scholarly journals Obturation of Root Canals By Vertical Condensation of Gutta-Percha – Benefits and Pitfalls

2021 ◽  
Vol 21 (3) ◽  
pp. 103-109
Author(s):  
Calkovsky Bruno ◽  
Slobodnikova Ladislava ◽  
Bacinsky Martin ◽  
Janickova Maria
Keyword(s):  
Clinical Success ◽  
Three Dimensional ◽  
Poor Quality ◽  
Ancient Egypt ◽  
Long Term Results ◽  
Term Survival ◽  
Root Canals ◽  
Treatment Techniques ◽  
Gutta Percha

Abstract Vertical condensation of gutta-percha is one of the frequently used techniques of hermetic and three-dimensional obturation of root canal system which is one of the primary goals of endodontic tooth treatment. Techniques for filling root canals have been described since ancient Egypt and have undergone dynamic development in recent decades. The aim of the article is to analyze the technique of obturation of root canals using vertical condensation of guttapercha and to point out its benefits and pitfalls. The poor-quality treatment of the tooth deteriorates its prognosis, function, and long-term survival in the oral cavity; thus, the hermetic obturation of the root canals is one of the most important pillars of the complex tooth treatment. Obturation of the root canals by vertical condensation of warm gutta-percha is nowadays considered in the correct indications as one of the most commonly used techniques in the excellent dental practices. Even though it is quite technologically challenging and time-consuming it enables to reach high level of predictability and clinical success. Currently, the obturation technique based on master gutta-percha cone combined with the calcium-silicate based sealer is emerging. However, long term results of clinical studies and follow-up are needed to make a significant improvement in the area of endodontics.

scholarly journals Fem and Von Mises Analysis of OSSTEM ® Dental Implant Structural Components: Evaluation of Different Direction Dynamic Loads

2018 ◽  
Vol 12 (1) ◽  
pp. 219-229 ◽  
Author(s):  
Gabriele Cervino ◽  
Umberto Romeo ◽  
Floriana Lauritano ◽  
Ennio Bramanti ◽  
Luca Fiorillo ◽  
...  
Keyword(s):  
Dental Implant ◽  
Clinical Success ◽  
Three Dimensional ◽  
Long Term Results ◽  
Dimensional System ◽  
Dental Abutment ◽  
Materials Used ◽  
Von Mises ◽  
Different Response

Purpose: The objective of this investigation is to study prosthodontics and internal components resistance to the masticatory stress and considering different force directions by using Finite Element Method analysis (FEM). The structural materials of the components are usually Titanium alloy grade 4 or 5 and thus, guarantee the integration of the fixture in the bone due to the osteointegration phenomena. Even if the long-term dental implant survival rate is easy to be obtained and confirmed by numerous researches, the related clinical success, due to the alteration of the mechanical and prosthodontics components is still controversial. Methods: By applying engineering systems of investigations like FEM and Von Mises analyses, it has been investigated how dental implant material was held against the masticatory strength during the dynamic masticatory cycles. A three-dimensional system involved fixture, abutment and the connection screws, which were created and analyzed. The elastic features of the materials used in the study were taken from recent literature data. Results: Data revealed a different response for both types of devices, although implant neck and dental abutment showed better results for all conditions of loading while the abutment screw represented aweak point of the system. Conclusion: The data of this virtual model showed all the features of different prosthetic retention systems under the masticatory load. Clinicians should find better prosthetic balance in order to better distribute the stress over the component and to guarantee patients’ clinical long-term results.

Surgical reconstruction for unilateral iliac artery lesions in patients younger than 50 years

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 474-481 ◽  
Author(s):  
Radak ◽  
Babic ◽  
Ilijevski ◽  
Jocic ◽  
Aleksic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Limb Salvage ◽  
Iliac Artery ◽  
Graft Patency ◽  
Long Term Results ◽  
Surgical Reconstruction ◽  
Safe Procedure ◽  
Term Survival

