Πέμπτη 27 Δεκεμβρίου 2018
Reporting Adverse Events in Plastic Surgery: A Systematic Review of Randomized Controlled Trials
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2rYGt7t
ASPS/PSF Sponsored Symposia and Workshops
Discussion: Total Muscle Coverage versus AlloDerm Human Dermal Matrix for Implant-Based Breast Reconstruction
Reply: Motiva Ergonomix Round SilkSurface Silicone Breast Implants: The Tale of Goldilocks: Never Be Afraid of Exploring Unknown Territory
Prepectoral Breast Reconstruction in the Setting of Postmastectomy Radiation Therapy: An Assessment of Clinical Outcomes and Benefits
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2rXKfhl
Leaders in Plastic Surgery: The Dingman-Grabb Era 1946–1986
Discussion: Prepectoral Breast Reconstruction in the Setting of Postmastectomy Radiation Therapy: An Assessment of Clinical Outcomes and Benefits
Reply: The Lateral Thigh Perforator Flap for Autologous Breast Reconstruction: A Prospective Analysis of 138 Flaps
Discussion: Tissue Expander Complications Do Not Preclude a Second Successful Implant-Based Breast Reconstruction
Porcine Acellular Peritoneal Matrix in Immediate Breast Reconstruction: A Multicenter, Prospective, Single-Arm Trial
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s0G3xz
Ethical Issues in Aesthetic and Reconstructive Surgical Innovation: Perspectives of Plastic Surgeons
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LCim7E
Function and Strength after Free Abdominally Based Breast Reconstruction: A 10-Year Follow-Up
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2rYaXXt
Reply: Intraoperative Nerve Blocks Fail to Improve Quality of Recovery after Tissue Expander Breast Reconstruction: A Prospective, Double-Blinded, Randomized, Placebo-Controlled Clinical Trial
The Use of Tumescent Technique in Mastectomy and Related Complications: A Meta-Analysis
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2rWkRIZ
Reply: The Smile Index: Part 1. A Large-Scale Study of Phenotypic Norms for Preoperative and Postoperative Unilateral Cleft Lip
Reporting Adverse Events in Plastic Surgery: A Systematic Review of Randomized Controlled Trials
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2rYGt7t
ASPS/PSF Sponsored Symposia and Workshops
Discussion: Total Muscle Coverage versus AlloDerm Human Dermal Matrix for Implant-Based Breast Reconstruction
Reply: Motiva Ergonomix Round SilkSurface Silicone Breast Implants: The Tale of Goldilocks: Never Be Afraid of Exploring Unknown Territory
Prepectoral Breast Reconstruction in the Setting of Postmastectomy Radiation Therapy: An Assessment of Clinical Outcomes and Benefits
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2rXKfhl
Leaders in Plastic Surgery: The Dingman-Grabb Era 1946–1986
Tissue Expander Complications Do Not Preclude a Second Successful Implant-Based Breast Reconstruction
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2rZrgDg
Assessing Quality of Life and Patient-Reported Satisfaction with Masculinizing Top Surgery: A Mixed-Methods Descriptive Survey Study
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LAuqWW
Discussion: Tissue Expander Complications Do Not Preclude a Second Successful Implant-Based Breast Reconstruction
Current Best Peripheral Nerve Transfers for Spinal Cord Injury
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LCyje9
Porcine Acellular Peritoneal Matrix in Immediate Breast Reconstruction: A Multicenter, Prospective, Single-Arm Trial
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s0G3xz
Ethical Issues in Aesthetic and Reconstructive Surgical Innovation: Perspectives of Plastic Surgeons
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LCim7E
Function and Strength after Free Abdominally Based Breast Reconstruction: A 10-Year Follow-Up
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2rYaXXt
Reply: Intraoperative Nerve Blocks Fail to Improve Quality of Recovery after Tissue Expander Breast Reconstruction: A Prospective, Double-Blinded, Randomized, Placebo-Controlled Clinical Trial
The Use of Tumescent Technique in Mastectomy and Related Complications: A Meta-Analysis
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2rWkRIZ
Reply: The Smile Index: Part 1. A Large-Scale Study of Phenotypic Norms for Preoperative and Postoperative Unilateral Cleft Lip
Correlation between temporomandibular joint temporal component pneumatization and morphology: analysis by cone beam computed tomography
The aim of this study was to evaluate whether a correlation exists between temporal bone pneumatization and the morphology of the articular eminence and glenoid fossa. A sample of 100 cone beam computed tomography scans was used, for a total of 200 temporomandibular joints (TMJ). Paracoronal and parasagittal images of the TMJ were evaluated by two examiners. For all TMJ, pneumatization was classified in the mid-lateral direction using a score of 0 or 1, and in the anteroposterior direction using a score ranging from 0 to 3. (Source: International Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GKtvVn
Correlation between temporomandibular joint temporal component pneumatization and morphology: analysis by cone beam computed tomography
The aim of this study was to evaluate whether a correlation exists between temporal bone pneumatization and the morphology of the articular eminence and glenoid fossa. A sample of 100 cone beam computed tomography scans was used, for a total of 200 temporomandibular joints (TMJ). Paracoronal and parasagittal images of the TMJ were evaluated by two examiners. For all TMJ, pneumatization was classified in the mid-lateral direction using a score of 0 or 1, and in the anteroposterior direction using a score ranging from 0 to 3. (Source: International Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GKtvVn
Pediatric Asthma Risk Score Has Good Sensitivity, Specificity
PARS has improved ability over API for predicting asthma in children with mild - to - moderate risk (Source: Pulmonary Medicine News - Doctors Lounge)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EPX6uN
Pediatric Asthma Risk Score Has Good Sensitivity, Specificity
PARS has improved ability over API for predicting asthma in children with mild - to - moderate risk (Source: Pulmonary Medicine News - Doctors Lounge)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EPX6uN
Management of postoperative pain in maxillofacial surgery
In this review we describe the evidence base for postoperative analgesia after maxillofacial surgery. We discuss the implications of poorly managed pain, risk factors for the development of severe pain, and pharmacological and non-pharmacological analgesic strategies to manage it. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ENUlJk
Simulation-based training in maxillofacial surgery: are we going to be left behind?
