Use of Subepithelial Connective Tissue Graft as a Biological Barrier: A Human Clinical and Histologic Case Report

2014 ◽  
Vol 40 (4) ◽  
pp. 465-468 ◽  
Author(s):  
Mario Santagata ◽  
Luigi Guariniello ◽  
Rosario V. E Prisco ◽  
Gianpaolo Tartaro ◽  
Salvatore D'Amato
Keyword(s):  
Protective Factor ◽  
Healing Process ◽  
Periodontal Regeneration ◽  
Long Term Stability ◽  
Connective Tissue Graft ◽  
Keratinized Tissue ◽  
Expansion Technique ◽  
Subepithelial Connective Tissue Graft

The aim of the present study was to develop a method to study the healing process after gingival grafting and to observe the histologic results after use of the modified edentulous ridge expansion technique. A 47-year-old nonsmoking woman with a noncontributory past medical history affected by edentulism associated with a horizontal alveolar ridge defect was referred to the authors for surgical correction of the deficit to improve implant support and the final esthetics of an implant-borne prosthesis. At the 4-month follow-up visit, a biopsy was performed by a punch technique in the same sites of healing abutment connection. The tissue was elevated from the attached gingival. Clinically, the grafted tissues seemed to be attached to the bone surfaces. The histologic findings revealed dense grafted tissues, providing long-term stability to the area. No ligament or bone, characteristic for periodontal regeneration, were observed. The presence of thick attached keratinized tissue around implants may constitute a protective factor against marginal inflammation or trauma.

scholarly journals Resolution of Abfraction-Associated Gingival Fenestration Utilizing Connective Tissue Grafting

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Braydon Haskell ◽  
J. Kobi Stern ◽  
Jordan Ghiassi ◽  
Andrew Kurialacherry ◽  
Sadja Gaud-Quintana ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Root Surface ◽  
Case Presentation ◽  
Long Term Stability ◽  
Connective Tissue Graft ◽  
Uncertain Etiology ◽  
Noncarious Cervical Lesion ◽  
Oral Soft Tissue

Introduction. Gingival fenestration (GF) is a distinct clinical entity of uncertain etiology that is seldom documented in the literature. It has been associated mainly with submucosal mechanical irritants such as calculus that subsequently create an opening in the oral soft tissue, usually at facial anterior sites. Surgical correction may be indicated to address functional and/or esthetic concerns. Case Presentation. The patient, a 74-year-old male, presented to the clinic with a chief complaint of “something is poking through my gum.” Clinical exam revealed a gingival fenestration on the facial of tooth #11, associated with what appeared to be a pronounced noncarious cervical lesion (NCCL). Surgical treatment consisted of a connective tissue graft and odontoplasty of the sharp protruding edge of the root surface. Healing was uneventful with excellent closure of the fenestration and no evidence of recurrence after 18 months of follow-up. Conclusion. GF is a perforation of the mucosa typically associated with underlying sharp mechanical etiology. This report describes a fenestration that developed from a probable abfractive lesion, which later was successfully closed and exhibits long-term stability.

scholarly journals Periodontics, Implantology, and Prosthodontics Integrated: The Zenith-Driven Rehabilitation

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Fausto Frizzera ◽  
Mateus Tonetto ◽  
Guilherme Cabral ◽  
Jamil Awad Shibli ◽  
Elcio Marcantonio
Keyword(s):  
Tooth Extraction ◽  
Treatment Plan ◽  
Oral Rehabilitation ◽  
Long Term Stability ◽  
Connective Tissue Graft ◽  
Implant Placement ◽  
Immediate Implant ◽  
The Ideal

A customized treatment plan is important to reach results that will satisfy the patient providing esthetics, function, and long-term stability. This type of oral rehabilitation requires professionals from different dental specialties where communication is a major key point. Digital Smile Design allows the practitioners to plan and discuss the patient’s condition to establish the proper treatment plan, which must be driven by the desired zenith position. The ideal gingival position will guide the professionals and determine the need to perform surgical procedures or orthodontic movement before placing the final restorations. In this article, the zenith-driven concept is discussed and a challenging case is presented with 4-year follow-up where tooth extraction, immediate implant placement, bone regeneration, and a connective tissue graft were performed.

