scholarly journals Surgical Management of Peri-implantitis

2020 ◽  
Vol 7 (3) ◽  
pp. 283-303
Author(s):  
Ausra Ramanauskaite ◽  
Karina Obreja ◽  
Frank Schwarz
Keyword(s):  
Soft Tissue ◽  
Bone Loss ◽  
Treatment Options ◽  
Intrabony Defects ◽  
Minimum Depth ◽  
Soft Tissue Inflammation ◽  
Open Flap Debridement ◽  
Keratinized Mucosa ◽  
Augmentative Therapy

Abstract Purpose of Review To provide an overview of current surgical peri-implantitis treatment options. Recent Findings Surgical procedures for peri-implantitis treatment include two main approaches: non-augmentative and augmentative therapy. Open flap debridement (OFD) and resective treatment are non-augmentative techniques that are indicated in the presence of horizontal bone loss in aesthetically nondemanding areas. Implantoplasty performed adjunctively at supracrestally and buccally exposed rough implant surfaces has been shown to efficiently attenuate soft tissue inflammation compared to control sites. However, this was followed by more pronounced soft tissue recession. Adjunctive augmentative measures are recommended at peri-implantitis sites exhibiting intrabony defects with a minimum depth of 3 mm and in the presence of keratinized mucosa. In more advanced cases with combined defect configurations, a combination of augmentative therapy and implantoplasty at exposed rough implant surfaces beyond the bony envelope is feasible. Summary For the time being, no particular surgical protocol or material can be considered as superior in terms of long-term peri-implant tissue stability.

scholarly journals Peri-Implant Bone Loss and Peri-Implantitis: A Report of Three Cases and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Vanchit John ◽  
Daniel Shin ◽  
Allison Marlow ◽  
Yusuke Hamada
Keyword(s):  
Soft Tissue ◽  
Bone Loss ◽  
Dental Implant ◽  
Patient Selection ◽  
Treatment Options ◽  
Prevalence Rates ◽  
Review Of The Literature ◽  
Follow Up Care ◽  
Nonsurgical Therapy

Dental implant supported restorations have been added substantially to the clinical treatment options presented to patients. However, complications with these treatment options also arise due to improper patient selection and inadequate treatment planning combined with poor follow-up care. The complications related to the presence of inflammation include perimucositis, peri-implant bone loss, and peri-implantitis. Prevalence rates of these complications have been reported to be as high as 56%. Treatment options that have been reported include nonsurgical therapy, the use of locally delivered and systemically delivered antibiotics, and surgical protocols aimed at regenerating the lost bone and soft tissue around the implants. The aim of this article is to report on three cases and review some of the treatment options used in their management.

scholarly journals Influence of Biologically Oriented Preparation Technique on Peri-Implant Tissues; Prospective Randomized Clinical Trial with Three-Year Follow-Up. Part II: Soft Tissues

2019 ◽  
Vol 8 (12) ◽  
pp. 2223 ◽  
Author(s):  
Rubén Agustín-Panadero ◽  
Naia Bustamante-Hernández ◽  
Carlos Labaig-Rueda ◽  
Antonio Fons-Font ◽  
Lucía Fernández-Estevan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Soft Tissue ◽  
Bone Loss ◽  
Randomized Clinical Trial ◽  
Soft Tissues ◽  
Clinical Parameters ◽  
Preparation Technique ◽  
Bleeding On Probing ◽  
Prospective Randomized Clinical Trial ◽  
Keratinized Mucosa