Simulation is an important way both to optimise a trainee 's learning time and reduce morbidity and operating time for patients. We have reviewed the current use of simulation in training for maxillofacial surgery, and provide an overview of areas of practice where it may be useful. A web-based survey of trainees' opinions of it was made in February 20 18, and disseminated using the Junior and Fellows in Training group mailing lists. We also reviewed popular current simulation courses that are available. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ES7Okr
Has TNM 8 had an effect on P16 staining & HPV-PCR Correlation in Head and Neck cancer staging, an 8 month review in Europe's largest pathology department
Introduction/Aims: Staging of Head and Neck Cancers (HNC), have moved on greatly since their first inclusion as "Buccal", "Pharynx" and "Larynx". The staging systems have evolved to incorporate Tumour Biology, Cancer Behaviour and the emergence of new stains of disease. The 8th Edition was introduced on the 1st of January 2018, with many centres including Glasgow phasing its introduction alongside TNM from October 2017. One of three new schema introduced includes HPV p16-mediated oropharyngeal carcinoma (OPC). (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EQqHmO
Comparison of Three Internal Fixation Techniques in Mandibular Sagittal Split Osteotomy, A Finite Element Analysis
The aim of this study was to analyse and compare the biomechanical properties of 3 internal fixation techniques (2.0mm bi-cortical screws, 2.0mm miniplate and 1.7mm miniplate) in mandibular sagittal split osteotomy (SSO). A 3-D hemi-mandible model was developed from a patient's skull CT. It underwent sagittal split osteotomy (SSO) virtually and was reproduced 9 models consisting of the 3 fixation techniques with mandibular movements of 3mm setback, 3mm advancement, and 7mm advancement. Bite forces applied were 50, 75, and 100N for the incisors, and 100, 200 and 300N for the molars. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EUrlQ6
Penetrating Maxillofacial Trauma – epidemiology and injury characteristics in terror-related violence, interpersonal violence and deliberate self-harm at a Level 1 Trauma Centre
Introduction: Penetrating trauma to the head and neck presents specific diagnostic and therapeutic challenges. Aetiologies includes interpersonal violence (IPV), deliberate self-harm (DSH) and terror-related violence (TRV). Data from a Major Trauma Centre which straddles the two boroughs with the highest incidence of violent knife crime in the country will be presented, including data of victims of a major terrorist attack in 2017. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ETGgei
A 5 year review of extended (abdominal and chest) staging scan findings for head and neck cancer patients in NHS Lanarkshire
Introduction: Radiological staging of head and neck (H&N) cancer patients is essential to direct clinical management. Extended cross-sectional imaging facilitates pre-operative planning and acts as prognostic factor. The extension of head and neck staging scan below the neck region may provide extra information. We aimed to identify the incidence of findings below the neck, in an extended field. The significance of these were to be analyzed. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ERnqDG
Educational profile and qualifications of non-surgical aesthetic trainers
The aesthetics industry is booming, with the increased social acceptance of having non-surgical treatments undertaken and the more affordable costs in doing so. In all branches of medicine, clinicians are being pursued to attend courses to allow them to be part of this sub-specialist area injecting neurotoxins and other materials on a non-permanent basis. Whilst, a form of regulation is being promoted via the RCS England aesthetics accreditation scheme, this remains a poorly governed area of practice, and those providing the training are also currently unregulated. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ESzN2j
5-year follow-up of older patients undergoing orthognathic surgery- The East Grinstead experience
Introduction: In the last decade, there has been a growing number of older patients (above 35) undergoing orthognathic surgery. Previous studies have looked at the complication rates related to orthognathic surgery in older patients and compared outcomes with a younger cohort. We aimed to look at the satisfaction of older patients undergoing orthognathic surgery at their 5-year follow-up. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ETq64v
Workforce planning in OMFS and the importance of the dentistry programme for medical graduates at King's College London to higher recruitment training
Background: King's College London (KCL) offers the only three-year dental-programme for medical graduates within Europe. It produces a significant proportion ofST3 applicants for OMFS training. Now in its tenth year, we have conducted a retrospective study looking at various parameters. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EQq9NM
Additional benefits of Virtual Planning in Orthognathic Surgery
Introduction: The role of virtual planning in orthognathic surgery is well documented. We aim to highlight what further information is available to help optimise patient outcomes. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ERe63z
Management of postoperative pain in maxillofacial surgery
In this review we describe the evidence base for postoperative analgesia after maxillofacial surgery. We discuss the implications of poorly managed pain, risk factors for the development of severe pain, and pharmacological and non-pharmacological analgesic strategies to manage it. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ENUlJk
Simulation-based training in maxillofacial surgery: are we going to be left behind?
Simulation is an important way both to optimise a trainee 's learning time and reduce morbidity and operating time for patients. We have reviewed the current use of simulation in training for maxillofacial surgery, and provide an overview of areas of practice where it may be useful. A web-based survey of trainees' opinions of it was made in February 20 18, and disseminated using the Junior and Fellows in Training group mailing lists. We also reviewed popular current simulation courses that are available. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ES7Okr
Has TNM 8 had an effect on P16 staining & HPV-PCR Correlation in Head and Neck cancer staging, an 8 month review in Europe's largest pathology department
Introduction/Aims: Staging of Head and Neck Cancers (HNC), have moved on greatly since their first inclusion as "Buccal", "Pharynx" and "Larynx". The staging systems have evolved to incorporate Tumour Biology, Cancer Behaviour and the emergence of new stains of disease. The 8th Edition was introduced on the 1st of January 2018, with many centres including Glasgow phasing its introduction alongside TNM from October 2017. One of three new schema introduced includes HPV p16-mediated oropharyngeal carcinoma (OPC). (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EQqHmO
Melanotic Neuroectodermal Tumours of Infancy: lessons Learnt From Nine Cases
Introduction: Melanotic Neuroectodermal Tumours of Infancy (MNTI) are particularly rare and although predominantly benign in nature, behave in an aggressive and locally infiltrative manner. Presenting most often in the first year of life and with surgical resection the accepted management, prompt diagnosis and treatment are critical in reducing morbidity in the early stages of each child's development. Here we aim to illustrate the lessons we have learnt from managing these tumours at Great Ormond Street Hospital (GOSH). (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ERe8bH
Comparison of Three Internal Fixation Techniques in Mandibular Sagittal Split Osteotomy, A Finite Element Analysis
The aim of this study was to analyse and compare the biomechanical properties of 3 internal fixation techniques (2.0mm bi-cortical screws, 2.0mm miniplate and 1.7mm miniplate) in mandibular sagittal split osteotomy (SSO). A 3-D hemi-mandible model was developed from a patient's skull CT. It underwent sagittal split osteotomy (SSO) virtually and was reproduced 9 models consisting of the 3 fixation techniques with mandibular movements of 3mm setback, 3mm advancement, and 7mm advancement. Bite forces applied were 50, 75, and 100N for the incisors, and 100, 200 and 300N for the molars. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EUrlQ6
Penetrating Maxillofacial Trauma – epidemiology and injury characteristics in terror-related violence, interpersonal violence and deliberate self-harm at a Level 1 Trauma Centre
Introduction: Penetrating trauma to the head and neck presents specific diagnostic and therapeutic challenges. Aetiologies includes interpersonal violence (IPV), deliberate self-harm (DSH) and terror-related violence (TRV). Data from a Major Trauma Centre which straddles the two boroughs with the highest incidence of violent knife crime in the country will be presented, including data of victims of a major terrorist attack in 2017. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ETGgei
A 5 year review of extended (abdominal and chest) staging scan findings for head and neck cancer patients in NHS Lanarkshire
Introduction: Radiological staging of head and neck (H&N) cancer patients is essential to direct clinical management. Extended cross-sectional imaging facilitates pre-operative planning and acts as prognostic factor. The extension of head and neck staging scan below the neck region may provide extra information. We aimed to identify the incidence of findings below the neck, in an extended field. The significance of these were to be analyzed. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ERnqDG
Rural and urban differences in orthoganthic surgery patients in the North East of Scotland
Introduction: Rural and urban differences in presentation of patients with cancer have been demonstrated at our centre, but have not yet been demonstrated in orthognathic surgery patients. We hypothesised that patients from areas further from our hospital face higher costs to attend, and may not present with minor problems as often as patients who live close to the hospital. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ETjSlq
