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Surgical Placement (surgical + placement)
Selected AbstractsFunctional Restoration of Implants on the Day of Surgical Placement in the Fully Edentulous Mandible: A Case SeriesCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2005Alexandre-Amir Aalam DDS ABSTRACT Purpose: The purpose of this article is to report the clinical experience and outcome of a study of the functional rehabilitation of 16 completely edentulous mandibles with immediately loaded cross-arch screw-retained hybrid prostheses at the University of Southern California. Materials and Methods: After signing informed consent forms 16 patients (9 male, 7 female) aged 47 to 84 years (mean age, 62.6 ± 11.6 years) received 90 Brånemark System® Mk III dental implants (Nobel Biocare USA, Yorba Linda, CA, USA). Stability and radiographs of the dental implants were evaluated at the time of surgery, at 3 months, at 1 year, and at 3 years post loading. Results: Three implants failed to meet the criteria of success, bringing the cumulative success rate to 96.6%, with a 100% prosthetic success rate at 3 years. Thirty-nine (43.3%) of the dental implants placed were 15 mm in length. Seventy-seven (85.5%) of the dental implants were placed in high-density bone. At 3 years post loading, the average bone loss was ,1.2 ± 0.1 mm. Conclusion: Within the limitations of this study, restoration of implants by unreinforced hybrid prostheses at the time of placement provided satisfactory results. The outcome was stable at 3 years post restoration. Mandibular rehabilitation by functional loading of the implants on the day of the insertion requires the comprehension and proper application of surgical and restorative principles. [source] Addition of nimesulide to small intestinal submucosa biomaterial inhibits postsurgical adhesiogenesis in ratsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 1 2010Mark A. Suckow Abstract Adhesion formation is a common complication in abdominal surgery with incidence as high as 93% and small bowel obstruction a common complication. Because the extracellular matrix material, small intestinal submucosa (SIS), is commonly used in various surgical procedures, methods to inhibit adhesiogenesis are of great interest. This study was undertaken to determine if incorporation of nimesulide (NM), a selective cyclooxygenase (COX)-2 inhibitor, could reduce the extent and tenacity of intraabdominal adhesion formation associated with SIS implantation. Female Sprague,Dawley rats underwent a cecal abrasion surgical procedure to induce adhesiogenesis. Rats were either left untreated or treated by direct application over the injured cecum with polypropylene mesh (PPM); SIS; SIS containing a low dose of NM; or SIS containing a high dose of NM. Rats were euthanized 21 days later, and adhesion extent and tenacity were evaluated using standard scales (0 = minimal adhesiogenesis; 4 = severe adhesiogenesis). Addition of NM to SIS resulted in a significant (p < 0.05) reduction in adhesion extent and in a similar reduction in adhesion tenacity for SIS containing a low dose of NM. Adhesions typically extended from the abraded cecal surface to the body wall and were characterized histologically by fibrous tissue adherent to the cecal wall. In conclusion, addition of the nonsteroidal anti-inflammatory, COX-2 selective drug, NM, to SIS attenuates adhesion extent and tenacity when compared with surgical placement of SIS or PPM alone. © 2010 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2010 [source] The critical-size supraalveolar peri-implant defect model: characteristics and useJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2006Ulf M. E. Wikesjö Abstract Objective: Novel implant technologies and reconstructive therapies for alveolar augmentation require pre-clinical evaluation to estimate their biologic potential, efficacy, and safety before clinical application. The objective of this report is to present characteristics and use of the critical-size, supraalveolar, peri-implant defect model. Methods: Bilateral extraction of the mandibular premolars was performed in 12 Hound Labrador mongrel dogs following horizontal surgical cut-down of the alveolar ridge approximating 6 mm. Each jaw quadrant received three custom-produced TiUniteÔ, ,4.0 × 10 mm threaded implants placed into osteotomies prepared into the extraction sites of the third and fourth premolars. The implants exhibited a reference notch 5 mm from the implant platform to facilitate surgical placement leaving 5 mm of the implant in a supraalveolar position, and to serve as a reference point in the radiographic, histologic and histometric analysis. The implants were submerged under the mucoperiosteal flaps for primary intention healing. Fluorescent bone markers were administered at weeks 3 and 4 post-surgery, and pre-euthanasia. The