scholarly journals EVALUATION OF USE OF NARROW DIAMETER IMPLANTS IN POSTERIOR REGION OF THE JAWS

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Kumari Upasana ◽  
Dr. Shivendra Choudhary
Keyword(s):  
Load Transfer ◽  
Mandibular Canal ◽  
Posterior Region ◽  
Marginal Bone Loss ◽  
Mandibular Molar ◽  
Implant Restoration ◽  
Group B ◽  
Maxilla And Mandible ◽  
Narrow Diameter Implants

The molars are one of the first teeth to be lost over lifetime; thus, their replacement is frequently needed. Implantation is generally the preferred choice to replace a missing single tooth avoiding vital teeth preparation and bridge fabrication. Placement of implant to replace a molar presents diagnostic, surgical, and prosthetic demands, such as an enlarged mesiodistal dimension and occlusal forces distribution.  Poor bone quality in the posterior regions, especially the maxilla, could jeopardize the short- and long-term implant success.  Anatomical considerations and adjacent vital structures (ie, maxillary sinus and mandibular canal), occlusal loads, and the occlusal table, which is frequently wider than the implant diameter, should also be of some concern.  Quality and density of the bone in the posterior regions can compromise initial implant stabilization and load transfer to the bone. The most frequent single molar to be replaced is the first mandibular molar, because this tooth is lost first. Implantation in the posterior area is a predictable procedure over time. The low rate of complications in addition to the high long-term success rate make implant restoration a reliable solution to treat posterior partial edentulism. Hence the present study was planned for evaluation for evaluation of use of narrow diameter implants in in posterior region of the jaws. The present study was planned in Department of Impalantology, Manipal College of dental sciences Manipal. Total 20 cases were enrolled in the present study. Out of that 10 cases were scheduled for single unit prosthetic rehabilitation supported by implant in the posterior region of the jaws was evaluated in Group A. These cases were implemented with the Narrow Diameter Implant (NDI).  Remaining 10 cases were evaluated in the Group B as control cases. These control patients received the Regular Diameter Implant (RDI). The data generated from the present study concludes that NDIs placed in posterior region of the jaws without sufficient bone thickness for placement of RDIs presented a high success and survival rate. In addition to that, NDIs presented marginal bone loss patterns similar to those for RDIs, both in the maxilla and mandible. Thus, it can be suggested that NDIs may be successfully used in the posterior regions of the jaws. More studies with longer follow-up intervals are, however, necessary to further evaluate single crowns supported by NDIs in the posterior region of the jaws. Keywords: Narrow Diameter Implants, Posterior Region of the Jaws, Regular Diameter Implant, NDI, RDI, etc.

scholarly journals Does Implant-Abutment Interface affect Marginal Bone Levels around Implants?

2019 ◽  
Vol 13 (01) ◽  
pp. 047-052 ◽  
Author(s):  
Eser Elemek ◽  
Artun Urgancioglu ◽  
Janberd Dincer ◽  
Altug Cilingir
Keyword(s):  
Bone Loss ◽  
Dental Implants ◽  
Marginal Bone Loss ◽  
Single Crown ◽  
Implant Abutment ◽  
Different Types ◽  
Group A ◽  
Group B ◽  
Switch Group

Abstract Objective The use of dental implants with different types of surface roughness and implant-abutment interface has brought about a situation of marginal bone loss. Therefore, the aim of this study was to analyze and compare marginal bone levels of different types of osseointegrated dental implants with platform switch (Group A: Ankylos, Mannheim, Germany) and platform match (Group B: Dentsply Xive, Mannheim, Germany, and Group C: MIS Implant Technologies, Karmiel, Israel). Materials and Methods One hundred and seven patients (52 men and 55 women) with a mean age of 54.79 (standard deviation ± 12.35) years and a total of 321 dental implants (Group A, n = 198; Group B, n = 58; and Group C, n = 65) placed in a private practice between April 2006 and May 2015 were retrospectively analyzed. In addition to demographic information and implant characteristics, marginal bone levels were evaluated by Image J (Wayne Rasband, National Institute of Health, Maryland) program. Results The mean age of all patients was 54.79 ± 12.35 years, and 51.5% of them were women. Implants supporting fixed bridge were most commonly used in all groups (65%), whereas only 20% were restored with a single crown and 15% with overdentures. In total, 47.5% of all implants showed no marginal bone loss. Mean bone loss in Group A was significantly lower (0.81 ± 1.60 mm) as compared to Group B (1.58 ± 1.59 mm) and Group C (1.18 ± 1.36) (p < 0.005). Conclusion Among different types of dental implants, platform switch seems to preserve marginal bone levels and increase the long-term success of dental implants.

