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1.
Swiss Dent J ; 131(4): 349-352, 2021 Apr 06.
Artículo en Francés | MEDLINE | ID: mdl-33789418

RESUMEN

Bone resorption is a consequence of the loss of a tooth. Alveolar ridge resorption can restrict the volume of bone available for the positioning of a dental implant. Bone graft is a routinely performed procedure in order to increase this volume and provide an adequate situation for the replacement of the tooth. However, autogenous bone is the gold standard for this procedure, xenogenous bone is a good alternative. It presents reliable results and a low complication rate. In this article, we describe the case of an infection resulting in a facial skin fistula following a guided bone regeneration. A 52-year-old woman visited a maxillofacial unit with complaints of persistent swelling of the right cheek, associated to a facial skin fistula. She had a history of xenograft with OsteoBiol Gen-os©, performed at a dental office nine months earlier. Clinical examination and computed tomography suggested that there was a migration process of the bone substitute inside the cheek, which had led to the infection with a facial skin fistula. Loss of stability of the bone graft and particular anatomy of the posterior region of the mandible could explain the migration of the particles and the formation of the fistula.


Asunto(s)
Aumento de la Cresta Alveolar , Fístula Cutánea , Regeneración Ósea , Fístula Cutánea/diagnóstico por imagen , Fístula Cutánea/etiología , Fístula Cutánea/cirugía , Implantación Dental Endoósea , Femenino , Humanos , Mandíbula/cirugía , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/terapia
2.
Gan To Kagaku Ryoho ; 48(3): 428-430, 2021 Mar.
Artículo en Japonés | MEDLINE | ID: mdl-33790177

RESUMEN

BACKGROUND AND PURPOSE: Simulation computed tomography colonography(sCTC), which combines CTC and 3-dimensional vascular imaging, is popular for the surgery of colorectal cancer. We experience anomaly, called arc of Riolan(aR), rarely but its definition and details are unclear. Using sCTC, we identified aR and investigated the simulation of aR-conserving high ligation. PATIENT AND METHOD: The patients were 3 cases of sigmoid colorectal cancer with aR in 369 patients who underwent sCTC before colorectal cancer surgery. We identified the running morphology of aR. And we classified Griffiths' point as presence(P)and absence(A). Narrow or mesh-shaped artery which were ischemic risk factors of intestinal tract was P groups and normal artery was A groups in the marginal artery of splenic flexure. We simulated aR-conserving lymph node dissection using sCTC. RESULT: Case 1. The patient was 60-year-old man with rectal cancer, cT4aN1M0, Stage Ⅲa. The running morphology of aR was between the left branch of middle colic artery(MCA lt)and LCA. Griffiths point: P. Surgical simulation was D3 lymph node dissection with preservation of aR and high ligation of IMA. Pathological findings was pT3N1M0, Stage Ⅲa. Case 2. The patient was 65-year-old woman with sigmoid colon cancer, cT3N2M0, Stage Ⅲb. The running morphology of aR was between MCA lt and IMA. Griffiths point: P. Surgical simulation was D3 lymph node dissection with preservation of aR and high ligation of IMA. Pathological findings was pT3N2M0, Stage Ⅲb. Case 3. The patient was 75-year-old woman with sigmoid colon cancer, cT1bN0M0, Stage Ⅰ. The running morphology of aR was between first jejunal artery and IMA. Griffiths point: A. Surgical simulation was D3 lymph node dissection with preservation of aR and high ligation of IMA. Pathological findings was pT1bN0M0, Stage Ⅲb. CONCLUSION: Using sCTC, we could identify the various running morphology of aR and simulate aR-conserving lymph node dissection in high ligation.


Asunto(s)
Colonografía Tomográfica Computarizada , Laparoscopía , Neoplasias del Recto , Anciano , Femenino , Humanos , Ligadura , Escisión del Ganglio Linfático , Masculino , Arteria Mesentérica Inferior/diagnóstico por imagen , Arteria Mesentérica Inferior/cirugía , Persona de Mediana Edad , Neoplasias del Recto/cirugía
4.
J Headache Pain ; 22(1): 18, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33794769

