scholarly journals What is the survival rate of deciduous molars in cases with agenesis of premolar successors? A systematic review

2021 ◽  
Author(s):  
Cibelle Cristina Oliveira dos Santos ◽  
Dandara Lopes Melo ◽  
Paula Pires da Silva ◽  
David Normando
Keyword(s):  
Survival Rate ◽  
Oral Cavity ◽  
Observational Studies ◽  
Root Resorption ◽  
Grey Literature ◽  
Synthesis Methods ◽  
Level Of Evidence ◽  
Deciduous Molar ◽  
Deciduous Molars

ABSTRACT Objectives To systematically review the literature on the survival rate of deciduous molars in cases of agenesis of premolar successors. Materials and Methods Four electronic databases and partial grey literature were searched up to November 2020. The PECOS eligibility criteria included (P) second deciduous molar (E) exposed to agenesis of a premolar successor (O) evaluated by the survival rate in the oral cavity, infraocclusion, and root resorption through (S) observational studies. Risk of bias (RoB) was assessed using the checklists from the Joanna Briggs Institute and the level of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) tool. Results Three studies were included: one with low, one with moderate, and one with high RoB. Synthesis methods included the frequency of persistent deciduous second molars during the follow-up. Approximately 82% to 89% remained in the oral cavity after 5 to 13 years. The incidence of root resorption was 11%, and the infraocclusion was 1 mm. The level of evidence was considered low for each outcome. There was considerable RoB regarding the observational studies and a need for clinical and radiographic monitoring of the deciduous molars. Conclusions Maintaining a deciduous molar in the oral cavity in patients with agenesis of the premolar successor is a viable clinical choice since 82% to 89% of the retained molars evaluated were in good condition over a follow-up ranging from 5 to 13 years. Infraocclusion and root resorption did not seem to increase considerably. The level of evidence was considered low for each outcome.

scholarly journals Minimum 10-Year Clinical Outcome of Lateral Collagen Meniscal Implants for the Replacement of Partial Lateral Meniscal Defects: Further Results From a Prospective Multicenter Study

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712199491
Author(s):  
Alberto Grassi ◽  
Gian Andrea Lucidi ◽  
Giuseppe Filardo ◽  
Piero Agostinone ◽  
Luca Macchiarola ◽  
...  
Keyword(s):  
Survival Rate ◽  
Case Series ◽  
Final Analysis ◽  
Activity Level ◽  
Long Term Results ◽  
Level Of Evidence ◽  
Unicompartmental Knee Arthroplasties ◽  
Tegner Score

Background: The collagen meniscal implant (CMI) is a biologic scaffold aimed at replacing partial meniscal defects. The long-term results of lateral meniscal replacement have never been investigated. Purpose: To document the clinical outcomes and failures of lateral CMI implantation for partial lateral meniscal defect at a minimum 10-year follow-up. Study Design: Case series; Level of evidence, 4, Methods: This study included 24 consecutive patients who underwent lateral CMI implantation for partial lateral meniscal defects between April 2006 and September 2009 and who were part of a previous study with a 2-year follow-up. Outcome measures at the latest follow-up included the Lysholm score, Knee injury and Osteoarthritis Outcome Score, visual analog scale (VAS) for pain, Tegner activity level, and EuroQol 5-Dimensions score. Data regarding complications and failures were collected, and patients were asked about their satisfaction with the procedure. Results: Included in the final analysis were 19 patients (16 male, 3 female) with a mean age at surgery of 37.1 ± 12.6 years and a mean follow-up of 12.4 ± 1.5 years (range, 10-14 years). Five failures (26%) were reported: 1 CMI removal because of implant breakage and 4 joint replacements (2 unicompartmental knee arthroplasties and 2 total knee arthroplasties). The implant survival rate was 96% at 2 years, 85% at 5 years, 85% at 10 years, 77% at 12 years, and 64% at 14 years. Lysholm scores at the final follow-up were rated as “excellent” in 36% (5 of 14 nonfailures), “good” in 43% (6 of 14), and “fair” in 21% (3 of 14). The VAS score was 3.1 ± 3.1, with only 16% (3 of 19 patients) reporting that they were pain-free; the median Tegner score was 3 (interquartile range, 2-5). All clinical scores decreased from the 2-year follow-up; however, with the exception of the Tegner score, they remained significantly higher compared with the preoperative status. Overall, 79% of patients were willing to undergo the same procedure. Conclusion: Lateral CMI implantation for partial lateral meniscal defects provided good long-term results, with a 10-year survival rate of 85% and a 14-year survival rate of 64%. At the final follow-up, 58% of the patients had “good” or “excellent” Lysholm scores. However, there was a general decrease in outcome scores between the short- and the long-term follow-up.

