Implantes imediatos: revisão de literatura

TCC (graduação) - Universidade Federal de Santa Catarina. Centro de Ciências da Saúde. Odontologia.A técnica de implantes imediatos exige a realização de anamnese minuciosa e exame clínico cauteloso bem como avali-ar a história médica e odontológica do paciente, para estabelecer o correto diagnóstico e planejamento. Entre as indicações estão: dente com razão coroa-raiz desfavorável, lesões de cárie irrepa-ráveis, fraturas radiculares, reabsorções radiculares e retrata-mento endodôntico duvidoso. A colocação de implantes imedia-tos requer criteriosa indicação e habilidade cirúrgica. A exodon-tia deve ser realizada com o menor trauma possível, com a finali-dade de preservar a arquitetura alveolar. Curetagem alveolar minuciosa é realizada com vistas à eliminação de todo ou qual-quer tecido patológico e restos do ligamento periodontal. A reab-sorção alveolar é ocorrência frequente após a exodontia nos ca-sos de utilização ou não de implantes imediatos. A presença de patologia periapical ou doença periodontal, podem não ser con-traindicação para realização da técnica. A taxa de sobrevivência dos implantes imediatos está entre 93% e 100%, o que ressalta sua alta confiabilidade e previsibilidade. O emprego de implantes imediatos mostra-se uma alternativa viável para reposição de elementos dentais perdidos. O presente trabalho tem como obje-tivo revisar a literatura sobre o emprego de Implantes Imediatos e enfatizar os aspectos que influenciam o sucesso e/ou insucesso da técnica.The insertion of implants immediately requires both patient selection criteria and steady surgical skills. In order of establish-ing a sound diagnosis and treatment planning, the medical history and dental records must be taken in consideration very seriously. Among tooth extraction indications we found: inadequate root crown ratio, non-restorable caries, root fractures, root resorption and endodontic treatment failure. Tooth extraction must be per-formed with no trauma and preservation of socket bone walls. Surgical curettage is performed aiming at the removal of patho-logical tissue and remainings of periodontal ligament. Some re-searchers claim that alveolar resorption is a common result after tooth extraction with no regards of immediate implants insertion. Sites infected chronically with periodontal disease or apical pa-thology are no longer related to contraindication of immediat im-plants. The immediate implants success rate according to litera-ture varies form 93% to 100%. Pointing to the technique high reliability and previsibility. Therefore, immediate implant treatment is a viable therapy in teeth replacement. The aim of this study was to review the experimental and clinical outcomes of immedi-ate therapy

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

non present