Technique of Framework Cemented on Prepared Abutments to Obtain Passive Fit at Fixed Complete Denture: A 2-Year Follow-Up Report

The passive fit of implant-supported dentures is fundamental to the rehabilitation success due the absence of the periodontal ligament in osseointegrated implants. Many techniques to obtain passive fit have been reported in the literature, some inaccessible for the clinicians and dental laboratories. This case report presents a technique to fabricate fixed complete dentures aiming at obtain passive fit with reduced time and cost, but without demerit for the aesthetics, function and longevity. A 40-year-old woman was referred for treatment presenting some teeth in the maxilla and an edentulous mandible, reporting eating problems related to instability and little retention of the mandibular complete denture. Treatment based on the reverse planning was performed to guide the rehabilitation with a complete mandibular fixed complete denture and maxillary occlusal plane adjustment. The framework of the fixed complete denture was manufactured luting a cast metal bar above the prepared titanium cylinder abutments using resin cement. The aim of this technique was to obtain a fixed complete denture with passive fit presenting positive esthetic and functional outcomes after 2 years of follow-up.

A adaptação passiva de próteses implantossuportadas é fundamental para o sucesso da reabilitação devido à inexistência de ligamento periodontal em implantes osseointegrados. Inúmeras técnicas de confecção da infraestrutura destas próteses tem sido relatadas na literatura, algumas inacessíveis para os clínicos e laboratórios de prótese. Este relato de caso apresenta uma técnica para confecção de próteses totais fixas visando obtenção de adaptação passiva com tempo e custo reduzido, porém sem demérito à estética, função e longevidade. Uma paciente de 40 anos se apresentou para tratamento apresentando alguns dentes na maxila e mandíbula edêntula, relatando dificuldades na mastigação relacionados a instabilidade e falta de retenção da prótese total inferior. Foi realizado um planejamento reverso para orientar a reabilitação com prótese total mandibular fixa e adequação do plano oclusal da maxila. A infraestrutura da prótese total fixa foi confeccionada pela cimentação de uma barra metálica em cilindros de titânio preparados com cimento resinoso. O objetivo desta técnica foi obter uma prótese total fixa com adaptação passiva apresentando resultados positivos em termos de estética e função após 2 anos de acompanhamento.

Câncer de Cólon 2 - Resenha / Colon Cancer 2 - Review

Purpose: To investigate oxaliplatin combined with fluorouracil-based chemoradiotherapy as preoperative treatment for locally advanced rectal cancer. Patients and methods: Seven hundred forty-seven patients with resectable, locally advanced (cT3-4 and/or cN1-2) adenocarcinoma of the mid-low rectum were randomly assigned to receive pelvic radiation (50.4 Gy in 28 daily fractions) and concomitant infused fluorouracil (225 mg/m(2)/d) either alone (arm A, n=379) or combined with oxaliplatin (60 mg/m(2) weekly × 6; arm B, n=368). Overall survival is the primary end point. A protocol-planned analysis of response to preoperative treatment is reported here. Results Grade 3 to 4 adverse events during preoperative treatment were more frequent with oxaliplatin plus fluorouracil and radiation than with radiation and fluorouracil alone (24% vs 8% of treated patients; P<.001). In arm B, 83% of the patients treated with oxaliplatin had five or more weekly administrations. Ninety-one percent, compared with 97% in the control arm, received ³ 45 Gy (P<.001). Ninety-six percent versus 95% of patients underwent surgery with similar rates of abdominoperineal resections (20% vs 18%, arm A vs arm B). The rate of pathologic complete responses was 16% in both arms (odds ratio = 0.98; 95% CI, 0.66 to 1.44; P=.904). Twenty-six percent versus 29% of patients had pathologically positive lymph nodes (arm A vs arm B; P=.447), 46% versus 44% had tumor infiltration beyond the muscularis propria (P=.701), and 7% versus 4% had positive circumferential resection margins (P=.239). Intra-abdominal metastases were found at surgery in 2.9% versus 0.5% of patients (arm A vs arm B; P=.014). Conclusion: Adding oxaliplatin to fluorouracil-based preoperative chemoradiotherapy significantly increases toxicity without affecting primary tumor response. Longer follow-up is needed to assess the impact on efficacy end points.

Radioterapia em combinação com as fluoropirimidinas é a abordagem neoadjuvante padrão do adenocarcinoma do reto médio e baixo. Na busca de tratamentos cada vez mais eficazes os autores avaliam, uma vez mais, se a adição de oxaliplatina ao tratamento convencional (radioterapia + 5-FU) poderia trazer algum benefício adicional. O estudo foi bem controlado e os pacientes, quase 750 no total, distribuídos aleatoriamente entre os dois braços.A taxa de resposta completa (16%) foi idêntica nos dois grupos. Em ambos os grupos a quase totalidade dos pacientes pode ser submetida à cirurgia, sendo que a necessidade de amputação abdominoperineal foi muito semelhante entre eles (20% versus 18% - p < 0,001).A maior diferença entre os dois braços foi no tocante à toxicidade. Efeitos colaterais graus 3 e 4 foram muito mais frequentes no grupo com oxaliplatina (24% versus 8%).Em suma, o tratamento primário padrão do adenocarcinoma do reto continua sendo a combinação de radioterapia e fluoropirimidina. A inclusão de oxaliplatina não se acompanhou de melhores resultados, o que já fora observado em estudos anteriores.

