scholarly journals Overdenture on dental remaining in oncological patients: Case report

2020 ◽  
Vol 23 (4) ◽  
pp. 7p
Author(s):  
Victoria Garcia De Carvalho ◽  
Cláudio Moreira Júnior ◽  
Lucio Murilo Dos Santos ◽  
Tarcísio José de Arruda Paes Júnior
Keyword(s):  
Head And Neck ◽  
Clinical Success ◽  
Oral Rehabilitation ◽  
Surgical Interventions ◽  
Oncological Patients ◽  
Total Cancer ◽  
Edentulous Patients ◽  
And Function ◽  
Head And Neck Radiotherapy

Head and neck cancer occupy the seventh place among the most common neoplasms in the world, with an annual incidence of approximately 640,000 new cases. Radiotherapy treatment has been highlighted, because there is greater tissue preservation, possibility of regression of the disease, decreased tumor volume, prevention of possible tumor recurrences and metastases, and even total cancer cure, but patients undergoing radiotherapy are at high risk of osteoradionecrosis if they perform surgical interventions in the region, such as dental implants and dental extraction, making prosthetic rehabilitation of partially edentulous patients after treating oral cancer something complex and often omitted; although it is a crucial factor in restoring oral function. Thus, the aim of the present study was to describe the planning, treatment and follow-up of a twelve-month prosthetic approach to rehabilitate the lower arch shape and function of a partially edentulous patient undergoing head and neck radiotherapy with a full denture mucus supported and tooth retained. After twelve months of follow-up, it was possible to evidence the functional and aesthetic clinical success, with preserved occlusal pattern, soft and bone tissue around[ and dental roots.KEYWORDSRadiotherapy; Head and Neck Neoplasms; Overdentures; Oral Rehabilitation.  

scholarly journals Review of follow-up of clinical success of implant-supported complete dental prostheses

2014 ◽  
Vol 62 (3) ◽  
pp. 261-266
Author(s):  
Gustavo Diniz GRECO ◽  
Amanda Beatriz Dahdah Aniceto de FREITAS ◽  
Cláudia Silami de MAGALHÃES ◽  
Allyson Nogueira MOREIRA
Keyword(s):  
Success Rate ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Success Rates ◽  
Oral Rehabilitation ◽  
Dental Prostheses ◽  
Feasible Alternative ◽  
Edentulous Patients ◽  
Very High

OBJECTIVE: The aim of this study was to assess the clinical success rate of implant-supported complete dental prostheses, which are being used as a feasible alternative in planning of oral rehabilitation. Over the years, the two-stage surgical protocol has increasingly been replaced by immediate loading procedures, especially in the mandibular anterior region in cases of rehabilitation of completely edentulous patients. This procedure has become feasible due to the high success rate of the technique with very satisfactory results. METHODS: By means of a literature review focused on published articles with clinical follow-up between 8 and 15 years. RESULTS: Implants placed in the mandible had higher success rates than those inserted in the maxilla. Cases with longer follow-up periods, 15 years, showed higher success rates in comparison with follow-up periods of 8 and 10 years. CONCLUSION: Success rates of implant-supported complete dental prostheses are very high.

scholarly journals Oral Rehabilitation with Zygomatic Implants in a Patient with Cleft Palate

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Guilherme José Pimentel Lopes de Oliveira ◽  
Mariana Schaffer Brackmann ◽  
Larissa Carvalho Trojan ◽  
Paulo Domingos Ribeiro Júnior ◽  
Luis Eduardo Marques Padovan
Keyword(s):  
Cleft Palate ◽  
Fibrous Tissue ◽  
Oral Rehabilitation ◽  
Atrophic Maxilla ◽  
Zygomatic Implants ◽  
Fixed Prosthesis ◽  
Edentulous Patients ◽  
The Right ◽  
Zygomatic Implant

Edentulous patients with an atrophic maxilla associated with lip-palate fissures have unpredictable results after undergoing grafting procedures. In situations where the atrophic maxilla does not adequately allow reconstruction, the use of zygomatic implants has been indicated, and probably these implants can be indicated for the rehabilitation of patients with lip-palate fissures. This case report describes the oral rehabilitation treatment of a patient with a lip-palate cleft treated with zygomatic implants and implant-supported fixed prosthesis with two years of follow-up. A 65-year-old female patient had a lip-palate cleft and previously underwent surgery to close the cleft. The patient had a severely atrophic maxilla and had difficulty adapting to a removable total prosthesis. Due to the small amount of bone remaining and extensive fibrous tissue in the palate region, a rehabilitation with conventional implants associated with zygomatic implants was chosen. Two zygomatic implants and a conventional implant were placed on the right side, and a zygomatic implant and conventional implant were placed on the left side; these implants were later activated by a protocol-type prosthesis. The zygomatic implants provided an adequate aesthetic and functional outcome of the prosthesis in a patient with cleft palate.