Withdrawn 31/05/2018
(Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EOsUiO
Sentinel node biopsy for oral cancer – from guideline to reality. A review of UK training
Introduction: In January 2016, the National Institute of Health and Care Excellence (NICE) recommended that patients with cT1-T2 N0 oral cancer not requiring reconstruction should be offered sentinel node biopsy (SNB). At that time three units in the UK were routinely offering SNB. With this in mind a national training program was created to facilitate quality assured training for head and neck units nationwide. This review appraises the process and progress of training in the UK. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EVBahy
Educational profile and qualifications of non-surgical aesthetic trainers
The aesthetics industry is booming, with the increased social acceptance of having non-surgical treatments undertaken and the more affordable costs in doing so. In all branches of medicine, clinicians are being pursued to attend courses to allow them to be part of this sub-specialist area injecting neurotoxins and other materials on a non-permanent basis. Whilst, a form of regulation is being promoted via the RCS England aesthetics accreditation scheme, this remains a poorly governed area of practice, and those providing the training are also currently unregulated. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ESzN2j
5-year follow-up of older patients undergoing orthognathic surgery- The East Grinstead experience
Introduction: In the last decade, there has been a growing number of older patients (above 35) undergoing orthognathic surgery. Previous studies have looked at the complication rates related to orthognathic surgery in older patients and compared outcomes with a younger cohort. We aimed to look at the satisfaction of older patients undergoing orthognathic surgery at their 5-year follow-up. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ETq64v
Workforce planning in OMFS and the importance of the dentistry programme for medical graduates at King's College London to higher recruitment training
Background: King's College London (KCL) offers the only three-year dental-programme for medical graduates within Europe. It produces a significant proportion ofST3 applicants for OMFS training. Now in its tenth year, we have conducted a retrospective study looking at various parameters. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EQq9NM
Additional benefits of Virtual Planning in Orthognathic Surgery
Introduction: The role of virtual planning in orthognathic surgery is well documented. We aim to highlight what further information is available to help optimise patient outcomes. (Source: The British Journal of Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ERe63z
GUNA-ALLERGY T (Ammonium Carbonate - Apis Mellifera - Arsenic Trioxide - Blatta Orientalis - Cupric Acetate - Drimia Maritima Bulb - Epinephrine - Galphimia Glauca Flowering Top - Histamine Dihydrochloride - Luffa Operculata - Manganese Gluconate - Onion - Schoenocaulon Officinale Seed - Sodium Chloride - Sus Scrofa Adrenal Gland - Sus Scrofa Bronchus - Sus Scrofa Nasal Mucosa -) Solution/ Drops [Guna Spa]
Updated Date: Dec 26, 2018 EST (Source: DailyMed Drug Label Updates)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GG1PAM
GUNA-ALLERGY T (Ammonium Carbonate - Apis Mellifera - Arsenic Trioxide - Blatta Orientalis - Cupric Acetate - Drimia Maritima Bulb - Epinephrine - Galphimia Glauca Flowering Top - Histamine Dihydrochloride - Luffa Operculata - Manganese Gluconate - Onion - Schoenocaulon Officinale Seed - Sodium Chloride - Sus Scrofa Adrenal Gland - Sus Scrofa Bronchus - Sus Scrofa Nasal Mucosa -) Solution/ Drops [Guna Spa]
Updated Date: Dec 26, 2018 EST (Source: DailyMed Drug Label Updates)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GG1PAM
Pediatric Asthma Risk Score Has Good Sensitivity, Specificity
PARS has improved ability over API for predicting asthma in children with mild - to - moderate risk (Source: Pulmonary Medicine News - Doctors Lounge)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EPX6uN
Pediatric Asthma Risk Score Has Good Sensitivity, Specificity
PARS has improved ability over API for predicting asthma in children with mild - to - moderate risk (Source: Pulmonary Medicine News - Doctors Lounge)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EPX6uN
Infarct Volume Predicts Hospitalization Costs in Anterior Circulation Large-Vessel Occlusion Stroke [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Anterior circulation large-vessel occlusion stroke, one of the most devastating stroke subtypes, is associated with substantial economic burden. We aimed to identify predictors of increased acute care hospitalization costs associated with anterior circulation large-vessel occlusion stroke.
MATERIALS AND METHODS:Comprehensive cost-tracking software was used to calculate acute care hospitalization costs for patients with anterior circulation large-vessel occlusion stroke admitted July 2012 to October 2014. Patient demographics and stroke characteristics were analyzed, including final infarct volume on follow-up neuroimaging. Predictors of hospitalization costs were determined using multivariable linear regression including subgroup cost analyses by treatment technique (endovascular, IV tPA-only, and no reperfusion therapy) and sensitivity analyses incorporating patients initially excluded due to early withdrawal of care.
RESULTS:Three hundred forty-one patients (median age, 69 years; interquartile range, 57–80 years; median NIHSS score, 16; interquartile range, 13–21) were included in our primary analysis. Final infarct volume, parenchymal hematoma, baseline NIHSS score, ipsilateral carotid stenosis, age, and obstructive sleep apnea were significant predictors of acute care hospitalization costs. Final infarct volume alone accounted for 20.87% of the total cost variance. Additionally, final infarct volume was consistently the strongest predictor of increased cost in primary, subgroup, and sensitivity analyses.
CONCLUSIONS:Final infarct volume was the strongest predictor of increased hospitalization costs in anterior circulation large-vessel occlusion stroke. Acute stroke therapies that reduce final infarct volume may not only improve clinical outcomes but may also prove cost-effective.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Sqcn8r
High-Definition Zoom Mode, a High-Resolution X-Ray Microscope for Neurointerventional Treatment Procedures: A Blinded-Rater Clinical-Utility Study [INTERVENTIONAL]
BACKGROUND AND PURPOSE:
Quality of visualization of treatment devices during critical stages of endovascular interventions, can directly impact their safety and efficacy. Our aim was to compare the visualization of neurointerventional procedures and treatment devices using a 194-μm pixel flat panel detector mode and a 76-μm pixel complementary metal oxide semiconductor detector mode (high definition) of a new-generation x-ray detector system using a blinded-rater study.
MATERIALS AND METHODS:Deployment of flow-diversion devices for the treatment of internal carotid artery aneurysms was performed under flat panel detector and high-definition-mode image guidance in a neurointerventional phantom simulating patient cranium and tissue attenuation, embedded with 3D-printed intracranial vascular models, each with an aneurysm in the ICA segment. Image-sequence pairs of device deployments for each detector mode, under similar exposure and FOV conditions, were evaluated by 2 blinded experienced neurointerventionalists who independently selected their preferred image on the basis of visualization of anatomic features, image noise, and treatment device. They rated their selection as either similar, better, much better, or substantially better than the other choice. Inter- and intrarater agreement was calculated and categorized as poor, moderate, and good.
RESULTS:Both raters demonstrating good inter- and intrarater agreement selected high-definition-mode images with a frequency of at least 95% each and, on average, rated the high-definition images as much better than flat panel detector images with a frequency of 73% from a total of 60 image pairs.
CONCLUSIONS:Due to their higher resolution, high-definition-mode images are sharper and visually preferred compared with the flat panel detector images. The improved imaging provided by the high-definition mode can potentially provide an advantage during neurointerventional procedures.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Alx5iX
Reliability of MR Imaging-Based Posterior Fossa and Brain Stem Measurements in Open Spinal Dysraphism in the Era of Fetal Surgery [SPINE]
BACKGROUND AND PURPOSE:
Fetal MR imaging is part of the comprehensive prenatal assessment of fetuses with open spinal dysraphism. We aimed to assess the reliability of brain stem and posterior fossa measurements; use the reliable measurements to characterize fetuses with open spinal dysraphism versus what can be observed in healthy age-matched controls; and document changes in those within 1 week after prenatal repair.
MATERIALS AND METHODS:Retrospective evaluation of 349 MR imaging examinations took place, including 274 in controls and 52 in fetuses with open spinal dysraphism, of whom 23 underwent prenatal repair and had additional early postoperative MR images. We evaluated measurements of the brain stem and the posterior fossa and the ventricular width in all populations for their reliability and differences between the groups.
RESULTS:The transverse cerebellar diameter, cerebellar herniation level, clivus-supraocciput angle, transverse diameter of the posterior fossa, posterior fossa area, and ventricular width showed an acceptable intra- and interobserver reliability (intraclass correlation coefficient > 0.5). In fetuses with open spinal dysraphism, these measurements were significantly different from those of healthy fetuses (all with P < .0001). Furthermore, they also changed significantly (P value range = .01 to < .0001) within 1 week after the fetal operation with an evolution toward normal, most evident for the clivus-supraocciput angle (65.9 ± 12.5°; 76.6 ± 10.9; P < .0001) and cerebellar herniation level (–9.9 ± 4.2 mm; –0.7 ± 5.2; P < .0001).
