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1.
Plant Phenomics ; 6: 0202, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38939746

RESUMO

Grape cluster architecture and compactness are complex traits influencing disease susceptibility, fruit quality, and yield. Evaluation methods for these traits include visual scoring, manual methodologies, and computer vision, with the latter being the most scalable approach. Most of the existing computer vision approaches for processing cluster images often rely on conventional segmentation or machine learning with extensive training and limited generalization. The Segment Anything Model (SAM), a novel foundation model trained on a massive image dataset, enables automated object segmentation without additional training. This study demonstrates out-of-the-box SAM's high accuracy in identifying individual berries in 2-dimensional (2D) cluster images. Using this model, we managed to segment approximately 3,500 cluster images, generating over 150,000 berry masks, each linked with spatial coordinates within their clusters. The correlation between human-identified berries and SAM predictions was very strong (Pearson's r2 = 0.96). Although the visible berry count in images typically underestimates the actual cluster berry count due to visibility issues, we demonstrated that this discrepancy could be adjusted using a linear regression model (adjusted R 2 = 0.87). We emphasized the critical importance of the angle at which the cluster is imaged, noting its substantial effect on berry counts and architecture. We proposed different approaches in which berry location information facilitated the calculation of complex features related to cluster architecture and compactness. Finally, we discussed SAM's potential integration into currently available pipelines for image generation and processing in vineyard conditions.

2.
J Dent ; 146: 105067, 2024 07.
Artigo em Inglês | MEDLINE | ID: mdl-38763385

RESUMO

OBJECTIVES: The aim of this study is to compare the aesthetic outcomes of metal porcelain (C), lithium disilicate (T1) and porcelain-layered zirconium (T2) immediate implant-supported single crowns in the anterior maxilla. MATERIALS AND METHODS: Forty-five immediate dental implants were provided for 45 patients that required the extraction of a single tooth in the anterior maxilla. A temporary prosthesis was provided at 8 weeks after placement followed by the final prosthesis at 24 weeks post-implantation. The patients were randomly allocated into 3 groups: 15 patients in the control group (C) received a metal-porcelain restoration, 15 patients (T1) received a lithium disilicate (LD) restoration and 15 patients (T2) received a porcelain-layered, zirconium (Z) restoration. Pink (PES) and White (WES) esthetic scores, radiographic bone levels, periodontal parameters and patient's esthetic satisfaction using a visual analogue scale (VAS) were evaluated at the time of final restoration placement (t0) and at 12-months post-loading (t12). RESULTS: No implants were lost during the duration of this study. Statistically significant higher WES and VAS scores (p < 0.05) were recorded in T1 vs C and T1 vs T2 groups respectively. Similar radiographic bone levels and periodontal parameters were recorded in all groups. CONCLUSION: Within the limitations of this study, it was concluded that T1 restorations provided better WES outcomes when compared to C restorations and better VAS scores when compared to T2 restorations at 12 months post-loading. Besides, different material interphases did not have an impact in PES, bone levels or periodontal parameters. CLINICAL RELEVANCE: There is limited data comparing aesthetic outcomes of implant supported single crowns made of different ceramic materials based on accepted and comparable indexes and the evaluation of the patient's perspective regarding these aesthetic outcomes.


Assuntos
Coroas , Implantes Dentários para Um Único Dente , Porcelana Dentária , Prótese Dentária Fixada por Implante , Estética Dentária , Carga Imediata em Implante Dentário , Zircônio , Humanos , Feminino , Masculino , Zircônio/química , Porcelana Dentária/química , Adulto , Pessoa de Meia-Idade , Resultado do Tratamento , Satisfação do Paciente , Materiais Dentários/química , Maxila/cirurgia , Ligas Metalo-Cerâmicas/química , Planejamento de Prótese Dentária , Adulto Jovem
3.
Contemp Clin Trials Commun ; 29: 100995, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36105265

RESUMO

Pain is known to reduce hemodialysis treatment adherence, reduce quality of life, and increase mortality. The absence of effective strategies to treat pain without medications has contributed to poor health outcomes for people with end-stage kidney disease (ESKD) on hemodialysis. It is now recognized that symbiotic microbiota in the gut play a critical role in health and disease, and new evidence sheds light on the role of the microbiome in chronic pain. The pilot study protocol presented here (BIOME-HDp) employs a longitudinal repeated measures design to interrogate the effects of a nonpharmacological pain intervention on the composition and function of the gut microbiome and circulating metabolites. This pilot study is an ancillary study of the HOPE Consortium Trial to reduce pain and opioid use in hemodialysis, which is part of the NIH's Helping to End Addiction Long-term (HEAL) initiative. The BIOME-HDp pilot study will establish clinical microbiome research methods and determine the acceptability and feasibility of fecal microbiome and serum metabolite sample collection.