RESUMEN

BACKGROUND: Existent animal models of migraine are not without drawbacks and limitations. The aim of our study was to evaluate imaging photoplethysmography (PPG) as a method of assessing intracranial blood flow in rats and its changes in response to electrical stimulation of dural trigeminal afferents. METHODS: Experiments were carried out with 32 anesthetized adult male Wistar rats. Trigeminovascular system (TVS) was activated by means of electrical stimulation of dural afferents through a closed cranial window (CCW). Parameters of meningeal blood flow were monitored using a PPG imaging system under green illumination with synchronous recording of an electrocardiogram (ECG) and systemic arterial blood pressure (ABP). Two indicators related to blood-flow parameters were assessed: intrinsic optical signals (OIS) and the amplitude of pulsatile component (APC) of the PPG waveform. Moreover, we carried out pharmacological validation of these indicators by determining their sensitivity to anti-migraine drugs: valproic acid and sumatriptan. For statistical analysis the non-parametric tests with post-hoc Bonferroni correction was used. RESULTS: Significant increase of both APC and OIS was observed due to CCW electrical stimulation. Compared to saline (n = 11), intravenous administration of both the sumatriptan (n = 11) and valproate (n = 10) by using a cumulative infusion regimen (three steps performed 30 min apart) lead to significant inhibitory effect on the APC response to the stimulation. In contrast, intravenous infusion of any substance or saline did not affect the OIS response to the stimulation. It was found that infusion of either sumatriptan or valproate did not affect the response of ABP or heart rate to the stimulation. CONCLUSIONS: Imaging PPG can be used in an animal migraine model as a method for contactless assessment of intracranial blood flow. We have identified two new markers of TVS activation, one of which (APC) was pharmacologically confirmed to be associated with migraine. Monitoring of changes in APC caused by CCW electrical stimulation (controlling efficiency of stimulation by OIS) can be considered as a new way to assess the peripheral mechanism of action of anti-migraine interventions.


Asunto(s)
Trastornos Migrañosos , Fotopletismografía , Animales , Estimulación Eléctrica , Frecuencia Cardíaca , Masculino , Trastornos Migrañosos/diagnóstico por imagen , Ratas , Ratas Wistar , Sumatriptán/farmacología
6.
Arch Esp Urol ; 74(3): 359-362, 2021 Apr.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33818434

RESUMEN

OBJECTIVES: We present a unique case with a ureteral fibroepithelial tumor originating from the ureter, which could be confused with a bladder tumor on ultrasound examination due to its movement in and out of the bladder. METHODS: In cystoscopy, a papillary tumor lesion emerging from the right ureteral orifice was seen. After scanning the other quadrants, however, the tumor was not observed at the right ureteral orifice. It was then protruded back into the bladder. The tumor was seen several times to protrude into the bladder and return to the ureter, possibly due to ureteral peristalsis. Then, a semi-rigid ureteroscope was introduced through the right ureteric orifice, and the tumor was excised in one piece using Holmium laser fiber with 365µm of diameter. The size of the removed tumor was approximately 8 cm long. A double-j stent of 4.8 Fr was placed in the ureter. RESULTS: The patient was discharged on the first day without complications. The fibroepithelial polyps of the ureter, which consist of the stroma of mesoderm origin, covered with histologically normal or hyperplastic urothelial epithelial cells, are extremely rare tumors. It is important to distinguish these polyps from urothelial cancers, since these two entities are different in treatment and prognosis, although similar in symptoms and imaging procedures. CONCLUSIONS: Minimally invasive treatment techniques can be safely applied in the treatment of such exceedingly rare tumors.


Asunto(s)
Pólipos , Uréter , Neoplasias Ureterales , Humanos , Pólipos/diagnóstico por imagen , Pólipos/patología , Pólipos/cirugía , Uréter/patología , Neoplasias Ureterales/diagnóstico por imagen , Neoplasias Ureterales/patología , Neoplasias Ureterales/cirugía , Ureteroscopía , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/patología , Vejiga Urinaria/cirugía
7.
Urologiia ; (1): 45-49, 2021 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-33818934

