Digital workflow for image-guided immediate implant placement by using the socket-shield technique and custom abutment in the esthetic area.

Marginal bone loss around immediately placed implants may compromise esthetic outcomes in the anterior maxilla. The relatively recent socket-shield technique of partial extraction therapy has been described as being useful to maintain the structure of peri-implant tissues. The present technique report introduced a digital workflow to perform image-guided implant placement after partial extraction therapy. In this technique, digital 3-dimensional images are used to plan and orient the flapless surgical procedure and to digitally design a custom abutment based on the natural emergence profile as segmented from the tooth to be extracted.

Fully Digital Workflow with Magnetically Connected Guides for Full-Arch Implant Rehabilitation Following Guided Alveolar Ridge Reduction.

This technique report describes a fully digital workflow in which two surgical guides (i.e. one for alveolar bone reduction and the other for implant placement) are magnetically connected to ensure stability during full-arch implant surgery following guided bone reduction. Digital prosthesis design as well as virtual bone reduction and implant planning are developed from the superimposition of facial, intraoral and CBCT scans. With this technique, different surgical guides and interim poly(methylmethacrylate) (PMMA) fixed prosthesis are precisely connected with magnets after being digitally designed and 3D-printed. As a result, such magnetic connection allows for satisfactory stability of the implant surgical guide, as well as of the interim fixed PMMA fixed prosthesis during capture of screw-retained abutments.

Impacto del proceso enseñanza-aprendizaje sobre la calidad del laboratorio clínico en la Misión Barrio / Adentro Impact of the teaching-learning process on the clinical laboratory quality in Barrio Adentro Mission

Se realizó un estudio descriptivo y longitudinal para medir el impacto del proceso de enseñanza-aprendizaje de la Licenciatura en Laboratorio Clínico sobre la calidad de los servicios brindados en 49 laboratorios clínicos durante el 2008. Se compararon indicadores en 2 momentos a través de una lista de observación, entrevistas a pacientes e informe del control de calidad externo, estimados en valores promedios. De 16 indicadores, 15 mejoraron. En todos los laboratorios se efectuaron el control interno de la calidad, el control de reproducibilidad, la confirmación de los exámenes patológicos y el uso correcto de las unidades de medida en la indicación médica. El control externo de la calidad fue mejorando progresivamente durante todo el año y dando muestras de mayor confiabilidad, mejor estandarización de los métodos y diferencias menores entre los resultados interlaboratorios. Se confirmó que el proceso de enseñanza-aprendizaje estaba directamente relacionado con el mejoramiento de la calidad en los laboratorios clínicos del estado de Zulia en la Misión Barrio Adentro.

A descriptive and longitudinal study was conducted to evaluate the impact of the teaching-learning process of the First Degree of Clinical Laboratory on the quality of the services rendered in 49 clinical laboratories during 2008. Indicators were compared in 2 moments through an observation list, interviews to patients and report of the external control of quality estimated in average values. Out of 16 indicators, 15 improved. In all laboratories the internal control of the quality, control of reproducibility, confirmation of pathological examinations and the correct use of measurement units in the medical prescription were made. The external control of the quality was improving progressively all the year round and yielding more reliability, better standardization of methods and littler differences among the results of laboratories. It was confirmed that the teaching-learning process was directly related to the improvement of the quality in clinical laboratories of the Zulia state in the Barrio Adentro Mission.

Dilemas éticos en la Sífilis / Ethical dilemmas in syphilis

Se realizó una actualizada revisión de la sífilis y los dilemas éticos que frecuentemente encontramos al tratar este tipo de enfermo, se analizaron algunos ejemplos muy frecuentes en la práctica médica en general y dermatológica en particular. Destacándose como principales problemas éticos, la confidencialidad, el secreto médico y la autonomía del enfermo.(AU)