4.
Clin Oral Implants Res ; 33(3): 231-277, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35044012

RESUMO

OBJECTIVE: Two focused questions were addressed: Focused question (Q1) 1) Are there any differences between immediate and delayed placement in terms of (i) survival rate, (ii) success rate, (iii) radiographic marginal bone levels, (iv) height/(v)thickness of buccal wall, (vi) peri-implant mucosal margin position, (vii) aesthetics outcomes and (viii) patient reported outcomes? Focused question 2 (Q2) What is the estimated effect size of immediate implant placement for all parameters included in Q1? MATERIALS AND METHODS: An electronic search (MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials and OpenGray) and hand search were conducted up to November 2019. Randomised controlled trials (RCT) with delayed implant placement as controls were eligible in the analysis for Q1. Immediate dental implant arms RCTs, controlled clinical trials (CCTs) and prospective case series of immediate implant placement were eligible in the analysis for Q2. RESULTS: Six papers (RCTs) were included in the analysis for Q1 and 53 papers (22 RCTs, 11 CCTs and 20 case series) for Q2. Q1: Meta-analyses did not show any significant difference in implant survival, but it did for bone levels and PES scores at 1 year post-loading, favouring the immediate group. Q2: Meta-analyses showed that immediate implants had a high survival rate (97%) and presented high PES scores (range 10.36 to 11.25). Information regarding marginal bone loss and gingival/papillary recession varied among all included studies. CONCLUSION: Similar survival rate was found between immediate and delayed implants. Immediate implants presented threefold early complications and twofold delayed complications. Success criteria should be reported more consistently, and the incidence/type of complications associated with immediate implants should be further explored.


Assuntos
Implantes Dentários , Retração Gengival , Carga Imediata em Implante Dentário , Implantação Dentária Endóssea , Estética Dentária , Humanos
6.
Clin Oral Implants Res ; 32(9): 1115-1126, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34218469

RESUMO

OBJECTIVES: Comparing PES/WES scores, modified success rate, survival, success, buccal bone thickness and patient-reported outcomes of immediate dental implants placed in fresh alveolar sockets using a flap or a minimal split-thickness envelope flap (MSTEF). MATERIALS AND METHODS: Implants following random assignment into a flap or MSTEF group were placed immediately in anterior and premolar areas. Guided bone regeneration and autogenous connective tissue graft were used in all cases. A temporary prosthesis was provided followed by the final prosthesis at 16-18 weeks. Success and survival rates together with radiographic buccal bone thickness and patient satisfaction were evaluated at 12-month post-loading. The aesthetic outcome was evaluated through the Pink (PES) and White (WES) Aesthetic Score by 8 blind clinicians of different training background and incorporated in modified success criteria. RESULTS: 28 implants were placed on 28 patients. No statistically significant differences were noted in PES (10.54 control versus 10.80 test), WES scores (6.97 control versus 6.95 test) or success criteria including aesthetic parameters (modified success criteria) for the different specialty groups (Range 69%-92%). In addition, no statistically significant differences were noted in survival (100%), success (100%), buccal wall thickness between control (0.72 ± 0.22) and test group (0.92 ± 0.31) and patients' reported outcomes. CONCLUSIONS: Immediate dental implant treatment with flap/ MSTEF provided similar mean PES/WES scores, modified success rate, survival, mean buccal bone levels and patients' satisfaction. However, aesthetic failures were common in both groups.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Carga Imediata em Implante Dentário , Coroas , Estética Dentária , Seguimentos , Humanos , Extração Dentária , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia , Resultado do Tratamento
7.
Artigo em Inglês | MEDLINE | ID: mdl-34073250

