scholarly journals Endodontic management of incisors with horizontal root fractures using H-file as endodontic implant – Two Case Reports.

2020 ◽  
Author(s):  
Vandana Kokane ◽  
Snehal Sonarkar ◽  
Mohit Gunwal ◽  
Noopur Kokane
Keyword(s):  
Simple Procedure ◽  
Case Reports ◽  
Cost Effective ◽  
Young Female ◽  
Accidental Injury ◽  
Cost Effective Method ◽  
Root Fractures ◽  
Long Term Prognosis

Accidental injury to anterior region with fractured and mobile teeth can be an awful experience to young female patient. Treating such patient requires knowledge judgment and skill of the operator. In the present case report multiple horizontal root fracture in cervical third region with mobile undetached crown was successfully stabilized by a very simple procedure using hedstrome endodontic file as an endodontic implant. In a two year follow-up period the tooth was completely asymptomatic clinically as well as radiographically. Immobilization of fractured root by endodontic instrument with MTA considered to be a simple ,reliable and cost effective method to save a tooth that would have been difficult to restore with good long term prognosis. Key-words: Incisors, Horizontal Root Fractures, H File

scholarly journals Direct Restorations for Anterior Esthetic Rehabilitation and Smile Symmetry Recovery: Two Case Reports

Symmetry ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 1848
Author(s):  
Inês Amaro ◽  
José Saraiva ◽  
Ana Catarina Gomes ◽  
Ana Araújo ◽  
Carlos Miguel Marto ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Orthodontic Treatment ◽  
Case Reports ◽  
Cost Effective ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Anterior Teeth ◽  
Long Term Prognosis ◽  
And Function

Esthetics is an increasing concern for patients, particularly in anterior teeth. The current approaches to manage the esthetic demands include options such as prosthodontic rehabilitation, orthodontic treatment, and direct restorations. Direct restorative procedures for anterior teeth have become a reliable alternative, since current composite materials can mimic teeth’s esthetics and function perfectly. This article describes two clinical cases of anterior esthetic rehabilitations where the direct reshaping of the four maxillary incisors was performed using the buccolingual layering technique with the help of a silicone index. In Case 1, a diastema closure was also performed, whereas in Case 2, the replacement of old restorations was also carried out. It was possible to achieve excellent final esthetic results in both cases, recovering the smile symmetry, and both patients were satisfied. The literature supports the use of direct restorations in the anterior region with very good long-term prognosis. It is a minimally invasive approach that is reversible, repairable, cost-effective, and when combined with layering techniques and adequate restorative materials, it is possible to achieve good esthetic and functional outcomes. However, regular maintenance appointments are mandatory, and all cases should be carefully planned to ensure predictable and long-lasting results.

scholarly journals 920 Long Term Outcomes After Resection of A 'Normal' Appendix

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
F Hammett ◽  
S Ali ◽  
R Adair ◽  
M Peter ◽  
B Dobbins ◽  
...  
Keyword(s):  
Cost Effective ◽  
Normal Appendix ◽  
Suspected Appendicitis ◽  
Operative Outcomes ◽  
Primary Surgery ◽  
Cost Effective Method ◽  
Negative Appendicectomy ◽  
The Cost

Abstract Introduction Recent studies have suggested that there should be diagnostic confirmation of appendicitis prior to surgical resection to reduce the rate of negative (normal) appendicectomy. There are few long-term analyses of morbidity after negative appendicectomy. Method All appendicectomy specimens removed for suspected appendicitis from June 2010 to August 2015 at a single-centre surgical unit were identified. Patients with a histologically 'normal' appendix were analysed. Demographics, pre-operative and operative details and post-operative outcomes (Clavien-Dindo system) were recorded. Minimum follow-up was 5 years. Results There were 1977 patients. Most (1938 patients, 98%) had a laparoscopic procedure. There were 241 normal specimens (12.1%); none of these patients had pre-operative CT imaging. Thirty-two patients had at least one re-admission in the 5 years after surgery; 12 of these patients had multiple re-admissions (range, 2-5 re-admissions). 22 patients (69%) had a re-admission within 30 days after primary surgery. 4 patients (<1%) required further surgery and mortality was 0%. 6 patients (2%) had a Grade III complication, and none had a Grade IV complication. Conclusions There was low long-term morbidity after negative appendicectomy in this study. The cost of confirming a normal diagnosis by way of mandatory pre-operative CT does not represent a cost-effective method of management.

scholarly journals Periodontal Healing of a Horizontal Root Fracture: A Case Report with a Two-year Follow-up

10.2341/08-27 ◽  
2009 ◽  
Vol 34 (1) ◽  
pp. 109-113
Author(s):  
G. Petersilka
Keyword(s):  
Case Report ◽  
Cost Effective ◽  
Minimal Invasive ◽  
Lower Incisor ◽  
Long Term Stability ◽  
Adhesive Dentistry ◽  
Root Fractures ◽  
And Function

Clinical Relevance Scientific rationale for this case report: Traumatically-induced tooth loss due to root fractures necessitates time-consuming and expensive prosthetic rehabilitation measures. To date, however, the appropriate use of minimal invasive periodontal surgery, in combination with adhesive dentistry, may allow cost-effective, reliable therapeutic options for the treatment of root fractures even below the gumline. Principal findings: The coronal part of a fractured lower incisor was reattached to the apical fragment using the periodontal flap technique, endodontic therapy and adhesive fixation measures. Uncompromised aesthetics and function, and periodontal health, were maintained over a two-year observation period. Practical implications: Data on the long-term stability of the proposed approach is scarce. However, in treatment planning for teeth with horizontal root fractures, re-bonding of the coronal part using flap surgery may be considered a treatment option.

