Case Report and Review of Literature: Late Retrograde Type A Aortic Dissection With Rupture after Repair of Type B Aortic Dissection with a GORE TAG Endovascular Prosthesis

Acute aortic dissection is the most common catastrophic condition of the aorta. Treatment options include open surgery and thoracic endovascular aortic reconstruction (TEVAR). We present a late Type A dissection as a complication of the management of descending aortic dissections with TEVAR and a review of the literature. TEVAR of the thoracic aorta is a viable treatment option for the management of complicated descending thoracic aortic dissections. Careful patient selection is necessary as medical therapy successfully treats the majority of uncomplicated Type B dissections. TEVAR should be reserved for patients with complicated Type B dissections or those who fail nonoperative management. Close postoperative monitoring is necessary when TEVAR is performed and should be accompanied by lifelong surveillance. A high level of suspicion is important to identify retrograde Type A dissections in these patients given its rarity and the ambiguity of its clinical presentation.     

Ridge alterations following immediate implant placement and the treatment of bone defects with Bio-Oss in an animal model

Background: Conflicting data exist on the outcome of placing Bio‐Oss® (Geitslich Pharm AG, Wolhausen, Switzerland) into extraction sockets. It is therefore relevant to study whether the incorporation of Bio‐Oss into extraction sockets would influence bone healing outcome at the extraction sites. Purpose: The aim of this study was to assess peri‐implant bone changes when implants were placed in fresh extraction sockets and the remaining defects were filled with Bio‐Oss particles in a canine mandible model. Materials and Methods: Six mongrel dogs were used in the study. In one jaw quadrant of each animal, the fourth mandibular premolars were extracted with an elevation of the mucoperiosteal flap; implants were then placed in the fresh extraction sockets and the remaining defects were filled with Bio‐Oss particles. After 4 months of healing, micro‐computed tomography at the implant sites was performed. Osseointegration was calculated as the percent of implant surface in contact with bone. Additionally, bone height was measured in the peri‐implant bone. Results: Average osseointegration was 28.5% (ranged between 14.8 and 34.2%). The mean crestal bone loss was 4.7 ± 2.1 mm on the buccal aspect, 0.4 ± 0.5 mm on the mesial aspect, 0.4 ± 0.3 mm on the distal aspect, and 0.3 ± 0.4 mm on the lingual aspect. Conclusion: The findings from this study demonstrated that the placement of implants and Bio‐Oss® particles into fresh extraction sockets resulted in significant buccal bone loss with low osseointegration.     

牙周炎患者种植体即刻负载的研究进展

即刻负载由于可以为患者提供即刻的功能和美观而成为近年来的研究热点。牙周炎患者作为一个广泛的特殊患者群体,长期以来学者在其种植修复方面持保守态度。然而近年来,随着种植技术的发展以及种植材料的进步,越来越多的学者对牙周炎患者采用即刻负载并获得了成功。有学者进一步指出:将即刻种植与即刻负载联合应用,可以在最短的治疗时间内获得最佳的疗效。本文就国内外学者对牙周炎患者即刻负载的研究进展作一综述。     

Metallic Clip Migration to T-tube Sinus Tract after Laparoscopic Choledochotomy

Migration and translocation of metallic clips in the abdominal cavity after laparoscopic bile duct surgery have been reported to occur in the common bile duct (CBD), hepatic duct, duodenum, and even the ovarium, which could cause severe complications. Here we present three cases of metallic clip migration to the T-tube sinus tract after laparo-scopic choledochotomy. Metallic clips were discharged from the sinus tract of the T-tube into the drainage bag in two cases. In another case, clips were found to translocate into the sinus tract during choledochoscopic examination for residual stones in CBD.     

Stereoscopic Technique for Conversion of Radiographic Guide into Implant Surgical Guide

Purpose: The aim of this study was to develop and evaluate a new stereoscopic technique for conversion of radiographic guide into surgical guide for dental implant placement. Materials and Methods: Ten partially dentate patients requiring 18 implants for tooth replacement were recruited. Radiographic guides were modified with the addition of index rods for double computed tomography scanning. Implant positions were planned with implant planning software, and the stereoscopic angulations were measured. The radiographic guides were converted into surgical guides using either a generic bench drill (Group A, n = 9) or a milling machine (Group B, n = 9). Stereolithographic surgical guides were also made for three patients (Group S, n = 5). Differences between the planned and actual angulations were tested by pair‐sample t‐test. Difference of mean angle deviation among groups was tested by Brown–Forsythe test. Differences were considered significant if p < .05. Results: Eighteen implant sites were successfully treated with the converted surgical guides. The mean angle deviation of Group A (1.3 ± 0.6°) was significantly greater than Group S (0.4 ± 0.6°), while no differences were found between Group B (0.9 ± 0.3°) and Group S. The linear error was greatest in Group A with 1.5 mm at the head and 1.8 mm at the apex of the implant. Conclusions: The use of this new stereoscopic technique appears to be an acceptable alternative method for converting radiographic guide into surgical guide.     

上颌窦底微创提升的短期临床疗效评价

目的：通过临床试验评估一种上颌窦底微创提升技术的疗效。方法试验组11例患者的上颌后牙区行上颌窦底微创提升技术并同期植入短种植体14枚。对照组10例患者进行了使用扩孔钻的上颌窦冲顶技术并同期植入短种植体13枚。两组患者术后6个月行暂冠修复,进行咬合训练及软组织塑形,3个月后永久修复。术后定期复诊,检查患者的上颌窦、种植体骨结合情况,并使用锥形束CT（CBCT）测量骨增量水平。结果试验组及对照组均无种植体松动、脱落及上颌窦炎发生,CBCT显示种植体与周围组织形成良好的骨性结合。经2~28个月随访观察,临床效果良好。试验组和对照组平均窦底垂直骨增量分别为5.87和5.45 mm。结论上颌窦底微创提升联合短种植体同期植入是一种创伤小、操作简单、行之有效的上颌后牙区种植外科技术,可用于上颌窦底垂直骨量严重不足,余留牙槽骨高度不足4 mm的病例。     

Detection of Tract Formation for Prevention of Bile Peritonitis after T-Tube Removal. Case Report

Bile leakage after removal of T-tube is a relatively rare complication caused by inadequate tract formation around the tube. We report a case of bile peritonitis after removal of a latex T-tube. The patient underwent reoperation and a new T-tube was introduced. The T-tube was removed six weeks later. Immediately after removal of the tube, the cutaneous ostium of the tube was catheterized with a thin Nelaton catheter. The administration of gastrographin showed the presence of an intact tract. The removal of the t-tube was uneventful. We would propose this method for detecting the tract after removal of the T-tube in order to prevent severe bile leakage after inadequate tract formation.