RESUMO

BACKGROUND: Recent data have shown that short dental implants can be the preferred treatment in most of cases of posterior atrophic alveolar ridges, offering higher survival and lower complication rates than long implants. The survival rates, stability, and marginal bone level changes were compared between short implants (7 and 8.5 mm) and standard-length implants (≥10 mm). METHODS: Prospective observational study in which adult patients requiring ≥1 osseointegrated implants to replace missing teeth were recruited consecutively. A clinical examination was performed on the day the definitive prosthesis was placed and after 6 and 12 months. Implant stability quotient (ISQ), marginal bone level (MBL) changes, and the correlation between these parameters and the characteristics of the implants were evaluated. RESULTS: A total of 99 implants were inserted (47 short, 52 standard) in 74 patients. The 12-month survival rate was 100%. ISQ values showed a similar pattern for both types of implants. No correlation was found between ISQ changes after one year and MBL values, nor between the latter and the characteristics of the implants. CONCLUSIONS: With clinical treatment criteria, shorter implants (7 and 8.5 mm in length) can be just as useful as standard-length implants in atrophic alveolar ridges, demonstrating similar rates of survival, stability, and crestal bone loss.


Assuntos
Implantes Dentários , Adulto , Processo Alveolar , Falha de Restauração Dentária , Seguimentos , Humanos , Estudos Prospectivos , Resultado do Tratamento
8.
Artigo em Inglês | MEDLINE | ID: mdl-33802261

RESUMO

We present the preliminary results of the treatment of teeth with a deep, non-contained periodontal residual defect, vestibular bone dehiscence, and soft tissue recession, by combining an apical non-incised papilla surgical approach (NIPSA) to the defect and leukocyte platelet-rich fibrin (L-PRF) in the vestibular aspect. Four patients (upper left first premolar, upper left central incisor, upper right central incisor and upper right lateral incisor) have been treated. At one year of follow up, all cases showed a considerable reduction in the periodontal pocket depth, a gain in clinical attachment and no bleeding on probing, as well as an improvement in the marginal soft tissue minimizing soft tissue contraction (recession and/or loss of papilla) and improving soft tissue architecture. NIPSA plus L-PRF seem to improve clinical outcomes in deep non-contained intrabony defects associated with soft tissue recession.


Assuntos
Perda do Osso Alveolar , Fibrina Rica em Plaquetas , Perda do Osso Alveolar/cirurgia , Regeneração Tecidual Guiada Periodontal , Humanos , Leucócitos , Perda da Inserção Periodontal/cirurgia , Resultado do Tratamento
9.
Artigo em Inglês | MEDLINE | ID: mdl-33498884

RESUMO

Medication-induced jaw osteonecrosis (MRONJ) is a rare and serious disease with a negative impact on patients' quality of life, whose exact cause remains unclear and which may have a multifactorial origin. Although there are different therapeutic protocols, there is still no consensus. This case series evaluated three patients diagnosed with staged 2 MRONJ treated at the University of Murcia dental clinic according to the protocols described by the Spanish Society of Oral and Maxillofacial Surgery and the American Association of Oral and Maxillofacial Surgeons. Within 12 months of the application of therapeutic protocols, the lesions were completely healed in all cases. Radiography showed slow but progressive healing with normal bone structure. Conservative treatment with antibiotics, chlorhexidine rinses and minimally invasive surgical intervention with necrotic bone resection is effective in treating stage 2 of MRONJ. In cases of refractory osteonecrosis, the application of platelet and leukocyte-rich fibrin (PRF-L) in the surgical approach improves the outcome in soft tissue healing and bone regeneration but further research is needed to confirm its effectiveness.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/cirurgia , Tratamento Conservador , Humanos , Qualidade de Vida , Cicatrização
10.
Med. oral patol. oral cir. bucal (Internet) ; 25(6): e720-e727, nov. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-197178

RESUMO

BACKGROUND: Few studies have reported the outcomes of immediate placement at infected post-extraction sites. The aim of this study was to compare clinical and radiological outcomes of immediately placed implants with im-mediate prosthetic provisionalization in sockets with or without acute periapical pathology. MATERIAL AND METHODS: A total of 100 patients with immediately placed implants with immediate provisionalization and 1- year of follow up were included (50 patients with acute periapical pathology and a control group of 50 patients without acute periapical pathology). Clinical parameters (bleeding on probing, buccal keratinized mucosa width, clinical recession, and probing depth) and radiological parameters (distance from implant shoulder to first point of bone-to-implant contact [IS-BIC]) were assessed. RESULTS: Clinical parameters showed no significant differences between the study and control groups after 1-year follow up (p > 0.05). IS-BIC presented the following values: 0.35 ± 0.51 mm (study group) and 0.15 ± 0.87 mm (control), without significant differences between the groups (p = 0.160). None of the 50 radiographs of immediate implants placed in sockets with periapical pathology revealed retrograde peri-implantitis. CONCLUSIONS: Immediate placement of implants with immediate prosthetic provisionalization at sites with acute periapical pathology can be a successful treatment modality for at least 1-year