scholarly journals Clinical Significance of Internal Friction Connection and Micro-Threads in Implant-Supported Prostheses: A Literature Review

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Ki-Won Jeong ◽  
Jeong Chan Kim ◽  
In-Sung Luke Yeo ◽  
Keyword(s):  
Load Transfer ◽  
Structural Features ◽  
Tissue Response ◽  
Marginal Bone Loss ◽  
Load Transfer Mechanism ◽  
Implant Abutment ◽  
Conical Connection ◽  
Bone Level ◽  
Marginal Bone Level

A connection structure using both a screw and friction is advantageous to secure an abutment to an implant. Understanding the biomechanics of the implant-abutment connection is necessary for the long-term clinical survival of a dental implant with decreased complications. The internal conical friction connection structure and micro-threads have shown favorable biological hard tissue response with exceptional structural features. The internal conical connection structure maintains the soft tissue seal and the marginal bone level around the implant. The durability of the implant wall thickness at the top is balanced via micro-threads with the load-transfer mechanism, resulting in proper peri-implant bone strain. These two structural devices are designed to achieve implant-abutment connection stability by redistributing an external load and by minimizing screw loosening events that cause implant component fractures and marginal bone loss.

scholarly journals Unconventional Implant Strategy for Patients With Limited Interocclusal Space in the Posterior Region: A Clinical Cohort Study With 1-year Follow-Up

2021 ◽  
Author(s):  
Xun Xia ◽  
Zhen-Yu Wei ◽  
Jiang-Qin Huang ◽  
Chang-Qi Hu ◽  
Shui-Gen Guo ◽  
...  
Keyword(s):  
Bone Loss ◽  
Success Rate ◽  
Soft Tissues ◽  
Posterior Region ◽  
Marginal Bone Loss ◽  
Probing Depth ◽  
Tissue Changes ◽  
Implant Restoration ◽  
Soft Tissue Changes

Abstract BackgroundThis study aims to evaluate the clinical outcomes of a new implant restoration strategy for patients with limited interocclusal space in the posterior region.Materials and MethodsA total of 37 patients (19 females and 18 males) were enrolled in this study and received 62 implants. A locking taper implant (Bicon) was used for the first stage procedure, which was placed >2mm under the bone. An extraoral cementation technique was used to cement the crown and abutment. The survival and success rate of the implant restorations were evaluated using the plaque index, modified bleeding index, probing depth, marginal bone loss, and the patient's subjective satisfaction. ResultsThe soft tissues around the implant were healthy and did not show any indications of peri-implantitis. The success rate of the new implant restorations was >96% at the 1-year follow-up. The patients presented satisfactory outcomes at the 1-year follow-up. The marginal bone loss and soft tissue changes were not significantly different at different depths of placement (p>0.05).ConclusionsAccording to the results, the use of a locking taper implant and adoption of appropriate prosthetic strategies might be an effective procedure for the prosthetic rehabilitation of patients with limited interocclusal space and reduced occlusal vertical dimensions.

