A Six-Year Prospective Comparative Study of Wide and Standard Diameter Implants in the Maxillary and Mandibular Posterior Area

Background and Objectives: The aim of our study was to test whether wide diameter (6 mm) implants perform differently from standard diameter (4 mm) implants in terms of marginal bone level and survival rate. Materials and Methods: Our sample comprised 72 patients who underwent surgery; a total of 80 implants were placed in the maxillary or mandibular molar region. Patients were divided into two groups according to the diameter of the implant, and were followed up for six years after the final setting of the prosthetics. In the test group, 40 implants with 6-mm diameter were inserted; in the control group, 40 standard diameter implants were inserted. Using panoramic radiographs, we investigated mesial and distal marginal bone levels around the implant fixtures. Results: After the first implant surgery, three implants, including one wide diameter and two standard diameter implants, failed due to lack of osseointegration. We did not note any fixture fracture during the six-year follow-up. After loading, we observed a six-year survival rate of 97.29% with no statistically significant difference from standard diameter implants, with a survival rate of 94.87%. Conclusions: This study shows that 6-mm diameter implants may be considered in the presence of adequate alveolar ridge width in the posterior maxillary and mandibular regions.

Comparative assessment of the primary stability of Straumann® BLX implant design using an in-vitro sinus lift-simultaneous implant insertion model

Straumann ® BLX is a novel implant system, which has been proclaimed to provide an ideal primary stability in all types of bone. In the current study, the primary stability of Straumann ® BLX implant systems with Straumann ® tapered effect (TE) implants have been comparatively assessed in bovine ribs by using a simultaneous sinus elevation and implant insertion model. In the study group, BLX (4.0 x 12 mm), TE (4.1 x 12 mm), BLX (4,5 x 12 mm) and TE (4.8 x 12 mm) were placed in each bony window, which resembles sinus maxillaris. As a control, BLX and TE implants with same sizes were inserted into the proximal diaphysis of the bovine ribs. A total of 40 implant insertions were performed. The stability was measured with resonance frequence analysis. In the study group, TE implants of 4.8 mm showed significantly higher values compared to 4.5 mm BLX implants (p=0.116). However, BLX implants of 4.0 mm in the control group showed higher stability compared to TE with 4.0 mm diameter. (p=0.014). The primary stability of BLX implants in the control group was significantly higher compared to the experimental group in both widths (p=0.018 for BLX 4.0 and p=0.002 for BLX 4.5 respectively). The use of TE design with wide diameter in simultaneous implant placement with sinus lift could present higher ISQ values and might be more appropriate option for implant recipient sites with poor bone volume and quality. However, the advantage of BLX design in standard implant insertion protocols could be precious.

Radiology guided antegrade GASTROSTOMY deployment of mushroom (pull type) catheters with classical and modified methods in patients with oropharyngeal, laryngeal carcinoma, and anesthesia risk

