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1.
No Shinkei Geka ; 48(11): 1021-1027, 2020 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-33199659

RESUMO

We reported 10 cases of lumbo-peritoneal(L-P)shunt placement using the lateral approach without repositioning. Each patient was placed in a left lateral position under general anesthesia and fixed so that the spine did not rotate. The skin incision on the flank was made at the height of the L4 vertebral body, 4 cm in the left-right direction and 3cm in front of the vertebral body. The external oblique, internal oblique, and transverse abdominal muscles were dissected to reach the peritoneum and confirm that the intestinal tract was peristaltic below the peritoneum. The peritoneum was lifted with hooked tweezers in order to separate them from the intestinal tract, and the peritoneum was incised with a scalpel to reach the peritoneal cavity. Using a finger and a shunt passer, the ventral catheter was guided between the muscle layers. Preoperative abdominal CT showed that all 10 kidneys in this case series were cephalic from the predicted approach route. The ascending colons of three patients were partially in contact with the predicted approach route. During surgery, a ventral catheter could be inserted in all 10 cases. Postoperative abdominal CT showed no intraperitoneal hemorrhage or invasion into the retroperitoneal cavity of the ventral catheter. During the follow-up period, no invasion into the abdominal wall or infection was observed. The average operation time was 52.2 minutes. In order to avoid invasion into the retroperitoneal cavity, a surgical incision was performed without complications by incising the outer side of the lower abdomen and approaching via the external oblique aponeurosis.


Assuntos
Cateteres de Demora , Cavidade Peritoneal , Abdome , Humanos , Instrumentos Cirúrgicos , Derivação Ventriculoperitoneal
2.
Am J Vet Res ; 81(9): 755-759, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33112165

RESUMO

OBJECTIVE: To compare the bursting strength of the uterine horns (UHs) and cervical-vestibule junction (CVJs) of rabbits following sealing with a vessel-sealing device (VSD) or encircling ligatures. SAMPLE: UHs and CVJs collected from 30 rabbit (Oryctolagus cuniculus) cadavers. PROCEDURES: UHs and CVJs were randomly assigned to sealing with encircling Miller knot ligatures (LIG; n = 10 CVJs and 20 UHs) or a VSD (12 CVJs and 24 UHs). Lumens were infused with saline (0.9% NaCl) solution under pressure until seals burst or to a maximum pressure of 300 mm Hg. RESULTS: For CVJs, median (range) bursting pressure of the LIG and VSD groups was > 300 mm Hg (224 to > 300 mm Hg) and 35 mm Hg (0 to 60 mm Hg), respectively. Five of 12 CVJs in the VSD group failed at pressures < 33 mm Hg. For UHs, median (range) bursting pressure of the LIG and VSD groups was 255 mm Hg (120 to > 300 mm Hg) and 154 mm Hg (range, 44 to 202 mm Hg), respectively. CONCLUSIONS AND CLINICAL RELEVANCE: The evaluated VSD was effective in sealing UHs at bursting pressures well in excess of expected physiologic pressures, indicating that the VSD may be useful for ovariectomy procedures in rabbits. However, CVJ seals created with the VSD were ineffective and could potentially burst at low pressures, which could predispose to urine entering the abdomen. Given these results, we do not recommend sealing of the CVJ with a VSD for ovariohysterectomy in rabbits.


Assuntos
Histerectomia , Instrumentos Cirúrgicos , Animais , Feminino , Histerectomia/veterinária , Ligadura/veterinária , Ovariectomia/veterinária , Coelhos
3.
Anticancer Res ; 40(11): 6517-6523, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33109592

RESUMO

BACKGROUND/AIM: Precise tumor localization during gastrointestinal surgery improves curability and function preservation. We investigated the efficacy of preoperative endoscopic fluorescent clip marking using a Zeoclip FS with built-in near-infrared fluorescent resins in delineating gastrointestinal cancer for surgery. PATIENTS AND METHODS: We evaluated the intraoperative visibility of the Zeoclip FS using a VISERA ELITE 2 and the short-term outcomes of 37 cancer patients (colorectal, n=23; gastric, n=14) who underwent preoperative fluorescent clip marking. RESULTS: The study included 23 male and 14 female subjects with a mean age of 73 years (range=39-87 years). Thirty-three patients (89.1%) exhibited clear fluorescent clip marking and easily determined transection lines. Fluorescence was not observed in 1 sigmoid colon cancer patient (2.7%), who required a colonic stent for preoperative obstruction. Three patients (8.1%) required additional procedures for fluorescence visualization. CONCLUSION: Endoscopic fluorescent clip marking can delineate tumors well for determining the extent of resection.