Long-term Outcomes of Microfracture for Treatment of Osteochondral Lesions of the Talus

2021 ◽  
pp. 107110072199542
Author(s):  
Daniel Corr ◽  
Jared Raikin ◽  
Joseph O’Neil ◽  
Steven Raikin
Keyword(s):  
Survival Rate ◽  
Case Series ◽  
Return To Sport ◽  
Osteochondral Lesions ◽  
Long Term Outcomes ◽  
Level Of Evidence ◽  
Additional Surgery ◽  
Case Series Study

Background: Microfracture is the most common reparative surgery for osteochondral lesions of the talus (OLTs). While shown to be effective in short- to midterm outcomes, the fibrocartilage that microfracture produces is both biomechanically and biologically inferior to that of native hyaline cartilage and is susceptible to possible deterioration over time following repair. With orthobiologics being proposed to augment repair, there exists a clear gap in the study of long-term clinical outcomes of microfracture to determine if this added expense is necessary. Methods: A retrospective review of patients undergoing microfracture of an OLT with a single fellowship-trained orthopedic surgeon from 2007 to 2009 was performed. Patients meeting the inclusion criteria were contacted to complete the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sports subscales and visual analog scale (VAS) for pain, as well as surveyed regarding their satisfaction with the outcome of the procedure and their likelihood to recommend the procedure to a friend with the same problem using 5-point Likert scales. Patient demographics were reviewed and included for statistical analysis. Results: Of 45 respondents, 3 patients required additional surgery on their ankle for the osteochondral defect, yielding a 10-year survival rate of 93.3%. Of surviving cases, 90.4% (38/42) reported being “extremely satisfied” or “satisfied” with the outcome of the procedure. The VAS score at follow-up averaged 14 out of 100 (range, 0-75), while the FAAM-ADL and FAAM-Sports scores averaged 90.29 out of 100 and 82 out of 100, respectively. Thirty-six patients (85.7%) stated that their ankle did not prevent them from participating in the sports of their choice. Conclusion: The current study represents a minimum 10-year follow-up of patients undergoing isolated arthroscopic microfracture for talar osteochondral defects, with a 93.3% survival rate and 85.7% return to sport. While biological adjuvants may play a role in improving the long-term outcomes of microfracture procedures, larger and longer-term follow-up studies are required for procedures using orthobiologics before their cost can be justified for routine use. Level of Evidence: Level IV, retrospective cohort case series study.

OP39 Evaluation Of Discharge Planning And Transitional Care For The Elderly

2018 ◽  
Vol 34 (S1) ◽  
pp. 15-15
Author(s):  
Maggy Wassef ◽  
Marc-Olivier Trepanier ◽  
Sylvie Beauchamp
Keyword(s):  
Readmission Rate ◽  
Transitional Care ◽  
Discharge Planning ◽  
Grey Literature ◽  
The Elderly ◽  
Narrative Synthesis ◽  
Local Data ◽  
Post Discharge ◽  
Level Of Evidence

Introduction:According to our local data, elderly patients accounted for 14 percent of the population yet, represent 58 percent of hospitalization and, they are more likely to return after discharge. These patients are more likely to return to the hospital following discharge. In order to meet ministerial target for length of stay of patient on a stretcher, the UETMIS-SS was requested to evaluate interventions aiming to improve the fluidity of patient trajectories in the acute care services. The objective of this health technology assessment is to evaluate the effectiveness of discharge planning and transitional care interventions aiming at reducing the readmission rate of the elderly.Methods:An umbrella review was conducted following the PRISMA statement to summarize the scientific evidence. The search was conducted in five databases along with the grey literature search. Two reviewers independently performed the study selection, the quality assessment and the data extraction. To better illustrate the activities and the healthcare professionals (HCP) involved in the interventions, an analytical framework was developed. Results were summarized in a narrative synthesis. The contextual and experiential data were collected through interviews with HCP and directorates from different settings. The level of evidence was and a committee was then held to elaborate the recommendations.Results:In the nine systematic reviews included in the narrative synthesis, three models were identified: Post-discharge planning and follow-up by the same HCP was established to be effective in reducing the readmission rate. Discharge planning interventions with follow-up by non-specific HCP have been shown to be promising, while discharge planning without follow-up after the hospital discharge has shown to be ineffective in reducing the readmission rate.Conclusions:An individualized discharge plan, coordination of services and follow-up performed by the same HCP is established to be effective in reducing readmission rate.