Subepithelial Connective Tissue Graft for Gingival Recession Coverage: A Case Report

2020 ◽  
Author(s):  
Anita Mehta
Keyword(s):  
Case Report ◽  
Connective Tissue ◽  
Gingival Recession ◽  
Tooth Brushing ◽  
Vulnerable Area ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Subepithelial Connective Tissue Graft ◽  
Dentinal Hypersensitivity

The Gingival recession is considered a multi-factorial. The etiology may be an anatomically vulnerable area, faulty tooth brushing, high frenum attachment. In cases where there is progressive recession, aesthetics concern or increasing dentinal hypersensitivity, we can do recession coverage. Depending upon the presence or absence of adequate keratinized tissue we can choose the technique. In case of adequate width of keratinized tissue, usually we can do displaced flap and in case where there is inadequate width, we can do gingival grafting.

Long-Term Stability of Sutured Scleral Fixation of a Posterior Chamber Intraocular Lens With 10-0 Polypropylene for More Than 30 Years

2021 ◽  
pp. 247412642097887
Author(s):  
Gregg T. Kokame ◽  
Tarin T. Tanji ◽  
Jase N. Omizo
Keyword(s):  
Intraocular Lens ◽  
Posterior Chamber ◽  
Scleral Flap ◽  
Scleral Fixation ◽  
Polypropylene Suture ◽  
Long Term Stability ◽  
Posterior Chamber Intraocular Lens ◽  
Polypropylene Sutures

Purpose: We report the longest follow-up to our knowledge of stable scleral fixation of a posterior chamber intraocular lens (PC IOL) with 10-0 polypropylene sutures. Methods: A retrospective review is presented of a case with more than 30 years’ follow-up after performing sutured scleral fixation with 10-0 polypropylene suture using 2 sutures tied together under a scleral flap. One suture was a cow-hitch looped around the haptic, and the other suture was passed through the sclera to create the scleral fixation. Results: The scleral fixation with 10-0 polypropylene suture knots for both haptics of the PC IOL allowed central optic positioning with excellent vision for more than 30 years without suture breakage. Conclusions: Polypropylene sutures for scleral fixation of PC IOLs remained stable for more than 30 years with central positioning of the PC IOL, without exposure of the fixation suture knots through the conjunctiva, and without suture breakage.

scholarly journals Bioabsorbable vascular scaffolds in routine practice: long-term results

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
R M Mori ◽  
I N G Nunez
Keyword(s):  
Protective Factor ◽  
Randomized Clinical Trials ◽  
Real Life ◽  
Long Term Results ◽  
Routine Practice ◽  
Target Vessel ◽  
Intracoronary Imaging ◽  
Vascular Scaffolds