CONCLUSIONS:In fetuses with open spinal dysraphism, brain stem measurements varied substantially between observers. However, measurements characterizing the posterior fossa could be reliably assessed and were significantly different from normal. Following a fetal operation, these deviations from normal values changed significantly within 1 week.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SqF8Ce
What Causes Deep Gray Matter Atrophy in Multiple Sclerosis? [COMMENTARIES]
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2AlwXjt
Effect of Gadolinium on the Estimation of Myelin and Brain Tissue Volumes Based on Quantitative Synthetic MRI [ADULT BRAIN]
BACKGROUND AND PURPOSE:
The effect of gadolinium on the estimation of myelin has not been reported. The aim of the current study was to investigate the effects of gadolinium on automatic myelin and brain tissue volumetry via quantitative synthetic MR imaging.
MATERIALS AND METHODS:The study included 36 patients who were referred for brain metastases screening, and quantitative synthetic MR imaging data before and after gadolinium-based contrast agent administration were analyzed retrospectively. Brain metastases were detected in 17 patients. WM volume, GM volume, CSF volume, non-WM/GM/CSF volume, myelin volume, brain parenchymal volume, myelin fraction (myelin volume/brain parenchymal volume), and intracranial volume were estimated. T1 and T2 relaxation times, proton density, and myelin partial volume per voxel averaged across the brain parenchyma were also analyzed.
RESULTS:In patients with and without metastases after gadolinium-based contrast agent administration, measurements of WM and myelin volumes, and myelin fraction were significantly increased (+26.65 and +29.42 mL, +10.14 and +12.46 mL, +0.88% and +1.09%, respectively), whereas measurements of GM, CSF, brain parenchymal, and intracranial volumes were significantly decreased (–36.23 and –34.49 mL, –20.77 and –18.94 mL, –6.76 and –2.84 mL, –27.41 and –21.84 mL, respectively). Non-WM/GM/CSF volume did not show a significant change. T1, T2, and proton density were significantly decreased (–51.34 and –46.84 ms, –2.67 and –4.70 ms, –1.05%, and –1.28%, respectively) after gadolinium-based contrast agent administration, whereas measurements of myelin partial volume were significantly increased (+0.78% and +0.75%, respectively).
CONCLUSIONS:Gadolinium had a significant effect on the automatic calculation of myelin and brain tissue volumes using quantitative synthetic MR imaging, which can be explained by decreases in T1, T2, and proton density.
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A Call to Improve the Visibility and Access of the American College of Radiology Practice Parameters in Neuroradiology: A Powerful Value Stream Enhancer for Both Neuroradiologists and Patients [PRACTICE PERSPECTIVES]
SUMMARY:
Clinical practice guidelines and clinical practice parameters are among the tools that clinicians and radiologists use to inform decision making in the diagnosis and treatment of patients. Radiologists have been urged to objectively establish their value and measurable contributions to patient care. Radiology's contribution to the health care value stream can be established in the development of sound clinical practice guidelines. Neuroradiologists have been quite active in developing clinical guidelines, particularly in collaboration with the American College of Radiology, but there is a need to increase the visibility and accessibility of such documents. Increasing access and visibility can contribute to improved patient outcomes and an improved overall quality of care.
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Infarct Volume Predicts Hospitalization Costs in Anterior Circulation Large-Vessel Occlusion Stroke [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Anterior circulation large-vessel occlusion stroke, one of the most devastating stroke subtypes, is associated with substantial economic burden. We aimed to identify predictors of increased acute care hospitalization costs associated with anterior circulation large-vessel occlusion stroke.
MATERIALS AND METHODS:Comprehensive cost-tracking software was used to calculate acute care hospitalization costs for patients with anterior circulation large-vessel occlusion stroke admitted July 2012 to October 2014. Patient demographics and stroke characteristics were analyzed, including final infarct volume on follow-up neuroimaging. Predictors of hospitalization costs were determined using multivariable linear regression including subgroup cost analyses by treatment technique (endovascular, IV tPA-only, and no reperfusion therapy) and sensitivity analyses incorporating patients initially excluded due to early withdrawal of care.
RESULTS:Three hundred forty-one patients (median age, 69 years; interquartile range, 57–80 years; median NIHSS score, 16; interquartile range, 13–21) were included in our primary analysis. Final infarct volume, parenchymal hematoma, baseline NIHSS score, ipsilateral carotid stenosis, age, and obstructive sleep apnea were significant predictors of acute care hospitalization costs. Final infarct volume alone accounted for 20.87% of the total cost variance. Additionally, final infarct volume was consistently the strongest predictor of increased cost in primary, subgroup, and sensitivity analyses.
CONCLUSIONS:Final infarct volume was the strongest predictor of increased hospitalization costs in anterior circulation large-vessel occlusion stroke. Acute stroke therapies that reduce final infarct volume may not only improve clinical outcomes but may also prove cost-effective.
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High-Definition Zoom Mode, a High-Resolution X-Ray Microscope for Neurointerventional Treatment Procedures: A Blinded-Rater Clinical-Utility Study [INTERVENTIONAL]
BACKGROUND AND PURPOSE:
Quality of visualization of treatment devices during critical stages of endovascular interventions, can directly impact their safety and efficacy. Our aim was to compare the visualization of neurointerventional procedures and treatment devices using a 194-μm pixel flat panel detector mode and a 76-μm pixel complementary metal oxide semiconductor detector mode (high definition) of a new-generation x-ray detector system using a blinded-rater study.
MATERIALS AND METHODS:Deployment of flow-diversion devices for the treatment of internal carotid artery aneurysms was performed under flat panel detector and high-definition-mode image guidance in a neurointerventional phantom simulating patient cranium and tissue attenuation, embedded with 3D-printed intracranial vascular models, each with an aneurysm in the ICA segment. Image-sequence pairs of device deployments for each detector mode, under similar exposure and FOV conditions, were evaluated by 2 blinded experienced neurointerventionalists who independently selected their preferred image on the basis of visualization of anatomic features, image noise, and treatment device. They rated their selection as either similar, better, much better, or substantially better than the other choice. Inter- and intrarater agreement was calculated and categorized as poor, moderate, and good.
RESULTS:Both raters demonstrating good inter- and intrarater agreement selected high-definition-mode images with a frequency of at least 95% each and, on average, rated the high-definition images as much better than flat panel detector images with a frequency of 73% from a total of 60 image pairs.
CONCLUSIONS:Due to their higher resolution, high-definition-mode images are sharper and visually preferred compared with the flat panel detector images. The improved imaging provided by the high-definition mode can potentially provide an advantage during neurointerventional procedures.
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Reliability of MR Imaging-Based Posterior Fossa and Brain Stem Measurements in Open Spinal Dysraphism in the Era of Fetal Surgery [SPINE]
BACKGROUND AND PURPOSE:
Fetal MR imaging is part of the comprehensive prenatal assessment of fetuses with open spinal dysraphism. We aimed to assess the reliability of brain stem and posterior fossa measurements; use the reliable measurements to characterize fetuses with open spinal dysraphism versus what can be observed in healthy age-matched controls; and document changes in those within 1 week after prenatal repair.
MATERIALS AND METHODS:Retrospective evaluation of 349 MR imaging examinations took place, including 274 in controls and 52 in fetuses with open spinal dysraphism, of whom 23 underwent prenatal repair and had additional early postoperative MR images. We evaluated measurements of the brain stem and the posterior fossa and the ventricular width in all populations for their reliability and differences between the groups.
RESULTS:The transverse cerebellar diameter, cerebellar herniation level, clivus-supraocciput angle, transverse diameter of the posterior fossa, posterior fossa area, and ventricular width showed an acceptable intra- and interobserver reliability (intraclass correlation coefficient > 0.5). In fetuses with open spinal dysraphism, these measurements were significantly different from those of healthy fetuses (all with P < .0001). Furthermore, they also changed significantly (P value range = .01 to < .0001) within 1 week after the fetal operation with an evolution toward normal, most evident for the clivus-supraocciput angle (65.9 ± 12.5°; 76.6 ± 10.9; P < .0001) and cerebellar herniation level (–9.9 ± 4.2 mm; –0.7 ± 5.2; P < .0001).
