Maxillary sinus elevation in conjunction with transnasal endoscopic treatment of rhino-sinusal pathoses: preliminary results on 10 consecutively treated patients

A one-step surgical procedure is presented, including maxillary sinus floor elevation in association with functional endoscopic sinus surgery to remove rhino-sinusal malformations or pathoses that might contraindicate sinus floor elevation. Over a 2-year period, 10 patients requiring a sinus floor augmentation procedure to restore the missing dentition with endosseous implants, but presenting with local and reversible rhinologic contraindications to the augmentation procedure were consecutively treated with a surgical approach that included simultaneously functional endoscopic sinus surgery and a sinus floor elevation procedure through an intra-oral approach. Then 4-6 months after this procedure, oral implants were inserted and after a further waiting period, ranging from 3 to 6 months, patients were restored with prostheses and followed for 1 to 3 years after the completion of prosthetic restoration. In all 10 patients, complete recovery of para-nasal sinuses function was demonstrated and occurred in all cases within one month. All cases showed good integration and consolidation of the graft material used for maxillary sinus floor augmentation. None of the implants placed were lost during the follow-up period after completion of prosthetic loading. In conclusion, despite the limits of this study (which included only 10 patients), the combination of maxillary sinus augmentation procedures and functional endoscopic sinus surgery, to treat local contraindications to sinus augmentation has proven to be both effective and safe and has allowed the patient to avoid a second surgical procedure and a longer waiting period before final prosthetic rehabilitation. No sinusal complications related to sinus floor augmentation were encountered and the survival rate of implants placed in the augmented areas was consistent with those reported in cases of sinus floor augmentation performed in patients presenting with a healthy rhino-sinusal system

Guided Bone Regeneration Using Injectable Vascular Endothelial Growth Factor Delivery Gel

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141041/1/jper0230.pd

Immediate implant placement and provisionalization:Aesthetic outcome 1 year after implant placement. A prospective clinical multicenter study

Contains fulltext : 220439.pdf (Publisher’s version ) (Closed access)BACKGROUND: Prospective aesthetic outcomes on a high number of patients after immediate implant placement and provisionalization (IIPP) are lacking. PURPOSE: To analyze the aesthetic outcome after IIPP. MATERIALS AND METHODS: One hundred consecutive patients with a failing maxillary incisor were provided with an immediately placed and provisionalized nonloaded implant using a flapless procedure and palatal implant positioning. The remaining gap buccally was filled with a bone substitute. Preoperatively (T0), 2 weeks postoperatively (T1), direct after placement of the permanent crown (T2), and 1 year after IIPP (T3), standardized light photographs were made. Change in aesthetic score was the primary outcome measure. Both the white aesthetic score (WES) and pink aesthetic score (PES) were used. RESULTS: In the first year postsurgery, the mean total-WES and total-PES scores raised from 4.5 to 8.2, and from 9.9 to 12.1, respectively. The mean PES scores for mesial and distal papilla, soft tissue marginal level, contour, color, and texture, raised significantly (P < .05), while the alveolar process contour, on average, remained stable from T0 to T3. CONCLUSIONS: Within the limitations of this 1-year research, it may be concluded that, following this minimal invasive IIPP procedure, a high aesthetic outcome was achieved

Technical refinements in mandibular reconstruction with free fibula flaps: Outcome-oriented retrospective review of 99 cases = Accorgimenti tecnici nelle ricostruzioni mandibolari con lembi liberi di fibula: analisi retrospettiva dei risultati su 99 casi

Congenital disease, major trauma, tumour resection and biphosphonate-related osteonecrosis can lead to partial, subtotal, or total loss of the mandibular bone. Minor defects can be easily reconstructed using bone grafts, whereas microvascular free tissue transfer may be unavoidable in the case of major bone loss or poor quality of soft tissue. Simple bone or composite osteocutaneous fibula free flaps have proven invaluable and remain the workhorse for microvascular mandibular reconstruction in daily practice. Our experience with 99 consecutive fibular free flaps confirms the available data in terms of high success rate. In these cases, 90% had total success, while 7 had complete flap failures. Three of our patients showed skin paddle necrosis with bony conservation. This report focuses on the technical refinements used by the authors that can prove valuable in obtaining predictable and precise results: in particular, we discuss surgical techniques that avoid vascular pedicle ossification by removing the fibular periosteum from the vascular pedicle itself and reduce donor site morbidity and aid in management of the position in the new condylar fossa. Finally, new technologies such as intraoperative CT and custom premodelled fixation plates may also increase the predictability of morpho-functional results