Abstract Background Recent publications suggest that bioabsorbable vascular scaffolds (BVS) carry an excess of thrombotic complications. Our goal was to describe the results in real life and in the long term, in a series of patients who received a BVS which is currently off the market. Methods Two hundred and thirteen consecutive patients who received at least 1 BVS between May 2012 and December 2016 were analyzed. The primary objective was the incidence of the compound event “target vessel failure” that included infarction or target vessel revascularization and cardiac death. Results Seventy-five percent of patients were men with a mean age of 61.4 years. They had a high prevalence of dyslipidemia (62.44%) and smoking (65.26%). The most common cause of admission was myocardial infarction without ST elevation (53.52%). A total of 233 coronary lesions were treated, with an average of 1.3±0.3 lesions per patient. The implant was successful in 99.5% of cases. Predilatation was performed in 89.3% and post dilation in 33.5% of cases. The use of intracoronary imaging (Optical Coherence Tomography OCT and/or Intravascular ultrasonography IVUS) to optimize the BVS implant was performed in 86 patients (40.38%). With a mean follow-up of 42.5 months, the incidence of target vessel failure was 6.57% during the first 24 months and 7.98% at the end of the follow-up. Regarding the device, this included 6 cases (2.81%) of thrombosis (definitive, probable or possible) and 10 cases (4.69%) of restenosis. Patients with a history of diabetes mellitus (HR 1.72 95% CI 1.01–2.95 P=0,05) and/or chronic oral anticoagulation (HR 5.71 95% CI 1.12–28.94 P=0.04) had a higher risk of target vessel failure. The use of intracoronary imaging (OCT and/or IVUS) during the BVS implantation had a considerable trend toward significance as a protective factor (HR 0.32 95% CI 0.11–1.03 P=0.06). Conclusions In this series of patients; in real life conditions, the incidence of target vessel failure was comparable to that previously described in randomized clinical trials. The events were more frequent during the first 2 years of follow-up, in the presence of greater cardiovascular comorbidity and in the absence of intracoronary imaging during the implantation. FUNDunding Acknowledgement Type of funding sources: Other. Main funding source(s): European Society of Cardiology KM curve for target vessel failure (TVF) Predictor analysis for TVF

Abstract 11503: Mindfulness is Inversely Associated with Psychological Symptoms in Long-Term Cardiac Arrest Survivors

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Alex Presciutti ◽  
Jonathan Greenberg ◽  
Ethan Lester ◽  
Mary M Newman ◽  
Jonathan Elmer ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Protective Factor ◽  
Psychological Symptoms ◽  
Sudden Cardiac Arrest ◽  
Survey Study ◽  
Present Moment ◽  
Cross Sectional ◽  
Patient Health

Introduction: We sought to identify correlates with psychological symptoms in long-term cardiac arrest (CA) survivors. Mindfulness, or nonjudgmental awareness of the present moment, is a modifiable protective factor against psychological symptoms in various clinical populations and could be a potential treatment target for CA survivors. Methods: We conducted a longitudinal survey study between 10-11/2019 (baseline) and 10-11/2020 (1-year follow-up) with long-term CA survivor members of the Sudden Cardiac Arrest Foundation. We collected demographic and CA characteristics at baseline. At both timepoints, we assessed posttraumatic stress symptoms (PTS) through the PTSD Checklist-5 (PCL-5) and depression and anxiety symptoms through the Patient Health Questionnaire-4 (PHQ-4). At follow-up, we assessed mindfulness through the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R). We used adjusted linear regression to predict 1-year PCL-5 and PHQ-4 scores, with particular consideration of the CAMS-R as a cross-sectional correlate of outcome. Results: We included 129 CA survivors (mean age: 52 years, 52% male, 98% white). At 1-year follow-up, in adjusted models, CAMS-R (β: -0.35, p <0.001) and baseline PCL-5 scores (β: 0.56, p <0.001) were associated with 1-year PCL-5 scores. CAMS-R (β: -0.34, p <0.001) and baseline PHQ-4 scores were associated with 1-year PHQ-4 scores (β: 0.37, p<0.001). Conclusion: Mindfulness was inversely associated with psychological symptoms in long-term CA survivors. Future studies should examine the longitudinal relationship of mindfulness and psychological symptoms after CA.