Background: To evaluate safety, short and long-term graft patency, clinical success rates, and factors associated with patency, limb salvage and mortality after surgical reconstruction in patients younger than 50 years of age who had undergone unilateral iliac artery bypass surgery. Patients and methods: From January 2000 to January 2010, 65 consecutive reconstructive vascular operations were performed in 22 women and 43 men of age < 50 years with unilateral iliac atherosclerotic lesions and claudication or chronic limb ischemia. All patients were followed at 1, 3, 6, and 12 months after surgery and every 6 months thereafter. Results: There was in-hospital vascular graft thrombosis in four (6.1 %) patients. No in-hospital deaths occurred. Median follow-up was 49.6 ± 33 months. Primary patency rates at 1-, 3-, 5-, and 10-year were 92.2 %, 85.6 %, 73.6 %, and 56.5 %, respectively. Seven patients passed away during follow-up of which four patients due to coronary artery disease, two patients due to cerebrovascular disease and one patient due to malignancy. Limb salvage rate after 1-, 3-, 5-, and 10-year follow-up was 100 %, 100 %, 96.3 %, and 91.2 %, respectively. Cox regression analysis including age, sex, risk factors for vascular disease, indication for treatment, preoperative ABI, lesion length, graft diameter and type of pre-procedural lesion (stenosis/occlusion), showed that only age (beta - 0.281, expected beta 0.755, p = 0.007) and presence of diabetes mellitus during index surgery (beta - 1.292, expected beta 0.275, p = 0.026) were found to be significant predictors of diminishing graft patency during the follow-up. Presence of diabetes mellitus during index surgery (beta - 1.246, expected beta 0.291, p = 0.034) was the only variable predicting mortality. Conclusions: Surgical treatment for unilateral iliac lesions in patients with premature atherosclerosis is a safe procedure with a low operative risk and acceptable long-term results. Diabetes mellitus and age at index surgery are predictive for low graft patency. Presence of diabetes is associated with decreased long-term survival.

Three year results of endovascular therapy with a new generation nitinol stent for femoro-popliteal artery lesions - a single-center outcome analysis of a subcohort of MISAGO 2 study

VASA ◽  
2013 ◽  
Vol 42 (5) ◽  
pp. 340-349 ◽  
Author(s):  
Ivan Kralj ◽  
Irene Boos ◽  
Uwe Müller-Bühl
Keyword(s):  
Popliteal Artery ◽  
Clinical Success ◽  
Ankle Brachial Index ◽  
Long Term Results ◽  
Outcome Analysis ◽  
Stent Fracture ◽  
Nitinol Stent ◽  
New Generation ◽  
Stent Stenosis

Background: Advances in stent technology have widened the field of indications for stent treatment of femoro-popliteal artery lesions, however the use of stents in bending arterial segments is restricted because some first- and second-generation nitinol stent designs did not respond well to the mechanical forces of femoro-popliteal segments in motion which pose a substantial risk of stent fracture inducing in-stent-stenosis. New generation nitinol stents are supposed to overcome these limitations but long-term results are rare. Patients and methods: In forty-five patients (mean age 68 y, range 50 - 85) with peripheral arterial disease (TASC II A-C, Rutherford category 2 - 5) forty-six lesions of the superficial femoral artery (37) or popliteal artery (9) were treated [25 high-grade stenoses, mean length 53 mm (range 30 - 145 mm); 21 chronic total occlusions, mean length 74 mm (range 30 - 180 mm)]. 74 % of lesions were located in the mobile bending arterial segments in the distal femoral or the popliteal segment. Clinical reevaluation performed at discharge, at 6, 12, 24, and 36 months included at least the measurement of ankle-brachial index (ABI) and duplex sonography. Results: Procedural success rate was 100 %. At 6, 12, 24, and 36 months, cumulative primary patency rate was 93.5 %, 84.8 %, 80.5 %, and 74.3 % (SE<10); freedom from target lesion revascularization rate was 95.7 %, 89.2 %, 84.9 %, and 79.3 % (SE<10); Rutherford category and ABI improved in all patients and clinical success was maintained in more than 85 % of patients. Conclusions: Sustained technical and clinical success and good clinical long-term results were achieved with Misago™ nitinol stent implantation in femoro-popliteal lesions with moderate risk for in-stent-stenosis, and in the distal femoral and popliteal mobile segment.