RESUMEN

OBJECTIVES: Demonstrate the treatment of prostatic abscess with a minimally invasive method - abscess puncture with aspiration of purulent fluid and injection of an antibiotic into abscess cavity. MATERIALS AND METHODS: Diagnosis of prostatic abscess of 23 patients using ultrasonography, computed tomography and magnetic resonance imaging of the pelvic region. 19 patients with the abscess within the prostatic capsule were treated with perineal percutaneous puncture method with aspiration of the abscess fluid and injection of antibiotics into cavity. For 4 patients with prostatic abscess and purulent paraprostatitis we performed incision and drainage of purulent cavity with open transperineal access. RESULTS: Single abscess puncture was enough to normalize health status of 15 patients. In 4 cases additional puncture was required in 4-5 days after the first manipulation. All the patients recovered and were discharged from the clinic in 7-8 days. Patients after abscess incision and drainage stayed in hospital for 10-14 days. In 1-3 months after the surgery, imaging methods revealed a high-density lesion in prostate whatever the method was used. DISCUSSION: Treatment response was controlled by imaging methods. 2 days after puncture 4 patients had a lesion with liquid content larger than 50% of the initial purulent lesion size. Repeated puncture was performed in this patients. CONCLUSION: Abscess puncture with aspiration of fluid is an effective method of treatment when prostatic abscess is within the capsule. In cases of purulent paraprostetitis incision and drainage of an abscess cavity is needed.


Asunto(s)
Absceso , Enfermedades de la Próstata , Absceso/diagnóstico por imagen , Absceso/cirugía , Drenaje , Humanos , Masculino , Enfermedades de la Próstata/diagnóstico por imagen , Enfermedades de la Próstata/cirugía , Ultrasonografía
8.
Urologiia ; (1): 56-59, 2021 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-33818936

RESUMEN

INTRODUCTION: patients with urinary stone disease during consultation often cannot realize their condition and features of upcoming procedure. Creation of 3D printed models is also not always available or too expensive. AIM: to create a special program that allows for virtual intrarenal visualization of the collecting system and kidney stone on devices based on the Android operating system and evaluate its efficiency in counseling patients before the upcoming percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: a total of 15 patients who were scheduled to PCNL, were included in the study. All of them had two consultations. During the second consultation, the newly developed program was used. Patient data from DICOM (computed tomography) format were converted to stereolithography (STL) format in order to display it in the application. Each patient assessed the quality of the consultation using a questionnaire. RESULTS: patients understanding of the kidney anatomy improved by 55% (from 34 to 75 points, p=0.0001), and stone localization by 51% (from 37 to 75 points, p=0.0001). The stages of PCNL became clearer by 57% (from 32 points to 75, p=0.0001), and understanding of possible intra- and postoperative complications was improved by 48% (from 38 to 73 points, p=0.0002). Overall patient satisfaction with counseling improved by 53% (from 35 to 74 points, p=0.0001), and the number of patients who desired for better repeated counseling decreased by 89% (from 9 to 1, p=0.006). CONCLUSION: The InsKid app is an affordable and easy-to-use program, which doesnt require significant costs and allows patients to understand their disease and upcoming procedure.


Asunto(s)
Cálculos Renales , Aplicaciones Móviles , Nefrolitotomía Percutánea , Nefrostomía Percutánea , Urolitiasis , Humanos , Riñón , Cálculos Renales/diagnóstico por imagen , Cálculos Renales/cirugía , Resultado del Tratamiento
9.
Urologiia ; (1): 84-88, 2021 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-33818941

RESUMEN

In December 2019, a new SARS-CoV-2 virus, called COVID-19, was identified in the Wuhan province of China, the spread of which determined the development of a pandemic. The lack of publications with evidence-based clinical studies dictate the necessity to cover various, including rare, pathological effects of the virus on the human body and the subsequent effect on it. Nowadays, there is already evidence that the SARS-CoV-2 virus causes specific damage to the vessels (endothelium), myocardium, and kidneys. The pathophysiologic mechanisms leading to acute kidney injury during COVID-19 infection are unclear, but may be due to direct exposure of the kidney tubules and endothelial cells to the virus. We present a clinical case of a kidney infarction in a 17-year-old girl with a severe course of a new coronavirus infection. At the time of the description of this clinical case, there are no publications on COVID-19 associated with kidney infarction in children in the Russian and foreign literature which is available to us.