animals were euthanized following an 8-week healing interval when block biopsies were collected for analysis. Results: Healing was generally uneventful. The radiographic and histometric evaluations demonstrate the limited osteogenic potential of this defect model. Whereas lingual peri-implant sites exhibited a mean (±SE) bone gain of 0.4±0.1 mm, resorption of the buccal crestal plate resulted in a mean bone loss of 0.4±0.2 mm for an overall osteogenic potential following sham-surgery averaging 0.0±0.1 mm. Overall bone density and bone,implant contact in the contiguous resident bone averaged 79.1±1.1% and 76.9±2.3%, respectively. Conclusion: The results suggest that the critical-size, supraalveolar, peri-implant defect model appears a rigorous tool in the evaluation of candidate technologies for alveolar reconstruction and osseointegration of endosseous oral implants. Limited innate osteogenic potential allows critical evaluation of osteogenic, osteoconductive, or osteoinductive technologies in a challenging clinical setting. [source] A system for the diagnosis, placement, and prosthetic restoration of root form implants (U.S. Patent #5,769,636)JOURNAL OF PROSTHODONTICS, Issue 1 2003Francesco Di Sario DDS It is difficult to achieve a high degree of reproducibility when using a diagnostic wax-up as the template for fabrication of a definitive implant restoration. Here a method for implant prosthesis treatment planning is described that allows fabrication of the provisional restoration before surgical placement of the implant. The method involves 6 steps: (1) determining the mesiodistal inclination of the implant, (2) determining the buccolingual dimension of the alveolar ridge, (3) determining the proper position of the implant, (4) fabricating the surgical guide, (5) fabricating the provisional restoration, and (6) performing surgical placement of the implant followed by immediate placement of the provisional restoration. [source] Deep brain stimulation hardware complications: The role of electrode impedance and current measurementsMOVEMENT DISORDERS, Issue 5 2008MPAS, Sierra Farris PAC Abstract Deep brain stimulation (DBS) is an effective therapy for advanced Parkinson's disease patients. Successful DBS outcomes depend on appropriate patient selection, surgical placement of the lead, intact hardware systems, optimal programming, and medical management. Despite its importance, there is little guidance in reference to hardware monitoring, hardware troubleshooting, and patient management. Technical manuals produced by the hardware manufacturer (Medtronic, Minneapolis, MN) are not presented in an applied clinical format, making impedance and current measurements difficult to interpret when the results are not straightforward. We present four patients with evolving DBS hardware complications that occurred during long-term follow-up, that shaped our clinical protocol for long-term care management and hardware troubleshooting. © 2007 Movement Disorder Society [source] Innovative Techniques for Placement of Implantable Cardioverter-Defibrillator Leads in Patients with Limited Venous Access to the HeartPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 2 2006BRYAN C. CANNON Background: Because of venous occlusion, intracardiac shunting, previous surgery, or small size placement of implantable cardioverter-defibrillator (ICD) leads may not be possible using traditional methods. The purpose of this study was to evaluate and describe innovative methods of placing ICD leads. Methods: The records of all patients undergoing ICD implantation at our institution were reviewed to identify patients with nontraditional lead placement. Indications for ICD, method of lead and coil placement, defibrillation thresholds, complications, and follow-up results were reviewed retrospectively. Results: Eight patients (aged 11 months to 29 years) were identified. Six patients with limited venous access to the heart (four extracardiac Fontan, one bidirectional Glenn, one 8 kg 11-month-old) underwent surgical placement of an ICD coil directly into the pericardial sac. A second bipolar lead was placed on the ventricle for sensing and pacing. Two patients with difficult venous access had a standard transvenous ICD lead inserted directly into the right atrium (transatrial approach) and then positioned into the ventricle. All patients had a defibrillation threshold of <20 J, although one patient required placement of a second coil due to an elevated threshold. There have been no complications and two successful appropriate ICD discharges at follow-up (median 22 months, range 5,42 months). Conclusions: Many factors may prohibit transvenous ICD lead placement. Nontraditional surgical placement of subcutaneous ICD leads on the pericardium or the use of a transatrial approach can be effective techniques in these patients. These procedures