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

Comparative analysis of minimally invasive surgical decompression and fusion surgery in the treatment of stable stage i lumbar degenerative spondylolisthesis complicated by spinal stenosis

2020 ◽  
pp. 25-37
Author(s):  
Roman Kartavykh ◽  
Igor Borshchenko ◽  
Gennadiy Chmutin ◽  
Andrey Baskov ◽  
Vladimir Baskov
Keyword(s):  
Spinal Stenosis ◽  
Degenerative Spondylolisthesis ◽  
Stage I ◽  
Fusion Surgery ◽  
Unilateral Approach ◽  
Microsurgical Decompression ◽  
Group B ◽  
Lumbar Spondylolisthesis ◽  
Stable Stage

Purpose: a comparative analysis of long-term clinical and radiological outcomes of bilateral microsurgical decompression from unilateral approach and open fusion surgery in the treatment of patients with stable stage I lumbar degenerative spondylolisthesis complicated by spinal stenosis. Materials and methods: this study included 83 patients with degenerative stage I lumbar spondylolisthesis, combined with spinal stenosis at one/several levels. Bilateral microsurgical decompression from unilateral approach was performed in group A (n = 41), in group B (n = 42) we used transforaminal lumbar interbody fusion. Results: intraoperative blood loss and operation time significantly prevailed in group B (P < 0,05). Pain in the legs (VAS), Oswestry disability index significantly decreased in both groups in the long-term postoperative period. No statistical difference in these was found in groups A and B (P = 0,59; P = 0,10). Lower back pain in both groups at the follow-up period had a significant difference: in fusion group there was a significantly higher intensity, than in group А (P < 0,001). Assessment of radiological outcomes in group A at the level of spondylolisthesis showed a slight decrease in segment stability: an increase in anteroposterior displacement of the vertebrae by an average of 0,44 mm, the angular difference by 0,77°, an increase in displacement of the vertebral body by 1,30 % (P < 0,05). Conclusion: minimally bilateral microsurgical decompression from unilateral approach is an effective method for treatment of stable stage I degenerative lumbar spondylolisthesis, combined with spinal stenosis, allowing to achieve significant regression of leg pain and disability in the long-term postoperative period. And this method admits to significantly decrease of low back pain, then in fusion surgery, as well as a low risk of postoperative instability and reoperation with instrumentation.

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

scholarly journals Variations in vertical mucosal thickness at edentulous ridge according to site and gender measured by cone-beam computed tomography

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Motohiro Munakata ◽  
Koudai Nagata ◽  
Minoru Sanda ◽  
Ryota Kawamata ◽  
Daisuke Sato ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Treatment Plan ◽  
Cone Beam ◽  
Alveolar Ridge ◽  
Marginal Bone Loss ◽  
Mandibular Molar ◽  
Mucosal Thickness ◽  
And Gender ◽  
Edentulous Patients

Abstract Background The vertical thickness of the peri-implant mucosa is associated with the amount of post treatment marginal bone loss. However, the variations in mucosal thickness at the different edentulous sites have been sparsely documented. The purpose of the study was to conduct a survey of the frequency distribution of variations in mucosal thickness at the different sites of the edentulous alveolar ridge and to compare them according to gender. Our study included 125 partially edentulous patients having a total of 296 implant sites. Cone-beam computed tomography (CBCT) scans were obtained by placing a diagnostic template with a radiopaque crown indicator on the ridge to determine the mucosal thickness at the crest of the alveolar ridge. Results The mucosal thickness was 3.0±1.3 mm in the maxilla, which was significantly greater than the mucosal thickness of 2.0±1.0 mm in the mandible (p<0.001). In both the maxilla and the mandible, the mucosa was the thickest in the anterior region, followed by the premolar and molar regions. Sites were further classified into two groups based on whether the mucosal thickness was greater than 2 mm. In the mandible, more than half of the sites showed a mucosal thickness of 2 mm or less. Conclusions Although this study was a limited preoperative study, the vertical mucosal thickness at the edentulous ridge differed between the maxillary and mandibular regions. The majority of sites in the mandibular molar region had a mucosal thickness of less than 2 mm. Practitioners might be able to develop an optimal dental implant treatment plan for long-term biologic and esthetic stability by considering these factors.