CONCLUSIONS:In fetuses with open spinal dysraphism, brain stem measurements varied substantially between observers. However, measurements characterizing the posterior fossa could be reliably assessed and were significantly different from normal. Following a fetal operation, these deviations from normal values changed significantly within 1 week.
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What Causes Deep Gray Matter Atrophy in Multiple Sclerosis? [COMMENTARIES]
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Effect of Gadolinium on the Estimation of Myelin and Brain Tissue Volumes Based on Quantitative Synthetic MRI [ADULT BRAIN]
BACKGROUND AND PURPOSE:
The effect of gadolinium on the estimation of myelin has not been reported. The aim of the current study was to investigate the effects of gadolinium on automatic myelin and brain tissue volumetry via quantitative synthetic MR imaging.
MATERIALS AND METHODS:The study included 36 patients who were referred for brain metastases screening, and quantitative synthetic MR imaging data before and after gadolinium-based contrast agent administration were analyzed retrospectively. Brain metastases were detected in 17 patients. WM volume, GM volume, CSF volume, non-WM/GM/CSF volume, myelin volume, brain parenchymal volume, myelin fraction (myelin volume/brain parenchymal volume), and intracranial volume were estimated. T1 and T2 relaxation times, proton density, and myelin partial volume per voxel averaged across the brain parenchyma were also analyzed.
RESULTS:In patients with and without metastases after gadolinium-based contrast agent administration, measurements of WM and myelin volumes, and myelin fraction were significantly increased (+26.65 and +29.42 mL, +10.14 and +12.46 mL, +0.88% and +1.09%, respectively), whereas measurements of GM, CSF, brain parenchymal, and intracranial volumes were significantly decreased (–36.23 and –34.49 mL, –20.77 and –18.94 mL, –6.76 and –2.84 mL, –27.41 and –21.84 mL, respectively). Non-WM/GM/CSF volume did not show a significant change. T1, T2, and proton density were significantly decreased (–51.34 and –46.84 ms, –2.67 and –4.70 ms, –1.05%, and –1.28%, respectively) after gadolinium-based contrast agent administration, whereas measurements of myelin partial volume were significantly increased (+0.78% and +0.75%, respectively).
CONCLUSIONS:Gadolinium had a significant effect on the automatic calculation of myelin and brain tissue volumes using quantitative synthetic MR imaging, which can be explained by decreases in T1, T2, and proton density.
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A Call to Improve the Visibility and Access of the American College of Radiology Practice Parameters in Neuroradiology: A Powerful Value Stream Enhancer for Both Neuroradiologists and Patients [PRACTICE PERSPECTIVES]
SUMMARY:
Clinical practice guidelines and clinical practice parameters are among the tools that clinicians and radiologists use to inform decision making in the diagnosis and treatment of patients. Radiologists have been urged to objectively establish their value and measurable contributions to patient care. Radiology's contribution to the health care value stream can be established in the development of sound clinical practice guidelines. Neuroradiologists have been quite active in developing clinical guidelines, particularly in collaboration with the American College of Radiology, but there is a need to increase the visibility and accessibility of such documents. Increasing access and visibility can contribute to improved patient outcomes and an improved overall quality of care.
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El “complejo retentivo”: concepto de prótesis removible, cumple 30 años.
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Periodontal profile and oral hygiene status in pregnants at maternity hospital in the state of Goias, Brazil
ABSTRACT: Objective: The aim of this study was to assess the periodontal status of women during pregnancy attended in a maternity hospital, as well as their oral hygiene habits. Materials and Methods: The sample was composed by 100 pregnant women, ranging from their first to ninth month of pregnancy, were examined at a maternity hospital in Goiás, Brazil. They received information about oral hygiene techniques and they were submmited a periodontal examination in a dentist's office, where the Periodontal Screening and Recording (PSR) codes were verified along with bleeding on probing and tooth loss. Results: About their pregnancy period, the most (46%) were in their third trimester at the time of this study. The gingival index showed an average of 12% and 90% of the patients presented PSR Code 2. As for dental hygiene, 55% reported brushing three times a day and 48% used dental floss daily. Conclusion: The most pregnant women in the third trimester, showed a prevalence for gingivitis. They reported brushing their teeth three times a day and using dental floss daily.
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Evaluation of color change using CIE LAB coordinates on tooth structure subjected to different concentrations of peroxide carbamide
ABSTRACT: Aim: The aim of this study was to evaluate the optical behavior of tooth color using CIE L*A*B* space; the teeth were subjected to novel bleaching gels containing peroxide carbamide with potassium oxalate. Materials and Method: Three different carbamide peroxide gels were experimentally fabricated. They consisted of 10% (G10), 16% (G16) and 37% (G37) concentrations. Sixty recently extracted premolars were subjected to different bleaching protocols. Color change (ΔE) was assessed using the CIE L*a*b* system after the application of each gel. The data were analyzed using one-way ANOVA with Tukey's post hoc test (α=5%) and a t-test. Results: The G10 and G16 gels exhibited an increase in ΔE*ab parameters from T0 to T1 (T0: application day of the gels. T1: 14th day measurement); a small decrease from T1 to T2 was also noted (T2: control measurement, 28th day). However, no statistically significant differences were found (p=0,22 for G10 and p=0,10 for G16). The G37 gel also exhibited an increase in ΔE*ab parameters, with similar results after the first application of 45 min, the second application of 45 min, and the third application of 45 min (T1, T2 and T3, respectively. T4: control measurement, 14th day). No statistically significant differences were observed between the three times of application (p>0,69), and an appreciable difference was noted between times T3 and T4 (p=0,000). Conclusions: The presented formulations of peroxide carbamide at 10%, 16%, and 37% are clearly effective. The G10 and G16 gels exhibited better effectiveness than the G37 gel.
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Sobrevida de carcinoma oral de células escamosas: reporte de la Universidad de Chile.
RESUMEN: El carcinoma oral de células escamosas es la neoplasia maligna más frecuente en la cavidad oral. Sin embargo, los estudios sobre supervivencia general en pacientes con cáncer oral son escasos en Chile. Objetivo: Determinar las características sociodemográficas y la supervivencia general de pacientes diagnosticados con carcinoma en labio y cavidad oral en el Servicio de Anatomía Patológica de la Facultad de Odontología, Universidad de Chile. Material y métodos: Se seleccionaron los casos de carcinoma oral de células escamosas diagnosticados entre los años 2000-2012. Se incluyeron sólo los primeros diagnósticos y las recidivas fueron excluidas. Resultados: De 134 casos registrados, 120 cumplían los criterios de inclusión. El 60% correspondió a hombres (razón hombre-mujer 1,3:1) y la media de edad fue 63 años. La supervivencia general a dos años fue 48,3% y a cinco años 33,9% según estimación de Kaplan-Meier. Se detectó una mayor supervivencia en el grupo de pacientes que tenían menos de 55 años (p<0,05). 79,2% de los casos fallecidos registra como causa de muerte cáncer oral. Conclusiones: El mayor porcentaje de personas diagnosticadas fueron hombres y adultos mayores. La supervivencia general a cinco años fue menor a lo determinado en reportes nacionales previos. Los adultos de 55 años y mayores presentaron una menor supervivencia general.
ABSTRACT: Oral squamous cell carcinoma is the most common malignant neoplasm of oral cavity. Research about general survival rates in patients with oral cancer is limited in Chile. Objective: To determine the sociodemographic characteristics and general survival of patients diagnosed with lip and oral carcinoma in the Pathological Anatomy Service at the School of Dentistry, University of Chile. Material and methods: All cases of oral squamous cell carcinoma selected were diagnosed between the years 2000 and 2012. All cases included in this study corresponded to the first diagnosis and tumor recurrence was excluded. Results: The 134 registered cases, 120 were selected with inclusion criteria. 60% were men (male and female ratio of 1.3: 1) and median age 63 year-old. Overall survival at two years was 48.3% and at five years 33.9%, according to Kaplan-Meier estimate. A higher survival was detected in the group of patients younger than 55 years old (p <0.05). In 79.2% of dead patients, the cause of death was registered as oral cancer. Conclusions: The highest percentage of patients diagnosed was men and elders. Five-year survival was lower than previously reported in national reports. Adults aged 55 years and older had a lower overall survival.