Asunto(s)
Infecciones por Coronavirus , Coronavirus , Adolescente , Niño , Células Endoteliales , Femenino , Humanos , Infarto , Riñón/diagnóstico por imagen , Federación de Rusia
10.
Urologiia ; (1): 90-94, 2021 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-33818942

RESUMEN

PURPOSE: In order to determine the role and significance of functional magnetic resonance urography (fMRU) in the diagnosis of ureteropelvic junction obstruction (UPJO), a comparative analysis of the results of fMRU and dynamic renal scintigraphy (DRS) was carried out. MATERIALS AND METHODS: From January 2017 to December 2019, fMRU and diuretic DRS were performed in 36 patients (mean age 89+/-63 months). Boys - 26 (72.2%), girls - 10 (27.8%). Left-sided hydronephrosis was detected in 23 (63.9%) children, right-sided in 12 (33.3%) patients, and bilateral lesions in 1 (2.8%) patient (2 renal units (RU)). Antenatal hydronephrosis was detected in 9 (25%) patients, and postnatally in 27 (75%) patients. According to ultrasound data, grade II hydronephrosis occurred in 11 (29.8%) RU, grade III - in 21 RU (56.7%), and grade IV - in 5 RU (13.5%) according to the SFU classification. A diuretic test was performed in 26 patients. RESULTS: Median and quartiles of differential renal function (DRF) according to fMRU data on the affected side were 37% [29; 43], and according to DRS - 46% [40;49]. When performing fMRU, a positive diuretic test was detected in 20 patients, 5 patients - negative and 1 patient - doubtful, and according to the DRS data, 12 patients had a positive test, 10 patients - negative and 4 patients - doubtful. Differences in DRF between fMRU and DRS varied between 0.7-33%. The average value of differences in DRF on the affected side was 11.3+/-8.5%. When comparing the results of DRF on the affected side, a moderate correlation was found on the Cheddock scale (r=0.59, p<0.05) between fMRU and DRS data. In comparison of the DRF using the Wilcoxon test, statistically significant differences were revealed (p<0,05). SUMMARY: Our experience demonstrates the high potential of fMRU in terms of replacing the classical methods of diagnosis of UPJO in children, taking into account the high correlation coefficients between the results of fMRU and DRS. Standardization of the fMRU protocol will increase the diagnostic relevance of information and in the future will make fMRU the only necessary study to determine management tactics for patients with UPJO.


Asunto(s)
Hidronefrosis , Obstrucción Ureteral , Niño , Femenino , Humanos , Hidronefrosis/diagnóstico por imagen , Lactante , Pelvis Renal/diagnóstico por imagen , Espectroscopía de Resonancia Magnética , Masculino , Embarazo , Cintigrafía , Estudios Retrospectivos , Obstrucción Ureteral/diagnóstico por imagen , Urografía
11.
Urologiia ; (1): 95-102, 2021 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-33818943

RESUMEN

BACKGROUND: pneumovesicoscopic approach gives new possibilities for endovideosurgical correction of congenital ureteral and bladder pathology. AIM: To increase the efficiency of ureteral reimplantation in patients with vesicoureteral reflux (VUR), obstructive megaureter and bladder pathology by using pneumovesicoscopic access. MATERIALS AND METHODS: For the period 2014 - 2020 a total of 52 children aged from 10 months up to 15 years (median 2.5 years) were treated. In all patients, pneumovesicoscopic ureteral reimplantation according to the Cohen technique was performed, and in six cases bilateral procedure was done. 30 patients with obstructive megaureter (32 ureters) were treated, and intravesical suturing with ureteral plication was performed in 9 patients. Reimplantation for grade 3-5 VUR was performed in 22 patients (26 ureters), in combination with excision of the bladder diverticulum was done in 3 patients, while 3 children were undergone to simultaneous excision of the ureterocele. An original technique for fixation of the mobilized dilated ureter with a ligature to the bladder neck is proposed to simplify its intravesical suturing according to the Starr technique. RESULTS: The mean operation time was 142 (83-235 minutes). Conversion to open surgery was required in 1 (1.9%) child during the learning curve. The length of stay was 5-6 days, with an average of 5.21 days. According to ultrasound data, after 1, 3, 6 months there was a decrease in the size of the collecting system and ureter in all cases. At cystography after 6-12 months, VUR was detected in 3 (5.7%) children: in 2 (9%) patients with grade 3-5 VUR and in 1 (3.3%) patient with obstructive megaureter and ureteral suturing. CONCLUSION: Pneumovesicoscopic access for ureteral reimplantation in patients with VUR, obstructive megaureter, bladder diverticulum and ureterocele has proven its efficiency and reliability with a minimal complication rate (5.7%). Our proposed method of fixing the mobilized ureter with a ligature to the bladder neck helps to simplify the suturing of the ureter and to shorten the operation time.