scholarly journals Surgical Treatments of Talar Osteochondral Lesion: A Long-term Follow-up of Return to Sport and Patient-Reported Outcome Measures

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0037
Author(s):  
Andrew Schwartz ◽  
Shuo Niu ◽  
Faris Mirza ◽  
Ashley Thomas ◽  
Sameh Labib
Keyword(s):  
Outcome Measures ◽  
Osteochondral Lesion ◽  
Return To Sport ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Surgical Interventions ◽  
Patient Reported ◽  
Long Term Follow Up ◽  
And Function

Category: Ankle, Arthroscopy, Sports, Trauma Introduction/Purpose: Talar osteochondral lesion (TOCL) is a common problem in the young athletic population, mostly related to trauma. TOCL surgical treatment algorithm remains controversial, though results are improving as we gain experience. The results of TOCL surgical treatment on function and return to sport are promising, but quantified return to sport metrics remain largely unknown. Methods: A total of 156 consecutive patients following TOCL chondroplasty (10/1/2000-5/31/2018) by a single practice were retrospectively reviewed and included in this study. There were 54.5% female with a mean age 38.2 years, and mean follow-up 40.2 months following the index surgery. Patients were divided into four groups according to the type of chondroplasty performed: Antegrade arthroscopic drilling and/or microfracture (antegrade, 83 patients), retrograde arthroscopic drilling (retrograde, 35 patients), osteochondral autograft transfer (OATS, 26 patients), and allograft cartilage implantation (allograft, 12 patients). VAS scores for pain and function at the final clinic visit were collected. Patient-reported outcome measures including the short form-12 (SF-12), The Foot and Ankle Disability Index Sports Module (FADI-sports), Tegner score, Marx scale, Naal’s Sports inventory are also actively being collected. Results: Nearly 75% of patients are satisfied with surgical intervention of TOCLs. Allograft transplant was the least satisfying (71.4%), while OATS was the most satisfying (90%). Each surgical intervention yielded significantly decreased pain and increased function postoperatively (all p<0.001). Currently, 57 patients (36%) provided patient-reported outcome measures, with an average follow up of 79.8 months (Table 1). All surgical interventions trended toward decreased Tegner score, though only antegrade drilling showed a significant decrease (p<0.001). Based on Naal’s sports inventory, 85.7% of surgically treated patients reported participating in sport activities, on average 3 times/week and 50.6 minutes/session. Conclusion: Traditionally, TOCLs presented a difficult problem that is marred by unsatisfactory surgical outcomes in typically active patients. As our surgical understanding has evolved, we’ve continued to improve on outcomes. Our patients demonstrated a 74.5% satisfaction rate, a statistically significant improvement in pain and function, and a high rate of return to sport with little difference between surgical interventions at a long-term follow-up.

Clinical outcome of endoscopic treatment for symptomatic sterile walled-off necrosis

Endoscopy ◽  
2020 ◽  
Author(s):  
Lotte Boxhoorn ◽  
Jeska A. Fritzsche ◽  
Paul Fockens ◽  
Jeanin E. van Hooft ◽  
Pieter J. F. de Jonge ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Clinical Success ◽  
Necrotizing Pancreatitis ◽  
Outlet Obstruction ◽  
Case Series ◽  
Open Label ◽  
Surgical Interventions ◽  
Persistent Symptoms ◽  
Walled Off Necrosis

Background The majority of patients with symptomatic sterile walled-off necrosis (WON) can be treated conservatively. Although endoscopic transluminal drainage (ETD) is often performed in cases of persistent symptoms, post-procedural iatrogenic infection may occur. This study aimed to evaluate clinical outcomes after ETD of symptomatic sterile WON. Methods This was a retrospective, multicenter, open-label case series of 56 patients with necrotizing pancreatitis who underwent ETD for symptomatic sterile WON between July 2001 and August 2018 at two tertiary referral hospitals. Primary end point was clinically relevant post-procedural iatrogenic infection, defined as need for endoscopic transluminal necrosectomy. Secondary end points included mortality, total number of interventions, hospital stay, and resolution of symptoms at 1-year follow-up.  Results ETD of sterile WON was performed in 56 patients (median age 55 years, 57 % male), who presented with abdominal pain (71 %), gastric outlet obstruction (45 %), jaundice (20 %), and failure to thrive (27 %). A total of 41 patients (73 %) developed clinically relevant post-procedural iatrogenic infection, resulting in a median of 3 (interquartile range [IQR] 2 – 4) endoscopic, radiological, and/or surgical interventions. Mortality rate was 2 %. Median total hospital stay was 12 days (IQR 6 – 17). Resolution of symptoms was reported in 40 of 46 patients (87 %) for whom long-term follow-up data were available (median follow-up 13 months, IQR 6 – 29). Conclusions ETD of symptomatic sterile WON resulted in high clinical success. Nonetheless, the majority of patients required additional reinterventions for clinically relevant post-procedural iatrogenic infection.