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Criterios de selección de marca comercial de implantes dentales más usados por especialistas.
RESUMEN: Objetivo: Determinar los criterios de selección más usados al elegir una marca comercial de implantes dentales según odontólogos especialistas. Material y método: Se identificaron los parámetros para escoger una marca de implantes, estos se clasificaron en técnicos y mercadológicos, ordenándose en un cuestionario de tipo cerrado, valorándose por medio de escala psicométrica Likert del 1 al 5, además se incluyó una pregunta abierta. Se tomó una muestra por conveniencia de veinte odontólogos especialistas con experiencia al menos en tres marcas de implantes. Para el análisis estadístico descriptivo se usó Microsoft Excel 2011 versión para Mac, utilizando medidas de tendencia central como la Media Aritmética y Moda. Los parámetros técnicos se clasificaron de 1a hasta 1i, mercadológicos del 2a hasta el 2f y los sugeridos de p1 a p7. Resultados: La variabilidad en pilares de retención protésica, disponibilidad adecuada de los productos ofertados por la empresa y la compatibilidad de los aditamentos entre marcas comerciales, fueron los factores más relevantes considerados por especialistas a la hora de elegir un determinado sistema de implante. Conclusión: Las razones que más influyen en la elección de un sistema de implante son la variedad y disponibilidad de productos junto a la compatibilidad entre marcas.
ABSTRACT: Objective: The aim of this study is to determine the most used selection criteria when choosing a commercial brand of dental implant according to specialist. Material and methods: We identified the parameters to choose an implant brand, these were classified as technical and marketing, ordered in a closed questionnaire, assessed by means of a Likert psychometric scale from 1 to 5, plus an open question was included. A convenience sample of twenty specialists with experience in at least three implant brands. For the descriptive statistical analysis, Microsoft Excel 2011 version for Mac was used, using measures of central tendency such as Arithmetic Media and Fashion. For this same purpose, the technical parameters were classified from 1a to 1i, marketing parameters from 2a to 2f and suggested parameters from p1 to p7. Results: The variability in prosthetic retention pillars, adequate availability of the products offered by the company and the compatibility of the abutments between trademarks, were the most relevant factors considered by specialists when choosing a specific implant system. Conclusion: The arguments that most influence the choice of an implant system are variety and availability of products, as well as the compatibility between brands.
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Manifestaciones maxilofaciales en una familia chilena con adenomatosis poliposa familiar
RESUMEN: La Poliposis Adenomatosa Familiar (PAF) es un síndrome hereditario autosómico dominante causado por la mutación del gen APC. En su forma clásica se desarrollan más de 100 pólipos adenomatosos intestinales que progresan a cáncer colorrectal en casi el 100% de los casos no tratados. Dentro de las manifestaciones extracolónicas de PAF, se encuentran las maxilofaciales, como: osteomas y alteraciones dentales, que pueden preceder por años al desarrollo de poliposis colónica. A pesar de que en Chile hay estudios de PAF y cáncer de colon, son escasos los reportes de manifestaciones maxilofaciales en estos pacientes. En la familia en estudio se encontró manifestaciones descritas previamente como: odontoma, osteomas y malformaciones de incisivos; adicionalmente tags mucosos que no se han asociado previamente al síndrome.
ABSTRACT: Familial adenomatous polyposis (FAP) is an autosomal dominant hereditary syndrome caused by the mutation of the APC gene. In its classic form, more than 100 intestinal adenomatous polyps progress to colorectal cancer in almost 100% of cases if they are not treated. Within the extracolonic manifestations of FAP are the maxillofacial, such as: osteomas and dental alterations, which may precede the development of colonic polyposis. Although studies of colonic adenomatous polyposis and colon cancer exist in Chile, there are few reports of maxillofacial manifestations in these patients. In the family under study, previously described manifestations were found, such as: odontoma, osteomas and dental malformations; mucosal tags were also observed, with no previous association with the syndrom.
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Prevalencia de signos y síntomas de trastornos temporomandibulares previo a tratamiento de ortodoncia en una población de Santiago, Chile.
RESUMEN: Objetivo: El objetivo de este estudio fue establecer la prevalencia de signos y síntomas de trastornos temporomandibulares (TTM) en pacientes con maloclusión. Materiales y métodos: Estudio transversal descriptivo. Se revisaron de forma manual 951 fichas clínicas de pacientes ingresados en el Postítulo de Ortodoncia de la Facultad de Odontología de Universidad de Chile (FOUCH) entre los años 2013 y 2015. Se utilizaron los programas Excel 2013, Stata v. 12 y para la comparación entre grupos etarios se utilizó la prueba estadística de Kruskall Wallis. Resultados: Del total de pacientes con maloclusión, el 43,9% presentaron al menos un signo o síntoma de TTM, siendo la desviación mandibular el signo más prevalente con un 43,2%, seguido por el ruido articular con un 12,6%. El dolor fue el síntoma menos prevalente con un 2%. Los adultos fueron los que presentaron mayor prevalencia de signos y síntomas de TTM. No hubo diferencia estadística entre géneros. Conclusión: Debido a que los signos y síntomas de TTM son una condición tan común en pacientes con maloclusión, es necesaria la evaluación de la ATM siempre que se piense en iniciar un tratamiento ortodóncico, para así establecer un adecuado plan de tratamiento.
ABSTRACT: Objective: The aim of this study was to establish the prevalence of signs and symptoms of temporomandibular disorders (TMD) in patients with malocclusion. Materials and methods: Cross-sectional descriptive study. A total of 951 clinical records were reviewed, of patients admitted in the Postgraduate Program of Orthodontia from the Faculty of Dentistry of the University of Chile, between the years 2013 and 2015. The programs Excel 2013 and Stata v. 12 were used, and for the comparison between the age groups the statistical test of Kruskall Wallis was used. Results: Of the total number of patients with malocclusion, 43.85% had at least one sign or symptom of TMD, being the mandibular deviation the most prevalent sign with 43.22%, followed by joint noise with 12.62%. Pain was the least prevalent symptom with 2%. The adults group had the most prevalence of signs and symptoms of TMD. There was no statistical difference between genders. Conclusion: Since TMD signs and symptoms are such a common condition in patients with malocclusion, the assessment of TMJ is necessary to consider when planning an orthodontic treatment, to establish an adequate treatment plan.
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Características esqueletales para la determinación cualitativa del biotipo facial en telerradiografía lateral: Estudio Piloto.
RESUMEN: Objetivo: Determinar parámetros visuales sencillos para la evaluación de características esqueletales relacionadas con el biotipo facial en una telerradiografía lateral. Material y método: Estudio transversal descriptivo. Se confeccionó una guía visual impresa acerca de ocho características morfológicas del esqueleto facial visibles en la telerradiografía de perfil. Ésta fue entregada a un grupo de 69 estudiantes de Odontología de 5º año sin estudios previos en cefalometría, quienes la analizaron durante 10 minutos. Inmediatamente se les mostraron una serie de telerradiografías, y se les pidió que evaluaran las 8 características a través de una serie de opciones presentadas en una escala visual que se correspondía con la guía estudiada. Las respuestas fueron registradas utilizando un sistema digital de cliqueras. Los datos fueron analizados con el método Rasch para determinar la dificultad de los ítems, estableciéndose el grado de dificultad a través del Logit. Resultados: Los estudiantes lograron identificar y graduar sin dificultad 5 de las 8 características presentadas. Éstas fueron: Proyección del mentón (-2,49), Divergencia facial (-2,85), Ancho de la rama mandibular (-1,97), Escotadura sigmoidea (-0,96) y Relación de la rama con el cuerpo mandibular (-0,06). Conclusión: Se determinó que hay 5 características de la morfología ósea facial relacionadas con el biotipo que se pueden identificar y graduar sin dificultad por estudiantes de pregrado de odontología. Ésta información podría ser utilizada para construir una escala sencilla de identificación del biotipo facial.