Pollutant concentrations and exposure variability in four urban microenvironments of London

We compared various pollutant concentrations (PM1, PM2.5, PM10, PNC, BC) at four different urban microenvironments (MEs) in London (Indoor, IN; Traffic Intersection, TI; Park, PK; and Street Canyon, SC). The physico-chemical characteristics of particles were analysed, and the respiratory deposition doses (RDD) were estimated. Field measurements were conducted over a period of 121 days. The mean PM2.5 (PNC) concentrations were found to be 9.47 ± 7.05 (16366 ± 11815), 8.09 ± 4.57 (10951 ± 6445), 5.11 ± 2.96 (7717 ± 4576), 3.88 ± 3.06 (5672 ± 2934) μg m−3 (# cm−3) at TI, SC, PK and IN, respectively. PM2.5, PM10 and PNC exhibited a trend of TI > SC > PK > IN; higher concentrations for PM1 and BC were observed at IN than PK due to the emissions from printers, producing a trend of TI > SC > IN > PK. We observed 12%–30% higher fine PM concentrations at TI and SC sites during morning peak (07:00–09:30) than the evening peak hours (16:00–19:00); while IN showed a smaller variation in fine PM concentrations compared with outdoor TI, PK and SC sites owing to their prevalence in the IN for a longer time. Fine and ultrafine PM containing potentially toxic trace transition metals including Fe, Ti, Cr, Mn, Al and Mg were detected by high resolution electron microscopy at all sites. There was a similar relative abundance of different elements at the TI, IN and PK sites, which suggests a transport of PM between MEs. RDD for PM1 was highest (2.45 ± 2.27 μg h−1) at TI for females during running; PM2.5 and PM10 were highest at SC (11.23 ± 6.34 and 37.17 ± 20.82 μg h−1, respectively). The results show that the RDD variation between MEs does not follow the PM concentration trend. RDD at PK was found to be 39%–53% lower than TI and SC during running for all the PM fractions. Overall, the study findings show the air quality variation at different MEs and reveals the exposure inequalities around the city, which enable the management of personal exposure by selecting appropriate MEs for different activities

Fatigue and microgap behaviour of a three-unit implant-fixed dental prosthesis combining conventional and dynamic abutments

This is an in vitro study composed by a fatigue test followed by an optical microscopy analysis. Dynamic abutments concept, recently introduced on screw-retained implant dental prosthesis, consists on the screw channel customisation according to the individual needs of each rehabilitation. Geometry and tightening torque differences advise the assessment of their mechanical performance. Clarify whether the combination of dynamic and conventional abutments in a three-unit implant-fixed prosthesis has detrimental effects either on the mechanical performance under cyclic loading or on the implant-abutment microgap dimensions. The fatigue test was performed in agreement with the ISO standard 14801. Then on the samples that resisted 5 million cycles, the implant-abutment microgap was measured on dynamic and conventional abutments using optical microscopy. Two unloaded samples were used as control group. The samples supported a load of 1050 N. The implant-abutment microgap measurement did not show statistically significant differences (p=.086) between loaded and unloaded groups, but the loaded conventional abutments showed a significant lower implant-abutment microgap (p=.05) than the loaded dynamic abutments. The combination of conventional and dynamic abutments do not seem to produce a decrease in fatigue resistance to a level below the mastication forces or an increase in the joint dimensions.The study was supported in part by SciTech - Science and Technology for Competitive and Sustainable Industries, and the R&D project was cofinanced by the North Portugal Regional Operational Program ("NORTE2020") and the European Regional Development Fund (FEDER)