Clinical Management Protocol for Dental Implants Inserted in Patients with Active Lichen Planus. Part II 4‐Year Follow‐Up

Background and Objectives: To integrate the available published data on patients with oral lichen planus (OLP) rehabilitated with dental implants, as well as to review the recommendations for OLP patients receiving implants. Materials and Methods: An electronic search was undertaken in February 2019 using five databases. Publications reporting cases of patients with OLP and rehabilitated with implant-supported oral prosthesis were included. Results: Twenty-two publications were included (230 patients, 615 implants). The overall implant failure rate was 13.9% (85/610). In patients with oral squamous cell carcinoma (OSCC) the failure rate was 90.6% (29/32), but none of these implants lost osseointegration; instead, the implants were removed together with the tumor. One study presented a very high implant failure rate, 76.4% (42/55), in patients with “active lichen planus”, with all implants failing between 7–16 weeks after implant placement, and its conflicting and incongruent results are discussed in detail. There was a statistically significant difference between the failure rates in implants installed in different jaws (maxilla/mandible) and when implants of different surfaces were used (turned/moderately rough), but not between patients with reticular or erosive OLP types, or between male and female patients. If OSCC patients and the cases of the latter study are not considered, then the failure rate becomes very low (2.7%, 14/523). The time between implant placement and failure was 25.4 ± 32.6 months (range 1–112). The mean ± SD follow-up was 58.9 ± 26.7 months (1–180). Conclusions: When the results of the one study with a very high failure rate and of the cases that developed OSCC are not considered, the dental implant failure rate in OLP patients was 2.7% after a follow-up of approximately five years. Recommendations are given when treating OLP patients with dental implants.

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Supplemental Material for Eight-Year Prospective Follow-Up of Mentalization-Based Treatment Versus Structured Clinical Management for People With Borderline Personality Disorder

Personality Disorders Theory Research and Treatment ◽

10.1037/per0000422.supp ◽

2020 ◽

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Clinical Management ◽

Borderline Personality

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Clinical Management of Multiple Traumatic Dental Injuries and Treatment Approaches: 30 Months’ Follow-Up

Journal of Dental Health Oral Disorders and Therapy ◽

10.15406/jdhodt.2017.07.00245 ◽

2017 ◽

Author(s):

Nagarajan MP Sockalingam S

Keyword(s):

Clinical Management ◽

Treatment Approaches ◽

Traumatic Dental Injuries ◽

Dental Injuries

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Dental implant placement with inferior alveolar nerve repositioning in severely resorbed mandibles: a retrospective multicenter study of implant success and survival rates, and lower lip sensory disturbances

International Journal of Implant Dentistry ◽

10.1186/s40729-021-00334-x ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

George Deryabin ◽

Simonas Grybauskas

Keyword(s):

Dental Implants ◽

Dental Implant ◽

Healing Process ◽

Survival Rates ◽

Inferior Alveolar Nerve ◽

Reliable Technique ◽

Lower Lip ◽

Neurosensory Disturbances ◽

Sensory Disturbances

Abstract Background The purpose of this study was to analyze medium-to-long-term implant success and survival rates, and lower lip sensory disturbance after placement of dental implants with simultaneous inferior alveolar nerve (IAN) repositioning. Methods Fifteen patients (3 men, 12 women) treated in two centers were included in this retrospective study. The ages of the participants ranged from 19 to 68. A total of 48 dental implants were placed in 23 posterior mandibular segments simultaneously with IAN transposition or lateralization. The residual bone above the IAN ranged from 0.5 to 7.0 mm. Crestal bone changes were measured using cone beam computed tomography (CBCT) images. Disturbance of the IAN was evaluated subjectively using a modified questionnaire. Results The healing process was uneventful in fourteen patients. In one patient, spontaneous fracture of the operated mandible occurred on tenth day after the surgery. The implant in the fracture line was removed at the time of open reduction and fixation. One more implant was lost after 5 years of loading. Therefore, the overall dental implant survival rate was 95.8%, whereas all implants in function were judged as successful after a follow-up period of 1 to 10 years. Transient neurosensory disturbances (ND) were observed in all patients who underwent IAN lateralization and IAN transposition. At follow-up times of 3 years, 5 years, and 10 years, weak hypoesthesia remained in two subjects treated with IAN transposition. None of the patients developed neuropathic pain after the procedure. Conclusions Within the limitations of this study, we conclude that reconstruction of severely resorbed mandibles with dental implants in conjunction with IAN repositioning is an effective and reliable technique. Although neurosensory disturbances are the most common complication after surgery, they tend to resolve over time. Advanced surgical skills are required to perform this technique.

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Retinoblastoma genetics screening and clinical management

BMC Medical Genomics ◽

10.1186/s12920-021-01034-6 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Himika Gupta ◽

Sivasankar Malaichamy ◽

Ashwin Mallipatna ◽

Sakthivel Murugan ◽

Nallathambi Jeyabalan ◽

...

