ABSTRACT
Advancements in the field of implantology have made dental implants a mainstay treatment for both fully and partially edentulous patients. As a result, practitioners need to be able to identify clinical signs of peri-implant disease in its early stages and provide patients with reliable treatment options. The objective of this article is to provide a differential diagnosis of peri-implant lesions, outlining the clinical, radiographic, and histopathologic features of similar benign and malignant conditions. Additionally, two case studies are presented that showcase lesions that mimic peri-implantitis, providing practitioners with practical examples of how to apply the discussed features in a clinical setting. Lesions described in the differential diagnosis include physiologic bone loss, implant fracture, loosened abutments, pyogenic granuloma, peripheral giant cell granuloma, peripheral ossifying fibroma, squamous cell carcinoma, and metastasis extending to the oral cavity.
Subject(s)
Mouth, Edentulous , Peri-Implantitis , Humans , Diagnosis, Differential , Peri-Implantitis/diagnosis , SyndromeABSTRACT
OBJECTIVE. A medical implant that is made from metal must undergo proper MRI testing to ensure patient safety. The purpose of this investigation was to assess issues with MRI with a newly developed atrial-anchored transcatheter mitral valve replacement (TMVR) implant. MATERIALS AND METHODS. The atrial-anchored TMVR implant underwent an in vitro evaluation for MRI safety issues using standardized techniques and well-accepted methods. Magnetic field interactions including translational attraction and torque and artifacts were tested at 3 T. MRI-related heating was assessed at 1.5 T/64 MHz and 3 T/128 MHz using numeric simulations with analytical modeling and experimental testing. RESULTS. The atrial-anchored TMVR implant exhibited minor magnetic field interactions (9° deflection angle and no torque) at 3 T. The findings from the numeric simulations with analytical modeling were used to guide the placement of the implant in the phantom for the heating test and to identify the position on the implant that would result in the highest temperature rise. The highest temperature elevations recorded for the TMVR implant obtained on MRI at 1.5 T/64 MHz and 3 T/128 MHz were 2.7°C and 2.4°C, respectively. The maximum artifact size seen on a gradient echo pulse sequence extended approximately 5 mm relative to the size of the implant. CONCLUSION. The results of the tests performed on the atrial-anchored TMVR implant revealed no substantial concerns with respect to the conditions used in this investigation. Therefore, a patient with this new implant can safely undergo MRI by following the specific conditions defined by this study. The implant was deemed MR Conditional.