Long term stability of the subcutaneous cardioverter defibrillator implanted by means of the intermuscular two incision technique

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
G Bisignani ◽  
A Bisignani ◽  
AL Cavaliere ◽  
M Lovecchio ◽  
S Valsecchi ◽  
...  
Keyword(s):  
Thoracic Wall ◽  
Fat Tissue ◽  
Cardioverter Defibrillator ◽  
Long Term Stability ◽  
Funding Sources ◽  
Incision Technique ◽  
Post Implantation ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Background To ensure effective defibrillation with the subcutaneous implantable cardioverter defibrillator (S-ICD), both the lead and the generator must be adequately positioned extrathoracically. We assessed the long-term adequacy of the S-ICD system position and its stability in a group of patients who received the S-ICD by means of the two-incision intermuscular technique. Methods The PRAETORIAN score uses chest radiography to provide feedback on S-ICD positioning, and identifies patients with high defibrillation thresholds. We compared radiographs taken immediately after implantation and on 12-month follow-up examination. Results We analyzed data from 38 patients with the S-ICD generator positioned in an intermuscular pocket. The median PRAETORIAN score was 38 [25th to 75th percentile: 30 to 60]. Two (5%) patients had a score of 90 (intermediate risk of conversion failure). The thickness of the adipose tissue between the coil and the sternum was ≤1 coil width in 72% of patients, the generator was on, or posterior to, the midline in 94% of patients, and the amount of fat tissue between the generator and the thoracic wall was less than the generator width in 78% of patients. No generator or electrode dislodgments were detected on analyzing radiographs collected at the 12-month visit. In all patients, assessment of the PRAETORIAN score confirmed the values calculated on post-implantation analysis. During follow-up, no ineffective therapies, sudden cardiac or device-related deaths occurred. Conclusions The position of the S-ICD system implanted using the two-incision intermuscular technique was adequate at the time of implantation and remained stable after 12 months.

scholarly journals Middle Ear Transducer: Long Term Stability of the Latest Generation T2

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Nils Kristian Prenzler ◽  
Eugen Kludt ◽  
Thomas Giere ◽  
Rolf Salcher ◽  
Thomas Lenarz ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Observation Time ◽  
Term Stability ◽  
Long Term Stability ◽  
Average Observation ◽  
Technical Failures

Objectives/Hypothesis. Comparing long term stability of the Middle Ear Transducers (MET) of the 1st generation T1 (Otologics LLC) with the current generation T2 (Cochlear Ltd.) in all our clinical cases with standard incus coupling. Study Design. Retrospective chart review. Methods. 52 ears implanted with a MET device between 2008 and 2016 were analyzed retrospectively. All patients suffered from sensorineural hearing loss and the actuator was coupled to the body of the incus (standard coupling). 23 ears were implanted with the transducer T1 (Otologics LLC) between 2008 and 2011 and 29 ears were implanted with the current transducer T2 since 2011 (Otologics LLC/Cochlear Ltd.). Latest available in situ and bone conduction (BC) thresholds were exploited for a follow-up period of up to 7 years after first fitting. Long term stability of coupling and actuator performance was evaluated by tracking differences between in situ and BC thresholds. Results. In the T1 group, 9 out of 23 implants were still used by the patients at their last follow-up visit (average observation time 3.7 yrs.; min 1.0 yrs., max 7.4 yrs.). In 9 patients a technical failure identified by a decrease of in situ threshold of more than 15 dB compared to BC thresholds [Δ (in situ – BC)] lead to non-usage of the implant and 7 explantations. Five other explantations occurred due to medical reasons such as BC threshold decrease, infection, or insufficient speech intelligibility with the device. In the T2 group, 23 out of 29 implants were still used at the most current follow-up visit (average observation time 3.3 yrs.; min 1.0 yrs., max 4.8 yrs.). No technical failures were observed up to more than 4 years after implantation. Five T2 patients discontinued using the device due to insufficient benefit; two of these patients were explanted. One patient had to be explanted before the activation of the device due to disorders of wound healing. Nevertheless, a small but significant decrease of hearing loss corrected coupling efficiency [Δ (in situ – BC)] was seen in the T2 group. Conclusions. In contrast to the T1 transducers of the earlier generation of MET systems where technical failures occurred frequently, no technical failures were detected after 29 implantations with the current T2 transducers. However, a small but significant decline of transmission efficiency was observable even in the T2 implanted group.

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