can be performed at low risk to the patient with excellent defibrillation thresholds. [source] Intraoperative Assessment of an Implantable Electrode Array for Cavernous Nerve StimulationTHE JOURNAL OF SEXUAL MEDICINE, Issue 8 2008Arthur L. Burnett ABSTRACT Introduction., Erectile dysfunction remains a major functional complication of radical prostatectomy in the modern era despite surgical techniques to preserve the penile autonomic nerve supply. Aim., To develop and evaluate a neurostimulation system for cavernous nerve electrical stimulation for future use as a chronic implantation device that neurotrophically promotes erectile function recovery following radical prostatectomy. Method., After radical retropubic prostatectomy, the neurovascular bundle was stimulated using a temporarily placed electrode array of an implantable neurostimulation system (20 Hz frequency, 260 µ seconds pulse width, 5 mA,60 mA amplitude up to 10 minutes), and penile circumference increases were measured. Main Outcome Measure., Increase in penile circumference. Results., Among 12 men (mean age 60.3 years) enrolled in this study, 6 (50%) demonstrated measurable increases in penile circumference in response to cavernous nerve stimulation. Among these six men, the mean increase was 5.0 mm (range 1.6 mm to 7.0 mm). Temporary surgical placement of the device was done with relative ease, and there was no evidence of injury to the neurovascular bundle. Conclusions., A chronic implantable nerve stimulation system for cavernous nerve stimulation having possible neuromodulatory effects on the recovery of penile erections after radical prostatectomy is feasible. Burnett AL, Teloken PE, Briganti A, Whitehurst T, and Montorsi F. Intraoperative assessment of an implantable electrode array for cavernous nerve stimulation. J Sex Med 2008;5:1949,1954. [source] An Overview of Complete Artificial Fixed Dentition Supported by Endosseous ImplantsARTIFICIAL ORGANS, Issue 1 2005Dennis Flanagan Abstract:, The construction of a complete restoration of the dentition by the surgical placement of endosseous titanium implants that support a fixed prosthesis in each jaw is possible. The positionings of the implants and teeth in the prostheses are important factors for a successful long-term result. Distribution of the occlusal biting forces over as many implants as possible is important. Off-axial occlusal biting forces should be diverted to the anterior jaws where the forces are not as great. The posterior teeth should be designed with flat occlusal surfaces that separate during excursionary mandibular chewing movements. Medial mandibular flexure caused by the contraction of the medial pterygoid muscle can be addressed by constructing the prosthesis in segments, so as not to have a rigid entity encased in flexing bone that may induce stress in the bone, potentially leading to loss of implant integration and failure. Segmenting also ensures an appropriate fit of the prosthesis with respect to casting and porcelain firing distortion. Lip support by means of a flange in the prosthesis may be necessary when there has been a large amount of bone loss from edentulous resorption. Cleaning and routine maintenance of the prostheses every 3,6 months is essential. [source] Elbow joint luxation in a 1-month-old foalAUSTRALIAN VETERINARY JOURNAL, Issue 1-2 2008LM Rubio-Martínez This paper reports on luxation of the elbow joint without concomitant fracture in a 1-month-old foal. Conservative treatment, with closed reduction and full-limb bandaging, including caudal and lateral splints, seemed successful initially, however, failed to provide enough stability and luxation recurred, and open reduction and surgical placement of prosthetic collateral ligaments was required. Luxation of the elbow joint should be considered when acute non-weight bearing forelimb lameness occurs associated with pain and swelling in the area of the elbow in young foals. Closed reduction failed to provide sufficient joint stability. [source] The Establishment of a Protocol for the Total Rehabilitation of Atrophic Maxillae Employing Four Zygomatic Fixtures in an Immediate Loading System , A 30-Month Clinical and Radiographic Follow-UpCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2007Luis Rogério Duarte ABSTRACT Background:, The existing approaches to the treatment of the atrophic maxilla are difficult and involve an element of risk. Purpose:, The aim of the present study was to establish a new surgical/prosthetic protocol for the treatment of extremely atrophic maxillae using four zygomatic implants (ZIs) in an immediate loading system. Materials and Methods:, Twelve patients were treated with the surgical placement of 48 ZIs, and the totally edentulous maxillae were rehabilitated with protocol-type maxillary prostheses rigidly fixed to the ZIs in an immediate loading system. Follow-up