Assuntos
Neoplasias Colorretais/cirurgia , Endoscopia Gastrointestinal , Neoplasias Gastrointestinais/cirurgia , Laparoscopia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/fisiopatologia , Feminino , Corantes Fluorescentes/química , Gastrectomia/métodos , Neoplasias Gastrointestinais/diagnóstico por imagem , Neoplasias Gastrointestinais/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Instrumentos Cirúrgicos
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4704-4707, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019042

RESUMO

Disposable forceps are frequently used in different surgical procedures to prevent infections caused by poorly sterilized reusable metal forceps. Compared to traditional rigid-joint mechanisms, compliant mechanisms are much easier to sterilize due to their monolithic structure, hence they are widely used for designing disposable surgical forceps. However, the clamping performance of plastic compliant forceps is generally less robust than metal forceps, which has greatly limited their use in medical applications. To cope with this problem, a novel 3D-printed plastic compliant forceps with optimized clamping performance was developed in this paper for open surgery and physical nursing applications. Bio-inspired topology optimization techniques were employed to synthesize the forceps. The clamping capability of the proposed forceps was evaluated by finite element analysis and loading tests. Results showed that the proposed forceps can generate greater and more stable clamping forces than the previous model of disposable compliant forceps. The proposed bionic optimization method also has potential for synthesizing compliant devices for robotic surgery.


Assuntos
Equipamentos Descartáveis , Reutilização de Equipamento , Biônica , Biópsia , Constrição , Instrumentos Cirúrgicos
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5049-5052, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019121

RESUMO

Suture ligation of vascular tissues is slow and skill intensive. Ultrasonic (US) and radiofrequency (RF) devices enable more rapid vascular tissue ligation to maintain hemostasis, than sutures and mechanical clips, which leave foreign objects in the body and require exchange of instruments. However, US and RF devices are limited by excessive collateral thermal damage to adjacent tissues, and high jaw temperatures that require a long time to cool. A novel alternative method using infrared (IR) laser energy is being developed for more rapid and precise sealing of vessels. This study describes design, modeling, and initial testing of several optical beam shaping geometries for integration into the standard jaws of a laparoscopic device. The objective was to transform the circular laser beam into a linear beam, for uniform, cross-irradiation and sealing of blood vessels. Cylindrical mirrors organized in a staircase geometry provided the best spatial beam profile.Clinical Relevance-This study explored several optical designs for potential integration into the standard jaws of a laparoscopic vessel sealing device, transforming a circular laser beam into a linear beam for sealing of vascular structures.


Assuntos
Laparoscopia , Lasers , Ligadura , Instrumentos Cirúrgicos , Suturas
6.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(5): 546-549, 2020 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-33085240

RESUMO

OBJECTIVE: To investigate the application of nasal clip in the one-stage repair of unilateral cleft lip nasal deformity. METHODS: Sixty patients with unilateral cleft lip nasal deformity underwent one-stage repair in the Department of Cleft Lip and Palate, West China Hospital of Stomatology, Sichuan University, from January 2017-June 2018. Sixty patients were divided into three groups, nasal clip group, the nasal module group, and the control group. All of the patients were returned to the clinic after the operation (6-12 months), and the nasal appearance was evaluated. RESULTS: The nasal shape development and aesthetic effect in the nasal clip group were significantly improved than that in the control group (P<0.05). CONCLUSIONS: The nasal clip has a good effect on the improvement of nasal appearance after the one-stage repair of unilateral cleft lip nasal deformity. The nasal clip is easy to operate, and the patient compliance is good, which is worthy of clinical promotion.