ABSTRACT: Aim: Determine simple visual parameters to evaluate skeletal characteristics related to facial types in lateral teleradiographs. Materials and Methods: Descriptive cross-sectional study. A printed visual guideline about the eight visible morphological characteristics of the facial skeleton in cephalometric x-rays was created. The guideline was given to 69 undergraduate dental students (fifth year) without previous studies in cephalometric to analyze it for 10 minutes. Immediately after, they were shown a series of teleradiographs and were asked to evaluate 8 characteristics through a series of options presented in a visual scale according to the guideline. The answers were recorded through a digital audience response system (clickers). The data obtained were analyzed with the Rasch method to assess each item level of difficulty, establishing the Logit number for each one. Results: The students identified and graded without difficulty 5 of the 8 characteristics. These were: Chin projection (-2.49), Facial divergence (-2.85), Mandibular ramus width (-1.97), Sigmoid notch (-0.96) and Mandibular body with ramus relationship (-0.06). Conclusions: Five facial osseous morphological characteristics related to the facial types can be identified and graded without difficulty by undergraduate dental students. This information may be used to create a facial type identification scale.
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Immediate rehabilitation of the aesthetic area in infected alveolar with rpf. 24-month follow-up.
ABSTRACT: Aim: This study aimed to report the clinical case of an immediate implant-supported rehabilitation in infected alveolar socket with buccal bone resorption and apical periodontitis in the teeth 42 and 43. Case Report: The patient was rehabilitated with implants associated with guided bone regeneration and immediate provisionalization. After 4 months, the custom molding was made in order to receive the metal-ceramic prosthesis. The follow-up lasted 24 months and there was no painful symptomatology, infection, implant mobility or marked peri-implant bone loss in this period. Conclusion: Therefore, the placement of immediate implants on fresh infected alveolar sockets is viable for the implant-supported rehabilitation.
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Alargamiento de corona estético previo a rehabilitación protésica. Informe de caso
RESUMEN: Introducción: Uno de los procedimientos realizados con mayor frecuencia para el restablecimiento de la estética en la zona anterosuperior es el alargamiento de corona, el cual está indicado ante la presencia de una longitud insuficiente de la corona clínica de un diente, cuando existe caries o fracturas subgingivales y para la mejora de la estética en pacientes con margen gingival desigual. Objetivo: El objetivo de este artículo es presentar el alargamiento de corona estético realizado en una paciente que presentaba márgenes discrepantes y pérdida de las papilas en la zona anterosuperior, la cual fue remitida del área de prótesis para poder realizar posterior rehabilitación protésica. Resultados: Mediante el procedimiento quirúrgico se logró la corrección y restablecimiento de los márgenes gingivales. Conclusiones: La zona anterosuperior es el área estéticamente más comprometida, por lo que es indispensable la planeación interdisciplinaria del tratamiento para asegurar el éxito del mismo.
ABSTRACT: Introduction: One of the most frequently performed procedures for aesthetics restoration in the maxillary anterior area is the crown lengthening, which is indicated in the presence of an insufficient length of the clinical crown of a tooth, of cavities or subgingival fractures and for the improvement of aesthetics in patients with uneven gingival margin. Objective: The aim of this article is to present the aesthetic crown lengthening performed in a patient with discrepant margins and loss of the papillae in the maxillary anterior area, referred from the prosthesis department for subsequent prosthetic rehabilitation. Results: Through the surgical procedure, the correction and restoration of the gingival margins were achieved. Conclusions: The maxillary anterior area is the most aesthetically compromised area, which is why the interdisciplinary planning of the treatment is essential to ensure its success.
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Relación entre apiñamiento dentario y terceros molares
RESUMEN: Introducción: La relación entre terceros molares y el desarrollo o reincidencia de maloclusión y apiñamiento dental tras el tratamiento de ortodoncia, especialmente en el segmento anterior del arco dental, es un tema que ha sido discutido y presentado en la literatura, el cual aún permanece sin resolver. Métodos: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, preparamos tablas de resumen de los resultados utilizando el método GRADE. Resultados: Identificamos 7 revisiones sistemáticas que en conjunto incluyen 31 estudios primarios, de los cuales, 2 son ensayos aleatorizados. Conclusiones: El limitado desarrollo de estudios que relacionan los terceros molares con apiñamiento dental y el bajo nivel de evidencia de éstos no permiten tener claridad respecto a la posible asociación. Son necesarios nuevos estudios sobre el tema.
ABSTRACT: Introduction: The relationship between third molars and the development or recurrence of malocclusion and dental crowding after orthodontic treatment, especially in the anterior segment of the dental arch, is a subject that has been discussed and presented in the literature, which still remains unsolved. Methods: To answer this question we used Epistemonikos, the largest database of systematic health reviews, which combines searches in multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We extracted the data from the identified reviews, reanalyzed them from the primary studies and prepared summary tables of the results using the GRADE method. Results: We identified 7 systematic reviews that together included 31 primary studies, 2 of which were randomized trials. Conclusion: The limited development of studies that relate third molars to dental crowding and their low level of evidence does not allow us to be certain about the possible association. New studies are necessary.
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Uso de dentífricos y colutorios para el control de la hipersensibilidad dentinaria en adultos: una revisión narrativa.
RESUMEN: Objetivo: Describir la efectividad del uso de los distintos agentes desensibilizantes contenidos en dentífricos y colutorios para el control de la hipersensibilidad dentinaria en adultos. Método: Se realizó una búsqueda electrónica de la evidencia científica en las bases de datos PubMed, Epistemónikos, EBSCO, BEIC y Cochrane Library; utilizando una estrategia de búsqueda que incluye las palabras clave. Para cada artículo encontrado se analizó el nivel y calidad de evidencia, riesgo de sesgo y ética. Resultados: En total 36 artículos fueron incluidos, 29 ensayos clínicos controlados aleatorizados y 7 revisiones sistemáticas. De los ensayos clínicos encontrados, cinco probaron la eficacia de colutorios, dos realizaron una comparación con dentífricos y colutorios y 22 evaluaron sólo el uso de dentífricos. Los agentes desensibilizantes testeados principalmente encontrados fueron sales de potasio, arginina, nano-hidroxiapatita, fosfosilicato de calcio y sodio (CSFS) y sales de estroncio. Sólo los primeros dos agentes fueron evaluados en presentación dentífrico y colutorio. Todos los ensayos clínicos demostraron reducir la hipersensibilidad dentinaria con alguno de los agentes utilizados en comparación a la medición inicial. Conclusión: Se podría recomendar el uso de nitrato y citrato de potasio, arginina, fosfosilicato de calcio y sodio y nano-hidroxiapatita en dentífricos para el tratamiento de la hipersensibilidad.
ABSTRACT: Objectives: Describe the effectiveness of the use of different desensitizing agents contained in dentifrices and mouthwashes for the control of dentin hypersensitivity in adults. Method: An electronic search of the scientific evidence available was made in PubMed, Epistemónikos, EBSCO, BEIC and Cochrane Library; using a search strategy that included the key words. For each article found the level and quality of evidence, risk of bias and ethics were analyzed. Results: A total of 36 articles were included, 29 randomized controlled clinical trials and 7 systematic reviews. Of the clinical trials, five tested the efficacy of mouthwashes, two made a comparison using dentifrices and mouthwashes and 22 tested only the use of dentifrices. The desensitizing agents mainly found were potassium salts, arginine, nano-hydroxiapatite, calcium sodium phosphosilicate (CSPS) and strontium salts. Only the first two were tested in both presentations. All the clinical trials demonstrated a reduction in dentin hypersensitivity with the use of an agent in comparison to the initial measurement. Conclusions: The use of nitrate and citrate potassium, arginine, calcium sodium phosphosilicate and nano-hydroxyapatite in dentifrices for the treatment of hypersensitivity may be recommended.