Keyword(s):

Clinical Management ◽

Detection Rate ◽

Mutation Detection ◽

Gene Mutations ◽

Disease Recurrence ◽

Germline Mutations ◽

Global Studies ◽

Mutation Detection Rate ◽

Gene Deletions

Abstract Background India accounts for 20% of the global retinoblastoma (RB) burden. However, the existing data on RB1 gene germline mutations and its influence on clinical decisions is minimally explored. Methods Fifty children with RB underwent complete clinical examination and appropriate multidisciplinary management. Screening of germline RB1 gene mutations was performed through next-generation sequencing and Multiplex Ligation-dependent Probe Amplification (MLPA) analysis. The mutation and non-mutation groups were compared for clinical parameters especially severity, progression and recurrence. Results Twenty-nine patients had bilateral RB (BLRB) and 21 had unilateral RB (ULRB). The genetic analysis revealed 20 RB1 variations in 29 probands, inclusive of 3 novel mutations, known 16 mutations and heterozygous whole gene deletions. The mutation detection rate (MDR) was 86.2% in BLRB and 19% in ULRB. Associations of disease recurrence (p = 0.021), progression (p = 0.000) and higher percentage of optic nerve invasion, subretinal seeds and high-risk pathological factors were observed in the mutation group. Clinical management was influenced by the presence of germline mutations, particularly while deciding on enucleation, frequency of periodic follow up and radiotherapy. Conclusions We identified novel RB1 mutations, and our mutation detection rate was on par with the previous global studies. In our study, genetic results influenced clinical management and we suggest that it should be an essential and integral component of RB-care in India and elsewhere.

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Short (6 mm) and Regular Dental Implants in the Posterior Maxilla–7-Years Follow-up Study

Journal of Clinical Medicine ◽

10.3390/jcm10050940 ◽

2021 ◽

Vol 10 (5) ◽

pp. 940

Author(s):

Jakub Hadzik ◽

Paweł Kubasiewicz-Ross ◽

Izabela Nawrot-Hadzik ◽

Tomasz Gedrange ◽

Artur Pitułaj ◽

...

Keyword(s):

Survival Rate ◽

Dental Implants ◽

Clinical Results ◽

Implant Survival ◽

Implant Survival Rate ◽

Short Implants ◽

Posterior Maxilla ◽

Patient Reported ◽

Bone Level

Short 6 mm dental implants are considered as an alternative to the maxillary sinus elevation and bone augmentation procedure where there is a reduced alveolar ridge height. The aim of this study was to compare the implant survival rate between short dental implants (6 mm) and regular length implants (11–13 mm) when placed in combination with bone grafting and loaded with a single non splinted crown, seven years after placing the implant. It was conducted as a controlled clinical study of 30 patients with partial edentulism in the posterior maxilla. The protocol included radiological and clinical evaluation of the C/I ratio (length of the superstructure divided by the length of the implant crestal part), marginal bone level (MBL), ultrasonography measurement of soft tissue surrounding implant (STT), patient-reported outcomes, and biological and technical complications. A total number of 28 implants (93%) remained integrated during follow-up period. MBL of 0.50 and 0.52 mm was observed for short implants and regular implants, respectively. MBL was checked for correlation with STT, and a negative correlation was found between MBL: STT. Our study has demonstrated a significantly lower implant survival rate for short implants compared to regular implants (87% compared to 100%). Despite the loss of several implants, good clinical results were achieved in the remaining implants in both groups. It is, therefore, worth considering short implants as an alternative to regular implants with a sinus lift surgery.

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Limited cutaneous systemic sclerosis: Total rehabilitation with fixed prosthesis on dental implants

Journal of Scleroderma and Related Disorders ◽

10.1177/23971983211004362 ◽

2021 ◽

pp. 239719832110043

Author(s):

Miguel Angel Garcés Villalá ◽

Carolina Zorrilla Albert

Keyword(s):

Systemic Sclerosis ◽

Bone Loss ◽

Dental Implants ◽

Social Life ◽

Connective Tissue Diseases ◽

The Body ◽

Calcinosis Cutis ◽

Complex Disorders ◽

Standardized Parameters

Introduction: Limited cutaneous systemic sclerosis with special manifestations (calcinosis cutis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) is part of the group of connective tissue diseases, these rare autoimmune systemic pathologies cause thickening and hardening of tissues in different parts of the body and can lead to complex disorders. Oral manifestations of systemic sclerosis may include limited ability to open the mouth, xerostomia, periodontal disease, enlarged periodontal ligament, and bone resorption of the jaw. Case Description: A 54-year-old Caucasian patient presented with oral pain, swallowing, phonation and chewing difficulties associated with dental instability, hygiene/handling difficulties and her main problem with microstomia, which prevented her from removing the skeletal prosthesis for 4 years, depriving her of social life. Gradual treatment with dental implants was diagnosed and planned to support a fixed total denture adapted to the ridge with self-cleaning characteristics. After implant insertion, panoramic radiographs with standardized parameters were taken to compare crestal bone levels at the time of prosthesis placement and with 10 years of follow-up. Conclusion: The average crestal bone loss of the 12 implants after the 10 years of follow-up was 1.26 mm for the maxilla and 1.17 mm for the mandible. The survival of the 12 support implants of two total fixed prostheses in a clinical/radiographic follow-up of 10 years was 100%. After 10 years of follow-up, the 12 implants inserted had a bone loss similar to that of healthy patients and no pathologies were registered, recovering function, aesthetics, and self-esteem. This therapy must be implemented before the interincisal distance decreases to 30 mm to allow intraoral surgical/prosthetic access. Implant-supported total fixed rehabilitation is a viable, predictable, and recommended therapy in patients with limited cutaneous systemic sclerosis.

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