Mechanical thrombectomy in pediatric stroke: systematic review, individual patient data meta-analysis, and case series

2019 ◽  
Vol 24 (5) ◽  
pp. 558-571 ◽  
Author(s):  
Kartik Bhatia ◽  
Hans Kortman ◽  
Christopher Blair ◽  
Geoffrey Parker ◽  
David Brunacci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Neurological Outcomes

OBJECTIVEThe role of mechanical thrombectomy in pediatric acute ischemic stroke is uncertain, despite extensive evidence of benefit in adults. The existing literature consists of several recent small single-arm cohort studies, as well as multiple prior small case series and case reports. Published reports of pediatric cases have increased markedly since 2015, after the publication of the positive trials in adults. The recent AHA/ASA Scientific Statement on this issue was informed predominantly by pre-2015 case reports and identified several knowledge gaps, including how young a child may undergo thrombectomy. A repeat systematic review and meta-analysis is warranted to help guide therapeutic decisions and address gaps in knowledge.METHODSUsing PRISMA-IPD guidelines, the authors performed a systematic review of the literature from 1999 to April 2019 and individual patient data meta-analysis, with 2 independent reviewers. An additional series of 3 cases in adolescent males from one of the authors’ centers was also included. The primary outcomes were the rate of good long-term (mRS score 0–2 at final follow-up) and short-term (reduction in NIHSS score by ≥ 8 points or NIHSS score 0–1 at up to 24 hours post-thrombectomy) neurological outcomes following mechanical thrombectomy for acute ischemic stroke in patients < 18 years of age. The secondary outcome was the rate of successful angiographic recanalization (mTICI score 2b/3).RESULTSThe authors’ review yielded 113 cases of mechanical thrombectomy in 110 pediatric patients. Although complete follow-up data are not available for all patients, 87 of 96 (90.6%) had good long-term neurological outcomes (mRS score 0–2), 55 of 79 (69.6%) had good short-term neurological outcomes, and 86 of 98 (87.8%) had successful angiographic recanalization (mTICI score 2b/3). Death occurred in 2 patients and symptomatic intracranial hemorrhage in 1 patient. Sixteen published thrombectomy cases were identified in children < 5 years of age.CONCLUSIONSMechanical thrombectomy may be considered for acute ischemic stroke due to large vessel occlusion (ICA terminus, M1, basilar artery) in patients aged 1–18 years (Level C evidence; Class IIb recommendation). The existing evidence base is likely affected by selection and publication bias. A prospective multinational registry is recommended as the next investigative step.

scholarly journals Clinical presentations and long term prognosis of childhood onset polyarteritis nodosa in single centre of Korea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeong-Seon Lee ◽  
Joong-Gon Kim ◽  
Soyoung Lee
Keyword(s):  
Polyarteritis Nodosa ◽  
Clinical Manifestations ◽  
Long Term Outcomes ◽  
Childhood Onset ◽  
Laboratory Findings ◽  
Clinical Presentations ◽  
Long Term Prognosis ◽  
Digital Amputation

AbstractChildhood-onset polyarteritis nodosa (PAN) is a rare and systemic necrotising vasculitis in children affecting small- to medium-sized arteries. To date, there have been only a few reports because of its rarity. Thus, we aimed to investigate the clinical manifestations, laboratory findings, treatment, and long-term outcomes in patients with childhood-onset PAN and to evaluate the usefulness of the paediatric vasculitis activity score (PVAS). We retrospectively analysed the data of nine patients with childhood-onset PAN from March 2003 to February 2020. The median ages at symptom onset, diagnosis, and follow-up duration were 7.6 (3–17.5), 7.7 (3.5–17.6), and 7.0 (1.6–16.3) years, respectively. All patients had constitutional symptoms and skin manifestations, while five exhibited Raynaud’s phenomenon. Organ involvement was observed in one patient. The median PVAS at diagnosis was 7 (range: 2–32). Prednisolone was initially used for induction in all patients, and other drugs were added in cases refractory to prednisolone. All patients survived, but three patients with high PVAS at diagnosis experienced irreversible sequelae, including intracranial haemorrhage and digital amputation. In conclusion, early diagnosis and treatment may minimise sequelae in patients with childhood-onset PAN. This study suggests that high PVAS score at diagnosis may be associated with poor prognosis.