Assuntos
Fenda Labial , Rinoplastia , China , Fenda Labial/cirurgia , Humanos , Nariz/cirurgia , Instrumentos Cirúrgicos
7.
Medicine (Baltimore) ; 99(41): e22545, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031298

RESUMO

BACKGROUND: Nasogastric tubes can be easily inserted in patients under general anesthesia. However, for difficult cases, insertion techniques that can be used in routine clinical practice are limited. SUZY forceps are designed for the removal of pharyngolaryngeal foreign bodies under guidance of a McGrath videolaryngoscope. We hypothesized that using SUZY forceps under McGrath videolaryngoscopic guidance may facilitate nasogastric tube insertion and tested this in a randomized controlled trial. METHODS: Adult patients who underwent gastrointestinal or hepato-pancreato-biliary surgery were randomly allocated to 2 groups; the SUZY group and the Magill group. Patients, nurses, and all clinical staff except for the attending anesthesiologist were blinded to group assignment throughout the study. After anesthesia induction, insertion of the nasogastric tube was performed by skilled anesthesiologists with either SUZY or Magill forceps according to group allocation under McGrath videolaryngoscopic guidance. The primary endpoint was insertion time which was defined as the time required to advance the nasogastric tube by 55 cm from the nostril. Secondary endpoints were the success rates of the nasogastric tube insertion, which were defined as a 55-cm advancement from the nostril at the 1st, 2nd, and 3rd attempt, proper insertion rate, the severity of pharyngolaryngeal complications, and hemodynamic parameters during nasogastric tube insertion. RESULTS: Sixty patients were randomized and none of these patients were excluded from the final analysis. The median [interquartile range] insertion time was 25 [18-33] seconds in the SUZY group, and 33 [21-54] seconds in the Magill group (P = .02). Success rates were not different between the groups (97% and 80% in the SUZY and Magill group at 1st attempt, respectively, P = .10). Both, the severity score of the mucosal injury and the severity of sore throat were higher in the Magill than in the SUZY group, whereas the degree of hoarseness did not differ between the 2 groups. Hemodynamic parameters were not significantly different between the groups. CONCLUSION: Using SUZY forceps under McGrath videolaryngoscopic guidance reduced the time required to insert a nasogastric tube and the severity of pharyngolaryngeal complications, when compared to using Magill forceps.


Assuntos
Intubação Gastrointestinal/métodos , Laringoscopia/métodos , Instrumentos Cirúrgicos , Gravação em Vídeo , Idoso , Anestesia Geral , Desenho de Equipamento , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 6062-6065, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019353

RESUMO

Electrosurgery is used in the operating room on a daily basis as a means to cut tissue and maintain hemostasis. The principle of this technology lies in the transfer of electricity from an electrosurgical unit to the operating site on a patient's body and modifying the waveform of that electricity to achieve the desired surgical effect. Bipolar cautery uses two electrodes, an active and a return, both at the surgical site to perform electrosurgery. Bipolar cautery can be very useful in helping surgeons to operate; however, current designs are not well suited to a 2.1 mm working channel in endoscopic procedures due to their rigid structure, limited range of motion, and bulky design. This paper describes a novel approach to designing a minimally- invasive bipolar cautery tool suitable for flexible neuroendoscopy. The system features 1.9 mm diameter bipolar tips which resemble grasping forceps, making it easier for surgeons to hold tissue while performing electrosurgery. The electrode wires also function as the actuating cables used to open and close the tips, which require 2.10 mm to open the tips to 30.9 °. The results show that the tool can safely cauterize a porcine brain specimen at various settings on the electrosurgical unit, and increasing the setting increases the area of tissue affected by the electricity. Repeatability was demonstrated and exhaustion was reached after the tool was opened and closed 73 times. Future work will involve improving the current design to increase the number of cycles the tool can survive before losing function.