Transapical versus Conventional Aortic Valve Replacement�A Propensity-Matched Comparison

2012 ◽  
Vol 15 (1) ◽  
pp. 4 ◽  
Author(s):  
David M. Holzhey ◽  
William Shi ◽  
A. Rastan ◽  
Michael A. Borger ◽  
Martin H�nsig ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Survival Rates ◽  
Long Term Results ◽  
Term Survival ◽  
Kaplan Meier ◽  
Risk Patients ◽  
Short And Long Term ◽  
Good Treatment Option ◽  
Matched Comparison

<p><b>Introduction:</b> The goal of this study was to compare the short- and long-term outcomes after aortic valve (AV) surgery carried out via standard sternotomy/partial sternotomy versus transapical transcatheter AV implantation (taTAVI).</p><p><b>Patients and Methods:</b> All 336 patients who underwent taTAVI between 2006 and 2010 were compared with 4533 patients who underwent conventional AV replacement (AVR) operations between 2001 and 2010. Using propensity score matching, we identified and consecutively compared 2 very similar groups of 167 patients each. The focus was on periprocedural complications and long-term survival.</p><p><b>Results:</b> The 30-day mortality rate was 10.8% and 8.4% (<i>P</i> = .56) for the conventional AVR patients and the TAVI patients, respectively. The percentages of postoperative pacemaker implantations (15.0% versus 6.0%, <i>P</i> = .017) and cases of renal failure requiring dialysis (25.7% versus 12.6%, <i>P</i> = .004) were higher in the TAVI group. Kaplan-Meier curves diverged after half a year in favor of conventional surgery. The estimated 3-year survival rates were 53.5% � 5.7% (TAVI) and 66.7% � 0.2% (conventional AVR).</p><p><b>Conclusion:</b> Our study shows that even with all the latest successes in catheter-based AV implantation, the conventional surgical approach is still a very good treatment option with excellent long-term results, even for older, high-risk patients.</p>

scholarly journals Preoperative virtual simulation for synchronous multiple primary lung cancers using three-dimensional computed tomography lung reconstruction: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Weichun Wu ◽  
Yimin Wu ◽  
Gang Shen ◽  
Guofei Zhang
Keyword(s):  
Computed Tomography ◽  
Thoracoscopic Surgery ◽  
Three Dimensional ◽  
Primary Lung Cancer ◽  
Pulmonary Nodules ◽  
Term Survival ◽  
Lung Cancers ◽  
Multiple Primary ◽  
Feasible Alternative

Abstract Background As the positions and sizes of nodules in synchronous multiple primary lung cancer (SMPLC) patients differ, the development of surgical strategies to maximize long-term survival and preserved postoperative pulmonary function in SMPLC patients for whom surgical resection is an alternative strategy presents challenges. Case presentation We provide a case managed through video-assisted thoracoscopic surgery (VATS) resection using three-dimensional computed tomography lung reconstruction (3D-CTLR) to reconstruct lobes containing pulmonary nodules to preoperatively simulate and intraoperatively guide the extent and method of resection. Conclusion The successful attempt demonstrates a technically simplified, feasible alternative to preoperative plans utilizing less invasive VATS to manage SMPLC.

scholarly journals Clinical results of the Metha short hip stem: a perspective for younger patients?

2013 ◽  
Vol 5 (4) ◽  
pp. 34 ◽  
Author(s):  
Fritz Thorey ◽  
Claudia Hoefer ◽  
Nima Abdi-Tabari ◽  
Matthias Lerch ◽  
Stefan Budde ◽  
...  
Keyword(s):  
Bone Ingrowth ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Femoral Revision ◽  
Term Survival ◽  
Younger Patients ◽  
The Mean ◽  
Short Stems

In recent years, various uncemented proximal metaphyseal hip stems were introduced for younger patients as a bone preserving strategy. Initial osteodensitometric analyses of the surrounding bone of short stems indicate an increase of bone mass with secondary bone ingrowth fixation as a predictor of long-term survival of these types of implants. We report the outcome of 151 modular Metha short hip stem implants in 148 patients between March 2005 and October 2007. The mean follow-up was 5.8±0.7 years and the mean age of the patients was 55.7±9.8 years. Along with demographic data and co-morbidities, the Harris Hip Score (HHS), the Hip dysfunction and Osteoarthritis Outcome Score (HOOS), and also the results of a patient-administered questionnaire were recorded pre-operatively and at follow-up. The mean HHS increased from 46±17 pre-operatively to 90±5 the HOOS improved from 55±16 pre-operatively to 89±10 at the final follow-up. A total of three patients have been revised, two for subsidence with femoral revision and one for infection without femoral revision (Kaplan Meier survival estimate 98%). The radiological findings showed no radiolucent lines in any of the patients. The modular Metha short hip stem was implanted in younger patients, who reported an overall high level of satisfaction. The clinical and radiographic results give support to the principle of using short stems with metaphyseal anchorage. However, long-term results are necessary to confirm the success of this concept in the years to come.

