scholarly journals Diagnosis and Treatment Planning for Dental Implants – A Review

2021 ◽  
pp. 80-88
Author(s):  
. Saransh ◽  
Yasir S. Khan ◽  
Nikita Jain ◽  
Divya Dubey
Keyword(s):  
Treatment Planning ◽  
Dental Implants ◽  
Clinical Examination ◽  
Laboratory Tests ◽  
Treatment Plan ◽  
Radiographic Analysis ◽  
Sequential Process ◽  
Treatment Needs ◽  
Diagnosis And Prognosis ◽  
Implant Therapy

Establishing and arriving at a diagnosis is the key to treatment planning and often practitioners tend to create a treatment plan overlooking the fundamental principles that must be taken into consideration prior to performing implant surgeries. The sequential process of clinical examination, laboratory tests, radiographic analysis, diagnostic protocols, casts wax ups, along with the treatment needs and desires of the patient have to be factored in for the overall diagnosis and prognosis of implant therapy. A step-by-step methodology has been created to help the implant practitioner with a checklist that aims to create the optimal treatment plan for each case.

“ABCD” Implant Classification: A Comprehensive Philosophy for Treatment Planning in Completely Edentulous Arches

2020 ◽  
Vol 46 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Ali Tunkiwala ◽  
Udatta Kher ◽  
Nupur H. Vaidya
Keyword(s):  
Decision Making ◽  
Treatment Planning ◽  
Present Article ◽  
Treatment Plan ◽  
Bone Volume ◽  
Classification Systems ◽  
Decision Making Process ◽  
Careful Attention ◽  
Treatment Needs ◽  
Vital Parameters

A thorough and precise treatment plan that considers various factors such as age, availability of bone, interarch space for prosthesis design, smile line, lip support, patient desires, and economics is a necessity before implant surgery. Many previous classification systems for treatment planning in edentulous situations tend to focus on only a certain parameter such as esthetics, or available bone volume, or are specifically designed for the maxilla or mandible. The authors have proposed a simplified and universal ABCD classification that uses the 4 vital parameters of age, bone volume, cosmetic display, and degree of resorption to create an algorithm that satisfies the treatment needs of every patient. Various permutations of the 4 parameters can be used to arrive at a solution that streamlines the further phases of the rehabilitative process. The aim of the present article is to provide a science-driven approach to understand a patient's individual needs with careful attention to the interplay of all the aforementioned factors in the decision-making process.

Dental Implants for Patients with Periodontitis

2019 ◽  
Vol 8 (4) ◽  
pp. 54-61
Author(s):  
Rajiv M. Patel
Keyword(s):  
Treatment Planning ◽  
Dental Implants ◽  
Dental Implant ◽  
Narrative Review ◽  
Professional Support ◽  
Implant Therapy ◽  
Plaque Control ◽  
Partially Dentate ◽  
Implant Treatment

This article provides a narrative review of the use of dental implants in patients with periodontitis. Using clinical examples where possible, consideration is given to the survival and success of implants, peri-implantitis, comparison of periodontally compromised teeth to implants and to treatment planning to help achieve favourable outcomes. The challenges associated with restoring an edentulous arch or partially dentate dentition with implants where significant alveolar atrophy has occurred can be considerable. Compromised outcomes may be commonplace. Dental implant treatment is more likely to be successful for those patients who attain and maintain excellent plaque control. Professional support should focus on managing underlying periodontitis prior to commencing implant therapy and providing long term, regular supportive periodontal care upon completion of treatment.

History and examination

2020 ◽  
pp. 1-22
Keyword(s):  
Differential Diagnosis ◽  
Treatment Planning ◽  
Clinical Examination ◽  
Imaging Techniques ◽  
Treatment Plan ◽  
Medical Examination ◽  
History Taking ◽  
Advanced Imaging ◽  
Suggested Approach ◽  
Head Neck

The beginning of a patient’s journey will include a history and examination of some sort. This chapter introduces the fundamentals of history taking, clinical examination, and treatment planning. The relevance of a patient’s medical, social, and dental history is highlighted with examples of key questions and considerations. A summary of a full medical examination is provided and full examinations of the head, neck, and mouth are described. Investigations, both general and specific, are detailed. Tooth notation systems and investigations are also discussed, alongside radiology, radiography, and advanced imaging techniques. The chapter ends with a suggested approach to the differential diagnosis and treatment plan.

