Treatment of excessive gingival display using conventional esthetic crown lengthening versus computer guided esthetic crown lengthening: (a randomized clinical trial).

BACKGROUND: Surgical guides have been proposed in an attempt to reach more predictable outcomes for esthetic crown lengthening. The objective of the present study was to evaluate the effectiveness of esthetic crown lengthening using 3D-printed surgical guides in the management of excessive gingival display due to altered passive eruption type 1B. MATERIALS AND METHODS: Sixteen patients diagnosed with altered passive eruption type 1B, were divided into two groups. In the control group, the procedure was carried out conventionally, and in the study group, a dual surgical guide was used. The parameters of wound healing (swelling, color, probing depth, bleeding index, and plaque index), pain scores, gingival margin stability, and operating time were assessed at 1 week, 2 weeks, 3 months, and 6 months postoperatively. RESULTS: There was no statistically significant difference in terms of wound healing, pain scores, and gingival margin stability between both groups at different time intervals (P = 1), however, there was a statistical difference between both groups in terms of operating time with the study group being significantly lower (P < 0.001). CONCLUSION: Digitally assisted esthetic crown lengthening helps shorten the operating time and reduces the possibility of human errors during the measurements. This will be useful in helping practitioners achieve better results. PRACTICAL IMPLICATIONS: The conventional method remains to be the gold standard. However, shorter operating time and lower margins for errors will help reduce costs as the chair side time is reduced as well as the possibility for a second surgery is lower. This will improve patient satisfaction as well.

Patients 60 years of age and older should have the same chance for heart transplantation or not?

Heart transplantation is considered the best treatment modality for advanced heart disease. While old age has conventionally been considered a contraindication for heart transplantation due to the reported adverse effect of advanced age, however donor hearts' shortage continues to stimulate the discussion about the recipient's upper age limit. Our study was based on a retrospective analysis for the results of 52 (18%) patients aged 60 years and older undergoing heart transplantation between May 2008 and December 2015, and these patients were compared with 236 (82%) adult recipients who were younger than 60 years at the time of transplantation and during the same period. In older group, 71% were males with the mean age of 63.38±3.55 years, and in younger group, 83.4% were males with a mean age of 43.72±11.41 years (P=0.27). Dilated cardiomyopathy was the most common indication for transplantation among patients in both groups (P=0.147). In older group, the 3-month survival rate was higher than that in younger group (P=0.587), however the 6-month survival rate showed no significant difference (P=0.225). Although the 1-year survival rate was higher in older group (P=0.56), yet the 3-year survival rate between the two groups showed no statistically significant difference (P=0.48). According to our experience among older heart transplant candidates who were 60 years and older, we believe that advanced age should not be an excluding criterion to cardiac transplantation.

Patients 60 Years of Age and Older Should Have the Same Chance for Heart Transplantation or Not? / 华中科技大学学报（医学）（英德文版）

Heart transplantation is considered the best treatment modality for advanced heart disease.While old age has conventionally been considered a contraindication for heart transplantation due to the reported adverse effect of advanced age,however donor hearts' shortage continues to stimulate the discussion about the recipient's upper age limit.Our study was based on a retrospective analysis for the results of 52 (18％) patients aged 60 years and older undergoing heart transplantation between May 2008 and December 2015,and these patients were compared with 236 (82％) adult recipients who were younger than 60 years at the time of transplantation and during the same period.In older group,71％ were males with the mean age of 63.38+3.55 years,and in younger group,83.4％ were males with a mean age of43.72±11.41 years (P=0.27).Dilated cardiomyopathy was the most common indication for transplantation among patients in both groups (P=0.147).In older group,the 3-month survival rate was higher than that in younger group (P=0.587),however the 6-month survival rate showed no significant difference (P=0.225).Although the 1-year survival rate was higher in older group (P=0.56),yet the 3-year survival rate between the two groups showed no statistically significant difference (P=0.48).According to our experience among older heart transplant candidates who were 60 years and older,we believe that advanced age should not be an excluding criterion to cardiac transplantation.