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At least 109 records · Page 6Linked to original sources
PubMed2003

Interventions for replacing missing teeth: different times for loading dental implants.

BACKGROUND: To minimize the risk of implant failure, osseointegrated oral implants are conventionally kept load-free during the healing period. During healing removable prostheses are used, however many patients find these temporary prostheses rather uncomfortable and it would be beneficial if the healing period could be shortened without jeopardizing implant success. Nowadays immediate and early loaded implants are commonly used in mandibles of good bone quality. It would be useful to know whether there is a difference in success rates between immediately or early loaded implants compared with conventionally loaded implants. OBJECTIVES: To test the null hypothesis of no difference in the clinical performance between osseointegrated implants loaded at different times one year after loading. SEARCH STRATEGY: The Cochrane Oral Health Group Trials Register, The Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE were searched. Handsearching included several dental journals. Authors of all identified trials and 55 oral implant manufacturers were contacted to find unpublished RCTs. The last electronic search was conducted on 8 May 2002. SELECTION CRITERIA: All RCTs of root-form osseointegrated oral implants having a follow-up of one year comparing the same osseointegrated root-form oral implants loaded at different times. DATA COLLECTION AND ANALYSIS: Data were independently extracted, in duplicate, by two reviewers. Authors were contacted for details of randomization and withdrawals and a quality assessment was carried out. The Cochrane Oral Health Group's statistical guidelines were followed. MAIN RESULTS: Only three RCTs were identified and two trials including 68 patients in total were suitable for inclusion in this review. Implants have been either immediately loaded after insertion (two to three days), early loaded (six weeks) or conventionally loaded (three to eight months) in edentulous mandibles of adequate bone quality and shape. On a patient, rather than per implant basis, there were no statistically significant differences for prosthesis failures, implant failures and marginal bone loss on intra-oral radiographs. REVIEWER'S CONCLUSIONS: While it is possible to successfully load oral implants immediately after their placement in mandibles of adequate bone density and height of carefully selected patients, it is yet unknown how predictable this approach is. More well designed RCTs are needed to understand how predictable immediate and early loading are. Such trials should be simply designed and should be reported according to the CONSORT guidelines (http://www.consort-statement.org/). It is suggested that priority should be given to trials assessing the effectiveness of immediately loaded implants rather than early loaded ones.

Bone Density↗
PubMed2004

Interventions for replacing missing teeth: different times for loading dental implants.

BACKGROUND: To minimize the risk of implant failure, osseointegrated oral implants are conventionally kept load-free during the healing period. During healing removable prostheses are used, however many patients find these temporary prostheses rather uncomfortable and it would be beneficial if the healing period could be shortened without jeopardizing implant success. Nowadays immediate and early loaded implants are commonly used in mandibles of good bone quality. It would be useful to know whether there is a difference in success rates between immediately or early loaded implants compared with conventionally loaded implants. OBJECTIVES: To test the null hypothesis of no difference in the clinical performance between osseointegrated implants loaded at different times 1 year after loading. SEARCH STRATEGY: The Cochrane Oral Health Group's Trials Register, The Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE were searched. Handsearching included several dental journals. Authors of all identified trials, an internet discussion group and 55 oral implant manufacturers were contacted to find unpublished randomized controlled trials (RCTs). The last electronic search was conducted on 2 February 2004. SELECTION CRITERIA: All RCTs of root-form osseointegrated oral implants having a follow up of at least 1 year comparing the same osseointegrated root-form oral implants loaded at different times. DATA COLLECTION AND ANALYSIS: Data were independently extracted, in duplicate, by two reviewers. Authors were contacted for details of randomization and withdrawals and a quality assessment was carried out. The Cochrane Oral Health Group's statistical guidelines were followed. MAIN RESULTS: Seven RCTs were identified and five trials including 124 patients in total were suitable for inclusion. Implants have been either immediately loaded after insertion (2 to 3 days), early loaded (6 weeks) or conventionally loaded (3 to 8 months) in edentulous mandibles of adequate bone quality and shape. On a patient, rather than per implant basis, there were no statistically significant differences for prosthesis failures, implant failures and marginal bone loss on intra-oral radiographs. REVIEWERS' CONCLUSIONS: While it is possible to successfully load oral implants immediately after their placement in mandibles of adequate bone density and height of carefully selected patients, it is yet unknown how predictable this approach is. More well designed RCTs are needed to understand how predictable immediate and early loading are. Such trials should be simply designed and should be reported according to the CONSORT guidelines (http://www.consort-statement.org/). It is suggested that priority should be given to trials assessing the effectiveness of immediately loaded implants rather than early loaded ones.