Purpose: The objective of this prospective randomized clinical trial (RCT) was to analyze and compare the clinical behavior of three types of prosthesis supported by single implants in the posterior region after three years of functional loading. Materials and methods: Seventy-five implants were divided into three groups according to the type of prosthetic restoration: screw-retained crown (group GS); cemented crown without finishing line (biologically oriented preparation technique) (group GBOPT); and conventional cemented crown with finishing line (group GCC). After three years in function, clinical parameters (presence of keratinized mucosa, probing depths, bleeding on probing, and radiographic bone loss) were compared between the three experimental groups. The possible correlation between soft tissue clinical parameters and bone loss was also analyzed. Results: Statistical analysis found significant differences in clinical parameters between the different types of crown, with the cemented restoration without finishing line (BOPT) presenting fewer complications and better peri-implant health outcomes including: significantly different KMW data (mm), with significant differences between groups GBOPT and GCC (p < 0.001, Kruskal–Wallis test), with GBOPT obtaining larger quantities of keratinized mucosa (KM); statistically significant differences in probing depth (PD) values between groups GBOPT and GCC (p = 0.010, Kruskal–Wallis test); significant differences in bleeding on probing (BOP) between groups GBOPT and GCC (p = 0.018, Chi2 test) in favor of GBOPT. Conclusions: Soft tissue behavior around implants is related to the type of prosthetic restoration used, with cemented prostheses with BOPT presenting better peri-implant soft tissue behavior.

Diagnosis and Management of Humeral Head Bone Loss in Shoulder Instability

2012 ◽  
Vol 40 (11) ◽  
pp. 2633-2644 ◽  
Author(s):  
Jack G. Skendzel ◽  
Jon K. Sekiya
Keyword(s):  
Soft Tissue ◽  
Bone Loss ◽  
Humeral Head ◽  
Treatment Options ◽  
Glenohumeral Instability ◽  
Recurrent Instability ◽  
Soft Tissue Repair ◽  
Anterior Glenoid ◽  
Bony Lesions ◽  
Persistent Instability

Humeral head bone defects (Hill-Sachs lesions) are caused by anterior shoulder dislocation with impaction of the posterosuperior humeral head onto the anterior glenoid rim. Frequently, these bony lesions are associated with glenohumeral instability, and large lesions may contribute to recurrent instability after failure of a soft tissue repair. To improve outcomes and minimize the risk of persistent instability, a thorough understanding of the biomechanics of humeral bone loss is required. Detection and quantification of clinically relevant humeral head bone loss are performed through an accurate history, physical examination, and interpretation of imaging studies. The diagnosis and treatment options for reverse Hill-Sachs lesions are discussed, and the various treatment options for Hill-Sachs lesions are reviewed, including operative techniques to limit engagement of the deformity by soft tissue transfer, rotational osteotomy, bone grafting, or osteochondral transplantation.

Management options for the traumatised, intruded incisor in a growing patient

2016 ◽  
Vol 7 (3) ◽  
pp. 116-120
Author(s):  
Lakshmi Rasaratnam
Keyword(s):  
Soft Tissue ◽  
Treatment Options ◽  
Tissue Architecture ◽  
Management Options ◽  
Clinical Cases

The management of an intruded permanent incisor in a growing child can affect the long-term replacement options for the tooth. The various treatment options for managing a traumatised, intruded permanent incisor in a growing child are described, alongside two clinical cases managed differently but with the aim of providing the patient with adequate bone and soft-tissue architecture to ensure that all restorative replacement options would be feasible once growth was complete.

The Notion of Platform-Switching in Implants: A Review

2018 ◽  
Vol 4 (2) ◽  
pp. 454-460
Author(s):  
Ankit Rawat ◽  
Rupinder Singh Dhall ◽  
Nitish Bhat ◽  
Shivika Ahluwalia ◽  
Novika Sahni ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Bone Loss ◽  
Clinical Applications ◽  
Factors Affecting ◽  
Bone Maintenance ◽  
Crestal Bone Loss ◽  
Implant Therapy ◽  
Platform Switching

Platform switching implies to the mismatch in diameter of the abutment and that of the implant collar or in particular, use of the abutments with lesser diameter on a greater diameter implant collar. Platform switching was proposed as a process to improve long-term bone maintenance around implants. The clinical applications of platform switching are multiple, and all indicate better long-term predictability in implant therapy by allowing preservation of the peri-implant hard and soft tissue with time. In this review the influence of platform switching on various other factors affecting crestal bone loss around implants has been discussed.

scholarly journals A Case Report of Post-traumatic Osteomyelitis with Gap Non-union of Humerus with Segmental Bone Defect and Scarred Skin Treated with Open Reduction Internal Fixation with Osteomyocutaneous Fibula

