Mid-Term Outcomes after Percutaneous Closure of the Secundum AtrialSeptal Defect with the Figulla-Occlutech Device

The secundum atrial septal defect (ASD) is acommon congenital heart defect (CHD), especially inadults. 1 Most of these defects are amenable for transcatheter closure, which became the method of choice to treat most patients due to its safety and efficacy with excellent mid-to-long term outcomes. 2–5 Although cardiac erosions may occur after the use of the Amplatzer Septal Occluder (ASO),6 this complication is very rare. The Figulla-Occlutech device (FOD;Occlutech, Jena, Germany) is relatively new, being anitinol double-disk occluder with a self-centering mechanism provided by a central connecting waist...

Custom-made, selective laser sintering (SLS) blade implants as a non-conventional solution for the prosthetic rehabilitation of extremely atrophied posterior mandible.

The treatment of severely atrophied posterior mandibles with standard-diameter root-form implants may present a challenge. Bone reconstructive surgery represents the treatment of choice; however, it may not be accepted by some patients for economic reasons or due to higher morbidity. Computer-aided design/computer-aided manufacturing (CAD/CAM) technologies have recently opened new frontiers in biomedical applications. Selective laser sintering (SLS) is a CAD/CAM technique that allows the fabrication of complex three-dimensional (3D) structures created by computer-generated image-based design techniques. The aim of this study is to present a protocol for the manufacture and clinical use of custom-made SLS titanium blade implants as a non-conventional therapeutic treatment for the prosthetic rehabilitation of extremely atrophied posterior mandibles. Computed tomography datasets of five patients were transferred to a specific reconstruction software, where a 3D projection of the atrophied mandible was obtained, and custom-made endosseous blade implants were designed. The custom-made implants were fabricated with SLS technique, placed in the extremely atrophied posterior (<4 mm width) mandible, and immediately restored with fixed partial restorations. After 2 years of loading, all implants were in function, showing a good esthetic integration. Blade implants can be fabricated on an individual basis as a custom-designed device. This non-conventional approach may represent an option for restoring the atrophied posterior mandible of elderly patients.

Fixed bicortical screw and blade implants as a non-standard solution to an edentulous (toothless) mandible.

AIM: This paper deals with the treatment of an atrophied toothless mandible with a fixing bridge carried by two nonstandard implant systems. METHODOLOGY: Four bicortical screws were implanted into the frontal part of the mandible and one implant on each side was placed into the distal area of the mandible as a support for a fixing bridge. RESULTS: During the years 2002 - 2007 the authors placed a total of 256 bicortical screw and 84 blade implants. During this period only four bicortical screws and one blade implant failed. The primary and secondary surgical success rate was therefore above 98%, while the prosthetic success rate was 100%. (Bridges which had to be re-fabricated due to implant failure were not taken into account.) CONCLUSION: This approach is recommended as a highly successful and affordable option for a wide range of patients.

Fixed bicortical screw and blade implants as a non-standard solution to an edentulous (toothless) mandible / 国际口腔科学杂志·英文版

<p><b>AIM</b>This paper deals with the treatment of an atrophied toothless mandible with a fixing bridge carried by two nonstandard implant systems.</p><p><b>METHODOLOGY</b>Four bicortical screws were implanted into the frontal part of the mandible and one implant on each side was placed into the distal area of the mandible as a support for a fixing bridge.</p><p><b>RESULTS</b>During the years 2002 - 2007 the authors placed a total of 256 bicortical screw and 84 blade implants. During this period only four bicortical screws and one blade implant failed. The primary and secondary surgical success rate was therefore above 98%, while the prosthetic success rate was 100%. (Bridges which had to be re-fabricated due to implant failure were not taken into account.)</p><p><b>CONCLUSION</b>This approach is recommended as a highly successful and affordable option for a wide range of patients.</p>

Immediate implant placement after removal of a failed implant: a clinical and histological case report.

The purpose of this study was to evaluate the clinical success of an implant placed immediately after the explantation of a fractured blade implant. A healthy 58-year-old male nonsmoker presented with a fractured blade implant that had been subjected to biomechanical overload. A new blade implant was placed immediately after the removal of the fractured one. The new implant was placed with a composite graft of collagen gel and corticocancellous porcine bone and covered with a bioabsorbable membrane. Radiographic evaluation at 6 months postoperation showed complete bone healing. No residual bone defect was observed or probed during the uncovering phase; moreover, no mobility, pain, suppuration, or presence of peri-implant radiolucency were observed at the second-stage surgery.