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Implantação Dentária Endóssea/métodos , Extração Dentária/métodos , Implantes Dentários , Estudos Prospectivos , Fatores de Tempo , Seguimentos , Peri-Implantite/cirurgia , Resultado do Tratamento
11.
Pediatr Cardiol ; 41(4): 837-842, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32107585

RESUMO

Tetralogy of Fallot (ToF) treatment is difficult in patients with surgical risk factors or unfavorable anatomy. Stent implantation in the right ventricular outflow tract (RVOT) is an option for these patients. We report our initial experience in Chile with RVOT stenting in patients with ToF. Retrospective and descriptive study conducted in three pediatric cardiovascular centers in Chile between 2012 and 2015, including all ToF patients with stent in the RVOT as first procedure. Clinical records, echocardiographic, interventional, and surgical reports were reviewed for demographics and information of RVOT and pulmonary arteries. 12 newborns with ToF were included (75% female). Median age was 20 days (1-70) and mean weight was 2178 g (1400-3414). Saturations increased after the procedure from 74.3% (55-88) to 88.5% (80-98%), (p < 0.01). No complications or mortality were related to interventions. Follow-up was 11 months (7-36). Median right and left pulmonary arteries Z-score increased from - 4.0 (- 5.2 to - 0.3) and - 1.5 (- 4.8 to - 0.26) to + 0.53 (0.0 to 2.2) and + 1.1 (0.5 to 2.9), (p < 0.05), respectively. Nakata index increased from 63 mm2/mm2 (35 to 143) to 162 mm2/mm2 (107 to 197), (p < 0.05). Surgical repair was performed at a median of 4 months (2-7). Transannular patch repair was necessary in all patients and there was no surgical mortality. RVOT stenting is a safe and useful option for patients with ToF and surgical risk factors or unfavorable anatomy. It increases the pulmonary blood flow, improving saturation and pulmonary artery growth as a bridge for surgical repair.


Assuntos
Cateterismo Cardíaco/métodos , Stents , Tetralogia de Fallot/cirurgia , Cateterismo Cardíaco/efeitos adversos , Chile , Ecocardiografia , Feminino , Humanos , Lactente , Recém-Nascido de Baixo Peso , Masculino , Cuidados Paliativos/métodos , Artéria Pulmonar/patologia , Artéria Pulmonar/cirurgia , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
12.
Artigo em Inglês | MEDLINE | ID: mdl-31613938

RESUMO

This case report presents the preliminary results of combining a modification of the nonincised papillae surgical approach (NIPSA), attempting to improve outcomes in the treatment of teeth with advanced periodontal support loss. The modification added a connective tissue graft (CTG) in the buccal aspect of these unfavorable cases caused by deep buccal bone dehiscence, soft tissue deficiencies, or tooth malposition (especially when positioned outside the bony contour). Deep, intrabony, noncontained defects affecting the maxillary incisors were treated in four patients. At the 1-year follow-up, all cases showed an improvement in the marginal soft tissue with considerable reductions in periodontal pocket depth and gains in clinical attachment. NIPSA plus CTG seem to improve clinical outcomes in deep, noncontained intrabony defects.