Bone Density↗
PubMed2006

Outcome of prosthetic knee-associated infection: evaluation of 40 consecutive episodes at a single centre.

Few studies have compared the long-term success of different surgical strategies in prosthetic knee-associated infection. Accordingly, a retrospective cohort study was performed of 40 episodes in 35 consecutive patients undergoing revision surgery for prosthetic knee-associated infection at a single centre between 1988 and 2003. The median patient age was 70 (44-90) years; the median follow-up period was 28 (2-193) months; 45% of infections were early, 23% were delayed, and 32% were late; and 55% of infections were caused by staphylococci. The probability of survival without prosthesis failure was 92.4% (95% CI, 84.1-100) after 1 year, and 88.7% (95% CI, 78-99.4) after 2 years. Recurrence-free survival was observed in 20 (95%) of 21 patients treated with debridement and retention, in both patients with one-stage exchange, and in 11 (85%) of 13 patients with two-stage exchange. Patients with delayed infection had a worse outcome than those with early or late infection (67% vs. 97%; p < 0.03). Patients with at least partially adequate antimicrobial therapy had a higher success rate than those with inadequate treatment (94% vs. 60%; p 0.069). The outcome was similar for patients with a duration of therapy of 3 to < 6 months, and those with a duration of therapy of > or = 6 months (91% vs. 87% success). Different surgical procedures had similar success rates, provided that the type of infection, the pathogen, the stability of the implant and the local skin and soft-tissue condition were considered. Adherence to an algorithm defining a rational surgical and antibiotic treatment strategy contributed to a favourable outcome.

Adult↗
PubMed2002

Hepatocyte growth factor prevents intimal hyperplasia in rabbit carotid expanded polytetrafluoroethylene grafting.

PURPOSE: The major cause of vascular prosthesis failure is anastomotic intimal hyperplasia caused by the proliferation and migration of smooth muscle cells. Hepatocyte growth factor (HGF) is an endothelium-specific growth factor that exerts a mitogenic action on endothelial cells. This study was designed to examine the effect of HGF on the suppression of intimal hyperplasia after small-caliber expanded polytetrafluoroethylene (ePTFE) grafting. METHODS: An ePTFE graft, 2 mm in diameter and 30 mm in length, was implanted in the left common carotid arteries of Japanese white rabbits, after which the animals were fed with a 1.0% cholesterol diet. HGF was infused intravenously immediately and then every day for 7 days at doses of 0.3 mg/body (the 0.3-mg HGF group; n = 20) or 1.0 mg/body (the 1.0-mg HGF group; n = 17). A control group (n = 20) underwent infusion with saline solution. The rabbits were killed on postoperative days (PODs) 1, 2, 3, 5, 7, and 28. RESULTS: The patency rates on POD 28 were 33%, 55%, and 100% in the control, the 0.3-mg HGF, and the 1.0-mg HGF groups, respectively, with a significant difference between the control and the 1.0-mg HGF group (P <.05). Endothelial-like cells were seen on the intraluminal surface of the graft only near the anastomotic site on POD 5 in the 1.0-mg HGF group. Intimal thickness at the distal anastomosis was 284 +/- 140 microm, 106 +/- 18 microm, and 67 +/- 10 microm in the control, the 0.3-mg HGF, and the 1.0-mg HGF groups, respectively, with a significant difference between the control and both HGF groups (P <.05). The number of anti-embryonic smooth muscle antibody positive cells at the distal anastomosis was 28.6 +/- 0.8, 3.8 +/- 2.8, and 3.9 +/- 0.9 in the control, the 0.3-mg HGF, and the 1.0-mg HGF groups, respectively, with a significant difference between the control and both HGF groups (P <.01). CONCLUSION: HGF might suppress intimal thickness at the anastomotic site and improve the patency rate via rapid reendothelialization by POD 28 in a rabbit carotid ePTFE grafting model.

Animals↗
PubMed2001

Healing response to the Clamshell device for closure of intracardiac defects in humans.

The healing response to intracardiac devices in humans is largely unknown. During regulatory trials using the Clamshell device in over 800 patients, attempts were made to perform histopathological evaluation of all explanted devices. We reviewed all those with complete histopathological examination (n = 12) from Fontan baffles (n = 4), ventricular septal defects (n = 2), and atrial septal defects (ASD; n = 6), explanted at 2.7 months to 3.6 years (median, 1.6 years), at autopsy (n = 1) or surgery (n = 11), performed for residual defects (n = 5), atrial masses (n = 3), or Fontan revision (n = 3). All but one were nearly (n = 3) or completely (n = 8) covered by pseudointima, composed of fibroelastic tissue, predominantly collagen, with focal foreign body reaction in contact with fabric, without acute inflammation or infection. Atrial masses of granulation tissue were present in three cases (ASD), opposite to protruding fractured arms. No associations were identified between coverage and closure status, position, arm fractures, or implant period. In conclusion, the healing response to transcatheter Clamshell implantation in humans is characterized by a relatively rapid development of a nonthrombotic pseudointima composed of fibroelastic tissue with minimal foreign body reaction. Cathet Cardiovasc Intervent 2001;54:101-111.