was conducted at 6 months and again at 30 months. Results:, Of the 48 ZIs inserted, one implant failed to achieve osseointegration. The prosthetic components fitted well and no sinus pathology was detected in any of the patients. Conclusion:, The surgical/prosthetic protocol showed that it was possible to insert four ZIs in an immediate loading system and achieve stability for up to 30 months. [source] Effect of implant design on survival and success rates of titanium oral implants: a 10-year prospective cohort study of the ITI® Dental Implant SystemCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2004Ioannis K. Karoussis Abstract Aim: The aim of this 10-year study (observation time 8,12 years, mean: 10 years) was to compare the survival rates, success rates and incidences of biological complications using three different implant designs of the ITI® Dental Implant System. Material and methods: In 89 dental patients treated comprehensively, a total of 112 hollow screw (HS), 49 hollow cylinder (HC) and 18 angulated hollow cylinder (AHC) implants were installed depending on the available bone volume and according to prosthetic needs. One and 10 years after surgical placement, clinical and radiographic parameters were assessed. The incidences of peri-implantitis according to various thresholds were registered over 10 years of maintenance. Results: Success criteria at 10 years were set at: pocket probing depth (PPD)5 mm, bleeding on probing (BoP),, bone loss < 0.2 mm annually. The survival rate for HS was 95.4%, for HC 85.7% and for AHC 91.7%. Ninety percent of all the HS, 71% of the HC and 88% of the AHC did not present with an incidence of peri-implantitis over the 10 years, HC having significantly higher incidence of peri-implantitis than HS (P< 0.004). With the success criteria set above, a success rate for HS of 74%, for HC of 63% and for AHC of 61% was identified at 10 years. However, including a definition of PPD6 mm, BoP , and bone loss < 0.2 mm annually for success, the rates for HS were 78%, for HC 65% and for AHC 67%, respectively. Basing success criteria purely on clinical parameters (without radiographic analysis), such as: PPD5 mm and BoP,, the success rates increased to 90%, 76% and 89%, respectively. With PPD6 mm and BoP , as success criteria chosen, the respective rates were 94%, 82% and 94% for HS, HC and AHC implants, respectively. Conclusions: A significantly higher survival rate as well as a significantly lower incidence of peri-implantitis was identified for hollow screw design ITI® Dental Implants after 10 years of service when compared to hollow cylinder design ITI® Dental Implants (95.4% vs. 85.7%; 10% vs. 29%). Depending on the setting of the threshold criteria for success, success rates are highly variable and hence, reporting of success rates with elaboration on the criteria set appears crucial for comparison of different studies. Résumé Le but de ce suivi d'une décennie a été de comparer les taux de survie, les taux de succès et les incidences des complications biologiques de l'utilisation de trois modèles implantaires différents du système ITI® Dental Implant. Chez 89 patients, 112 vis creuses (HS), 49 cylindres creux (HC) et 18 cylindres creux angulés (AHC) ont été placés suivant le volume osseux disponible et les nécessités prothétiques. Une et dix années après leur placement, des paramètres cliniques et radiographiques ont été définis. Les incidences de paroïmplantite relatives aux différents seuils ont été enregistrées durant ces dix années de maintenance. Les succès des critères à dix ans étaient placés à : PPD5 mm, BoP-, perte osseuse <0,2 mm/an. Le taux de survie pour HS était de 95,4%, pour HC de 86% et pour AHC de 92%. Nonante pour cent de tous les HS, 71% des HC et 88% des AHC ne présentaient pas d'incidences de paroïmplantite durant ces dix années, HC ayant une plus importante incidence de paroïmplantite que HS (p<0,004). Grace aux critères de succès indiqués, un taux de succès de 74% pour HS, de 63% pour HC et de 61% pour AHC a été identifié après dix ans. Cependant, en définissant le succès avec PPD6mm, BoP- et perte osseuse <0,2mm/an, les taux étaient de 78% pour HS, de 65% pour HC et de 67% pour AHC. En basant les taux de succès uniquement sur les paramètres cliniques (sans l'analyse radiographique) tels que PPD5 mm et BoP-, les taux de succès augmentaient respectivement à 90, 76 et 89%. Avec PPD6mm et BoP- comme critères de succès, les taux s'élevaient respectivement à 94, 82 et 94%. Un taux de survie significativement plus important ainsi qu'une incidence significativement plus faible de paroïmplantite étaient constatés au niveau des implants vis creuses après dix ans de mise en fonction comparés aux cylindres creux. Suivant l'établissement du seuil pour les critères du succès, les taux de ce succès sont extrêmement variables et rapporter les taux de succès