Objective: The aim of study is to evaluate the results of deployment of Percutaneous Radiological Gastrostomy (PRG), which is a good alternative to Surgical Gastrostomy (SG), with transoral approach in cases where Percutaneous Endoscopic Gastrostomy (PEG) is contraindicated, difficult or unsuccessful, in patients with high risk of American Society of Anesthesiologists with four scores. In addition, we aimed to demonstrate the advantages of mushroom pull type catheters over push type gastrostomy catheters. Methods: This retrospective study included a total of 40 patients (18 females and 22 males) aged 21–92 years who underwent PRG with the antegrade transoral approach. PRG was performed by retrograde passing through the esophagus or snaring the guidewire from the stomach and taking out of the anterior abdominal wall. Patients’ demographic data, indications for PRG, procedural outcomes and complications were screened and recorded. Results: PRG was performed in 39 of 40 patients included in the study. Technical success rate was 97.5%. Procedure-dependent major complications such as death, aspiration, colon perforation, and deep abscess were not observed. Aspiration occurred in the first patient during the first feeding on the day after the procedure. Major complication rate was 2.5%. The total minor complication rate was 17.5% in 7 patients; parastomal leakage in 2 patients (5%), skin rash and infection in 3 (7.5%) patients, minor bleeding in 2 (5%) patients with oropharynx cancer, minimal bleeding from the gastrostomy catheter 1 week after the procedure in 1 (2.5%) patient. None of the cases had buried buffer. Tube functionality was preserved in all patients without any damage. Conclusion: Mushroom tip (pull type) gastrostomy catheter is a safe treatment method for patients requiring prolonged feeding because of wide diameter, endurance, long staying opening duration, less excessive dilatation and parastomal leakage, and no need for gastropexy. Lower cost and easier access are advantageous for mushroom tip pull type catheters compared to push type gastrostomy catheters in our country. The less invasive PRG is an alternative option in patients who are difficult to administer PEG, are at high anesthesia risk and cannot be sedated. Advances in knowledge: This article is valuable in terms of its contribution to develop an alternative radiological method for the deployment of gastrostomy tubes in medical difficult patients. This method has shortened the duration of the procedure and increased the success rate in patients with difficulty in transition from the stomach to the esophagus or with difficulty in the upper gastrointestinal tract. Mushroom tip catheters can be placed successfully by radiological methods.

A Case of A1 Wide-necked Aneurysm Embolization via the Front Communicating Artery

With the development of radiography, especially digital subtraction cerebrovascular angiography, which is widely used in clinical practice, interventional embolization of intracranial aneurysms has become more and more popular due to its advantages of minimal invasiveness, high efficiency, and rapid postoperative recovery. The choice of patients, often we have to formulate an unconventional and individualized treatment plan based on the specific conditions of each patient’s blood vessel. This case is a segment A1 aneurysm of the right anterior cerebral artery. Due to its special location and wide diameter, in order to reduce the difficulty and risk of the operation during the operation, a bilateral internal carotid artery approach was developed to complete the stent-assisted procedure and special treatment plan for aneurysm embolization.

Incorporation of Celiomesenteric Trunk With Double Kissing Directional Branches During Fenestrated-Branched Endovascular Aortic Repair

Purpose: Common celiomesenteric trunk (CMT) is a rare anatomical variation that occurs in 0.5% to 3.4% of the general population. Its presence may complicate planning and implantation of fenestrated and branched stent-grafts because the wide diameter and short length of the CMT to its bifurcation does not allow sufficient sealing for placement of bridging stents. Case Report: We report a patient with thoracoabdominal aortic aneurysm (TAAA) and CMT treated by fenestrated-branched endovascular aortic repair (FB-EVAR) using double kissing directional branches to incorporate the celiac axis and superior mesenteric artery. Pitfalls of stent design and implantation are outlined. Conclusion: Double kissing directional branches should be considered as an alternative to incorporate vessels with early bifurcation such as a CMT.

Impact of dental implant diameter on the efficiency of fatigue - a systematic review analysis

Objective: The present study explains the success and failure of dental implant diameter on the efficiency of fatigue by conducting a systematic review analysis. Methods: An extensive literature search was conducted to carry out systematic review using different scholarly platforms and libraries. A total of 12 studies published within the past 20-year time (1999-2019) were included following the inclusion and exclusion criteria based on the PRISMA guidelines. Additionally, the study outcomes were evaluated to determine their perceptions regarding the role of dental implant diameter in influencing the implant’s fatigue performance. Results: The implant diameter can be categorized into wide diameter (5-6 mm), regular diameter (3.75-4 mm), and small/narrow diameter (3-3.4 mm). The narrow diameter implants are indicated through thin alveolar ridges and mesiodistal spaces (less than 7 mm). The implants with narrow diameter would offer greater risk of fatigue failure for clinical situations with significant functional loading. No significant differences were found either in success or failure of dental implant diameter on fatigue efficiency after 1-year and 3-year follow-up. Conclusion: The technical complication of dental implant include abutment screw loosening or fracture, abutment and superstructure fracture, and implant body fracture. The study has study has mainly focused on the impact of dental implant diameter on the efficiency of fatigue and reviewed a significant impact of dental implant diameter on the fatigue efficiency. Keywords: Dental Implants, Efficiency, Perception. Continuous...

