Treatment of severe mandibular deficiency following TMJ ankyloses by distraction osteogenesis and orthodontic treatment with microimplants

2021 ◽  
pp. 146531252110598
Author(s):  
Ho-Jin Kim ◽  
Hyo-Sang Park
Keyword(s):  
Distraction Osteogenesis ◽  
Term Treatment ◽  
Long Term Stability ◽  
Anterior Teeth ◽  
Mandibular Distraction Osteogenesis ◽  
Long Term Treatment ◽  
History Of ◽  
Mandibular Retrognathia

Severe mandibular deficiency caused by temporomandibular joint (TMJ) ankyloses produces functional and aesthetic problems that require complicated long-term treatment. In this case report, we describe the benefits of using microimplant mechanics for controlling the direction of distraction during distraction osteogenesis and for performing the movement of teeth. We also present its remarkable results and long-term stability. A 20-year-old girl presented with a convex profile due to severe mandibular retrognathia after a history of several TMJ surgeries for bilateral TMJ ankyloses. Mandibular distraction osteogenesis (MDO) was performed, and elastics were placed between the microimplants to control the direction of distraction. Subsequently, after retraction of the maxillary anterior teeth and distalisation of the whole mandibular dentition, the facial profile was markedly improved, and good interdigitation was obtained. The six-year follow-up retention and overall stability were satisfactory with good interdigitation and jaw function.

scholarly journals Long term dual antiplatelet therapy after myocardial infarction: retrospective analysis in an outpatient population

2021 ◽  
Author(s):  
Gennaro Ratti ◽  
Antonio Maglione ◽  
Emilia Biglietto ◽  
Cinzia Monda ◽  
Ciro Elettrico ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Term Treatment ◽  
Multivessel Disease ◽  
Coronary Syndrome ◽  
Anticoagulant Drugs ◽  
Long Term Treatment ◽  
Risk Condition ◽  
History Of

Long term treatment with ticagrelor 60 mg and low-dose aspirin are indicated after acute coronary syndrome (ACS). We retrospectively reviewed aggregate data of 187 patients (155 M and 38 F) (mean age 63.8±9 years) in follow up after ACS with at least one high risk condition (Multivessel disease, diabetes, GFR<60 mL/min, history of prior myocardial infarction, age >65 years) treated with ticagrelor 60 mg twice daily (after 90 mg twice daily for 12 months). The results were compared with findings (characteristics of the patients at baseline, outcomes, bleeding) of PEGASUS-TIMI 54 trial and Eu Label. The highrisk groups were represented as follows: multivessel disease 105 pts (82%), diabetes 63 pts (33%), GFR< 60 mL/min 27 pts (14%), history of prior MI 33 pts (17%), >65 year aged 85 pts (45%). Treatment was withdrawn in 7 patients: 3 cases showed atrial fibrillation and were placed on oral anticoagulant drugs, one developed intracranial bleeding, in three patients a temporary withdrawal was due to surgery (1 colon polyposis and 2 cases of bladder papilloma). Chest pain without myocardial infarction occurred in 16 patients (revascularization was required in 9 patients). Dyspnea was present in 15 patients, but was not a cause for discontinuation of therapy. Long term treatment with ticagrelor 60 mg twice daily plus aspirin 100 mg/day showed a favourable benefit/risk profile after ACS.  In this study all patients had been given ticagrelor 90 mg twice daily for 12 months and the 60 mg twice daily dosage was started immediately thereafter, unlike PEGASUS-TIMI 54 trial in which it was prescribed within a period ranging from 1 day to 1 year after discontinuation of the 90 mg dose. This makes our results more consistent with current clinical practice. However, a careful outpatient follow-up and constant counseling are mandatory to check out compliance to therapy and adverse side effects.

scholarly journals Correction of Mandibular Retrognathia and Laterognathia by Distraction Osteogenesis: Follow up of 5 cases

2009 ◽  
Vol 03 (04) ◽  
pp. 335-342 ◽  
Author(s):  
Dogan Dolanmaz ◽  
Ali Ihya Karaman ◽  
Hakan Gurcan Gurel ◽  
Abdullah Kalayci ◽  
Hasan Kucukkolbasi ◽  
...  
Keyword(s):  
Distraction Osteogenesis ◽  
Clinical Success ◽  
Term Treatment ◽  
Mandibular Distraction ◽  
Gonial Angle ◽  
Affected Side ◽  
Long Term Treatment ◽  
Mandibular Retrognathia ◽  
Ramus Height