Asunto(s)
Uréter , Reflujo Vesicoureteral , Anciano , Niño , Humanos , Reproducibilidad de los Resultados , Estudios Retrospectivos , Uréter/diagnóstico por imagen , Uréter/cirugía , Reflujo Vesicoureteral/diagnóstico por imagen , Reflujo Vesicoureteral/cirugía
12.
Urologiia ; (1): 107-111, 2021 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-33818945

RESUMEN

A description of the successful surgical treatment of a patient with irreversible changes in both ureters and bladder resulting from a severe form of Ormond's disease and interstitial cystitis, resulting in contracted bladder, is presented. For the first time in clinical practice, a one-stage cystectomy, a bilateral ureterectomy with complete replacement of both ureters and the bladder with two isoperistaltic small bowel segment was performed. The postoperative course was uneventful. Follow-up contrast-enhanced computed tomography of the kidneys and newly formed urinary tract revealed good excretory function. The patient was discharged in a satisfactory condition on the 22nd day after the procedure with recommendations for taking 10 g of an aqueous solution of soda daily. At the follow-up after 3 months, she had complaints of slight weakness and voided voluntary up to 8 times a day; clinical and biochemical blood tests were normal. This clinical observation indicates the presence of two different diseases in one patient, namely interstitial cystitis and Ormond's disease. The possibility of one-stage complete replacement of both ureters and the bladder with a good immediate result is shown.


Asunto(s)
Fibrosis Retroperitoneal , Uréter , Neoplasias de la Vejiga Urinaria , Derivación Urinaria , Reservorios Urinarios Continentes , Cistectomía , Femenino , Humanos , Íleon , Uréter/diagnóstico por imagen , Uréter/cirugía , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/cirugía , Neoplasias de la Vejiga Urinaria/cirugía
13.
Urologiia ; (1): 126-130, 2021 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-33818948

RESUMEN

The article describes such fundamental and applied aspects of pathogenesis and clinical manifestations of such rare disease as endometriosis of ureters. Frequent involvement of left ureter in its pelvic part, close to distal colon, associated with its inflammatory diseases followed by leaky gut syndrome with bacterial spread to the fallopian tube causing its inflammation and dysfunction, provoking menstrual reflux and predisposing to affection of left ovary, peritoneum and contact spread of endometriosis to ureteral wall. This mechanism fits to the regurgitation theory of endometriosis. Surgery is the gold standard for endometriosis treatment and more beneficial, comparing with conservative treatment and essential for prevention of such dangerous complications as hydronephrosis and renal failure. But the early and in-time diagnostic of endometriosis depend on gynecologists, not urologist, that characterizes endometriosis as significant interdisciplinary problem. In the article symptoms, that must cause concern for this rare pathology are thoroughly described.


Asunto(s)
Endometriosis , Hidronefrosis , Laparoscopía , Uréter , Enfermedades Ureterales , Endometriosis/complicaciones , Endometriosis/cirugía , Femenino , Humanos , Hidronefrosis/diagnóstico por imagen , Hidronefrosis/etiología , Hidronefrosis/cirugía , Uréter/diagnóstico por imagen , Uréter/cirugía , Enfermedades Ureterales/etiología , Enfermedades Ureterales/cirugía
14.
Artículo en Inglés | MEDLINE | ID: mdl-33819322

RESUMEN

The purpose of this study was to evaluate vertical and horizontal alveolar resorption after the extraction of eight single maxillary molars using solvent-dehydrated bone allograft (Puros) covered with a nonresorbable membrane for ridge preservation. At implant placement 4 months later, ridge dimensions were measured clinically and radiographically and compared to baseline, and a histologic analysis was performed. The mean buccal height decreased by 1.51 mm at midpoint, 0.88 mm mesially, and 1.16 mm distally. The implants were placed without additional ridge augmentation, and six of eight required an internal sinus elevation. Within the limits of this study, this technique succeeded in preserving the alveolar bone.