Assuntos
Perda do Osso Alveolar , Transplantes , Tecido Conjuntivo , Seguimentos , Regeneração Tecidual Guiada Periodontal , Humanos , Perda da Inserção Periodontal , Bolsa Periodontal , Resultado do Tratamento
13.
Clin Oral Investig ; 17(1): 147-58, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22323056

RESUMO

OBJECTIVES: The pineal gland hormone, melatonin, is an immunomodulator and neuroendocrine hormone; it also stimulates monocyte, cytokine and fibroblast proliferations, which influence angiogenesis. The aim of this study was to investigate the effects of melatonin on angiogenesis during bone defect repair by means of radiological and histomorphometric evaluations of bone response to melatonin implants. MATERIALS AND METHODS: Twenty New Zealand rabbits weighing 3,900-4,500 g were used. Twenty melatonin implants were inserted in the proximal metaphyseal area of the animals' right tibia and 20 control areas were located in the left proximal metaphyseal area. Following implantation, the animals were sacrificed in groups of five, after 1, 2, 3 and 4 weeks, respectively. Anteroposterior and lateral radiographs were taken, and radiographic thermal imaging analysis was performed for all groups at different time stages following implant insertion. Samples were sectioned at 5 µm and stained using Hematoxylin-Eosin and Masson's trichrome, supplementing radiographic findings with histomorphometric analysis. RESULTS: After 4 weeks, radiological images showed complete repair of the bone defects. No healed or residual bone alterations attributable to the presence of the melatonin implant were observed. Histomorphometric analysis at 4 weeks showed the presence of a higher density newly formed bone. There were statistically significant differences in the length of cortical formation between the melatonin group and the control group during the first weeks of the study; there were also statistically significant differences in the number of vessels observed in the melatonin groups at the first two study stages. CONCLUSION AND CLINICAL RELEVANCE: Melatonin may have potential beneficial effects on bone defect repair.


Assuntos
Indutores da Angiogênese/farmacologia , Remodelação Óssea/efeitos dos fármacos , Melatonina/farmacologia , Neovascularização Fisiológica/efeitos dos fármacos , Tíbia/efeitos dos fármacos , Animais , Densidade Óssea/efeitos dos fármacos , Capilares/patologia , Colágeno/análise , Corantes , Implantes de Medicamento , Processamento de Imagem Assistida por Computador/métodos , Linfócitos/patologia , Macrófagos/patologia , Osteoblastos/patologia , Osteogênese/efeitos dos fármacos , Osteotomia/métodos , Coelhos , Intensificação de Imagem Radiográfica/métodos , Termografia/métodos , Tíbia/irrigação sanguínea , Tíbia/diagnóstico por imagem , Fatores de Tempo , Cicatrização/efeitos dos fármacos
14.
Clin Oral Implants Res ; 23(2): 228-235, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21435017

RESUMO

PURPOSE: The aim of the present study was to evaluate bone remodeling and bone-to-implant contact (BIC) after immediate placement at different levels in relation to the crestal bone of Beagle dogs. MATERIALS AND METHODS: The mandibular bilateral second, third and fourth premolars of six Beagle dogs were extracted and six implants were immediately placed in the hemi-arches of each dog. Randomly, three cylindrical and three tapered implants were inserted crestally (control group) and 2 mm subcrestally (experimental group). Both groups were treated with a minimal mucoperiosteal flap elevation approach. A gap from the buccal cortical wall to the implant was always left. Three dogs were allowed a 4-week submerged healing period and the other three an 8-week submerged healing period. The animals were sacrificed and biopsies were obtained. Biopsies were processed for ground sectioning. Histomorphometric analysis was carried out in order to compare buccal and lingual bone height loss, and BIC between the two groups. RESULTS: All implants osseointegrated clinically and histologically. Healing patterns examined microscopically at 4 and 8 weeks for both groups (crestal and subcrestal) yielded similar qualitative bone findings. The distance from the top of the implant collar to the first BIC in the lingual crest (A-Lc) showed a significant difference (P=0.0313): 1.91 ± 0.2 mm in the control group and 1.08 ± 0.2 mm in the experimental group. There was less bone resorption in subcrestal implants than crestal implants. The mean percentage of newly formed BIC was greater with the cylindrical implant design (46.06 ± 4.09%) than with the tapered design (32.64 ± 3.72%). CONCLUSION: These findings suggest that apical positioning of the top of the implant does not jeopardize bone crest and peri-implant tissue remodeling. However, less resorption of the Lc may be expected when implants are placed 2 mm subcrestally.