ABSTRACTThis article evaluates the use of distraction osteogenesis in the treatment of mandibular retrognathia and laterognathia and the long term treatment results of the patients treated with this technique. The procedure was carried out in 5 subjects (3 males and 2 females, mean age 18.4 years) aged between 14 years and 27 years. In patients treated with bilateral mandibular distraction, it was observed that the ANB angle decreased by a mean of 5°, the mandibular corpus length increased by a mean of 14.5 mm and the overjet decreased by a mean of 12.2 mm after treatment. In patients treated with unilateral mandibular distraction, a mean of 3.5° reduction was achieved in ANB angle, the mandibular corpus length increased by a mean of 5.5 mm and a mean of 7 mm correction was achieved in relation to craniofacial midline with treatment. One of these patients showed an increase of 10 mm in ramus height on the affected side and a decrease of 5° in gonial angle whereas the other one showed an increase of 12.5° in gonial angle and an increase of 11 mm in ramus height on the affected side after treatment. The most significant long term relapse was observed in one of the patients treated with bilateral mandibular distraction. Long term relapse seen in the rest of the patients was within clinically acceptable limits. It can be concluded that distraction of the deformed mandible is a feasible and effective technique for treating mandibular retrognathia and laterognathia. However, it must be borne in mind that accurate placement of the distractors and determining the correct distraction vector are crucial factors that have an influence on long term clinical success. (Eur J Dent 2009;3:335-342)

Essential Thrombocythemia: A Prospective Analysis of Efficacy and Safety of Anagrelide for Long Term Treatment in Patients Below and Above the Age of 60 Years.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3561-3561 ◽  
Author(s):  
Heinz Gisslinger
Keyword(s):  
Disease Progression ◽  
Essential Thrombocythemia ◽  
Term Treatment ◽  
Younger Patients ◽  
Platelet Counts ◽  
Patient Cohort ◽  
Long Term Treatment ◽  
History Of

Abstract Thromboembolic complications and less frequently bleeding characterize morbidity and mortality in patients with essential thrombocythemia (ET). The average estimated risk for thrombotic episodes in ET is 6.6% per patient year and platelet counts above 1000G/L, older age (&gt;60 years) and a history of thrombosis were identified as major risk factors for serious complications. Since a direct correlation of platelet numbers with the number of thrombotic events is suggested by numerous prospective trials, it is generally accepted that these patients should receive platelet lowering treatment. Although hydroxyurea is considered as the treatment of choice in ET, there is still major concern about leukemogenicity of this compound. Anagrelide, on the other hand seems to be better tolerated in younger patients, but this has not been proved by prospective studies. It is therefore the aim of the present study to compare tolerability and efficacy of anagrelide (Thromboreductin, a novel non-immediate release formulation of anagrelide) over a prolonged time between ET patients below the age of 60 years with those above the age of 60 years. Among a total of 722 patients with ET on anagrelide who were prospectively documented within a standardized patient registry, 386 patients were previously untreated at the time of initiation of anagrelide therapy and this therapy was prospectively documented up to 5 years. The median age of this previously untrated patient cohort was 58 years (6 to 91 years), 179 (46,4%) patients were older than 60 years and 274 (71%) patients were female. Sixtythree patients (16,3%) had a history of thrombosis. The main inclusion criteria were those defined for qualifying a patient to be at high risk. During the first two years of follow up, the group of younger patients (&lt; 60 years) did receive higher daily doses of anagrelide as compared to the older patient cohort (2,0mg vs.1,5mg). Anagrelide reduced platelet counts from a median baseline value of 920G/L to 581G/L and 382 G/L on month 3 and month 60 respectively. The overall response rate (platelet counts&lt; 600G/L) was 64%. The rate of complete response (platelet counts &lt;450G/L) went up from 58% after one year to 71% after 5 years of treatment. Group comparisons showed that a significant response to anagrelide was achieveable in patients below and above the age of 60 years with no significant difference between the two groups. With regard to safety, there is no evidence that anagrelide gives concern to an increased rate of bleeding (2%) or disease progression. Over the 5 year follow up period an adverse event was recorded in 24% of patients. The rate of treatment discontinuation as a result of adverse events was low (5%), treatment was discontinued when no further response was achieved or a negative risk benefit judgement of the treating physician was made. Only 4 patients of the whole cohort discontinued anagrelide due to disease progression. A small number of patients (12/722), 1,7%) died during the 5 years observation period, all cases were described as not drug related. In summary the data confirm that anagrelide yields comparable response rates in the two age groups during long term treatment.

scholarly journals Homocysteine (Hcy) Follow-Up Study

2007 ◽  
Vol 30 (1) ◽  
pp. 21 ◽  
Author(s):  
Arnon Blum ◽  
Ihsan Hijazi ◽  
Michal Mashiach Eizenberg ◽  
Nava Blum
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Natural History ◽  
Beta Blockers ◽  
Term Treatment ◽  
Channel Blockers ◽  
Long Term Treatment ◽  
History Of

