RESUMO
The severely defective socket, in which implant placement within the remaining bone will result in a significantly off-axis implant position, precludes immediate implant placement and requires bone grafting as an initial surgical intervention. The aims of this study were to evaluate autogenous chin bone ring consolidation after the augmentation of severely defective sockets and the clinical application of these rings in the premolar-molar region with simultaneous implant placement in a one-stage procedure. Ten patients with 12 defective sockets were included. Sockets were prepared with a trephine bur. Bone rings with a tapped implant osteotomy were harvested from the chin with a larger trephine bur. Bone rings were fitted in the prepared sockets. An implant drill was used to prepare the bone apical to the ring through its central osteotomy. Implants were screwed through the rings and the apical bone. Patients were examined clinically and radiographically immediately and at 6 months postoperative. Crestal bone changes were measured and evaluated statistically. All grafted sockets showed bone healing with no significant crestal bone resorption and no infection; only one ring showed dehiscence, which healed during the follow-up period. All implants showed radiographic evidence of osseointegration. The autogenous chin bone ring augmentation technique was found to be a reliable alternative method for the management of severely defective sockets.
Assuntos
Aumento do Rebordo Alveolar/métodos , Transplante Ósseo/métodos , Carga Imediata em Implante Dentário/métodos , Alvéolo Dental/cirurgia , Adulto , Densidade Óssea , Tomografia Computadorizada de Feixe Cônico , Implantes Dentários , Feminino , Humanos , Masculino , Mandíbula , Osteotomia , Estudos Prospectivos , Retalhos Cirúrgicos , Resultado do TratamentoRESUMO
Background: Human epidermal growth factor receptor 2 [HER2] is a significant predictive factor for benefit from adjuvant Trastuzumab [HER2-targeted therapy] which is considered the standard treatment for patients with HER2+ early breast cancer [EBC] after completion of adjuvant chemotherapy. We aimed to determine whether the high level of HER2 positivity would influence the outcome of adjuvant Trastuzumab and the prognosis at diagnosis
Patients and Methods: A total of 157 patients with EBC [HER2 positive, lymph nodepositive, hormonal receptors negative] who received adjuvant chemotherapy and Trastuzumab [8 mg/kg intravenously as a loading dose followed by 6 mg/kg every 3 weeks for 6 months] at Albairouni University Hospital. This is a single institute study with two arms based on HER2 positivity ratio. Group A [HER2 FISH ratio 4; n = 66 patients]. The primary endpoint was 3-year disease free survival [DFS] in relation to HER2 FISH ratio
Results: The 3-year DFS in the group A was 75.8Percent, while it was 77.2Percent in the group B [p = 0.31]. Stages II and III in the group A were 32Percent and 68Percent respectively, while in the group B they were 27.27Percent and 72.72Percent respectively. Grades [I-II] and [III-IV] in group A were 60.4Percent and 39.6Percent respectively, while in group B they were 68.18Percent and 31.81Percent respectively. Differences were not statistically significant
Conclusion: The high degree of HER2 amplification [FISH ratio > 4 vs.