Medicolegal Implications of Dental Implant Therapy

2013 ◽  
Vol 2 (2) ◽  
pp. 34-38 ◽  
Author(s):  
Jonathan Rees
Keyword(s):  
Dental Implants ◽  
Dental Implant ◽  
Early Stage ◽  
Treatment Plan ◽  
Economic Downturn ◽  
Risk Area ◽  
High Risk Area ◽  
Clinical Scenarios ◽  
Implant Therapy ◽  
Clinical Records

Despite the recent economic downturn, the dental implant market continues to grow year on year. Many more dentists are involved in the placement restoration of dental implants and dental implants are being placed in an extended range of clinical scenarios. Dental implant therapy remains a high risk area for the inexperienced in terms of civil negligence claims and General Dental Council hearings. Risk can be mitigated by: • Ensuring appropriate indemnity • Complying with the published requirements for training • Maintaining detailed and extensive clinical records • Completing the initial phases of history, examination and investigations robustly • Recording a diagnosis • Providing a bespoke written treatment plan that includes details of the need for treatment, the treatment options (the risks and benefits), the phases of treatment, the costs of treatment, the expected normal sequelae of surgery, the risks and complications of implant therapy and the requirement for future maintenance. The provision of treatment that is different in nature or extent to that agreed can result in a breach of contract as well as a claim for negligence • Engaging sufficiently with the patient to obtain consent • Providing written postoperative instructions detailing emergency arrangements, patients who are anxious or in pain may not retain oral information • Making a frank disclosure of complication or collateral damage • Considering referral at an early stage particularly if reparative surgery is required The stress of complications or failure may impair a dentist's normally sound judgement; there may be financial pressure, or concerns regarding reputation. In some cases, dentists avoid making a frank disclosure, feel obliged to undertake complicated reparative surgery, fail to make a timely referral, fail to respond appropriately to patient's concerns and in some cases attempt to alter the clinical records. However, in the best of hands and without negligence complications can and do occur. Complications that occur in the presence of good planning and communication and are managed appropriately do not amount to negligence, and are unlikely to lead to a successful claim.

Managing the Transition to Edentulousness Using Partial Transitional Dentures for First Time Prosthodontic Patients: Addressing Unrealistic Expectations – A Case Report

2017 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Case Report ◽  
Treatment Outcomes ◽  
Treatment Planning ◽  
Clinical Relevance ◽  
Treatment Plan ◽  
Sequential Treatment ◽  
Aesthetic Result ◽  
Abutment Teeth ◽  
First Time ◽  
Unrealistic Expectations

Aim: The aim of this report is to describe the management of a prosthodontic patient expressing unrealistic expectations with respect to the transition to edentulousness. Objectives: To outline (1) the diagnosis and explicit expectations of the patient on presentation (2) considerations made during treatment planning to address the wishes of the first time prosthodontic patient (3) a sequential treatment plan utilizing transitional partial removable dentures to manage the change to edentulousness (4) functional and aesthetic result achieved. Results: Delivery of immediate removable partial dentures retaining key abutment teeth in upper and lower arches was a viable prosthodontic solution in the transition to edentulousness of a patient expecting unrealistic treatment outcomes. Conclusions: Addressing impractical expectations and devising a treatment plan amenable to both clinician and patient is difficult. Strategies to manage these wishes in prosthodontic dentistry can include transitional partial dentures. Clinical relevance: Practitioners who encounter similar situations may consider this report valuable.

Cytomorphometric characteristics of imprints of the contact area between the gingiva and the dental implant after one-step implantation

2017 ◽  
pp. 77-82
Author(s):  
А.С. Рыбалко ◽  
А.С. Григорьян ◽  
А.А. Орлов
Keyword(s):  
Dental Implants ◽  
Dental Implant ◽  
Contact Area ◽  
Inflammatory Reactions ◽  
Diagnosis And Prognosis ◽  
Dental Implantation ◽  
Data Points ◽  
One Step ◽  
Cytological Method ◽  
Clinical Pictures

