Interproximal contact loss between implant-supported restorations and adjacent natural teeth: A retrospective cross-sectional study of 83 restorations with an up to 10-year follow-up.

STATEMENT OF PROBLEM: Interproximal contact loss between implant-supported restorations and adjacent natural teeth is a frequently encountered complication that could negatively affect surrounding tissues and/or patient satisfaction with treatment. The effect of interproximal contact loss on peri-implant tissue health and patient awareness of food impaction is currently unknown. PURPOSE: The purpose of this retrospective cross-sectional study was to explore the effect of interproximal contact loss on peri-implant tissue health and determine whether interproximal contact loss leads to increased patient awareness of food impaction around the affected area. This study also aimed to identify whether specific patient or local factors could cause interproximal contact loss. MATERIAL AND METHODS: Eighty-three participants with posterior single-unit implant-supported restorations were examined. The mean follow-up time after prosthesis insertion was 4 ±2.2 years (range 4 months to 10.6 years). Interproximal contacts were evaluated by using waxed dental floss. Patient age, sex, implant location, opposing tooth status, presence of endodontically treated adjacent tooth, and regular use of an occlusal device at night were recorded. Peri-implant probing depths and the presence of bleeding on probing were also recorded. Each participant was asked to indicate whether they had noticed increased food impaction around their implant-supported restoration. Statistical analysis included nonparametric Mann-Whitney U tests, the Spearman rank-order correlation, the Pearson chi-squared tests, and the paired t test (α=.05). RESULTS: Among all examined mesial contacts, 34.1% were recorded as open, with an overall mesial interproximal contact loss (open and loose contacts combined) incidence of 48.8%. Restorations placed in premolar sites exhibited significantly tighter mesial interproximal contacts compared with those placed in molar sites (U=566, P=.041). A significant negative correlation was found between follow-up time after insertion and mesial contact tightness (rs=-0.226, P=.041). CONCLUSIONS: Interproximal contact loss appears to increase over time, with more surfaces being affected after longer periods of service. This study did not find an association between interproximal contact loss and peri-implant inflammation as measured by bleeding on probing, with the exception of the distolingual implant surface. Participants with interproximal contact loss were more aware of food impaction around their implant crown. Use of an occlusal device at night did not prevent interproximal contact loss.

Clinical and Patient-Reported Outcomes of Single Posterior Implant-Supported Restorations Completed by Predoctoral Students: A Retrospective Study with Up to 10 Years of Follow Up.

PURPOSE: To assess clinical outcomes of screw-retained implant-supported restorations as well as patient satisfaction and Oral Health-related Quality of Life (OHQoL), when treatment is performed in an academic setting by supervised predoctoral students. MATERIALS AND METHODS: Ninety patients (n = 129 restorations) consented to participate in the study. The mean follow-up period was 4.2 years (range: 4 months to 10.6 years) after crown insertion. All patients filled out a modified Oral Health Impact Profile questionnaire, consisting of 14 questions (OHIP-14). A comprehensive examination of the implant-supported restoration was completed and restorative complications were recorded. Statistical analysis was performed using SPSS (IBM SPSS Statistics, v25; IBM Corp). Restoration survival rates were calculated using Kaplan-Meier survival analysis. RESULTS: The most frequent complication was loss of the mesial interproximal contact (32.2%). The overall restoration survival and success rates were 93.8% and 74.4%, respectively. The majority of patients (95.6%) reported high satisfaction with their decision to get implant treatment in the predoctoral clinic. CONCLUSIONS: In the context of this study, clinical and patient-based outcomes of implant treatment rendered in an academic setting are favorable and comparable to those reported in the literature for restorations completed by experienced dentists.

"Mirror, Mirror on the Wall" Pediatric liver transplantation in the case of situs inversus totalis with a disrupted inferior vena cava.

We present the unique case of a 15-month-old male born with biliary atresia and situs inversus totalis and disrupted inferior vena cava who underwent a successful liver transplantation. The patient had previously undergone a failed Kasai procedure and presented with persistent hyperbilirubinemia. The patient was transplanted with a left lateral segment donor having standard arterial anatomy. Technical considerations included identifying completely replaced arterial anatomy in the recipient from the superior mesenteric artery and creating a branch patch between the gastroduodenal artery and HA, anastomosing the donor left hepatic vein to confluences of the donor left, middle, and right hepatic veins, using a "lazy-S" configuration of portal vein anastomosis, and suspending the allograft to the abdominal wall. Post-operatively, his liver function tests and total bilirubin normalized and he progressed to tolerating an oral diet with tube-feed supplementation.