Assuntos
Neuroendoscopia , Animais , Eletrocoagulação , Eletrocirurgia , Humanos , Neuroendoscópios , Instrumentos Cirúrgicos , Suínos
9.
J Card Surg ; 35(11): 2987-2994, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33111445

RESUMO

OBJECTIVE: The Cor-Knot automated fastener has been used to eliminate the need for manual knot-tying in cardiac valve surgery for over a decade. We review the current literature pertaining to Cor-Knot and discuss its benefits and shortcomings with respect to cardiac valve surgery. METHODS: A comprehensive literature search was conducted to identify articles discussing the use of automated fasteners and manually tied knots in the setting of cardiac valve surgery. The search terms used were "heart", "valve surgery", "cardiac", "Cor-Knot", "fastener", "automated fastener", "aortic valve", "mitral valve", "minimally invasive", and "titanium". These terms were used as keywords and, in combination, as MeSH terms to maximize the output of literature searches. Twenty-four relevant articles were identified and reviewed. RESULTS: Current literature provides evidence to support the role of Cor-Knot in facilitating enhanced intraoperative efficacy by reducing total operation times as compared with manual knot-tying. However, studies to date fail to provide evidence for the translation of these intraoperative advantages into improved patient outcomes. Moreover, Cor-Knot is associated with a significant financial burden. CONCLUSION: A plethora of evidence exists to support the intraoperative advantages provided by Cor-Knot. However, the literature is yet to support its role in facilitating superior clinical outcomes as compared with manual knot tying. Larger high-quality trials and studies are required to provide evidence supporting the ongoing use of Cor-Knot in valve surgery.


Assuntos
Procedimentos Cirúrgicos Cardíacos/instrumentação , Valvas Cardíacas/cirurgia , Dispositivos de Fixação Cirúrgica , Procedimentos Cirúrgicos Cardíacos/métodos , Humanos , Instrumentos Cirúrgicos , Titânio
10.
Biomed Instrum Technol ; 54(5): 332-337, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-33049773

RESUMO

This review sought to provide an overview of proposed methods and protocols for processing surgical instruments contaminated with prions. A search of PubMed was conducted to identify studies published between January 1, 2012, and January 2, 2019, with no language restrictions and using varying combinations of the following terms: prions (Medical Subject Heading [MeSH]) OR decontamination (MeSH) OR cleaning OR disinfection OR sterilization. Articles were excluded if they did not involve medical device surfaces or describe the processing protocol. At least two reviewers independently selected articles, extracted data, and assessed data. A total of 627 articles published in peer-reviewed journals were identified. Of the 55 articles assessed for full-text eligibility, eight met the inclusion criteria. Only a few studies investigated protocols and methods for processing prion-contaminated medical devices; therefore, determining the best way to sterilize device surfaces and preserve the integrity of surgical instruments remains challenging. Moreover, the perspective of sterile processing department staff continues to be overlooked when designing studies.


Assuntos
Príons , Desinfecção/normas , Humanos , Instrumentos Cirúrgicos
11.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1658-1661, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018314

RESUMO

Laparoscopic cholecystectomy surgery is a minimally invasive surgery to remove the gallbladder, where surgical instruments are inserted through small incisions in the abdomen with the help of a laparoscope. Identification of tool presence and precise segmentation of tools from the video is very important in understanding the quality of the surgery and training budding surgeons. Precise segmentation of tools is required to track the tools during real-time surgeries. In this paper, a new pixel-wise instance segmentation algorithm is proposed, which segments and localizes the surgical tool using spatio-temporal deep network. The performance of the proposed has been compared with the state-of-the-art image-based instance segmentation method using the Cholec80 dataset. It is also compared with methods in the literature using frame-level presence detection and spatial detection with good results.


Assuntos
Algoritmos , Laparoscopia , Vesícula Biliar/diagnóstico por imagem , Procedimentos Cirúrgicos Minimamente Invasivos , Instrumentos Cirúrgicos
12.
BMC Neurol ; 20(1): 351, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32948136