Trapeziometacarpal total joint arthroplasty for osteoarthritis: 199 patients with a minimum of 10 years follow-up

2019 ◽  
Vol 45 (5) ◽  
pp. 443-451 ◽  
Author(s):  
Miguel Martin-Ferrero ◽  
Clarisa Simón-Pérez ◽  
Maria B. Coco-Martín ◽  
Aureliio Vega-Castrillo ◽  
Héctor Aguado-Hernández ◽  
...  
Keyword(s):  
Survival Rate ◽  
Total Joint Arthroplasty ◽  
Hand Function ◽  
Joint Arthroplasty ◽  
Implant Survival ◽  
Level Of Evidence ◽  
Term Survival ◽  
Cumulative Survival

We report outcomes of 228 consecutive patients with total joint arthroplasty using the Arpe® prosthesis, among which 216 trapeziometacarpal joints in 199 patients had a minimum of 10 years follow-up. The cumulative survival rate of the 216 implants at 10 years using the Kaplan–Meyer method was 93%. Two hundred joints were functional and painless. We found good integration and positioning of the components in 184 (93%) of the joints. Sixteen prostheses failed. We conclude that this implant has acceptable long-term survival rate and restores good hand function. We also report our methods to improve implant survival and to decrease the risk of component malpositioning, and failure rate. Level of evidence: II

Arpe total joint arthroplasty for trapeziometacarpal osteoarthritis: 80 thumbs in 63 patients with a minimum of 10 years follow-up

2020 ◽  
Vol 45 (5) ◽  
pp. 465-469 ◽  
Author(s):  
Raphaëlle Dumartinet-Gibaud ◽  
Nicolas Bigorre ◽  
Guy Raimbeau ◽  
Jérome Jeudy ◽  
Yann Saint Cast
Keyword(s):  
Survival Rate ◽  
First Year ◽  
Implant Survival ◽  
Level Of Evidence ◽  
Technical Errors ◽  
Lack Of Information ◽  
Trapeziometacarpal Osteoarthritis ◽  
Long Run ◽  
Lost To Follow Up

In this retrospective study, we report a series of 80 Arpe prostheses for trapeziometacarpal osteoarthritis in 63 patients. Twenty-seven prostheses (20 patients) were lost to follow-up. Twenty-one were revised, eight of them during the first year after operation. The calculated cumulated implant survival rate was 85% at 10 years but could be lower due to the lack of information on the patients lost to follow-up. The number of complications due to technical errors was high; but after we had done 30 cases, the number of early revisions decreased markedly. At follow-up, 23 of 32 thumbs were totally free of pain, and the patients were satisfied with 31 thumbs. We conclude that the implant survival declines progressively in the long run, with a survival rate of 80% after 15 years of follow-up and a further decline thereafter. We also found that this surgery was difficult to master. We advise selecting this implant for thumb trapeziometacarpal osteoarthritis with caution. Level of evidence: IV

Medium-Term Outcomes for Amandys Implant: A 5-Year Minimum Follow-Up of 63 Cases

2021 ◽  
Author(s):  
Youssouf Tanwin ◽  
Catherine Maes-Clavier ◽  
Victor Lestienne ◽  
Etienne Gaisne ◽  
Thierry Loubersac ◽  
...  
Keyword(s):  
Survival Rate ◽  
Grip Strength ◽  
Functional Outcomes ◽  
Case Series ◽  
Contralateral Side ◽  
Short Version ◽  
Level Of Evidence ◽  
Functional Scores ◽  
Wrist Arthroplasty