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Revisiones Sistemáticas: definición y nociones básicas
RESUMEN: El desarrollo de la Odontología Basada en Evidencia ha generado la necesidad constante de actualización e información por parte de los profesionales(1). Ante esto, los artículos actualizados que sintetizan información y poseen altos estándares, son las mejores fuentes de evidencia, siendo para ello las revisiones sistemáticas las mejores herramientas(2). Éstas, corresponden a resúmenes claros y estructurados de la información disponible orientada a responder una pregunta clínica específica(3). Poseen un proceso de elaboración estructurado que comienza con el planteamiento de una pregunta clínica específica, con los cuales se realizará la búsqueda en las bases de datos. Una vez obtenida la información se deben seleccionar los artículos y, a partir de los seleccionados, se obtendrán los datos y se realizarán los análisis críticos y estadísticos de la información, finalmente exponiendo los resultados del trabajo.
ABSTRACT: The development of Evidence Based Dentistry has generated the constant need for updating and information from professionals (1). Given this, updated articles synthesizing information and with high standards are the best sources of evidence, being systematic reviews the best tools (2). Systematic reviews are clear and structured summaries of the available information aimed at answering a specific clinical question(3). They have a structured elaboration process that begins with the presentation of a specific clinical question, which will be used for the search in the databases. Once the information has been obtained, the articles must be selected and, starting from the selected ones, the data will be obtained and the critical and statistical analysis of the information will be carried out. Finally, the results of the work will be exposed.
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Sinopsis de la Situación de Salud Oral en Chile - Parte I: Garantías Explícitas y Guías Clínicas.
RESUMEN: El presente artículo realiza una breve revisión y síntesis sobre las Garantías Explícitas en Salud Bucal vigentes en Chile y las Guías de Práctica Clínica asociadas a su ejercicio. Se muestra una breve cronología de la reforma de salud de la cual se originan, describiendo sus principales pilares de desarrollo. Esta actualización tiene como objetivo orientar a los profesionales odontólogos de los Servicios de Salud, Sociedades Científicas, Universidades y entidades públicas y privadas que desarrollan la práctica odontológica en Chile, en el conocimiento del material existente, validado y disponible a la fecha.
ABSTRACT This article makes a brief review and synthesis of the Explicit Guarantees in Oral Health in force in Chile and the Clinical Practice Guidelines associated with their practice. It shows a brief chronology of the health reform from which they originate, describing their main pillars of development. The purpose of this update is to guide the dental professionals of the Health Services, Scientific Societies, Universities and public and private services that develop the dental practice in Chile, with the knowledge of the existing material, validated and available to date.
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El “complejo retentivo”: concepto de prótesis removible, cumple 30 años.
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Periodontal profile and oral hygiene status in pregnants at maternity hospital in the state of Goias, Brazil
ABSTRACT: Objective: The aim of this study was to assess the periodontal status of women during pregnancy attended in a maternity hospital, as well as their oral hygiene habits. Materials and Methods: The sample was composed by 100 pregnant women, ranging from their first to ninth month of pregnancy, were examined at a maternity hospital in Goiás, Brazil. They received information about oral hygiene techniques and they were submmited a periodontal examination in a dentist's office, where the Periodontal Screening and Recording (PSR) codes were verified along with bleeding on probing and tooth loss. Results: About their pregnancy period, the most (46%) were in their third trimester at the time of this study. The gingival index showed an average of 12% and 90% of the patients presented PSR Code 2. As for dental hygiene, 55% reported brushing three times a day and 48% used dental floss daily. Conclusion: The most pregnant women in the third trimester, showed a prevalence for gingivitis. They reported brushing their teeth three times a day and using dental floss daily.
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Evaluation of color change using CIE LAB coordinates on tooth structure subjected to different concentrations of peroxide carbamide
ABSTRACT: Aim: The aim of this study was to evaluate the optical behavior of tooth color using CIE L*A*B* space; the teeth were subjected to novel bleaching gels containing peroxide carbamide with potassium oxalate. Materials and Method: Three different carbamide peroxide gels were experimentally fabricated. They consisted of 10% (G10), 16% (G16) and 37% (G37) concentrations. Sixty recently extracted premolars were subjected to different bleaching protocols. Color change (ΔE) was assessed using the CIE L*a*b* system after the application of each gel. The data were analyzed using one-way ANOVA with Tukey's post hoc test (α=5%) and a t-test. Results: The G10 and G16 gels exhibited an increase in ΔE*ab parameters from T0 to T1 (T0: application day of the gels. T1: 14th day measurement); a small decrease from T1 to T2 was also noted (T2: control measurement, 28th day). However, no statistically significant differences were found (p=0,22 for G10 and p=0,10 for G16). The G37 gel also exhibited an increase in ΔE*ab parameters, with similar results after the first application of 45 min, the second application of 45 min, and the third application of 45 min (T1, T2 and T3, respectively. T4: control measurement, 14th day). No statistically significant differences were observed between the three times of application (p>0,69), and an appreciable difference was noted between times T3 and T4 (p=0,000). Conclusions: The presented formulations of peroxide carbamide at 10%, 16%, and 37% are clearly effective. The G10 and G16 gels exhibited better effectiveness than the G37 gel.
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Sobrevida de carcinoma oral de células escamosas: reporte de la Universidad de Chile.
RESUMEN: El carcinoma oral de células escamosas es la neoplasia maligna más frecuente en la cavidad oral. Sin embargo, los estudios sobre supervivencia general en pacientes con cáncer oral son escasos en Chile. Objetivo: Determinar las características sociodemográficas y la supervivencia general de pacientes diagnosticados con carcinoma en labio y cavidad oral en el Servicio de Anatomía Patológica de la Facultad de Odontología, Universidad de Chile. Material y métodos: Se seleccionaron los casos de carcinoma oral de células escamosas diagnosticados entre los años 2000-2012. Se incluyeron sólo los primeros diagnósticos y las recidivas fueron excluidas. Resultados: De 134 casos registrados, 120 cumplían los criterios de inclusión. El 60% correspondió a hombres (razón hombre-mujer 1,3:1) y la media de edad fue 63 años. La supervivencia general a dos años fue 48,3% y a cinco años 33,9% según estimación de Kaplan-Meier. Se detectó una mayor supervivencia en el grupo de pacientes que tenían menos de 55 años (p<0,05). 79,2% de los casos fallecidos registra como causa de muerte cáncer oral. Conclusiones: El mayor porcentaje de personas diagnosticadas fueron hombres y adultos mayores. La supervivencia general a cinco años fue menor a lo determinado en reportes nacionales previos. Los adultos de 55 años y mayores presentaron una menor supervivencia general.
ABSTRACT: Oral squamous cell carcinoma is the most common malignant neoplasm of oral cavity. Research about general survival rates in patients with oral cancer is limited in Chile. Objective: To determine the sociodemographic characteristics and general survival of patients diagnosed with lip and oral carcinoma in the Pathological Anatomy Service at the School of Dentistry, University of Chile. Material and methods: All cases of oral squamous cell carcinoma selected were diagnosed between the years 2000 and 2012. All cases included in this study corresponded to the first diagnosis and tumor recurrence was excluded. Results: The 134 registered cases, 120 were selected with inclusion criteria. 60% were men (male and female ratio of 1.3: 1) and median age 63 year-old. Overall survival at two years was 48.3% and at five years 33.9%, according to Kaplan-Meier estimate. A higher survival was detected in the group of patients younger than 55 years old (p <0.05). In 79.2% of dead patients, the cause of death was registered as oral cancer. Conclusions: The highest percentage of patients diagnosed was men and elders. Five-year survival was lower than previously reported in national reports. Adults aged 55 years and older had a lower overall survival.
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