Assuntos
Processo Alveolar/cirurgia , Remodelação Óssea , Reabsorção Óssea/patologia , Implantação Dentária Endóssea/métodos , Processo Alveolar/patologia , Análise de Variância , Animais , Cães , Implantes Experimentais , Mandíbula/cirurgia , Osseointegração/fisiologia , Projetos Piloto , Distribuição Aleatória , Cicatrização/fisiologia
15.
Implant Dent ; 16(2): 155-64, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17563506

RESUMO

PURPOSE: This article describes how the concept of platform switching has been incorporated into a new implant design as a method of reducing crestal bone loss and maintaining the gingival papillae. A 6-month study of the effects of this implant on bone loss is described. MATERIALS: Ten new platform switched implants were placed into fresh anterior maxillary extraction sites in 3 men and 7 women, ranging in age between 29 and 45 years old, and immediately provisionalized. The adjoining bone height was evaluated with digital radiography on the day after implant placement, and at 15 days, 1, 2, 3, and 6 months later. RESULTS: After 6 months, the mean bone loss on the mesial of the central-incisor implants was 0.05 mm. The mean bone loss was 0.07 mm on the distal of the central incisor implants, 0.07 mm on the mesial of the lateral-incisor implants, and 0.06 mm on the distal of the lateral-incisor implants. CONCLUSIONS: An implant design that incorporates the concept of platform switching is a simple and effective way to control circumferential bone loss around dental implants, helping to ensure a predictable esthetic result.


Assuntos
Perda do Osso Alveolar/prevenção & controle , Implantes Dentários , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Estética Dentária , Adulto , Processo Alveolar/diagnóstico por imagem , Coroas , Dente Suporte , Feminino , Seguimentos , Gengiva/patologia , Humanos , Incisivo , Masculino , Maxila/diagnóstico por imagem , Maxila/cirurgia , Pessoa de Meia-Idade , Radiografia Dentária Digital , Propriedades de Superfície , Alvéolo Dental/cirurgia
16.
J Ir Dent Assoc ; 53(4): 187-90, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-18201023

RESUMO

Narrow alveolar ridges remain a serious challenge for the successful placement of endosseous implants. This article reports a technique for widening the atrophic ridge by splitting the alveolar bone longitudinally and filling the bone gap with collagenised pig bone, treatment of ridges as thin as 2.5mm at the alveolar crest and simultaneous placement of dental implants. Treatment of a 22-year-old female patient with a severely resorbed anterior maxilla is described. 4mm wide by 13mm long threaded Osseotite implants were immediately placed within the split ridge and surrounded with a mixture of autogenous tuberosity and collagenised pig bone. The advantages of this technique for patients include less surgical trauma and reduced treatment time.


Assuntos
Aumento do Rebordo Alveolar/métodos , Implantação Dentária Endóssea/métodos , Maxila/cirurgia , Adulto , Animais , Regeneração Óssea , Restauração Dentária Temporária/métodos , Feminino , Humanos , Maxila/anormalidades , Suínos
17.
Ann Thorac Surg ; 82(5): 1611-8; discussion 1618-20, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17062214

RESUMO

BACKGROUND: Avoidance of cardiopulmonary bypass (CPB) and aortic cross-clamping during the Fontan procedure has been advocated to improve outcomes. We continue to use CPB with aortic cross-clamping for the Fontan procedure. METHODS: We performed a review of patients undergoing the Fontan procedure between January 1, 2000 and December 31, 2004. RESULTS: The Fontan procedure was performed in 160 patients. The median age was 2.2 years (range, 1.0 to 29.1 years). Hypoplastic left heart syndrome or a variant was present in 114 patients (71%), and heterotaxy was present in 19 (12%). CPB and modified ultrafiltration were used in all patients. Aortic cross-clamping was used in 154 (96%) of 160 patients and deep hypothermic circulatory arrest (DHCA) in 132 (83%). A lateral tunnel Fontan was performed in 69 patients (43%) and an extracardiac Fontan in 91 (57%). A fenestration was created in 144 patients (90%). Two patients died. Freedom from death or takedown was 98% (157/160). Median duration of pleural drainage was 2 days (range, 1 to 44 days) and was more than 14 days in 16 patients. Median duration of hospitalization was 6 days (range, 3 to 55 days). The small number of deaths precluded assessment of risk factors for mortality. By multivariable analysis, risk factors for pleural drainage longer than 3 days were extracardiac connection (p < 0.001) and increasing mean pulmonary artery pressure before the Fontan procedure (p = 0.033). By multivariable analysis, risk factors for hospitalization for more than 7 days were extracardiac connection (p = 0.003), increasing duration of total support (CPB and DHCA, p = 0.027), and decreasing systemic oxygen saturation before the Fontan procedure (p = 0.048). CONCLUSIONS: The Fontan procedure can be performed using CPB and aortic cross-clamping with low morbidity and mortality.