RESUMO

BACKGROUND: Oculomotor nerve palsy (ONP) is a common symptom of posterior communicating artery aneurysm (PcomAA) that can lead to impaired eye movement and pupil dilation. Currently, surgical clipping and endovascular embolization are the two most popular treatment methods for PcomAA-induced ONP; however, the recovery outcome between the two methods remains to be elucidated. METHODS: In the present study, we thoroughly compared the pretreatment factors and recovery outcome of the two treatments on 70 patients with PcomAA-induced ONP. The patients were separated into two groups based on the treatment that was received. Pretreatment factors, including age, sex, time period between ONP onset and treatment, ONP type, aneurysm diameter, status of subarachnoid hemorrhage and aneurysm rupture were recorded for each individual patient. Recovery outcome of the patients was assessed over a 12-month period. RESULTS: No significant differences were observed in any of the analyzed factors. Importantly, we revealed a significantly higher full recovery rate for the patients receiving the surgical clipping treatment than the ones that received the endovascular embolization treatment. In addition, we showed that patients' age was negatively correlated with the recovery extent in both treatment groups. CONCLUSIONS: The outcome of our study suggests that surgical clipping might be a better option to treat PcomAA-induced ONP.


Assuntos
Embolização Terapêutica/métodos , Procedimentos Endovasculares/métodos , Aneurisma Intracraniano/terapia , Doenças do Nervo Oculomotor/etiologia , Recuperação de Função Fisiológica , Adulto , Idoso , Feminino , Humanos , Aneurisma Intracraniano/complicações , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Instrumentos Cirúrgicos
13.
Chirurgia (Bucur) ; 115(4): 526-529, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32876027

RESUMO

Surgical clip migration in the common bile duct with consecutive stone formation is a rare occurrence after laparoscopic cholecystectomy, less than 100 cases being reported so far. We report a case of a 55-year-old woman with obstructive jaundice due to bile duct stone formed around a migrated surgical clip 9 years after laparoscopic cholecystectomy. The patient presented with pain in the upper abdomen and jaundice. Abdominal ultrasound diagnosed dilation of the common bile duct and intrahepatic bile ducts. The diagnosis was confirmed by computed tomography which revealed a metal clip in the distal part of the common bile duct. The patient was managed successfully by endoscopic retrograde cholangiopancreatography (ERCP) and the surgical clip was retrieved using the Dormia basket. The exact mechanism of clip migration is not fully understood but may be explained by local inflammation and ineffective clipping. Although a rare occurrence, clip migration should not be excluded when considering the differential diagnosis of patients presenting with obstructive jaundice or cholangitis after laparoscopic cholecystectomy. Minimally invasive management by ERCP is the procedure of choice for migrated clips related complications but surgical common bile duct exploration may be necessary.


Assuntos
Colecistectomia Laparoscópica/efeitos adversos , Coledocolitíase/etiologia , Ducto Colédoco/cirurgia , Migração de Corpo Estranho/etiologia , Icterícia Obstrutiva/etiologia , Instrumentos Cirúrgicos/efeitos adversos , Colangiopancreatografia Retrógrada Endoscópica , Colecistectomia Laparoscópica/instrumentação , Coledocolitíase/diagnóstico por imagem , Coledocolitíase/cirurgia , Ducto Colédoco/diagnóstico por imagem , Remoção de Dispositivo , Feminino , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/cirurgia , Humanos , Icterícia Obstrutiva/diagnóstico por imagem , Icterícia Obstrutiva/cirurgia , Pessoa de Meia-Idade , Resultado do Tratamento
16.
Asian Cardiovasc Thorac Ann ; 28(9): 618-620, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32856930

RESUMO

The left atrial appendage is thought to be responsible for the majority of embolic strokes, and has become an important target in the surgical management of atrial fibrillation. We present an original clip-and-loop technique using an AtriClip via a left minithoracotomy for post-stroke patients with atrial fibrillation. This procedure was performed in 43 cases between March 2018 and January 2020. No patient had a thrombus at the edge of the clip or communication into the left atrial appendage 3 months after surgery. Anticoagulant could be discontinued in all patients. Follow-up at 23 ± 10 months showed no recurrence of stroke.