Cyclic soil-root mechanical interaction

<p>Plant roots have been considered to be effective to reinforce shallow soil slopes under rainfall conditions. Recent evidence from geotechnical centrifuge modelling shows that plant roots could improve earthquake-induced slope stability and reduce slope crest settlement. However, the underlying fundamental mechanisms of soil-root mechanical interaction against seismic loading are unclear. Although there has been a large volume of studies focusing on root reinforcement, cyclic soil-root mechanical interaction has rarely been investigated. Moreover, whether plant roots could reduce the liquefaction potential of rooted soil. This presentation will present some new test data and evidence about (1) cyclic root biomechanical behaviour and (2) cyclic responses of root-reinforced soil. In part (1), results of cyclic uniaxial tensile tests on roots of a wide diameter range will be presented, including any root hardening or softening and change in the size of hysteresis loops under displacement-controlled loading condition. Special attention will be paid on any observation of cyclic-induced root mechanical fatigue. In part (2), results of a comprehensive set of monotonic and cyclic triaxial tests on rooted soil will be presented. The cyclic behaviour observed will be interpreted through the monotonic behaviour observed along both the triaxial compression and extension paths. Any change in soil failure mechanism from limited flow failure to cyclic mobility due to plant roots, and how/when this change occurs at different root volume and cyclic stress ratio, will be discussed in detailed. A new attempt to interpret the liquefaction resistance through an energy-based approach will be made to evaluate the energy dissipation mechanism in rooted soils.</p>

Reabilitação implantossuportada de molar superior com implante cônico interno de diâmetro extra-largo – relato de caso

Tooth loss can occur due to several factors including dental caries. Immediate replacement of posterior teeth with dental implants facilitates to plan and to obtain consistent results with good prognosis. Factors such as minimally traumatic extraction, primary implant stability, maintenance of proximal bone ridges, buccal and lingual bone plates, in addition to a temporary or customizable component for tissue stabilization are important parameters to make the case predictable. The immediate technique for implants placement in the posterior regions has been described in the literature since the 1990s, presenting a high success rate and predictability of patients rehabilitation with shorter waiting times and maintenance of soft and bone tissue architecture. This study reports a clinical case of extraction of an upper molar tooth (26) with dental caries and placement of an extra-wide diameter implant, followed by filling of the surgical alveolar socket with bioactive calcium phosphate ceramic and placement of a customizable healing abutment. Clinical and radiographic control was performed after 8 months with success, with maintenance of soft tissue and marginal bone.

Distribution Pattern, Nest-Tree Features and Breeding Performance of Population of the Black Stork, Ciconia nigra (Ciconiiformes, Ciconiidae), in Northwestern Serbia

Distribution pattern, nest-tree characteristics and reproductive features of Black Stork’s population were evaluated in the floodplains of Gornje Podunavlje in Northwestern Serbia over five consecutive years. In total, 44 different nests were discovered and monitored. Nests were mostly placed on wide-diameter European Oaks and White Poplars between 5.5 and 18 m above ground level. Annually, the number of occupied nests varied between 26 and 16 with the declining trend over study years. The mean nesting density was 9.8 ± 2 occupied nests per 100 km2. Through study area, occupied nests were uniformly distributed and very isolated concerning the conspecific pairs. Predominantly, Black Stork preferred to nest on the lateral branches of the autochthonous mature trees with straight trunks and extensive crowns. These results suggest that the existence of old native forest stands represent crucial microhabitat criteria in the choice of the particular nesting site. In almost half of successful nesting cases, the most frequent number of fledglings was three. Overall productivity was relatively low with some variations between years implying poor nesting success.