Maxillary sinus floor elevation surgery:effects on maxillary sinus performance

In a prospective study, the effects of elevation surgery of the maxillary sinus floor on maxillary sinus physiology were assessed. Seventeen consecutive patients without preoperative anamnestic, clinical and radiological signs of maxillary sinusitis underwent sinus floor elevation surgery with iliac crest bone grafts. All patients were subjected to unilateral endoscopic examination of the maxillary sinus, taking of a biopsy specimen from the sinus floor mucosa, and collection of a sinus lavage-fluid aspirate. This triad of evaluations was performed immediately preceding the elevation procedure, and 3 months (at implant insertion) and 9 months (at uncovering of implants) postoperatively. All procedures were performed under general anesthesia. Preoperatively, three out of 17 patients showed pre-existing mucosal pathology endoscopically, while the 3- and 9-month results revealed the presence of mucosal pathology in four and two patients, respectively. The 3-month microbiological evaluation showed a significant increase in cultures with bacterial growth, while the 9-month culture results were comparable to the preoperative status of the maxillary sinus. Morphologically, neither fibrosis nor an altered inflammatory response or thickening of the epithelium and lamina propria was observed postoperatively. The number of goblet cells in the epithelial layer was increased. From this study it is concluded that the effect of maxillary sinus floor elevation surgery with autogenous bone grafts does not appear to have clinical consequences in patients without signs of pre-existing maxillary sinusitis.

The Paradox of Process Philosophy

This essay critically discusses the rising interest in process philosophy in recent years. I argue that the appeal of process philosophy lies in its ability to circumnavigate the binary dichotomies pervasive in European philosophy and defend an interpretation of process philosophy in terms of relationality, difference, and change. After outlining the central tenets of process philosophy, Graham Harman’s critique of a relational account of process philosophy is examined, particularly his assertion that this type of philosophy cannot fully explain genuine change. Despite the merits of Harman’s critique, I will show that his object-oriented ontology faces similar limitations. Turning to Graham Priest’s dialethism I suggest that philosophy, instead of striving for a consistent representation of fundamental metaphysics, must embrace paradox to some extent. This leads the philosophical discipline to understand itself as a transformative process. This essay critically discusses the rising interest in process philosophy in recent years. I argue that the appeal of process philosophy lies in its ability to circumnavigate the binary dichotomies pervasive in European philosophy and defend an interpretation of process philosophy in terms of relationality, difference, and change. After outlining the central tenets of process philosophy, Graham Harman’s critique of a relational account of process philosophy is examined, particularly his assertion that this type of philosophy cannot fully explain genuine change. Despite the merits of Harman’s critique, I will show that his object-oriented ontology faces similar limitations. Turning to Graham Priest’s dialethism I suggest that philosophy, instead of striving for a consistent representation of fundamental metaphysics, must embrace paradox to some extent. This leads the philosophical discipline to understand itself as a transformative process

Morbidity and complications of bone grafting of the floor of the maxillary sinus for the placement of endosseous implants.

Placement of endosseous implants in the atrophic maxilla is often limited because of a lack of supporting bone. A technique to augment the floor of the maxillary sinus with autogenous bone graft seems to be a new reliable treatment modality. The morbidity and complication rate of augmentation of the maxillary sinus floor was studied in 75 patients. The sinus floor was augmented with iliac crest (n = 65, 128 sinuses, 276 implants), mandibular symphysis (n = 8, ten sinuses, 21 implants), or maxillary tuberosity grafts (n = 2, two sinuses, two implants). The width of the alveolar crest had to be reconstructed in 52 patients, while in the other 23 patients augmentation and implantation were performed simultaneously. Perforation of the sinus membrane occurred in 45 patients, but this did not predispose them to the development of sinusitis. Loss of bone particles and sequesters were observed in one (diabetic) patient only, in whom a mucosal dehiscence occurred. A second augmentation procedure was successful. Symptoms of transient sinusitis were observed in two of the seven patients with a predisposition for sinusitis. These symptoms were successfully treated with decongestants and antibiotics. One patient developed a purulent sinusitis which resolved after a nasal amrostomy. The bone volume was sufficient for insertion implants in all patients. Twenty of 299 patients (6.7%) in whom Brånemark implants had been inserted were lost to follow-up (mean, 32 months); no sinus pathology was observed. The patients received implant-supported overdentures (58 patients) or fixed bridges (17 patients) and experienced no complaints with regard to the grafts or implants. We conclude that the morbidity and complication rate of bone grafting of the floor of the maxillary sinus floor with autogenous bone is low.</p

Mental well-being and diversity, equity, and inclusiveness in the veterinary profession: Pathways to a more resilient profession

Mental well-being (MWB) and diversity, equity, and inclusiveness (DEI) continue to be critical within the veterinary profession but there is less information regarding how professional associations around the world tackle these issues. A mixed-method study including an international online survey in English (n = 137 responses via snowball sampling), fourteen interviews, and two webinars was used to identify the availability and impact of MWB and DEI support programs for veterinarians. Survey results showed that more veterinary organizations designated MWB and DEI challenges (54%, n = 43/79 and 58%, n = 45/78, respectively) as a key priority area than veterinary clinics (26%, n = 15/57 and 33%, n = 19/57, respectively). Whereas, MWB support programs were available in a moderate number of mainly English-speaking countries, DEI support programs were available in only a few countries and focused primarily on specific groups, with an unknown impact due to their recent implementation. Universally, survey respondents believed activities for specific groups, such as MWB webinars, training, and awareness campaigns, as well as MWB/DEI helplines and DEI peer-to-peer support programs had a high impact (median 3.5–4/5) yet were underemployed by both veterinary organization and veterinary clinics. Further feedback from respondents during focused interviews indicated that requiring initial and continuing training as well as tailored group activities would be most beneficial to improve MWB/DEI throughout the veterinary professional career. There are many areas of the intersection between MWB and DEI that remain to be elucidated in the future studies. Having a sufficient sample size, improving accessibility, and addressing varying cultural perceptions are the main challenges, as seen in our study. To truly address MWB and DEI disparities, change is also needed in veterinary workplace culture and environment. In conclusion, raising awareness for an inclusive profession, including increasing openness and acceptance to enhance DEI and destigmatizing MWB challenges, is needed to ensure a thriving, modern veterinary profession

Histology and Physiology of Tissue Expansion

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75136/1/j.1524-4725.1993.tb01002.x.pd