2021 ◽  
Vol 11 (3) ◽  
Author(s):  
Prakash K. George ◽  
Bibhas Dasgupta ◽  
Bhanuprakash Reddy ◽  
P. V. Shubhanshu Bhaladhare
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Bone Loss ◽  
Bone Defect ◽  
Treatment Options ◽  
Bone Union ◽  
Soft Tissue Coverage ◽  
Segmental Bone Defect ◽  
Non Union ◽  
Segmental Bone

Introduction: Non-union of closed humerus fractures is estimated to be about 5.5% and this figure is even higher in open fractures. In cases of non-union of the humerus with segmental bone defect, if a conventional treatment has failed, free fibular transfer is often considered for satisfactory bone union. In some cases, where there is severe scarring due to multiple previous surgeries. In such cases, skin cover may not be adequate and tight closures often lead to necrosis and failure excision. Segmental bone defects of the upper limb that is >6 cm with soft-tissue coverage defects have limited options for reconstruction. Osteomyocutaneous fibula may provide to be a valuable option in such cases. Case Report: This is a report a case of a 27-year-old male presented with a history of road traffic accident with Gustilo-Anderson Grade 3 B open fracture of humerus midshaft. He developed humerus osteomyelitis, for which he underwent surgical debridement. He presented to us with gap non-union with segmental bone loss. The overlying skin was scarred and had significant limb shortening. Treatment options for such a case are reconstruction or amputation. Challenges for reconstruction were to deal with the segmental bone loss and the soft-tissue defect following scar excision. We tackled both these challenges with an osteomyocutaneous fibula flap. At 1-year follow-up, the humerus showed union and flap uptake was good. Conclusion: Osteomyocutaneous fibula flap is a valuable treatment options in such complicated cases allowing for both bone union and soft-tissue coverage with a single surgical procedure. Keywords: Osteomyocutaneous flap, humerus gap nonunion, osteomyelitis humerus.

Új lehetőségek a refrakter és relabált Hodgkin-lymphomás betegek kezelésében

2015 ◽  
Vol 156 (45) ◽  
pp. 1824-1833 ◽  
Author(s):  
Árpád Illés ◽  
Ádám Jóna ◽  
Zsófia Simon ◽  
Miklós Udvardy ◽  
Zsófia Miltényi
Keyword(s):  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Survival Rates ◽  
Relapse Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Novel Treatment ◽  
Refractory Hodgkin Lymphoma

Introduction: Hodgkin lymphoma is a curable lymphoma with an 80–90% long-term survival, however, 30% of the patients develop relapse. Only half of relapsed patients can be cured with autologous stem cell transplantation. Aim: The aim of the authors was to analyze survival rates and incidence of relapses among Hodgkin lymphoma patients who were treated between January 1, 1980 and December 31, 2014. Novel therapeutic options are also summarized. Method: Retrospective analysis of data was performed. Results: A total of 715 patients were treated (382 men and 333 women; median age at the time of diagnosis was 38 years). During the studied period the frequency of relapsed patients was reduced from 24.87% to 8.04%. The numbers of autologous stem cell transplantations was increased among refracter/relapsed patients, and 75% of the patients underwent transplantation since 2000. The 5-year overall survival improved significantly (between 1980 and 1989 64.4%, between 1990 and 1999 82.4%, between 2000 and 2009 88.4%, and between 2010 and 2014 87.1%). Relapse-free survival did not change significantly. Conclusions: During the study period treatment outcomes improved. For relapsed/refractory Hodgkin lymphoma patients novel treatment options may offer better chance for cure. Orv. Hetil., 2015, 156(45), 1824–1833.

Antiretroviral Treatment-Associated Labia Majora Lipohypertrophy: A Rare Case and Plastic Surgical Treatment Options

2017 ◽  
Vol 2 (1) ◽  
pp. 43
Author(s):  
Akmal Hisham ◽  
Devananthan Ilenghoven ◽  
Wan Syazli Wan Ahmad Kamal ◽  
Salina Ibrahim ◽  
Shah Jumaat Mohd Yussof
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Daily Living ◽  
Treatment Options ◽  
Hiv Positive ◽  
Highly Active ◽  
Labia Majora ◽  
The Face ◽  
Central Fat

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

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