Adolescent↗
PubMed1997

Introl bladder neck support prosthesis: international clinical experience.

The Introl bladder neck support prosthesis is a ring-shaped silastic device with two prongs located at one side such that when placed within the vaginal canal the bladder neck is suspended in a fashion similar to a surgical urethropexy. Since its initial description in 1988 the device has undergone clinical trials in the US and Japan, documenting its effectiveness in the treatment of stress and mixed incontinence in women. Introl is available for clinical use in the United States and has been well accepted by practicing clinicians. In Japan, exposure has occurred through clinical trials, which resulted in a high efficacy rate, i.e. 81% of the patients had either maximum benefit or benefit in the global usefulness rating, and 26% experienced minor adverse effects. This paper will summarize Introl clinical study findings and describe various clinical observations made during increased clinical usage.

Clinical Trials as Topic↗
PubMed2003

[Reconstruction of the frontal sinus with a calvarium split galea periosteum transplant after inflammatory complications].

After reconstruction of the frontal sinus with alloplastic material, with or without obliteration of the lumen, inflammatory complications may occur. The authors present a plastic-surgical functional reconstruction technique for revision surgery in cases of inflammatory complications following frontal sinus implantation of alloplastic material, by means of a modified autologous calvarian split graft. The inflammatory complications after primary reconstruction or obliteration of the frontal sinus occurred after a period of 1-10 years. The previously implanted material was removed from the frontal sinus and the anterior wall was reconstructed with a combined calvarian split/galea periost-transplant. During follow-up, which ranged from 1-5 years, no further inflammatory complications occurred. Furthermore, an appealing cosmetic result was achieved in all cases. We conclude that the functional and aesthetic result depends primarily on (1) embedding and protection of the graft by an additional covering with a galea-periost-flap, and (2) reconstruction of the frontal drainage pathways.

Abscess↗
PubMed2004

[Endoprostheses of the knee joint].

Due to the advances in prosthesis design and standardisation of implant techniques, the maintenance of implants in arthroplasty of the knee joint has enormously increased during the past few years. Various arthroplastic designs enable an adjustment towards the patient's individual indiction and anatomy. For one-compartmental arthrosis, monocondylous prosthesis can be implanted using microinvasive operation techniques. Prerequisite for mere joint resurfacing is an intact lateral ligament apparatus, whereas the the symmetrical ligament balancing is essential for long-term analgesia, joint stability and good flexion. Aseptic loosening, discreet infections, instabilities and patellar problems are common reasons for painful knee arthroplastics.

Arthroplasty, Replacement, Knee↗
PubMed2006

[Shoulder prostheses].

The design of shoulder prostheses has been developed through four generations which mirror adaptation to our increasing knowledge of the biomechanics of the shoulder joint. Modern shoulder prostheses are adapted to the size, inclination, posterior offset, and retrotorsion of the shoulder. The main reasons for implantation of a shoulder prosthesis are primary osteoarthritis, posttraumatic and rheumatoid arthritis, avascular necrosis, instability arthritis and cuff defect arthropathy. Typical implants are cup prostheses for surface replacement, anatomical stem prostheses, and reverse prostheses. Total prostheses are functionally better as soon as the arthritis involves the glenoid, whereas hemiprostheses should be preferred as long as the glenoid is intact. The stem is mostly cemented, whereas in younger patients with good bone quality a cementless stem may be used. Cemented glenoids may be considered as standard.

Arthritis, Rheumatoid↗
PubMed2006

[Implants in the hand].

Increasingly, implants in the region of hand joints and the wrist represent an alternative for the treatment of post-traumatic, inflamed, or degenerative joint damage. The diversity of hand functions also results in varied solutions, which are effective in their stability, mobility, and distraction. Different materials are necessary for this, and they require subtile radiological control. The native X-ray represents the substantial method to observe migration of the implants. Each interface between titanium, ceramic, zirconium, pyrocarbon, and silicon to the bone has to be assessed differently in order to obtain a relevant statement. The finger joints and to a limited extent the wrist represent the artificial joints with limited alternative therapy. Other implants in the hand should only be applied after strict indication and patient compliance, as arthrodesis and resection arthroplasty have shown very good long-term results.

Arthritis↗