scholarly journals Reconstructive Approaches in Surgical Management of Congenital Pseudarthrosis of the Tibia

2020 ◽  
Vol 9 (12) ◽  
pp. 4132
Author(s):  
Andrea Laufer ◽  
Adrien Frommer ◽  
Georg Gosheger ◽  
Robert Roedl ◽  
Frank Schiedel ◽  
...  
Keyword(s):  
External Fixation ◽  
Bone Transport ◽  
Bone Union ◽  
Complication Rates ◽  
Union Rate ◽  
Bone Fusion ◽  
Group A ◽  
Primary Bone ◽  
Group B

Treatment of congenital pseudarthrosis of the tibia remains a major challenge in pediatric orthopedics. Ideal timing and preference of surgical procedures are discussed controversially. A variety of reconstructive treatment strategies have been described in literature, but so far none has proven its superiority. The aim of treatment is to obtain long-term bone union, to prevent refracture, and to correct angular deformities and leg length discrepancies. This study retrospectively evaluates the outcome of different reconstructive strategies. Sixty-nine patients were identified who presented to our outpatient department between 1997 and 2019. Twenty-six of these patients underwent reconstructive surgical treatment and were included in this study. The study cohort was divided into three groups. Excision of the pseudarthrosis was performed in all patients in Group A and B, and in two patients of Group C. Group A (six/26 patients) received subsequent bone transport through external fixation maintaining original length. In Group B (15/26 patients), patients underwent either previous, simultaneous, or subsequent extrafocal lengthening through external fixation to reconstitute length. In Group C (five/26 patients), internal fixation with intramedullary nails was applied. Radiological and clinical evaluation was performed to assess bone union and complication rates. Results varied considerably between the study groups. Overall, the primary bone fusion rate was 69.2%. There were four refractures, all occurring in Group B. The long-term bone union rate without refracture was 53.8%. The overall complication rate was 53.8% and 23.1% showed persistent pseudarthrosis. Two secondary amputations were performed due to failed bone fusion. In conclusion, excision of the pseudarthrosis and extrafocal lengthening achieves a satisfying bone union rate and limb reconstruction, while bone transport does not offer significant advantages but shows higher complication rates. Intramedullary stabilization should be applied to maintain bone union, but shows lower bone union rates when used as a stand-alone treatment regimen. Regardless of the primary bone fusion rates, the probability of long-term bone union remains unpredictable.

scholarly journals 439 Conservative Versus Surgical Management of Complicated Diverticulitis - A Retrospective Study of Long-Term Outcomes

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Durity ◽  
G Elliott ◽  
T Gana
Keyword(s):  
Complicated Diverticulitis ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Female Ratio ◽  
Stoma Reversal ◽  
Group A ◽  
Grade 3 ◽  
Group B

Abstract Introduction Management of complicated diverticulitis has shifted towards a conservative approach over time. This study evaluates the feasibility and long-term outcomes of conservative management. Method We retrospectively evaluated a consecutive series of patients managed with perforated colonic diverticulitis from 2013-2017. Results Seventy-three (73) patients were included with a male to female ratio of 1:2. Thirty-one (31) underwent Hartmann’s procedure (Group A) and 42 patients were managed with antibiotics +/- radiological drainage (Group B). Mean follow-up was 64.9 months (range 3-7 years). CT Grade 3 and 4 disease was observed in 64.5% and 40.4% of Group A and Group B patients, respectively. During follow-up, 9 (21.4%) Group B patients required Hartmann’s. Group A had longer median length of stay compared to Group B (25.1 vs 9.2 days). Post-operative complications occurred in 80.6% with 40% being Clavien-Dindo grade III or higher in group A. Stoma reversal was performed in 8 patients (25.8%). Conclusions In carefully selected cases, complicated diverticulitis including CT grade 3 and 4 disease, can be managed conservatively with acceptable recurrence rates (16.7% at 30 days, 4.8% at 90 days, 19.0% at 5 years). Surgical intervention on the other hand, carries high post-operative complication rates and low stoma reversal rates.

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