Colonic cancer in Mosul, Iraq - a study of 454 cases over 25 years

The incidence of colonic cancer in Europe and United States of America is high, while it is moderate in the Middle East. To identify the different pathological types of malignant tumors of colon, clinical aspects, management, probable causes and prognosis in Mosul area. A retrospective study of 454 patients diagnosed with colonic cancer and treated in the Hospital for Oncology And Nuclear Medicine in Mosul between 1982 and 2007. Tumor type, incidence, age, sex distribution, anatomical sites, clinical presentations, staging, methods of treatment and prognosis of colonic cancer in Mosul area were studied. 454 colonic cancer cases in Mosul area were diagnosed during the period [1982 to 2007].They constituted [1.19%] of all malignancies. Colonic cancer were more common in males [male: female = 1.25: 1], the commonest age at presentation was the sixth decade. The most frequent sites were the sigmoid colon then the cecum.Most common presenting symptoms were abdominal pain, alteration of bowel habit, palpable abdominal mass and intestinal obstruction.The majority of patients subjected to curable resection 69.16% and the remaining to palliative surgery or conservative management, in addition to radiotherapy and/or chemotherapy, but prognosis was generally unsatisfactory. Carcinoma of the colon is rare in Mosul, usually presented in advanced stage, and hence carry poor prognosis.The common site has been the sigmoid colon

Es necesaria la raioterapia en el control del cáncer colorrectal? / Is radiotherapy necessary for the control of colorrectal cancer?

Entre 1966 y 1983 seleccionamos a 209 pacientes con adenocarcinomas colorrectales, en estadios B (14 por ciento) y C (86 por ciento) de Dukes, tratados con cirugía idónea en el 100 por ciento de casos, 5-fluorouracilo en el 85 por ciento y con radioterapia postoperatoria mediante telecobalto en el 46.41 por ciento de casos, dosis de 5000 cGy en 25 y 30 fracciones. Los resultados postcirugía a 5 años de control fueron: pacientes del colon que recibieron radioterapia tuvieron una supervivencia promedio de 34, meses versus 17 meses de aquellos que no la recibieron; los del recto que admitieron radioterapia con supervivencia promedio de 20 meses versus de los que no la recibieron. Las recurrencias locales en enfermos que admitieron radioterapia fueron de 9.30 por ciento para carcinomas del colon y 11.53 por ciento para los del recto, y en los pacientes que no la recibieron las recidivas fueron de 22.22 por ciento para los del colon y 37.83 por ciento para los del recto

Cancer anorectal: tratamiento radiante operatorio / Anorectal cancer: pre-operative radiotherapy

Se estudiaron 20 pacientes con cancer de recto y ano, tratados en el servicio de Oncologia entre 1989-1991 mediante la braquiterapia intraluminal preoperatoria, para investigar la eficacia de este procedimiento. Los tumores que se encontraban entre 0-7 cm de las margenes del ano tuvieron una radiorrespuesta mas favorable que los localizados entre 8-15 cm. La respuesta al tratamiento fue buena en las lesiones que producen estenosis parcial o moderada, y mala en las estenosis total. El 80 porciento de los adenocarcinomas tuvo mejoria, y el carcinoma epidermoide y el basaloide presentaron remision completa. La mayoria de los tumores se encontraba en el estadio I (Dukes A) y II (Dukes B) al finalizar el tratamiento, por lo que se demostro la eficacia del mismo como metodo preoperatorio

Leiomiosarcoma de colon / Colonic leiomyosarcoma

Se presenta una observación de leiomiosarcoma de colon izquierdo, posiblemente la primera de este tipo en la literatura nacional. Se hacen consideraciones sobre los diferentes problemas diagnósticos y terapéuticos en base a una extensa revisión bibliográfica

Differential radiosensitization of radioresistant human cancer cells by caffeine.

The effect of caffeine, the methylated xanthine, in sensitizing the lethal action of ionizing radiation in vitro was investigated in human cancer cells which were clinically known to be radioincurable. The tumor lines were hepatocellular carcinoma and colon adenocarcinoma. Plateau phase cultures, after absorbing doses of 2 Gy, survived at a rate of 56.30 per cent for colon cancer and at 66.05 per cent for liver cancer. Both lines were radiosensitized by caffeine but at different potencies. Noteworthily, hepatocellular carcinoma whilst less radiosensitive than colon adenocarcinoma was 4 times more susceptible to caffeine. The lowest effective caffeine concentration for liver cancer was 2 mM which slightly exceeded the anticipated lethal concentration in humans. Research on radiosensitizing effect of methylated xanthines on hepatoma system still remains intriguing. Future work should be pursued with the use of less toxic compounds, such as theobromine.

Câncer nos cólons e no reto: mesmos e outros aspectos / Cancer of the colon and rectum: know and less know aspects

Este livro apresenta uma visäo geral do câncer, e a seguir salienta as características do câncer colo-retal. Embora a abordagem da doença, assim como seu tratamento sejam idênticos aqueles relatados nos tratados comuns, säo, contudo, aqui apresentados em línguagem amena, acessível, inclusive a leitores leigos. Ao contrário de outros textos, tópicos menos conhecidos, näo obstante igualmente relevantes säo aqui discutidos, como os fatores emocionais relativos à morte. A obra termina com capítulos adicionais acerca de radioterapia, quimioterapia, e uma extensa análise estatística