Assuntos
Aorta/cirurgia , Ponte Cardiopulmonar , Técnica de Fontan , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Constrição , Técnica de Fontan/mortalidade , Cardiopatias Congênitas/cirurgia , Humanos , Lactente , Resultado do Tratamento
18.
Med Oral Patol Oral Cir Bucal ; 11(1): E52-5, 2006 Jan 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-16388295

RESUMO

AIM: The aim of this article is to assess the efficiency of the technique for the posterior alveolar expansion and elevation of the upper maxillary alveolar ridge through the use of compressive osteotomes (Quirurgical Bontempi, España) which have been specifically designed for Osseotite NT and Osseotite NT Certain of 3i implants (Implants Innovations, USA). MATERIALS AND METHODS: 24 adult patients (16 female and 12 male), who were selected according to Albrektsson's inclusion and exclusion criteria, took part in the study. All the patients presented bone deficiency in the width and height of the upper maxilla. 48 Osseotite implants were performed (four Osseotite Standard; six Osseotite NT; 38 NT Certain (3i, Implants Innovations, CA, USA)). Implant diameters were 4 mm in 44 cases and 5 mm in 4 cases with lengths varying between 11.5 (n = 4) and 13 mm (n = 44). The alveolar ridges of the 24 patients had initial widths from 1.5 mm to 5 mm and heights between 5 and 13 mm. RESULTS: The data obtained were analysed using the SPSS 11.0 program. In the 48 areas treated with immediate implants, an increase in bone height of 6.75 mm -/+ 1.25 mm was achieved. In the case of the alveolar expansion for the 48 implants, the average was 3.2 mm -/+ 0.15 mm. CONCLUSIONS: The technique for alveolar expansion and elevation of the upper maxilla with compressive osseotomes can lead to a 100% success rate after a 9-month follow-up of the implants and insertion of prostheses. It is a highly predictable surgical procedure which allows implants to be performed at the same time as surgery, thus reducing the number of such interventions while recovering aesthetic and functional losses in the patient.


Assuntos
Perda do Osso Alveolar/cirurgia , Implantação Dentária Endóssea/métodos , Implantes Dentários , Seio Maxilar/cirurgia , Procedimentos Cirúrgicos Pré-Protéticos Bucais/métodos , Adolescente , Adulto , Idoso , Transplante Ósseo , Instrumentos Odontológicos , Planejamento de Prótese Dentária , Feminino , Humanos , Arcada Edêntula/reabilitação , Masculino , Doenças Maxilares/cirurgia , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Pré-Protéticos Bucais/instrumentação , Osteotomia/instrumentação
19.
Med. oral patol. oral cir. bucal (Internet) ; 11(1): 52-55, ene. 2006. ilus
Artigo em Es | IBECS | ID: ibc-042629

RESUMO

Objetivo: El objetivo de este artículo es evaluar la eficacia de la técnica del ensanchamiento alveolar posterior y elevación del rebordealveolar del maxilar superior mediante el uso de los osteótomos compresivos ( Quirurgical Bontempi, España) especialmente diseñados para los implantes Osseotite NT y Osseotite NT Certain de 3i ( Implants Innovations, USA). Material y métodos: En el estudio se incluyeron 24 pacientes (16 mujeres y 8 hombres) siguiendo los criterios de inclusión y exclusiónde Albrektsson, que presentaban un déficit óseo en anchura y altura del maxilar superior. Se colocaron 48 implantes Osseotite ( cuatro Osseotite Standard, seis Ossoetite NT y treinta y ocho NT Certain (3i, Implantes Innovations, CA, USA). El diámetro de los implantes fueron 44 de 4 mm y 4 de 5 mm con longitudes que variaban entre 11.5 (n=4) y 13 mm (n= 44). La cresta alveolar inicial tenía una anchura que variaba de 1.5mm a 5 mm y una altura que oscilaba entre 5 mm y 13 mm en los 24 pacientes. Resultados: Los datos obtenidos fueron analizados con el programa SPSS 11.0. En los 48 sitios tratados donde se colocaron los implantes inmediatos se obtuvo un aumento de altura ósea de 6.75 mm ± 1.25 mm. En el ensanchamiento alveolar de los 48 sitios implantados la media fue de 3.2 mm ± 0.15 mm. Conclusiones: La técnica de ensanchamiento y elevación alveolar del maxilar superior con osteótomos compresivos permiteobtener un porcentaje de éxito de un 100 % a los 9 meses de seguimiento en los implantes y prótesis colocadas. Es un procedimiento quirúrgico con alta predictibilidad y además permite la colocación los implantes en el mismo acto quirúrgico reduciendo el número de cirugías, devolviendo la estética y función del paciente perdidas


