asunto(s)
Encía/trasplante , Recesión Gingival/cirugía , Regeneración Tisular Guiada Periodontal/métodos , Implantes Absorbibles , Colágeno/uso terapéutico , Tejido Conectivo/trasplante , Epitelio/trasplante , Gingivoplastia/métodos , Humanos , Membranas Artificiales , Pronóstico , Colgajos Quirúrgicos , Técnicas de Sutura , Recolección de Tejidos y Órganos/métodos , Raíz del Diente/cirugía , Trasplante Heterólogo , Trasplante Homólogo , Resultado del Tratamiento
17.
Br Dent J ; 211(6): 251-4, 2011 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-21941318

RESUMEN

Gingival recession is a common finding in many patients. Some patients will not be concerned whereas others will have aesthetic concerns or complain of sensitivity. This paper highlights the aetiology of gingival recession, the treatment options available to treat any associated sensitivity and the non-surgical treatment options available to restore aesthetics in patients with gingival recession. Subsequent papers in this series discuss the surgical treatment options available to correct localised recession defects.


Asunto(s)
Recubrimiento Dental Adhesivo/métodos , Diseño de Prótesis Dental , Encía , Recesión Gingival/terapia , Prótesis Periodontal , Porcelana Dental , Recubrimientos Dentinarios/uso terapéutico , Estética Dental , Recesión Gingival/clasificación , Recesión Gingival/etiología , Humanos
18.
Br Dent J ; 211(3): 113-8, 2011 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-21836574

RESUMEN

Resin bonded bridges are a minimally invasive option for replacing missing teeth. Although they were first described over 30 years ago, evidence regarding their longevity remains limited and these restorations have developed an undeserved reputation for failure. This article provides a brief review of the literature regarding bridge success and continues to highlight aspects of case selection, bridge design and clinical procedure which may improve outcome.


Asunto(s)
Recubrimiento Dental Adhesivo/métodos , Diseño de Dentadura , Retención de Dentadura/métodos , Dentadura Parcial Fija con Resina Consolidada , Arcada Parcialmente Edéntula/rehabilitación , Fracaso de la Restauración Dental , Estética Dental , Humanos
19.
Dentomaxillofac Radiol ; 40(2): 130-2, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-21239578

RESUMEN

A 16-year-old female presented with a sinus on the skin just medial to the right clavicle, which had discharged clear fluid on a daily basis for a number of years. A sinogram was performed and showed a long sinus tract extending from the region of the right clavicle to the lateral pharyngeal wall. Surgical treatment would have required an extensive procedure and seemed inappropriate in view of the relatively mild symptoms the patient was experiencing. Instead sclerotherapy was used to induce healing of the lesion. This was performed using 3% sodium tetradecyl sulphate foam delivered via a catheter along the entire length of the tract. There were no immediate complications from this procedure and on review at 1 and 6 weeks post-procedure the patient reported a significant improvement in the fluid discharge. At 1 year post-procedure this improvement had been sustained. The patient did report an occasional discharge from the sinus tract orifice at the base of her neck, but she did not feel that this was a significant problem and declined any further treatment.


Asunto(s)
Branquioma/terapia , Fístula Cutánea/terapia , Escleroterapia/métodos , Adolescente , Branquioma/diagnóstico por imagen , Femenino , Humanos , Radiografía , Soluciones Esclerosantes/uso terapéutico , Tetradecil Sulfato de Sodio/uso terapéutico
20.
Ann R Coll Surg Engl ; 92(8): 660-4, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20663278

RESUMEN

INTRODUCTION: In the National Institute for Health and Clinical Excellence (NICE) guidance on cancer services published in 2004, it was recommended that specialist clinics should be set up for the assessment of patients with neck lumps, structured in a similar way to one-stop breast lump clinics with a cytopathologist present and preferably ultrasound guidance. The aim of this study was to audit the performance of ultrasound-guided fine needle aspiration (FNA) with on-site cytology in a one-stop neck lump clinic at The Royal Liverpool University Hospital. PATIENTS AND METHODS: Data were collected between November 2008 and May 2009 (7 months). Details of the adequacy rate for the FNA were recorded and whether multiple passes were required. The likely adequacy rate if ultrasound guidance was not available was also calculated. RESULTS: A total of 274 patients were included in the audit. Of these, 227 (83%) patients required a single pass for adequate diagnostic material. Of the remaining, 45 (16%) required two passes and 2 (1%) required three passes. The overall sample inadequacy rate was 11 of 274 (4%). From these results, it could be predicted that, if immediate cytological evaluation was unavailable, the inadequacy rate would have been 41 of 274 (15%). CONCLUSIONS: This audit has illustrated the benefits of a one-stop clinic with on-site cytology in providing a rapid diagnostic head and neck cancer service.


Asunto(s)
Neoplasias de Cabeza y Cuello/patología , Servicio Ambulatorio en Hospital/organización & administración , Biopsia con Aguja Fina/métodos , Biopsia con Aguja Fina/normas , Diagnóstico Precoz , Inglaterra , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Auditoría Médica , Servicio Ambulatorio en Hospital/normas , Estudios Retrospectivos , Ultrasonografía Intervencional
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