Sulcoflex Piggyback Intraocular Lens Implantation For Correction Of Refractive Errors Following Cataract Surgery

Purpose: To investigate the visual and refractive outcomes following implantation of a Sulcoflex intraocular lens (IOL) to correct pseudophakic refractive error. Methods: This retrospective chart review included 14 pseudophakic eyes of 13 patients who underwent implantation of a Sulcoflex IOL. The Sulcoflex IOL is a piggyback IOL technique where a secondary, supplementary lens is implanted in the ciliary sulcus. Results: Eleven eyes (78.6%) had a postoperative SE within 0.50 D of the targeted SE. Preoperative UDVA was 20/30 in 4 eyes (28.6%), and 20/40 or worse in 10 eyes (71.4%). Postoperative UDVA was 20/30 or better in all eyes, where half (50.0%) of eyes were 20/20 or better. The mean preoperative logMAR (0.50 ± 0.33) significantly improved to 0.06 ± 0.09, p<.01. There were no complications. Conclusions. The significant improvement in UDVA and the precision in reaching the target refraction suggest that the Sulcoflex is a viable and successful treatment option for pseudophakic refractive error

Clinical treatment of postoperative infection following sinus augmentation

Purpose: The aim of this case report is to present the successful clinical treatment of two cases of postoperative infection following maxillary sinus augmentation. Methods: In the two cases of postoperative infection, immediate total removal of the grafted material from the sinus was conducted to stop the spread of the infection, after which a high dose of antibiotics was administrated. Re-augmentation procedures were then conducted after the infection subsided. Results: No further complications occurred after sinus re-augmentation. The dental implants placed in the re-augmented sinus were clinically osseointegrated, and the implant-supported restorations in the two cases of postoperative infection have been functioning very well for over 2 years. Conclusions: In the case of infection of the grafted sinuses, it is necessary to completely remove the graft materials and then administer a high dose of antibiotics to treat the acute infection, after which sinus re-augmentation is suggested. ?? 2010 Korean Academy of Periodontology

Analysis of the influence of residual alveolar bone height on sinus augmentation outcomes

Introduction Maxillary sinus augmentation is a predictable implant site development technique for posterior atrophic maxillary ridges. However, graft consolidation requires adequate angiogenesis and migration of osteogenic cells from native bone. Therefore, the amount of residual bone height ( RBH ) may play a role in the rate of graft maturation. The purpose of this study was to analyze the influence of RBH in the histomorphometric outcomes of maxillary sinus augmentation procedures. Material and methods Patients in need of sinus augmentation were recruited for the study. Customized radiographic guides were fabricated and a cone‐beam computerized tomography scan was obtained at baseline. Two examiners measured RBH on the scans at the locations marked by the radiographic guide. Sinus grafting was performed by a lateral window approach using a particulated mineralized allograft. Patients were followed up for 6 months. At the time of implant placement, bone core biopsies were harvested using the radiographic guide, which was converted into a surgical guide. Samples were histomorphometrically analyzed. Proportion of vital bone (% VB ), remaining allograft particles (% RA ), and non‐mineralized tissue (% NMT ) were quantified. Categorical analysis of correlation of RBH (<4 or ≥4 mm) with% VB and% RA was performed using a statistical model. Results Twenty‐one patients underwent sinus augmentation for a total of 21 sinuses. One patient developed an infection after grafting and was excluded. Histomorphometric analysis revealed that mean% VB was 20.47 ± 18.25, mean % RA was 29.04 ± 24.94, and average % NMT was 50.47 ± 12.76. No significant correlation between RBH and % VB ( r  = 0.016; P  =   0.951), and RBH and % ( r  = 0.009; P  =   0.971) was found. Similarly, categorical analysis of correlation showed no statistical significance. Conclusion These findings suggest that the remaining alveolar bone height does not appear to influence the maturation and consolidation of an allograft in the maxillary sinus.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93580/1/clr2270.pd