Asunto(s)
Aumento de la Cresta Alveolar , Tomografía Computarizada de Haz Cónico Espiral , Aloinjertos , Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/cirugía , Trasplante Óseo , Humanos , Diente Molar/diagnóstico por imagen , Diente Molar/cirugía , Proyectos Piloto , Politetrafluoroetileno , Solventes , Extracción Dental , Alveolo Dental/cirugía
15.
Artículo en Inglés | MEDLINE | ID: mdl-33819323

RESUMEN

A clinical case series of three patients is presented using a novel implant design to not only address primary stability but also to prevent damage to the labial bone plate and improve the interdental space for papillae preservation with immediate tooth replacement therapy. This unique implant design features an apicocoronal inverted body-shift in diameter (wide to narrow), shape (tapered to cylindrical), thread depth (deep to shallow), and thread pattern (V-shaped to square) to achieve uncompromised primary stability and esthetics, particularly in extraction sockets, in a singular body form. In addition, the implant possesses a prosthetic angle correction within the implant body to facilitate screw-retention of the restoration and avoid the risk of apical socket perforation.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Estética Dental , Humanos , Extracción Dental , Alveolo Dental/diagnóstico por imagen , Alveolo Dental/cirugía
16.
Artículo en Inglés | MEDLINE | ID: mdl-33819328

RESUMEN

A postextraction socket is always open to different treatment possibilities. A straightforward clinical classification may help evaluate which surgical approach is best suited for the case being treated. Four different classes are defined on the basis of the local anatomy of the site, available bone volume, and soft tissue level. For every clinical situation, either immediate placement, early placement, alveolar ridge preservation, or staged approach can be selected as a treatment modality according to the classifications listed.


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Proceso Alveolar/cirugía , Atención Odontológica , Humanos , Extracción Dental , Alveolo Dental/diagnóstico por imagen , Alveolo Dental/cirugía
17.
Artículo en Inglés | MEDLINE | ID: mdl-33819330

RESUMEN

Immediate implant placement in molar sites has the potential to improve the patient experience by reducing the number of appointments and the overall treatment time. However, primary closure remains a technical challenge. The present prospective case series evaluated the soft tissue contours and the radiographic bone levels of 17 patients who received immediate implants in molar sites and a digitally customized CAD/CAM sealing socket abutment. At the 2-year follow-up, the mean buccal tissue contours at the most coronal portion were reduced horizontally by an average of 1 mm at 1, 2, 3, and 4 mm below the gingival margin. A mean 0.53-mm apical migration of the gingival margin was seen, and the mean interproximal bone level at the 2-year follow-up was 0.89 mm. The use of CAD/CAM-generated customized healing abutments in immediate molar sites yielded minimal hard and soft tissue changes at the 2-year follow-up.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Pilares Dentales , Implantación Dental Endoósea , Humanos , Diente Molar/diagnóstico por imagen , Diente Molar/cirugía , Estudios Prospectivos , Alveolo Dental/cirugía
18.
Artículo en Inglés | MEDLINE | ID: mdl-33819331

RESUMEN

This study aimed to assess how frequently the maxilla anatomy allows for lingualized immediate implants in the central incisor region with a screw channel that has an ideal distance of 1.5 mm from the incisal margin. The effect of abutments with angle correction on case selection will also be verified. A retrospective cross-sectional study of 181 CBCT scans was carried out. Using an implant-planning software, implant placement was simulated in the lingual aspect of the socket. The location of the prospective screw channel was registered as incisal, lingual, or facial. The angle between the actual screw channel and the position of the ideal one was calculated. The effect of angle correction on allowing an ideal screw channel configuration was computed. Out of 161 eligible cases, 144 presented favorable anatomy for an immediate implant. The screw channel had an incisal position in 40 cases (28%), a lingual position in 60 cases (42%), and a facial position in 44 cases (30%). The screw channel could be placed at the planned distance from the incisal edge in 35 cases (24%). The position was unfavorable in the remaining 109 cases. In 103 of these cases, an abutment with an angled screw channel could make the conditions feasible. Within the simulated conditions, a majority of maxillary central incisors present favorable ridge anatomy for lingualized immediate implant placement. Achieving a proper location of the screw channel requires abutments with angle correction in a majority of cases.