Aim: The aim of this article is to assess the efficiency of the technique for the posterior alveolar expansion and elevation of the upper maxillary alveolar ridge through the use of compressive osteotomes (Quirurgical Bontempi, España) which have been specifically designed for Osseotite NT and Osseotite NT Certain of 3i implants (Implants Innovations, USA). Materials and Methods: 24 adult patients (16 female and 12 male), who were selected according to Albrektsson’s inclusion and exclusion criteria, took part in the study. All the patients presented bone deficiency in the width and height of the upper maxilla. 48 Osseotite implants were performed (four Osseotite Standard; six Osseotite NT; 38 NT Certain (3i, Implants Innovations, CA, USA)). Implant diameters were 4 mm in 44 cases and 5 mm in 4 cases with lengths varying between 11.5 (n = 4) and 13 mm. (n = 44). The alveolar ridges of the 24 patients had initial widths from 1.5 mm to 5 mm and heights between 5 and 13mm. Results: The data obtained were analysed using the SPSS 11.0 program. In the 48 areas treated with immediate implants, an increase in bone height of 6.75 mm ± 1.25 mm. was achieved. In the case of the alveolar expansion for the 48 implants, the average was 3.2 mm. ± 0.15 mm. Conclusions: The technique for alveolar expansion and elevation of the upper maxilla with compressive osseotomes can lead to a 100% success rate after a 9-month follow-up of the implants and insertion of prostheses. It is a highly predictable surgical procedure which allows implants to be performed at the same time as surgery, thus reducing the number of such interventions while recovering aesthetic and functional losses in the patient


Assuntos
Masculino , Feminino , Adulto , Idoso , Adolescente , Pessoa de Meia-Idade , Humanos , Perda do Osso Alveolar/cirurgia , Implantação Dentária Endóssea/métodos , Implantes Dentários , Seio Maxilar/cirurgia , Procedimentos Cirúrgicos Pré-Protéticos Bucais/métodos , Instrumentos Odontológicos , Planejamento de Prótese Dentária , Arcada Edêntula/reabilitação , Doenças Maxilares/cirurgia , Procedimentos Cirúrgicos Pré-Protéticos Bucais/instrumentação , Osteotomia/instrumentação , Transplante Ósseo
20.
J Ir Dent Assoc ; 51(4): 173-6, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16358677

RESUMO

This article describes the immediate replacement of two maxillary lateral incisors teeth after extraction of the left lateral deciduous incisor at the same time with immediate Osseotite implants and immediate restoration. A traumatic dental extraction of a deciduos (b) lateral incisor was performed and a 4mm diameter x 15 mm 3i tapered Osseotite (Implants Innovations, Palm Beach, CA, USA) implant was immediately placed. The other lateral incisor place was treated at the same time and provisional temporary crowns were placed at the same surgery. The provisional crowns did not have any occlusal contact to reduce negative lateral forces. Final impression for definitive restoration was made five months after implant placement veneer ceramic crowns were bonded to the Gingihue abutment (3i, Implants Innovations, Palm Beach, CA) one month later. This article describes the use of immediate implants with immediate loading of Osseotite combined with provisional crowns resulted in an excellent outcome after a two-year follow up period.


Assuntos
Coroas , Dente Suporte , Implantes Dentários para Um Único Dente , Restauração Dentária Temporária , Incisivo , Maxila/cirurgia , Adulto , Anodontia/terapia , Cerâmica , Prótese Dentária Fixada por Implante , Facetas Dentárias , Feminino , Seguimentos , Humanos , Alvéolo Dental/cirurgia , Dente Decíduo/cirurgia , Resultado do Tratamento
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