Chronic sinusitis associated with the use of unrecognized bone substitute: a case report.

Bone grafts are used for bone augmentation to ensure optimal implant placement. However, this procedure may sometimes cause sinusitis. The case of a 44-year-old woman with the diagnosis of recurrent and chronic sinusitis of her right maxillary sinus with a history of dental implant surgery is presented. After several attempts with normal standard sinusitis therapy, unrecognized bone substitute was removed from the sinus cavity, which finally led to resolution of the sinusitis. This case reiterates the importance of a careful examination, consultation, and second opinion for the selection of optimal treatment.

Torque Removal Force for Osseointegrated Implants - Two Experimental Studies

OBJECTIVE. To introduce a rabbit-based model for testing the torque removal force (TRF) of implants and to compare the TRF of a series of titanium implants. METHODS. Two experiments were performed at the University of the Witwatersrand. In the first; a Swedish- (SSM-N) or a South African-manufactured (SSM-S) implant was implantedinto the tibiae of 12 rabbits and the TRF measured at 1; 3 and 6 months. In the second experiment; the TRF of 4 South African-manufactured titanium implants in the tibia or femur of 32 rabbits were compared at 3 and 6 weeks. The implants were: 1 threaded machined (SSM-S); and 3 surface-enhanced - 1threaded (SLA); 1 threaded tapered (MTT) and 1 pitted (RI). RESULTS. In experiment 1; TRF increased significantly with time (p0.05) but there was no significant difference between TRF for the South African and Swedish machined-surface implant types. In experiment 2; the TRF of the MTT implant was significantly greater (p0.0001) than the other 3 types; which did not differ significantly from each other. Time had no significant effect. CONCLUSION. In an internationally used rabbit-based model; South African and Swedish machined-surface titanium implants were equivalent; surface-enhanced implants produced higher TRF; and a tapered implant showed the highest TRF

Immediately loaded blade implant retrieved from a after a 20-year loading period: a histologic and histomorphometric case report.

Immediate loading of root-form dental implants has shown promising results and offers treatment cost and convenience advantages to patients. Although blade implants have been immediately loaded for over 2 decades, the ability of this implant design to achieve osseointegration has been debated. The aim of the present study was to histologically evaluate the peri-implant tissues of an immediately loaded blade implant retrieved for abutment fracture after a 20-year loading period. Histologic samples were prepared and examined by light microscope. Compact, cortical, mature bone with well-formed osteons was present at the interface of the implant. Bone-to-implant contact was 51% +/- 6%. The histologic data showed that osseointegration was obtained in an immediately loaded blade implant inserted into the mandible, and that mineralized tissues were maintained at the interface over a long period (20 years).

Recurrent implantation failure in assisted reproduction: how to counsel and manage. B. Treatment options that have not been proven to benefit the couple.

The success of assisted reproduction, although gradually increasing over the years, is still less than satisfactory. Many couples have benefited from this treatment; however, many have also been left frustrated following multiple failed attempts. Couples who fail to conceive after multiple IVF/intracytoplasmic sperm injection (ICSI) treatments often seek treatment options that are new and that have not been offered before. Some of these include immunological testing and treatment, allogenic lymphocyte therapy, intratubal transfer of zygotes and embryos, blastocyst transfer, sequential embryo transfer, assisted hatching, co-cultures, and preimplantation genetic screening for aneuploidy. Although the evidence behind some of these is more robust, most suffer from lack of well designed randomized trials comparing them with other treatment options. Randomized studies are extremely difficult to conduct, as couples will resist being randomized into a treatment group where previously failed procedures will be repeated. In the mean time, assisted reproduction programmes should resist offering treatment options that are not evidence based, or at least they should share with the couple the information that is available and should stress that none of these is a panacea for their problem.

Placement and post-mortem retrieval of a 28-year-old implant: a clinical and histologic report.