Abstract Background Amandys is a pyrocarbon interposition implant used as a therapeutic alternative to total wrist fusion (TWF) or total wrist arthroplasty (TWA) in painful and disabling extensive destruction of the wrist. Objective To review mid-term outcomes in a continuous prospective series of patients who underwent wrist arthroplasty Amandys with a minimum follow-up of 5 years. Methods Clinical evaluation included a satisfaction survey, pain, two functional scores, the short version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and the Patient-Rated Wrist Evaluation (PRWE), active wrist mobility, and grip strength compared with the contralateral side. Radiological evaluation was used to detect implant subsidence, carpal migration, bone lysis, or implant malposition. All per- and postoperative complications were collected. Results Fifty-nine patients (63 procedures) were evaluated with a mean follow-up of 7 years; 57% of the patients were males, and the mean age was 58 years. Among the patients, 90% were satisfied or very satisfied. Pain was significantly improved, with a gain of 4/10 (p < 0.001). Functional outcomes also improved between the second and fifth year of follow-up. Active mobility was preserved and grip strength was significantly improved by 7 kg (p < 0.001). No implant subsidence or carpal migration was observed. Ten patients (11.9%) underwent revision surgery for conflict (1%), rotation (6%), or implant dislocation (5%). All complications and revisions occurred early with no new events after 1 year of follow-up. Discussion Mid-term clinical and radiological outcomes were stable with improvement of functional scores. The survival rate was comparable to that reported for TWF with conserved mobility. We report fewer complications compared with those reported for TWA or TWF. Early instability of the implant was the main etiology of the revisions. Repositioning of the implant was successful. No conversion to TWA or TWF was necessary. Conclusions Mid-term outcomes of the Amandys implants were encouraging. Patients conserved good wrist motion with improved strength and functional scores. The implant was well tolerated. Functional outcomes continue to improve with the follow-up. The survival rate remains stable after 2 years. The level of evidence of this study is IV (therapeutic case series).

Root resorption in deciduous teeth after applying orthodontic forces

2005 ◽  
Vol 29 (4) ◽  
pp. 283-286 ◽  
Author(s):  
A. Fiore Aguilar ◽  
A. Aquila ◽  
A. Ubios
Keyword(s):  
Orthodontic Treatment ◽  
Root Resorption ◽  
Deciduous Teeth ◽  
Root Fractures ◽  
Orthodontic Forces ◽  
Deciduous Molars

The relation between orthodontic forces applied to deciduous teeth and the occurrence of root resorption, as a possible outcome of these forces, has not been studied to date. The aim of this work was to study root resorption in deciduous teeth of patients receiving orthodontic treatment. Twenty-four deciduous molars extracted for therapeutic purposes were studied: nineteen molars treated with light orthodontic forces and five untreated molars that served as control. Histological and histomorphometric studies were performed to determine the magnitude of root resorption. Location of root resorption in treated deciduous teeth was different from that of physiological root resorption. Extent and volume of root resorption were more extensive and deeper in treated than in untreated teeth. These results suggest that radiographic follow-up of deciduous teeth subjected to orthodontic forces would be useful to prevent root fractures.

scholarly journals Survival at 11 to 21 years for 779 Metasul® metal-on-metal total hip arthroplasties

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902092626
Author(s):  
Roger Erivan ◽  
Guillaume Villatte ◽  
Stéphane Millerioux ◽  
Aurélien Mulliez ◽  
Stéphane Descamps ◽  
...  
Keyword(s):  
Survival Rate ◽  
Aseptic Loosening ◽  
Surface Coating ◽  
P Value ◽  
Level Of Evidence ◽  
Total Hip ◽  
Metal On Metal ◽  
Hip Arthroplasties ◽  
Oxford Score

Background: Total hip arthroplasties (THAs) bearing is one of the most important factors for hip replacement because THA survival depends on it. Metal-on-metal (MoM) bearing has lower wear than metal-on-polyethylene but lot of aseptic loosening decrease utilization. We analyze the survival rate of 28 mm Metasul® bearings after a mean follow-up of 12.9 years. Methods: The main objective of this study was to evaluate the survival of the MoM. We evaluate 779 consecutive THAs performed between January 1995 and December 2005 for primary osteoarthritis, congenital dysplasia classified Crowe I, or rheumatoid arthritis. Survival rate was calculated by the Kaplan–Meir method. The association between survival and age, gender, body mass index (BMI), and surface coating was investigated with a proportional odds model. The clinical assessment included Oxford score. Results: Six hundred fifty-two THAs were reviewed. Sixty-two revisions (9.5%) were performed including 34 aseptic loosening and 11 deep infections. The survival for prosthesis with any reason at 20 years was 87% (confidence interval (CI) 83–90.2) for aseptic loosening at 20 years was 90.1% (CI 87–93.8). There was no association with age, BMI, and surface coating. Gender was significant with lower aseptic loosening for men, hazard ratio = 0.45, p value = 0.035. Oxford score was 57 ± 6.7 (19–60). Conclusion: The survival rate of Metasul was well and seems to be like our clinical finding. However, radiographic aseptic loosening without surgery is not included in the survival rate. The Oxford score was very good with a lot of patients with asymptomatic hip. Level of Evidence: Level IV/Retrospective study