Primary versus radiation-associated craniofacial osteosarcoma

BACKGROUND. Craniofacial osteosarcoma differs from long bone osteosarcoma in that patients are older, tumors are often low grade, and prognosis is more favorable. Although most are sporadic, some tumors occur in association with prior radiation therapy. The purpose of the current study was to compare clinicopathologic and prognostic features of primary and radiation-associated osteosarcoma. METHODS. The study group consisted of 15 primary and 6 radiation-associated osteosarcomas. Clinical and follow-up data were obtained in every case. Tissue microarrays were immunohistochemically stained for p53, pRB, Ki-67 (MIB-1), and ezrin. DNA was sequenced for TP53 mutations. RESULTS. All radiation-associated osteosarcomas were high grade and half were fibroblastic. In contrast, 47% of primary craniofacial osteosarcomas were high grade and only 1 was fibroblastic. All radiation-associated osteosarcomas recurred, half the patients died of disease, 2 were alive with unresectable tumors, whereas only 1 was alive without disease. In contrast, 80% of patients with primary tumors were alive without disease, 33% had local recurrences, and 13% died of disease. Radiation-associated tumors overexpressed p53 more often (33% vs. 13%), more often had TP53 mutations (33% vs. 8%), had higher proliferative activity (67% vs. 0% showing >50% MIB-1 staining), and expressed ezrin more frequently (83% vs. 40%) than primary tumors. Compared with a control group of 24 high- and 7 low-grade primary extremity osteosarcomas, radiation-associated tumors marked as the high-grade tumors. CONCLUSIONS. Craniofacial radiation-associated osteosarcomas are high-grade tumors that behave more aggressively than most primary craniofacial osteosarcomas. In addition, they demonstrate higher expression rates of adverse prognostic indicators, further highlighting the distinction. Cancer 2006. © 2006 American Cancer Society.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55776/1/22019_ftp.pd

Imprint cytology of osteosarcoma of the jaw: a case report

Introduction. Osteosarcomas are highly malignant bone-forming neoplasms that account for about 20% of all sarcomas. In light of their aggressive behavior, early diagnosis is crucial for determining adequate treatment. Dental professionals may be the first to detect jaw osteosarcomas in their initial stages. The aim of this case report is to draw attention to the possibility of diagnosing this tumor based on clinical, radiographical and cytological characteristics before confirmation by histology. Case presentation. A 24-year-old Afro-Brazilian man presented with swelling and pain on the left side of the mandible in the region of the third molar (tooth 38). Radiography showed a poorly delimited intraosseous lesion with radiolucent and radiopaque areas. The cytological aspects were consistent with the diagnosis of osteosarcoma, which was confirmed by biopsy. Conclusion. Imprint cytology was found to be a reliable, rapid and easy complementary examination. An early diagnosis of osteosarcoma of the jaw is fundamental to the early determination of an adequate treatment. © 2009 Cabral et al; licensee BioMed Central Ltd

Evaluation of bone thickness around the mental foramen for potential fixation of a bone-borne functional appliance: a computer tomography scan study

AIM: A mandible bone-borne Herbst appliance (MBBHA) would avoid the proclination of the lower incisors that occurs with any teeth-borne functional appliance. But mapping of the bone characteristics at potential fixation areas around the mental foramen has not been carried out so far. The aim of this computer tomographic (CT) study was to evaluate bone thickness at specific positions around the mental foramen. MATERIAL AND METHODS: CT scans of 60 randomly chosen adult Hong Kong Chinese subjects (mean age 28 ± 6.3 years) were used to measure the bi-cortical bone thickness in the mandible in the mental foramen area. The thickness of buccal and lingual cortical and cancellous bone was assessed at the following locations: 10 mm (A10 mm) and 5 mm (A5 mm) anterior, 10 mm (P10 mm) and 5 mm (P5 mm) posterior, and 5 mm (Inf5 mm) below the mental foramen. RESULTS: The amount of buccal cortical bone thickness ranged between 1.89 mm, 10 mm anterior of the mental foramen, and 2.16 mm, 10 mm posterior to its location. At the A10 mm level, cortical thickness showed a marginal statistically significant difference between A5 and A10 mm. The total amount of bone thickness ranged from 10.19 to 12.06 mm. CONCLUSION: At the locations studied around the mental foramen, a mean bicortical bone thickness of 10-12 mm was measured. No large variation in the thickness was found between bicortical bone thicknesses in the measured locations around the mental foramen. Thorough evaluation on a case-by-case basis is advisable

Alveolar ridge preservation in the esthetic zone

In the esthetic zone, in the case of tooth extraction, the clinician is often confronted with a challenge regarding the optimal decision-making process for providing a solution using dental implants. This is because, after tooth extraction, alveolar bone loss and structural and compositional changes of the covering soft tissues, as well as morphological alterations, can be expected. Ideally, the therapeutic plan starts before tooth extraction and it offers three options: spontaneous healing of the extraction socket; immediate implant placement; and techniques for preserving the alveolar ridge at the site of tooth removal. The decision-making process mainly depends on: (i) the chosen time-point for implant placement and the ability to place a dental implant; (ii) the quality and quantity of soft tissue in the region of the extraction socket; (iii) the remaining height of the buccal bone plate; and (iv) the expected rates of implant survival and success. Based on scientific evidence, three time-periods for alveolar ridge preservation are described in the literature: (i) soft-tissue preservation with 6-8 weeks of healing after tooth extraction (for optimization of the soft tissues); (ii) hard- and soft-tissue preservation with 4-6 months of healing after tooth extraction (for optimization of the hard and soft tissues); and (iii) hard-tissue preservation with > 6 months of healing after tooth extraction (for optimization of the hard tissues)