scholarly journals Fibromuscular dysplasia with recurrence after “long-term” following percutaneous transcatheter renal angioplasty: two case reports with a review of 26 patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shuntaro Oribe ◽  
Takafumi Toyohara ◽  
Eikan Mishima ◽  
Takehiro Suzuki ◽  
Koichi Kikuchi ◽  
...  
Keyword(s):  
Fibromuscular Dysplasia ◽  
Age Of Onset ◽  
Case Reports ◽  
Case Presentation ◽  
Renal Angioplasty ◽  
Long Term Follow Up ◽  
Percutaneous Transluminal Renal Angioplasty ◽  
The Difference

Abstract Background Fibromuscular dysplasia (FMD) often causes renal artery stenosis with renovascular hypertension. Recent clinical outcomes encourage percutaneous transluminal renal angioplasty (PTRA) to treat FMD; however, the necessary follow-up period remains unclear. Moreover, previous studies have not revealed the difference in the period until recurrence between two major types of FMD—multifocal and focal. Case presentation We describe two patients with multifocal FMD who developed hypertension during their teenage years and had recurrence of FMD > 10 years after PTRA. We further examined the types of FMD and age of onset in 26 patients who underwent PTRA. The period until recurrence of multifocal FMD was longer than that of focal FMD. Moreover, patients with early-onset multifocal FMD are likely to have a delayed recurrence after PTRA compared to other types. Conclusions Our report suggests that patients with multifocal FMD, especially those with onset at an early age, may need long-term follow-up for at least ≥ 10 years.

scholarly journals Comparison of Short- and Long-Term Prognosis between ST-Elevation and Non-ST-Elevation Myocardial Infarction

2021 ◽  
Vol 10 (2) ◽  
pp. 180
Author(s):  
Frédéric Bouisset ◽  
Jean-Bernard Ruidavets ◽  
Jean Dallongeville ◽  
Marie Moitry ◽  
Michele Montaye ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rate ◽  
Confounding Factors ◽  
Coronary Syndrome ◽  
Short And Long Term ◽  
St Elevation ◽  
Probability Of Death ◽  
Long Term Prognosis

Background: Available data comparing long-term prognosis according to the type of acute coronary syndrome (ACS) are scarce, contradictory, and outdated. Our aim was to compare short- and long-term mortality in ST-elevated (STEMI) and non-ST-elevated myocardial infarction (non-STEMI) ACS patients. Methods: Patients presenting with an inaugural ACS during the year 2006 and living in one of the three areas in France covered by the Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) registry were included. Results: A total of 1822 patients with a first ACS—1121 (61.5%) STEMI and 701 (38.5%) non-STEMI—were included in the study. At the 28-day follow-up, the mortality rates were 6.7% and 4.7% (p = 0.09) for STEMI and non-STEMI patients, respectively, and after adjustment of potential confounding factors, the 28-day probability of death was significantly lower for non-STEMI ACS patients (Odds Ratio = 0.58 (0.36–0.94), p = 0.03). At the 10-year follow-up, the death rates were 19.6% and 22.8% (p = 0.11) for STEMI and non-STEMI patients, respectively, and after adjustment of potential confounding factors, the 10-year probability of death did not significantly differ between non-STEMI and STEMI events (OR = 1.07 (0.83–1.38), p = 0.59). Over the first year, the mortality rate was 7.2%; it then decreased and stabilized at 1.7% per year between the 2nd and 10th year following ACS. Conclusion: STEMI patients have a worse vital prognosis than non-STEMI patients within 28 days following ACS. However, at the 10-year follow-up, STEMI and non-STEMI patients have a similar vital prognosis. From the 2nd year onwards following the occurrence of a first ACS, the patients become stable coronary artery disease patients with an annual mortality rate in the 2% range, regardless of the type of ACS they initially present with.

scholarly journals Aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder with recurrent short partial transverse myelitis and favorable prognosis: Two new cases

2017 ◽  
Vol 23 (14) ◽  
pp. 1950-1954 ◽  
Author(s):  
Jinhua Zhang ◽  
Fang Liu ◽  
Yiqi Wang ◽  
Ying Yang ◽  
Yuehong Huang ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Transverse Myelitis ◽  
Acute Attack ◽  
Spectrum Disorder ◽  
Aquaporin 4 ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Attack Phase ◽  
Long Term Prognosis

Understanding the characteristics of neuromyelitis optica spectrum disorder (NMOSD) with recurrent short partial transverse myelitis (SPTM), which is very rare, contributes to the differential diagnosis of multiple sclerosis (MS). We present two Chinese aquaporin-4 immunoglobulin G (AQP4-IgG)-seropositive NMOSD cases who had at least twice SPTM during 4 and 6 years of follow-up, respectively. Their SPTMs have been mild and responded well to corticosteroids just like in the case of MS. The findings highlight the need of searching for serum AQP4-IgG (cell-based assay strongly recommended) in patients with recurrent SPTM and suggest that those patients may have a mild acute attack phase and favorable long-term prognosis.

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