scholarly journals An Alternative Technique for Fabrication of Frameworks in an Immediate Loading Implant Fixed Mandibular Prosthesis

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
André Gustavo Paleari ◽  
Cristina Dupim Presoto ◽  
Juliano Alencar Vasconcelos ◽  
José Maurício dos Santos Nunes Reis ◽  
Lígia Antunes Pereira Pinelli ◽  
...  
Keyword(s):  
Case Report ◽  
Immediate Loading ◽  
Safe Procedure ◽  
Alternative Technique ◽  
Oral Rehabilitation ◽  
Short Period ◽  
Passive Fit ◽  
High Predictability ◽  
Edentulous Patients ◽  
And Function

The oral rehabilitation of edentulous patients with immediate loading has become a safe procedure with high predictability. The success is related to immediate fabrication of a passive fit framework to attach the implants. Based on these considerations, this case report shows an alternative technique for mandibular rehabilitation using implants immediately loaded, where the framework was fabricated using cylinders with internal reinforcement and precast pieces, electrowelding, and conventional welding providing esthetics and function to the patient in a short period of time.

scholarly journals Reabilitação oral conservadora em paciente juvenil com alterações orofaciais secundárias ao tratamento de rabdomiossarcoma em cabeça e pescoço: relato de caso / Conservative oral rehabilitation in a juvenile patient with orofacial alterations secondary to the treatment of rhabdomyosarcoma in the head and neck: case report

2020 ◽  
Vol 65 (1) ◽  
pp. 1
Author(s):  
Paula Guimarães Moreira ◽  
Regina Maria Holanda de Mendonça ◽  
Paulo Sérgio Da Silva Santos ◽  
Katia Maria Coutinho Cappellaro ◽  
Luis Cândido Pinto da Silva
Keyword(s):  
Head And Neck ◽  
Developmental Disorders ◽  
Therapeutic Modality ◽  
Facial Growth ◽  
Oral Rehabilitation ◽  
The Face ◽  
Antineoplastic Treatment ◽  
Bone Anomalies ◽  
Juvenile Patient

Introdução: O tratamento antineoplásico multimodal para tumores em cabeça e pescoço de crianças frequentemente acarreta distúrbios de desenvolvimento em dentes e estruturas faciais. Dentre as alterações observadas estão as anomalias ósseas, agenesias dentárias, microdontia, anomalias de esmalte e, sobretudo, malformações radiculares e coronárias.A frequência e intensidade dessas alterações estão relacionadas com a idade da criança durante o tratamento, a modalidade terapêutica, o tipo de quimioterápico, a dose de radiação e o campo irradiado. Objetivo/Relato de Caso: Este trabalho tem como objetivo descrever o tratamento reabilitador oral conservador, por meio de confecção de prótese total superior do tipo overdenture, em paciente juvenil com severos distúrbios de desenvolvimento dentário e ósseo, consequentes do tratamento de rabdomiossarcoma em nasofaringe realizado aos dois anos de idade. Conclusão: Este relato enfatiza a importância do acompanhamento odontológico regular de pacientes pediátricos irradiados em face, até que o crescimento facial se complete, permitindo a manutenção da função e estética.Palavras Chave: Reabilitação bucal, Pediatria, Rabdomiossarcoma, Face, NasofaringeABSTRACTIntroduction: Multimodal antineoplastic treatment for tumors in the head and neck of children often leads to developmental disorders in teeth and facial structures. Among the alterations observed are bone anomalies, dental agenesis, microdontia, enamel anomalies and, mainly, root and coronary malformations. The frequency and intensity of these changes are related to the age of the child during treatment, the therapeutic modality, the type of chemotherapy, the radiation dose and the irradiated field. Aim/Report Case: This work aims to describe the conservative oral rehabilitation treatment, by means of the construction of a superior overdenture, in a patient with severe dental and bone developmental disorders resulting from the treatment of nasopharyngeal rhabdomyosarcoma performed at two years of age. Conclusion: This report emphasizes the importance of regular dental follow-up of pediatric irradiated patients on the face, until facial growth is complete, allowing maintenance of function and aesthetics.Keywords: Mouth rehabilitation, Pediatrics, Rhabdomyosarcoma, Face, Nasopharynx

scholarly journals Multicenter Study of Buruli Ulcer Disabilities in the Head and Neck Region