Assuntos
Apêndice Atrial/cirurgia , Fibrilação Atrial/cirurgia , Procedimentos Cirúrgicos Cardíacos/instrumentação , Acidente Vascular Cerebral/complicações , Instrumentos Cirúrgicos , Idoso , Idoso de 80 Anos ou mais , Apêndice Atrial/diagnóstico por imagem , Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/etiologia , Feminino , Humanos , Ligadura , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/diagnóstico , Resultado do Tratamento
17.
Skeletal Radiol ; 49(11): 1873-1877, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32827082

RESUMO

The ongoing coronavirus disease 2019 (COVID-19) pandemic has increased the need for safe and efficient testing as a key containment strategy. Drive-through testing with nasopharyngeal swab has been implemented in many places in the USA as it allows for expeditious testing of large numbers of patients, limits healthcare workers' risk of exposure, and minimizes the use of personal protective equipment. We present a case where the aluminum shaft of the nasopharyngeal swab fractured during specimen collection at a drive-through testing facility and was suspected to have remained in the asymptomatic patient. Initial evaluation with a series of radiographs covering the skull base, neck, chest, and abdomen did not reveal the swab. On further clinical evaluation, the swab was found endoscopically, lodged between the left inferior turbinate and nasal floor, and was removed by an otorhinolaryngologist. Using a phantom model, we aimed to delineate an imaging technique to better visualize the aluminum shaft of the nasopharyngeal swab on radiographs to help in identification. A technique using lower tube voltage (kVp) with tight collimation centered at the nasal bones area produced the best visualization of the aluminum shaft of the swab. Recognition that aluminum foreign bodies may be difficult to visualize radiographically and  optimization of radiograph acquisition technique may help guide clinical management in unusual cases. Further evaluation with computed tomography or endoscopy should be considered in suspected cases where radiographs are negative.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/instrumentação , Infecções por Coronavirus/diagnóstico , Falha de Equipamento , Corpos Estranhos/diagnóstico por imagem , Pneumonia Viral/diagnóstico , Manejo de Espécimes/instrumentação , Idoso de 80 Anos ou mais , Alumínio , Humanos , Masculino , Pandemias , Radiografia/métodos , Instrumentos Cirúrgicos
18.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(7): 869-870, 2020 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-32788026

RESUMO

The scalpel is the most practical tool for surgeons. The traditional scalpel is a blade with a split handle, but the length of the blade cannot be adjusted, and it is easy to scratch medical staff. In order to solve the above problems, a retractable scalpel handle was designed by the medical staffs of department of general surgery, Affiliated Hospital of Yangzhou University (Clinical Teaching Hospital of Dalian Medical University), and obtained the National Utility Model Patent of China (ZL 2019 2 0203154.9). The telescopic scalpel adopted the design of rotary telescopic sleeve and threaded column handle to achieve the purpose of built-in blade. By rotating the handle at one end of the handle, the length of the surgical blade extending out of the sleeve could be adjusted according to the actual needs. The structure of the device is simple and easy to operate. The adjustable blade length could also achieve the purpose of accurate operation while effectively avoiding the injury of medical personnel during the operation.


Assuntos
Instrumentos Cirúrgicos , China , Humanos
19.
J Oral Sci ; 62(4): 397-401, 2020 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-32848099

RESUMO

The aim of this study was to compare the clinical outcomes of implant-supported overdentures (ODs) with either bar-clip or ball attachments. The implant, prosthesis failure, and technical complications were the outcomes analyzed in this retrospective clinical study conducted in a specialty clinic. Seventy-five patients with 242 implants supported by 76 ODs (36 maxillary, 40 mandibular) were included in the study and followed up for 88.8 ± 82.9 months (mean ± standard deviation). Bar-clip and ball attachments were used in 78.9% and 21.1% of the cases, respectively. Forty-three implant failures (17.8%) in 17 prostheses (17/76; 22.4%) were observed in this study. The average period of implant failure was 43.3 ± 41.0 months, and most of them were maxillary turned implants. The bar-clip system demonstrated more complications in the attachment parts compared to the ball attachment system. Poor retention of the prosthesis was similar between the two systems. Loss of implants resulted in the failure of 10 ODs in this study. ODs opposed by natural dentition or fixed prostheses presented with more complications. The Cox proportional hazards model did not show a significant effect on prosthesis failure for any of the factors. These findings indicated that patients with ODs need constant maintenance follow-ups to address the technical complications and perform prosthodontic maintenance regardless of the attachment system used.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Humanos , Mandíbula , Estudos Retrospectivos , Instrumentos Cirúrgicos
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