Background: Hyperhomocysteinemia confers an increased risk of coronary artery disease, stroke, and deep vein thrombosis, and is a strong predictor of mortality among patients with ischemic heart disease. Purpose: To determne the long term clinical outcome of patients with risk factors to atherosclerosis with high concentrations of homocysteine (Hcy). Methods: 89 patients with one or more risk factors for atherosclerosis, whose plasma total Hcy concentrations were measured, were followed for 5 years. Patients were interviewed and underwent a clinical examination in the outpatient clinic. Their medical records were reviewed in the last 5 years including smoking habits, medications, other diseases (hypertension, diabetes mellitus, hyperlipidemia) and their management. SPSS was used to describe and explore possible relationships between Hcy concentration, other diseases, medications and the clinical long term outcome. Results: All men with normal Hcy concentrations (10.76±1.71µmol/L) survived during the 5 years’ follow up, while 5 of the men with high Hcy concentrations (21.27±5.37µmol/L), died (17%) (P< 0.05). In women Hcy concentration did not affect survival. No association was found between diabetes mellitus, hypercholesterolemia, hypertension and Hcy. Long term treatment with Beta Blockers, ACE inhibitors, Calcium Channel blockers, and especially with Aspirin prevented death and changed the natural history of patients with high Hcy concentrations (P < 0.05). Conclusions – Hyperhomocysteinemia may have an effect on survival in men. Long term treatment with Beta Blockers, ACE inhibitors, Calcium Channel Blockers, and especially with Aspirin – prevented death and changed the natural history of patients with high Hcy concentrations.

Long-Term Treatment Outcomes for Heroin Dependence: The 11-Year Follow-Up of the ATOS Study

2013 ◽  
Author(s):  
Christina Marel ◽  
Maree Teesson ◽  
Shane Darke ◽  
Katherine Mills ◽  
Joanne Ross ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Term Treatment ◽  
Heroin Dependence ◽  
Long Term Treatment

scholarly journals The changes of corneal biomechanical properties with long-term treatment of prostaglandin analogue measured by Corvis ST

2020 ◽  
Author(s):  
Na Wu ◽  
Yuhong Chen ◽  
Yaping Yang ◽  
Xinghuai Sun
Keyword(s):  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Biomechanical Properties ◽  
Term Treatment ◽  
Prostaglandin Analogue ◽  
Corvis St ◽  
Long Term Treatment ◽  
Corneal Biomechanical Properties

Abstract Background: To investigate the corneal biomechanical changes in primary open angle glaucoma (POAG) patients treated with long-term prostaglandin analogue (PGA). Methods: 111 newly diagnosed POAG patients, including 43 high tension glaucoma (HTG) and 68 normal tension glaucoma (NTG), were measured by Corvis ST to obtain intraocular pressure (IOP), central corneal thickness (CCT) and corneal biomechanical parameters at baseline and at each follow-up visit after initiation of PGA treatment. The follow-up measurements were analyzed by the generalized estimate equation model with an exchangeable correlation structure. Restricted cubic spline was employed to estimate the dose-response relation between follow-up time and corneal biomechanics．Results: The mean follow-up time was 10.3 ± 7.02 months. Deformation amplitude (β=-0.0015, P=0.016), the first applanation velocity (AV1, β=-0.0004, P=0.00058) decreased and the first applanation time (AT1, β=0.0089, P<0.000001) increased statistically significantly with PGA therapy over time after adjusting for age, gender, axial length, corneal curvature, IOP and CCT. In addition, AT1 was lower (7.2950 ± 0.2707 in NTG and 7.5889 ± 0.2873 in HTG, P=0.00011) and AV1 was greater (0.1478 ± 0.0187 in NTG and 0.1314 ± 0.0191 in HTG, P=0.00002) in NTG than in HTG after adjusting for confounding factors.Conclusions: Chronic use of PGA probably influences the corneal biomechanical properties directly, which is to make cornea less deformable. Besides, corneas in NTG tended to be more deformable compared to those in HTG with long-term treatment of PGA.

Dihydroergokryptine as long-term treatment of alzheimer type dementia: A multicenter two-year follow-up

1998 ◽  
Vol 26 ◽  
pp. 103-110 ◽  
Author(s):  
D. Cucinotta ◽  
D. De Leo ◽  
L. Frattola ◽  
M. Trabucchi ◽  
M.G. Albizatti ◽  
...  
Keyword(s):  
Term Treatment ◽  
Alzheimer Type ◽  
Alzheimer Type Dementia ◽  
Long Term Treatment

FOLLOW-UP OF LONG-TERM TREATMENT OF PREDIALYSIS RENAL BONE DISEASE WITH 1-α-HYDROXY-DERIVATIVES OF VITAMIN D

1983 ◽  
pp. 511-516
Author(s):  
J.R. JUTTMANN ◽  
D.H. BIRKENHÄGER-FRENKEL ◽  
T.J. VISSER ◽  
C. VAN KRIMPEN ◽  
J.C. BIRKENHÄGER
Keyword(s):  
Vitamin D ◽  
Bone Disease ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Renal Bone Disease ◽  
Derivatives Of
Sign in / Sign up

Export Citation Format

Share Document