Цель исследования состояла в разработке неинвазивного метода диагностики состояния тканей периимплантационной зоны после постановки дентальных имплантатов, а также прогноза течения послеоперационного периода и ранней диагностики послеоперационных осложнений, таких, как мукозит и периимплантит, при одноэтапном методе дентальной имплантации. Методы. В исследовании представлена цитологическая характеристика отпечатков из области контакта имплантата с десной, в которых оценивали состояние эпителиальных клеток при различных проявлениях цитопатологии. Определяли индекс деструкции (ИД) и воспалительно-деструктивный индекс (ВДИ) в клетках воспалительного инфильтрата, которые сопоставляли с клинической картиной течения послеоперационного периода. Сроки забора цитологического материала 1, 5, 15, 25, 30, 60, 120 дней после постановки имплантатов. Количество исследованных цитограмм - 442 от 11 пациентов (по 1-2 имплантата). Общий массив использованных для вычисления интегральных показателей составил »2550. Результаты. Было установлено, что в сроки 1-5 дней после постановки дентальных имплантатов происходит резкое повышение показателей ИД (до 7500 ± 15) и ВДИ (до 80 ± 20), что отражает процесс развития в области имплантатов острых воспалительных реакций. В отдаленные сроки наблюдений отмечалось 2 варианта развития событий. Первый из них характеризовался сохранением во все сроки высоких показателей ИД и ВДИ. Для второго варианта динамики показателей было характерно их падение, что соответствовало развитию процесса остеоинтеграции дентальных имплантатов. The objectives of the investigation were to develop protocols evaluating the validity and effectiveness of the cytological method for diagnosis and prognosis of tissue conditions adjacent to a dental implant. Methods. This study examined the cytological characteristics of imprints of the gingiva-implant contact area, a. the correlation of quantitative ratios of epithelial cells either with or without hystopathological manifestations (an index of destruction, ID); b. ratio of cells of the inflammatory infiltrate (an inflammatory and destructive index, IDI); these data were researched in relation with dynamics of the clinical pictures during a postoperative period.The cytological material was obtained 1, 5, 15, 25, 30, 60, 120 days after dental implantation. Totally 442 cytogramme from 11 patients (1-2 implant per a patient) were assayed. The data array for computation of integrated indicators was composed of ca. 2550 data points. Results. A significant increase of ID (7500 ± 15) and IDI (80 ± 20) indicators, which reflects the development of acute inflammatory reactions in tissues neighboring an implant, was observed within 1-5 days following the insertion of dental implants. Long-term observations revealed two scenarios. The first scenario was characterized by the retention of high levels of ID and IDI over the period of observations. The second scenario featured the reduction of ID and IDI indices, which corresponded to the development of the osseointegration of dental implants.

The Relationship of Metabolic and Endocrine Parameters with Associated Diseases in Diabetes Mellitus

2018 ◽  
Vol 69 (5) ◽  
pp. 1288-1291 ◽  
Author(s):  
Mariana Cornelia Tilinca ◽  
Sandor Pal ◽  
Zoltan Preg ◽  
Eniko Barabas Hajdu ◽  
Raluca Tilinca ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Scoring System ◽  
Laboratory Tests ◽  
Treatment Plan ◽  
Individual Treatment ◽  
Diabetic Patients ◽  
Thyroid Disorders ◽  
Associated Diseases ◽  
Investigation Methods ◽  
Predictive Role

The most common comorbidities in patients with diabetes mellitus are cardiovascular diseases, obesity, dyslipidemia, thyroid disorders but other associated diseases may frequently occur. Laboratory tests are useful investigation methods that may reveal the subclinical manifestations of the disease but they are also essential for patient monitoring. The aim of the study was to assess laboratory parameters and associated diseases in diabetic subjects and to implement a scoring system with a predictive role in the evolution of the cases. Material and methods: The study group consisted of 195 subjects with documented type 1 or type 2 diabetes. About half of the cases were collected from the Procardia outpatient unit, and the rest were patients admitted to the Diabetology Clinic in T�rgu Mure�. The study was performed between January - June 2017. The results of the laboratory tests, as well as the information regarding comorbidities and treatment, was collected and patients� body mass index was calculated. Based on the clinical data, a scoring system, called Diabetes Complication Severity Index (DCSI) with a predictive role, was implemented. The diabetic outpatients presented significantly better carbohydrate metabolic balance compared to the hospitalized subjects. No significant differences could be observed regarding kidney function, hepatic status and lipid profile of the two subgroups of diabetic subjects. The most important comorbidity observed in both patient groups was arterial hypertension. The hospitalized diabetic subjects had significantly higher incidence of ischemic heart disease and significantly lower incidence of thyroid disorders compared to the outpatients. The DCSI scoring system revealed that comorbidities are more frequently present in the hospitalized patients compared to the ambulant diabetic subjects. Evaluation of clinical status and laboratory results in diabetic patients followed by implementation of a scoring system based on the data obtained regarding comorbidities could help clinicians to set up an individual treatment plan for these patients, focusing on preventing other complications.

scholarly journals Adult-onset sporadic chorea: real-world data from a single-centre retrospective study

2021 ◽  
Author(s):  
Roberta Bovenzi ◽  
Matteo Conti ◽  
Rocco Cerroni ◽  
Mariangela Pierantozzi ◽  
Alessandro Stefani ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Real World ◽  
Laboratory Tests ◽  
Clinical Course ◽  
Diagnostic Workup ◽  
Adult Onset ◽  
Real World Data ◽  
Term Outcome ◽  
Long Term Outcome ◽  
World Data