Distal radio-ulnar implant arthroplasty: a systematic review

2017 ◽  
Vol 42 (8) ◽  
pp. 827-838 ◽  
Author(s):  
L.S. Moulton ◽  
G.E.B. Giddins
Keyword(s):  
Systematic Review ◽  
Survival Rate ◽  
Implant Survival ◽  
Short Term ◽  
Level Of Evidence ◽  
Joint Replacements ◽  
Meta Analyses ◽  
Joint Arthroplasties ◽  
Proper Consideration

The use of implant arthroplasty in the hand and wrist is increasing, often with little evidence of outcomes in the literature. We therefore undertook a systematic review of the outcomes of distal radio-ulnar joint arthroplasties following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Papers were assessed for outcomes, implant survival and methodological quality. Fourteen papers assessed ulna head replacements. The implant survival rate was 93% at a mean follow-up of 45 months. One paper assessed a partial ulna head replacement. Fourteen papers assessed total distal radio-ulnar joint replacements; all but two used the Aptis prosthesis. These implants had a survival rate of 97% at a mean of 56 months. Complications rates were 28% in both groups, and many were major. Although these data are impressive, worldwide there are many more implants placed and not followed up. All studies were level IV and V studies with low Coleman scores. This systematic review demonstrates that implant arthroplasty for the distal radio-ulnar joint has produced acceptable results in small numbers of patients. Whilst these short term outcomes are encouraging, the indications should be carefully considered and there should be proper consideration of the potential for later failure. Level of evidence: III

The long-term fate of persisting deciduous molars and canines in 42 patients with severe hypodontia: a 12-year follow-up

2019 ◽  
Vol 42 (6) ◽  
pp. 581-586 ◽  
Author(s):  
Christina L Hvaring ◽  
Kari Birkeland
Keyword(s):  
Root Resorption ◽  
Good Condition ◽  
Deciduous Tooth ◽  
Deciduous Teeth ◽  
The Mean ◽  
Deciduous Molars ◽  
Over Time ◽  
Observation Period

Summary Objectives The decision to preserve or to extract a deciduous tooth without a successor hinges upon whether it can be expected to be stable over time. This study aimed to record the number and location of deciduous teeth and to examine the condition of deciduous canines and molars in a group of patients with severe hypodontia, both at baseline and at follow-up. Material and methods A total of 50 patients participated in a follow-up study. The average age was 13.9 years (range 7–25 years) at baseline and 25.6 years (range 18–38 years) at follow-up. Of the 50 subjects, 44 had at least one persisting deciduous tooth at follow-up and 42 had at least one deciduous canine or molar at baseline. The presence of persisting deciduous teeth was identified on panoramic radiographs. Deciduous canines and second molars were classified as good or poor based on infraocclusion, root resorption, and restorations. Results The mean number of persisting deciduous teeth per patient was 6.3 (range 1–16) at baseline and 2.6 (range 0–9) at follow-up. The tooth types with the highest tendency to remain were canines and second molars, and in particular canines in the mandible. Among the 42 participants with a deciduous canine or molar, 183 teeth were present at baseline, of which 112 were classified as good. At follow-up, 86 (77 per cent) of these were still present, with 65 (58 per cent) classified as good. The number of teeth classified as poor due to infraocclusion decreased much more from baseline to follow-up than those classified as poor due to root resorptions and restorations, indicating that infraoccluded teeth were lost during the observation period. Conclusions Preserving deciduous canines and molars in good condition is often a dependable choice. Early infraocclusion is detrimental to the prognosis and often leads to tooth loss. Teeth with short roots proved to be more stable over time.

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