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Pius Agbenorku
Keyword(s):  
Head And Neck ◽  
Functional Disability ◽  
Buruli Ulcer ◽  
Neck Region ◽  
Clinical Findings ◽  
Head And Neck Region ◽  
Surgical Interventions ◽  
Ulcer Disease ◽  
Total Hospital Stay

Objective. To identify disabilities caused by Buruli Ulcer Disease (BUD) when it affects the Head and Neck Region (HNR) of patients in endemic areas and suggest possible ways to overcome the complications involved. Methods. Data for the study was collected from six different hospitals in the central part of Ghana from 2004–2009. Diagnosis of BUD was based on clinical findings and confirmed by positive result of Ziehl-Neelson Test for Acid Fast Bacilli, Polymerase Chain Reaction, or Histopathology. Treatment of BUD involved a combination of surgical interventions and antimycobacterial chemotherapy for 8 weeks. Results. The age of the 38 patients ranged from 0–56 years (mean age of 14.3 years), with males outnumbering females. Most (55.3%, ) of the patients reported to the facilities with developed BUD deformities. Patients who lost their eyeball () recorded the highest in terms of functional disability. A mean total hospital stay of 52 days and follow-up period of 2.3 years were recorded for the study. Conclusion. Visual impairment was the commonest form of disability recorded in the HNR. Management difficulties and BUD disabilities could be avoided by early detection of the disease and training of health professionals at district levels.

Oral rehabilitation of a cleft palate patient with tooth-supported, telescopic magnetic overdenture

2020 ◽  
Vol 13 (11) ◽  
pp. e233777
Author(s):  
Mohammed A Alfarsi ◽  
Sharaz Shaik
Keyword(s):  
Patient Education ◽  
Cleft Palate ◽  
Oral Hygiene ◽  
Oral Rehabilitation ◽  
Posterior Teeth ◽  
And Function ◽  
Palate Patient ◽  
Single Path

A 49-year-old male patient with residual cleft palate and missing pre-maxilla presented with an ill-fitting and unaesthetic maxillary denture. The posterior teeth were periodontally sound but crowded and had defective restorations and secondary caries. We restored the bilateral maxillary canines and first premolars with conical telescopic crowns having magnetic keepers. A metal-reinforced acrylic overdenture with magnetic attachments corresponding to the keepers of the telescopic crowns was fabricated. The telescopic crowns provided a single path of insertion, retention and stability to the prosthesis. The magnetic attachments provided additional retention and self-centring properties. The prosthesis effectively sealed the oronasal communication and enhanced the function, aesthetics and oral hygiene. The 6-month and 1-year follow-ups revealed that the patient was delighted, and the prosthesis provided excellent obturation and function. Periodic follow-up, maintenance, patient education and meticulous oral hygiene are vital for long-term success of such prostheses.

scholarly journals MANUTENÇÃO DA SAÚDE BUCAL EM UM PACIENTE PÓS RADIOTERAPIA DE CABEÇA E PESCOÇO: UM DESAFIO À ODONTOLOGIA

2019 ◽  
Vol 4 (1) ◽  
pp. 91
Author(s):  
Fabieli Bellé ◽  
Flaira Rita Albino ◽  
Letícia de Freitas Cuba
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Head And Neck ◽  
Oral Rehabilitation ◽  
Main Challenge ◽  
Care Protocol ◽  
Retromolar Region ◽  
Gingival Mucosa ◽  
Head And Neck Radiotherapy