Abstract Background Adult-onset sporadic chorea includes a wide and heterogeneous group of conditions whose differential diagnosis and treatments are often challenging and extensive. Objectives To analyse retrospectively cases of adult-onset sporadic chorea from a single Italian centre to provide insights for a practical approach in the management of these patients. Methods A total of 11,071 medical charts from a 9-year period (2012–2020) were reviewed, identifying 28 patients with adult-onset sporadic chorea (genetic forms excluded). All available data regarding phenomenology, diagnostic workup, aetiology, treatments, and long-term outcome from this cohort were collected and analysed. Results Adult-onset sporadic chorea occurred more frequently in females and presented with an acute-subacute onset. Cerebrovascular diseases accounted for 68% of aetiology; further causes were structural brain lesions, internal diseases, and other movement disorder syndromes. Clinical course was mild, with spontaneous resolution or minimal disturbances in 82% of cases. Neuroimaging was fundamental to diagnose 76% of adult-onset sporadic chorea, an appropriate clinical examination contributed to the 14% of diagnoses, whereas basic laboratory tests to the 10%. Conclusions Revision of real-world data of adult-onset sporadic chorea patients from a single Italian cohort suggests that an accurate clinical examination, neuroimaging, and routine laboratory tests are useful to identify those cases underlying potentially severe but treatable conditions. Although in the majority of cases adult-onset sporadic chorea has mild clinical course and good response to symptomatic treatments, it is essential to run a fast diagnostic workup.

scholarly journals Multicriterial CNN based beam generation for robotic radiosurgery of the prostate

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Stefan Gerlach ◽  
Christoph Fürweger ◽  
Theresa Hofmann ◽  
Alexander Schlaefer
Keyword(s):  
Deep Learning ◽  
Treatment Planning ◽  
Treatment Plan ◽  
Plan Quality ◽  
New Approach ◽  
Beam Generation ◽  
Radiological Features ◽  
Improve Treatment ◽  
Robotic Radiosurgery ◽  
Treatment Plans

AbstractAlthough robotic radiosurgery offers a flexible arrangement of treatment beams, generating treatment plans is computationally challenging and a time consuming process for the planner. Furthermore, different clinical goals have to be considered during planning and generally different sets of beams correspond to different clinical goals. Typically, candidate beams sampled from a randomized heuristic form the basis for treatment planning. We propose a new approach to generate candidate beams based on deep learning using radiological features as well as the desired constraints. We demonstrate that candidate beams generated for specific clinical goals can improve treatment plan quality. Furthermore, we compare two approaches to include information about constraints in the prediction. Our results show that CNN generated beams can improve treatment plan quality for different clinical goals, increasing coverage from 91.2 to 96.8% for 3,000 candidate beams on average. When including the clinical goal in the training, coverage is improved by 1.1% points.

scholarly journals The Role of Artificial Intelligence in the Diagnosis and Prognosis of Renal Cell Tumors

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 206
Author(s):  
Matteo Giulietti ◽  
Monia Cecati ◽  
Berina Sabanovic ◽  
Andrea Scirè ◽  
Alessia Cimadamore ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Renal Cancer ◽  
Renal Cell ◽  
Treatment Plan ◽  
Molecular Data ◽  
Receiver Operating Curve ◽  
Diagnosis And Prognosis ◽  
Study Results ◽  
Gene Panels ◽  
Next Generation Sequencing Ngs

The increasing availability of molecular data provided by next-generation sequencing (NGS) techniques is allowing improvement in the possibilities of diagnosis and prognosis in renal cancer. Reliable and accurate predictors based on selected gene panels are urgently needed for better stratification of renal cell carcinoma (RCC) patients in order to define a personalized treatment plan. Artificial intelligence (AI) algorithms are currently in development for this purpose. Here, we reviewed studies that developed predictors based on AI algorithms for diagnosis and prognosis in renal cancer and we compared them with non-AI-based predictors. Comparing study results, it emerges that the AI prediction performance is good and slightly better than non-AI-based ones. However, there have been only minor improvements in AI predictors in terms of accuracy and the area under the receiver operating curve (AUC) over the last decade and the number of genes used had little influence on these indices. Furthermore, we highlight that different studies having the same goal obtain similar performance despite the fact they use different discriminating genes. This is surprising because genes related to the diagnosis or prognosis are expected to be tumor-specific and independent of selection methods and algorithms. The performance of these predictors will be better with the improvement in the learning methods, as the number of cases increases and by using different types of input data (e.g., non-coding RNAs, proteomic and metabolic). This will allow for more precise identification, classification and staging of cancerous lesions which will be less affected by interpathologist variability.

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