Risk Factors Associated With Complication Rates of Becker-Type Expander Implants in Relation to Implant Survival: Review of 314 Implants in 237 Patients.

Although autologous tissue reconstruction is the best option for breast reconstruction, using implants is still a reliable and simple method, offering acceptable aesthetic results. Becker-type implants are permanent implants that offer a 1-stage reconstructive option. A retrospective study was carried out in our center reviewing the clinical reports of 237 patients, in whom a total of 314 Becker-type prostheses were implanted. Overall survival was calculated using a Kaplan-Meier estimate. Cox proportional hazard models were used to calculate adjusted hazard ratios. At the end of the study, 214 expanders (68.15%) presented no complications, 40 (12.47%) developed significant capsular contracture, in 27 (8.60%) infection occurred, 24 (7.64%) suffered minor complications, and 9 (2.87%) ruptured. The mean survival time of the expanders was 120.41 months (95% CI: 109.62, 131.19). Radiotherapy, chemotherapy, high Molecular Immunology Borstel, age, mastectomy performed previously to the implant, ductal carcinoma, advanced tumoral stage, experience of the surgeon, and Becker 35-type implants were significantly related to a high number of complications in relation to the survival of the implants. Cox regression analysis revealed that the main risk factors for the survival of expander implants included radiotherapy and surgeon experience. The complication hazard ratio or relative risk caused by these 2 factors was 1.976 and 1.680, respectively. One-stage reconstruction using Becker-type expanders is an appropriate, simple, and reliable option in delayed breast reconstruction in patients who have not received radiotherapy and as long as the procedure is carried out by surgeons skilled in the technique.

Comparative study of root canals instrumented manually and mechanically, with and without Er:YAG laser.

OBJECTIVE: The aim of this study was to compare the scanning electron microscopic (SEM) morphology of root canal walls instrumented manually and mechanically with and without the application of Er:YAG laser. METHODS: Single-rooted, human, extracted teeth were cut at the cementoenamel junction. The teeth were divided into four groups: teeth that were simply instrumented manually, those that were instrumented manually and laser treated, a group that was mechanically instrumented, and a fourth in which the teeth were mechanically instrumented and laser treated. After instrumentation, the teeth were split longitudinally to facilitate their evaluation by SEM. RESULTS: The results show that the use of the Er:YAG laser is effective in removing the smear layer from root canal walls. CONCLUSIONS: The removal of the smear layer is essential to the success of endodontic treatment; the use of the Er:YAG laser combined with rotary and manual techniques improves the cleanliness of root canals.

A comparative study of microleakage through enamel and cementum after laser Er:YAG instrumentation in class V cavity obturations, using scanning electron microscopy.

OBJECTIVE: The purpose of this study was to use scanning electron microscopy (SEM) in order to compare the surfaces of cavities prepared using laser with those prepared conventionally, and to measure the degree of leakage through both enamel and cementum. MATERIALS AND METHODS: We prepared 135 class V cavities and divided them randomly into three groups: laser-treated (group A), laser-treated, and acid-etched (group B) and rotary instrumented (group C). RESULTS: On analyzing the tooth enamel, the amount of leakage was found to be similar in groups A and B, whilst the samples in the group C were more prone to leakage. On analyzing the cementum, the group C samples appeared to display surfaces that were more conducive to the adhesion of the materials used in obturation (although this difference was not strictly significant), and this might have provoked the relatively low levels of leakage. CONCLUSION: The use of acid etching in conjunction with both conventional and laser cavity preparation improves the adhesion of the materials used in obturation to enamel surfaces.