BACKGROUND: The field of modern dental implantology is almost one century old. Its history reveals an evolution not only of implant design and placement techniques, but also of the definitions of clinical success and failure. The use of implants predates the universal concept of osseointegration as a benchmark for success. Some implants in clinical function today would not meet the commonly accepted standards of success currently used. CASE DESCRIPTION: The authors present a case of a patient who received a blade implant and a subsequent restoration in her maxilla in 1971. They describe placement and restorative techniques that were typical of the time, and are of historical interest. On the patient's death in 1989, the implant and surrounding tissues were retrieved, and a histologic examination was performed. Osseointegration had not been achieved, yet the implant functioned successfully for 28 years, most likely because it was well-supported by fibrous connective tissue with associated bone support, as well as because of the design of the restoration. CLINICAL IMPLICATIONS: The clinical outcome of an implant and associated restoration might not always be accurately predicted from a histologic perspective. An implant exhibiting biotolerance rather than classical osseointegration occasionally can exhibit a surprising degree of clinical success when looked at retrospectively.

Placement of plate-form implants using osteotomes.

This article describes the use of osteotomes for the placement of plate-form implants. Comparison is made between the use of cylinders and the plate form as it relates to bone mass and resistant forces. It concludes by showing several cases in function.

Diangóstico y plan de tratamiento en rehabilitación oral implantológica: reportaje de caso clínico / Diagnosis and treatment plan in oral implant rehabilitation: report of a clinical case

Para el tratamiento de pacientes que urgen de una rehabilitación bucal, sea dentaria y/o con implantes, es importante un proceso ordenado desde la primera cita, para poder diagnosticar correctamente la causa principal del por qué el paciente necesita una rehabilitación bucal para solucionar su problema. En este caso clínico específicamente se llega a determinar la necesidad de una rehabilitación bucal con implantes basándose en una historia clínica detallada, un examen clínico preciso, que incluye una reexaminación en el laboratorio a través de modelos de estudios correctamente articulados para una simulaciónn precisa, tanto en estática como en dinámica del paciente, complementada por exámenes auxiliares radiográficos. Igualmente, para el plan de tratamiento en este tipo de pacientes se necesita una esquematización adecuada de cada paso a seguir hasta el final del tratamiento

Evaluation of two vitallium blade-form implants retrieved after 13 to 21 years of function: a clinical report.

This article describes the clinical, radiographic, and histologic evaluation of 2 immediately loaded Vitallium blade-form implants retrieved from the posterior maxilla of 2 patients after 21 and 13 years of function. Neither implant demonstrated mobility or signs of pathosis, and both appeared to have integrated well with surrounding bone. The hydroxyapatite coating of the second implant, which was retrieved after 13 years of function, showed no dissolution. These observations suggest that immediately loaded dental implants have the potential to achieve and maintain osseointegration and that hydroxyapatite coatings can resist degradation over long-term service.

[Vertical ridge augmentation using a microplate in conjunction with a Gore-Tex membrane. A case report]. / Aumento verticale della cresta alveolare mediante utilizzazione di una micropiastra in combinazione con una membrana barriera Gore-Tex. Tecnica chirurgica.

Oral implantology is considered an acceptable treatment modality to replace missing teeth when a recipient site with a sufficient horizontal and vertical bone volume exists. Guided bone regeneration is based on the principle of selective exclusion of non osteogenic cells from the bony defect by a barrier membrane. Several supporting systems of the barrier membrane have been successfully used to treat non space-mantaining de-fects. A 35-year-old female affected by a partial edentulism in the molar area of the right mandible showed 8 mm of bone height of the residual ridge above the alveolar canal. A vertical ridge augmentation was performed using a Gore-Tex membrane in conjunction with a microplate and an irradiated freeze-dried cortico-cancellous allograft. Six months after the surgical procedure a 11.5 mm by 5 mm threaded implant was placed into the regenerated bone. After three months of healing, the implant was uncovered and considered integrated. Before the implant placement, a biopsy of the regenerated bone was arried out by a triphine. The histological examination of the bony core showed the attainment of biological goals of guided bone regeneration. The surgical technique followes in this case report has been effective in regenerating a vertical bone volume sufficient for implant treatment.

Salvage of a blade-implant bridge.

This paper describes an aesthetic and functional treatment for the replacement of a failing bridge supported by blade implants where the patient refused further surgery.