suivant l'élaboration des critères est donc crucial pour comparer différentes études. Zusammenfassung Ziel: Das Ziel dieser 10-Jahresstudie (Beobachtungszeit 8,12 Jahre, Mittelwert: 10 Jahre) war es, bei ITI® -Implantaten mit drei verschiedenen Designs, die Erfolgs- und Überlebensrate zu vergleichen, und das Auftreten von biologischen Zwischenfällen zu untersuchen. Material und Methode: Bei 89 synoptisch behandelten Patienten implantierte man in Abhängigkeit des vorhandenen Knochenvolumens und der prothetischen Anforderungen insgesamt 112 Hohlschraubenimplantate (HS), 49 Hohlzylinderimplantate (HC) und 18 abgewinkelte Hohlzylinderimplantate (AHC). Ein und zehn Jahre nach der Implantation nahm man die klinischen und radiologischen Parameter auf. Eine Periimplantitis registrierte während der 10-jährigen Erhaltungsphase anhand verschiedener Grenzwerte. Resultate: Die Kriterien für einen Erfolg nach 10 Jahren legte man bei den folgenden Werten fest: PPD <5mm, BOP-, jährlicher Knochenverlust <0.2mm. Die Überlebensrate für ein HS lag bei 95.4%, für ein HC bei 85.7% und für ein AHC bei 91.7%. 90% aller HS, 71% aller HC und 88% aller AHC zeigte während den 10 Jahren nie Anzeichen einer Periimplantitis, wobei die HC signifikant häufiger Periimplantitis hatten, als die HS (p<0.004). Mit den oben festgelegten Erfolgskriterien ergab sich nach 10 Jahren für die HS eine Erfolgsrate von 74%, für die HC eine von 63% und für die AHC eine von 61%. Veränderte man die Definition auf "PPD<6mm, BOP -, jährlicher Kochenverlust <0.2mm", so betrugen die Erfolgsraten für die HS 78%, für die HC 65% und für die AHC 67%. Basierten die Erfolgskriterien rein auf klinischen Parametern (PPD <5mm, BOP-, keine röntgenologische Anlyse), so stiegen die Erfolgsraten auf 90%, 76% und 89% an. Wählte man die Erfolgskriterien "PPD <6mm und BOP -", so betrugen die Erfolgsraten für die HS 94%, für die HC 82% und für die AHC 94%. Zusammenfassung: Verglich man nach 10-jähriger Funktion die Hohlschrauben des ITI® -Implantat-Systems mit den Hohlzylindern desselben Systems, so ergab sich für die HS sowohl eine signifikant höher Überlebensrate, wie auch ein selteneres Auftreten von Periimplantitis (95.4% vs. 85.7%; 10% vs. 29%). Die Erfolgsraten variieren in Abhängigkeit der in der Definition eines Erfolges festgelegten Grenzwerten enorm stark. Dies erweist sich im Vergleich von verschiedenen Studien als hinderlich, weil die Definition der Erfolgsraten meist auf verschiedenen Kriterien beruhen. Resumen Intención: La intención de este estudio de 10 años (tiempo de observación 8,12, media: 10 años) fue comparar los índices de supervivencia, índices de éxito e índices de complicaciones biológicas usando tres diferentes diseños de implantes del Sistema de Implantes Dentales ITI®. Material y Métodos: Se instalaron en 89 pacientes dentales tratados completamente un total de 112 tornillos huecos (HS), 49 cilindros huecos (HC) y 18 cilindros huecos angulados (AHC) dependiendo de la disponibilidad de volumen óseo y de acuerdo con las necesidades protésicas. Se valoraron parámetros clínicos y radiográficos uno y diez años tras la colocación quirúrgica. Se registraron las incidencias de periimplantitis de acuerdo con varios umbrales a lo largo de 10 años de mantenimiento. Resultados: Los criterios de éxito a los 10 años se situaron en PPD5mm, BoP-, pérdida ósea < 0.2mm por año. El índice de supervivencia para los HS fue del 95.4%, para los HC del 85.7% y para los AHC del 91.7%. El 90% de los HS, el 71% de los HC y el 88% de los AHC no presentaron ninguna incidencia de periimplantitis a lo largo de los 10 años, HC tuvo una significativamente mayor incidencia de periimplantitis que HS (p< 0.004). Con los criterios de éxito antes mencionados, se identificó un índice de éxito para HS del 74%, para HC del 63% y para AHC del 61% a los 10 años. De todos modos, incluyendo una definición de PPD6mm, BoP, y pérdida ósea <0.2mm al año para tener éxito, los índices para HS fueron del 78%, para HC 65% y para AHC 67%, respectivamente. Basando los criterios de éxito puramente en parámetros clínicos (sin análisis radiográficos), tales como: PPD5mm y BoP-, los índices de éxito subieron hasta el 90%, 76% y 89%, respectivamente. Con el PPD6mm y BoP , como criterios de éxito elegidos, los índices respectivos fueron del 94%,82% y 94% para implantes HS, HC y AHC, respectivamente. Conclusiones: Se identificó un significativamente mayor índice de supervivencia al igual que una menor incidencia de periimplantitis para el diseño de tornillo hueco Implante Dental ITI®. (95.4% vs. 85.7; 10% vs. 29%). Dependiendo de la definición del criterio del umbral de éxito, los índices de éxito son altamente variables y por tanto, los informes de los índices de éxito con elaboración de la definición de criterios parece ser crucial para la comparación de los diferentes estudios. [source] | ||||||||||