Asunto(s)
Implantes Dentales , Tomografía Computarizada de Haz Cónico Espiral , Tornillos Óseos , Estudios Transversales , Estudios de Factibilidad , Humanos , Incisivo/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Estudios Prospectivos , Estudios Retrospectivos
19.
Artículo en Inglés | MEDLINE | ID: mdl-33819333

RESUMEN

This study aimed to rehabilitate shortened maxillary dental arch with splinted crowns by connecting ultra-short implants with longer ones. In the posterior maxilla of 11 patients, one 10-mm (n = 11) and one or two ultra-short 4-mm (n = 17) dental implants were inserted. The insertion torque was lower than 20 Ncm in 55% of the 10-mm implants and in 94% of the 4-mm implants (P > .05). Median (range) implant stability quotients at the time of insertion and after 6 months were 61 (14 to 72) and 68 (51 to 79), respectively, for 4-mm implants, and 66 (52 to 78) and 78 (60 to 83), respectively, for 10-mm implants (P < .05). One 4-mm implant failed to integrate. All patients were restored with splinted metal-ceramic crowns connecting 4- and 10-mm implants. Median (range) clinical crown/implant ratios of 4-mm and 10-mm implants were 2.79 (1 to 3.66) and 1.06 (0.85 to 1.46), respectively (P < .05). Six months after prosthetic rehabilitation, the median (range) crestal bone loss was 0.3 mm (-0.7 to 1.7 mm) for 4-mm implants and was 0.5 mm (-0.8 to 3.5 mm) for 10-mm implants (P > .05). Splinted crowns combining 4- and 10-mm implants may contribute to a better force distribution in the treatment with ultra-short implant-supported prosthesis in the posterior maxilla.


Asunto(s)
Implantes Dentales , Maxilar , Coronas , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Seno Maxilar/cirugía
20.
Orv Hetil ; 162(15): 595-600, 2021 04 02.
Artículo en Húngaro | MEDLINE | ID: mdl-33798105

RESUMEN

Összefoglaló. A lateralis cysticus nyaki terimék két leggyakoribb oka a branchiogen cysta és a cysticus nyaki áttét. Az átfedo lokalizáció (a leggyakrabban a IIA nyaki régióban), a betegek életkora és az esetenként hirtelen kezdet alapján a két leggyakoribb ok differenciáldiagnózisa nagy kihívást jelenthet. Egy hirtelen fellépo fájdalmas, bal oldali nyaki duzzanattal, dysphagiával és lázzal jelentkezo 72 éves férfi esetét ismertetjük. A nyak komputertomográfiás vizsgálata egy 6 cm legnagyobb átméroju, vastag falú, többrekeszes cysticus terimét igazolt. Infektív branchiogen cysta lehetoségére gondolva az elváltozást eltávolítottuk. A szövettan azonban p16-pozitív laphámrákot igazolt. A primer tumort végül az ipsilateralis tonsilla palatina állományában sikerült azonosítani. A beteg definitív radioterápiában részesült, és 18 hónappal a diagnózis után tumormentes. A nyaki cystákon, az infektív nyaki cystákon és a cysticus metastasisokon kívül a humán papillómavírussal összefüggo szájgarati laphámrákok infektív cysticus vagy necroticus metastasisait is figyelembe kell venni a lateralis cysticus nyaki terimék differenciáldiagnózisában. Orv Hetil. 2020; 162(15): 595-600. Summary. Branchial cleft cysts and cystic neck metastases are the two most common causes of cystic lateral neck masses. Based on the overlapping location (neck level IIA), patient age at onset and the occasionally sudden onset, their differential diagnosis is challenging. We present a 72-year-old male presenting with a suddenly emerging painful, left-sided neck swelling, dysphagia and fever. Computed tomography showed a 6 cm thick-walled multicystic mass. With the suspected diagnosis of an infected branchial cleft cyst, the lesion was removed. Histology confirmed p16 positive squamous cell carcinoma. Primary tumor was identified in the ipsilateral palatine tonsil. Definive radiotherapy was performed and the patient is free of disease at the 18-month follow-up. Beyond pure and infected branchial cleft cysts and pure cystic metastases, infected cystic or necrotic metastasis of human papillomavirus associated oropharyngeal squamous cell carcinoma should be included in the differential diagnosis of cystic lateral neck lesions. Orv Hetil. 2021; 162(15): 595-600.


Asunto(s)
Neoplasias de Cabeza y Cuello , Inflamación , Anciano , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Humanos , Inflamación/diagnóstico por imagen , Masculino , Tomografía Computarizada por Rayos X
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