Long-term Results of Chemotherapy in 106 Cases of Lymphosarcoma and Reticulum Cell Sarcoma

1968 ◽  
Vol 54 (2) ◽  
pp. 127-134 ◽  
Author(s):  
Sergio Di Pietro
Keyword(s):  
Survival Rate ◽  
Alkylating Agents ◽  
Clinical Stage ◽  
Long Term Results ◽  
Reticulum Cell ◽  
Reticulum Cell Sarcoma ◽  
Term Survival ◽  
Cell Sarcoma ◽  
Pre Treatment

The survival rate of 106 cases of advanced lymphosarcoma and reticulum cell sarcoma that had received chemotherapy, with or without radiotherapy, between 1951 and 1962 is reported. The course of both diseases was initially highly malignant, with a median survival of 20 months for lymphosarcoma and 6 months for reticulum cell sarcoma. Cases surviving for over 3 years, however, have a good chance of long survival. Male sex and an age of under 40 (there were no cases of under 13 in our series) seem to be favorable prognostic factors. A long pre-treatment interval is favorable for lymphosarcoma and adverse for reticulum cell sarcoma. The clinical stage (3 or 4 according to the classification of Banfi et al.) does not significantly affect the prognosis of lymphosarcoma whereas in reticulum cell sarcoma survival is strongly correlated with clinical stage. Chemotherapy (with alkylating agents) yielded a 5-year survival rate of 20.8% in lymphosarcoma; with radiotherapy the rate rose to 32.3%. In reticulum cell sarcoma the 5-year survival rate was 20% for chemotherapy alone and 14.2% for chemotherapy in association with radiotherapy. Our data seem to confirm the usefulness of chemotherapy, with or without radiotherapy, in diffuse forms of lymphosarcoma and reticulum cell sarcoma, especially with regard to long-term survival.

scholarly journals A New Aortic Arch Dissection Classification: The Fuwai Classification

2021 ◽  
Vol 8 ◽  
Author(s):  
Juntao Qiu ◽  
Xinjin Luo ◽  
Jinlin Wu ◽  
Wei Pan ◽  
Qian Chang ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Survival Rates ◽  
Innominate Artery ◽  
Long Term Results ◽  
Surgical Mortality ◽  
Left Carotid Artery ◽  
Term Survival ◽  
Long Term Survival

Aims: We describe a new aortic arch dissection (AcD) classification, which we have called the Fuwai classification. We then compare the clinical characteristics and long-term prognoses of different classifications.Methods: All AcD patients who underwent surgical procedures at Fuwai Hospital from 2010 to 2015 were included in the study. AcD procedures are divided into three types: Fuwai type Cp, Ct, and Cd. Type Cp is defined as the innominate artery or combined with the left carotid artery involved. Type Cd is defined as the left subclavian artery or combined with the left carotid artery involved. All other AcD surgeries are defined as type Ct. The Chi-square test was adopted for the pairwise comparison among the three types. Kaplan-Meier was used for the analysis of long-term survival and survival free of reoperation.Results: In total, 1,063 AcD patients were enrolled from 2010 to 2015: 54 patients were type Cp, 832 were type Ct, and 177 were type Cd. The highest operation proportion of Cp, Ct and Cd were partial arch replacement, total arch replacement, and TEVAR. The surgical mortality in type Ct was higher compared to type Cd (Ct vs. Cd = 9.38 vs. 1.69%, p &lt; 0.01) and type Cp (Ct vs. Cp = 9.38 vs. 1.85%, p = 0.06). There was no difference in surgical mortality of type Cp and Cd (p = 0.93). There were no significant differences in the long-term survival rates (p = 0.38) and free of aorta-related re-operations (p = 0.19).Conclusion: The Fuwai classification is used to distinguish different AcDs. Different AcDs have different surgical mortality and use different operation methods, but they have similar long-term results.