O tratamento antineoplásico traz consigo alterações bucais imediatas e tardias. Essas podem interferir diretamente na qualidade de vida e saúde dos pacientes submetidos a estes tratamentos. Objetivo: O objetivo deste estudo é estabelecer alternativas dentro da odontologia para promover a saúde bucal em um paciente pós radioterapia de cabeça e pescoço, bem como salientar os desafios encontrados neste processo através de um relato de caso clínico. Relato de caso: Paciente sexo masculino, 59 anos, leucoderma, diagnosticado em com Carcinoma Epidermoide Infiltrativo (CEC) em epitélio orofaringeano com envolvimento de borda da língua, mucosa gengival, pilar tonsilar e região retromolar. O mesmo foi submetido à cirurgia ressectiva do tumor seguido de um ciclo de quimioterapia e radioterapia na região de cabeça e pescoço. Ao exame clínico inicial foram observadas diversas consequências destes tratamentos, as quais necessitavam de intervenção odontológica. O maior desafio encontrado neste estudo foi estabelecer um protocolo de atendimento. Conclusão: Ao término deste caso, foi possível avaliar que o paciente obteve resultados satisfatórios diante dos procedimentos adotados pela equipe, uma vez que o objetivo do tratamento odontológico é estabilizar as condições bucais para minimizar a infecção local e sistêmica e o risco de agravamento das sequelas durante e após o tratamento do câncer e consequentemente, melhorar a qualidade de vida do paciente. MAINTAINING ORAL HEALTH IN A PATIENT AFTER HEAD AND NECK RADIOTHERAPY: A CASE REPORT ABSTRACT The antineoplastic therapy brings immediate and late oral changes, and these alterations can interfere directly in the quality of life and health of patients submitted to these treatments. The goal of this paper was the oral rehabilitation of a patient after treatment of head and neck radiotherapy, by means of endodontic procedures, restorers and prosthetics, through a clinical case report. The male patient, 59 years old, leucoderma, diagnosed with Squamous Cell Carcinoma (CSS) in oropharyngeal epithelial with involvement of the border of the tongue, gingival mucosa, tonsillar pillar and retromolar region. The patient was submitted to surgical resection of the tumor followed by a cycle of chemotherapy, the treatment continued with radiotherapy. At the initial clinical examination it was observed many consequences of these treatments that needed odontological intervention. The main challenge found in this study was to establish a care protocol. At the end of this study it was possible to evaluate that the patient obtained satisfactory results regarding the procedures adopted by the team. The goal of the odontological treatment is to eliminate or to establish the oral conditions to minimize the local and systematic infection, during and after the cancer treatment, and consequently, to improve the patient’s quality of life.

Cementless 3D Printed Highly Porous Titanium-Coated Baseplate Total Knee Arthroplasty: Survivorship and Outcomes at 2-Year Minimum Follow-Up

2019 ◽  
Vol 33 (03) ◽  
pp. 279-283 ◽  
Author(s):  
Assem A. Sultan ◽  
Bilal Mahmood ◽  
Linsen T. Samuel ◽  
Kim L. Stearns ◽  
Robert M. Molloy ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Clinical Success ◽  
Base Plate ◽  
Porous Titanium ◽  
Implant Survivorship ◽  
3D Printed ◽  
Total Knee ◽  
And Function ◽  
Highly Porous

AbstractNewer generation cementless total knee arthroplasty (TKA) implants continue to develop with demonstrated clinical success in multiple recent reports. The purpose of this study was to investigate (1) survivorship, (2) complications, and (3) clinical outcomes of a newer generation cementless and highly porous titanium-coated base plate manufactured using three-dimensional (3D) printing technology. We reviewed a single-surgeon, longitudinally maintained database of patients who underwent primary TKA using cementless, highly porous titanium-coated base plate implants from July 1, 2013 to December 31, 2016. A total of 523 patients were identified. Of this cohort, 496 patients had a minimum of 2-year follow-up and were included in our final analysis. Among these patients, 72 had bilateral TKA yielding a total of 568 TKAs. There were 133 men and 363 women who had a mean body mass index of 33 kg/m2 (range, 20–61 kg/m2). The mean age was 66 years (range, 33–88 years). Average follow-up was 36 months (range, 24–48 months). Indications for TKA included osteoarthritis in 432 patients (87%), rheumatoid arthritis in 40 patients (8%), and knee osteonecrosis in 24 (5%) patients. Implant survivorship was defined as any revision leading to explantation of the base plate for any reason. Kaplan–Meier analysis was performed to determine all-cause implant survivorship at final follow-up for every patient. Complications were assessed using the Knee Society standardized list of TKA complications. Clinical outcomes were determined using the Knee Society pain and function scores. Range-of-motion values were also collected. There were a total of four failures, all were due to aseptic loosening with a survivorship rate of 99% at mean follow-up of 3 years (95% confidence interval = 0.984–0.999). In addition, there were a total of 12 surgical and 10 medical complications. Surgical complications did not affect the base plate or result in any additional implant revisions. A total of nine patients had thromboembolic disease complications; all received medical treatment and recovered adequately. Radiological evaluation did not show any signs of loosening or failures in other patients at final follow-up. Knee Society Scores for pain and function improved from 55 and 56 points preoperatively to 92 and 84 points at 2 years postoperatively. Our results are in concordance with the excellent clinical outcomes and survivorship demonstrated for the newer generation cementless TKA implants. In our experience, 3D printed titanium base plates demonstrated clinical success and excellent survivorship at minimum follow-up of 2 years.

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