Success rate and complications associated with dental implants in the incisive canal region: a systematic review.

A systematic review was conducted to evaluate the success rate of dental implants placed in the incisive canal region and the complications related to this procedure. An electronic search was performed in the PubMed, Scopus, and Web of Science databases. Articles reporting the incisive canal deflation technique or neurovascular bundle lateralization technique, with or without concomitant dental implant installation and grafting procedures, were evaluated. Ten articles met the inclusion criteria; only one retrospective study and one longitudinal clinical trial were found. A total of 91 implants were installed in this region, and implant success ranged from 84.6% to 100%. With regard to complications, three articles reported temporary sensory loss. Permanent sensory loss in the palatal mucosa region was reported in one study applying neurovascular bundle lateralization. Five studies were assessed in the quality analysis: four were of moderate quality and one was of low quality. Although a high success rate was described in the selected studies, caution is recommended when dental implants are installed in the incisive canal region due to the low level of evidence available. Regarding complications, there are no parameters for predicting the occurrence of sensory disturbances or the extent of damage with the use of incisive canal deflation or neurovascular bundle lateralization.

[Persistent alpha-vegetative state]. / Estado vegetativo-alfa persistente.

After briefly reviewing the concepts of "coma" and "alpha-coma", we report the case of a patient with presumable Pick's disease who spent several weeks in a vegetative state with a normal and reactive EEG in the alpha range in the later stages of her illness. We (a) emphasize some implications of the appearance of the eyes in such patients, b) stress the importance of distinguishing alpha activity from true alpha rhythm and (c) suggest the category "alpha-coma" should include only those individuals bearing evidence of disorders of the junctional tegmentum of the pons and midbrain. In a complementary way, we propose that patients in a persistent vegetative state displaying normal EEG should be separately classified as persistent "alpha-vegetative state".

Estado vegetativo-alfa persistente / Persistent alpha-vegetative state

Após revisäo sumária dos conceitos de "coma" e "coma-alfa", relatamos o caso de uma paciente com doença de Pick provável que, nos estágios teminais da doença, permaneceu várias semanas em estado vegetativo com EEG de vigília normal e reativo à fotoestimulaçäo. Enfatizamos (a) algumas das implicaçöes do aspecto dos olhos nesses pacientes, (b) a importância de distinguir a atividade alfa do ritmo alfa verdadeiro e (c) sugerimos que a categoria "coma-alfa" inclua apenas aqueles com afecçöes do tegmento da junçäo pontomesencefálica, de qualquer natrueza reservando a designaçäo "estado vegetativo-alfa" persistente para os que se encontrem em estado vegetativo e exibam EEG em virgília idêntico ao normal