Endoscopic Ultrasound-Guided Drainage and Treatment of Symptomatic Pancreatic Fluid Collection following Acute or Acute-on-Chronic Pancreatitis – A Single Center Case Series

2018 ◽  
Vol 143 (06) ◽  
pp. 577-585
Author(s):  
Dominik Kaczmarek ◽  
Jacob Nattermann ◽  
Christian Strassburg ◽  
Tobias Weismüller
Keyword(s):  
Success Rate ◽  
Endoscopic Ultrasound ◽  
Clinical Success ◽  
Fluid Collection ◽  
Clinical Success Rate ◽  
Long Term Results ◽  
Pancreatic Fluid Collection ◽  
Endoscopic Procedures ◽  
Pancreatic Fluid

Abstracts Introduction Pancreatic fluid collection (PFC) is a common complication of acute pancreatitis. Endoscopic ultrasound (EUS)-guided drainage, which is often followed by direct endoscopic necrosectomy (DEN), has become the primary approach to treat PFC, including pancreatic pseudocysts (PP) and walled-off necrosis (WON). We aimed to determine retrospectively the short- and long-term results of patients treated in our endoscopy unit and to identify parameters that are associated with treatment efficacy and outcome. Methods The data of 41 consecutive patients with post-pancreatitic PFC, who underwent endoscopic transmural intervention between 2014 and 2016, were analyzed retrospectively. After an initial EUS-guided puncture, one or more plastic stents were placed and DEN was performed if necrotic tissue remained. Results The mean diameter of the PFC was 74.0 ± 4.8 mm. Of the PFCs, 29.3% were classified as PP and 70.7% as WON. Altogether, 196 transmural endoscopic procedures were performed, including 73 endoscopic necrosectomies in a subgroup of 21 patients (20 WON, 1 PP). Initial technical success was achieved in 97.6% of patients and the short-term clinical success rate was 90.2%. The long-term clinical success rate was 82.9%, since four patients died from septic shock and/or multiple organ failure and three patients developed recurrent PFC some months after the initial discharge from endoscopic treatment. Procedural complications were registered in 9 patients during 10 of 196 endoscopic procedures (5.1%): bleeding (6), cardiorespiratory insufficiency (2), perforation with pneumoperitoneum (1), aspiration with respiratory insufficiency (1), and non-perforating superficial damage of the gastric wall (1). Neither the size of the PFC nor the initial value of C-reactive protein (CRP) or other biochemical markers were correlated with efficacy or outcome of treatment. Only the cumulative number of days with CRP > 50 mg/L significantly correlated with the number of follow-up endoscopic sessions and DEN. Fungal colonization of PFC correlated significantly (p < 0.05) with the risk of mortality (44% vs. 0%), need for intensive care treatment (66.7% vs. 25%), and sepsis (55.6% vs. 12.5%). Conclusions We confirm that EUS-guided drainage followed by DEN in patients with solid necrotic material is an effective and relatively safe therapeutic approach. Prolonged elevation of CRP and fungal colonisation of the PFC are associated with a worse course of the disease.

Post-Discharge Outcomes After Pancreatic Necrosectomy: A Single Institution Experience Following Endoscopic vs Open Debridement

2021 ◽  
pp. 000313482110385
Author(s):  
Manuel Martinez ◽  
Steven Medeiros ◽  
James Dove ◽  
Mohsen Shabahang
Keyword(s):  
Necrotizing Pancreatitis ◽  
Long Term Results ◽  
Source Control ◽  
Tertiary Referral Hospital ◽  
Term Survival ◽  
Pancreatic Necrosectomy ◽  
Medical Comorbidities ◽  
Number Of Patients ◽  
Significant Difference

Background Pancreatic necrosectomy outcomes have been studied extensively; however, long-term results of these procedures have not been well characterized. Our study aimed to assess the outcomes at and after discharge for patients following necrosectomy. Methods Data from patients undergoing pancreatic necrosectomy at a single tertiary referral hospital from January 1, 2007, to June 1, 2019 were retrospectively analyzed. Patients were stratified into an open pancreatic necrosectomy (OPN) and an endoscopic pancreatic necrosectomy (EPN) group. Results Cohorts were composed of an OPN (n = 30) and EPN (n = 31) groups with a mean follow-up of 22 and 13.5 months, respectively. There was no statistically significant difference in the demographics or etiology of disease; however, the presence of severe sepsis and elevated BISAP scores was significantly higher in the OPN group (40% vs 13% p = .016, 37% vs 10% p = .012, respectively). There was no significant difference in discharge parameters or disposition other than a higher need for wound care in the OPN group (14% vs 0% p =< .0001). No significant difference in the number of patients who returned to baseline, 12-month ED visits, 12-month readmissions, medical comorbidities, or long-term survival was noted. Conclusions Previous studies have demonstrated that OPN patients have a higher severity of disease and higher inpatient mortality; however, this does not hold true once the acute phase of the illness has passed. Long-term medical comorbidities and survival of patients with necrotizing pancreatitis who endure the primary insult do not differ in long term, regardless of the debridement modality performed for source control.

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