Immediate loading of implants placed with the osteotome technique: one-year prospective case series

Background: There is limited information regarding marginal bone‐level changes around immediately loaded implants placed with the osteotome technique. The aim of this case series is to prospectively evaluate the clinical and radiographic outcome of immediately loaded implants placed with the osteotome technique over a 12‐month period. Methods: Eighteen patients in need of oral prosthetic rehabilitation that included single implant placement in positions #4 to #13 and/or #20 to #29 participated in this prospective trial. A modified implant installation procedure with an under preparation of the implant bed using the osteotome technique and immediate loading of the implant was performed. Clinical examinations were performed at 2 weeks, 6 months, and 12 months of follow‐up. Radiographic examinations were performed at implant installation and at the 6‐ and 12‐month follow‐up visits. Results: One implant failed to integrate and was removed at 3 months after implant installation. Four of 20 implants had insertion torque value >35 Ncm. The mean marginal bone loss was ‐0.09 mm at the 6‐month and ‐0.19 mm at the 12‐month follow‐up visits. Conclusion: The present case series indicates that implants placed with the osteotome technique and immediately loaded did not demonstrate a high insertion torque and exhibited minimal marginal bone loss.     

Endovascular reconstruction of extracranial traumatic internal carotid artery dissections: a systematic review

Neurosurgical Review - Extracranial internal carotid artery dissection (ICAD) is a potential source of morbidity and mortality in trauma patients and requires high degree of suspicion for diagnosis...     

Retrospective Evaluation of Crestal Bone Changes Around Implants With Reduced Abutment Diameter Placed Non‐Submerged and at Subcrestal Positions: The Effect of Bone Grafting at Implant Placement

Background: There is limited information regarding the effect of grafting of the osteotomy after subcrestal implant placement. The primary aim of this study is to retrospectively evaluate the effect of bone grafting of the defect between the bone crest and the coronal aspect of implants with reduced abutment diameter placed non‐submerged and at subcrestal positions. Methods: Records of 50 consecutive patients treated with subcrestally placed dental implants grafted with a xenograft (Group A) and 50 consecutive patients with subcrestally placed dental implants without any grafting material (Group B) were reviewed. For each implant, the radiographs after placement were compared to images from the last follow‐up visit and evaluated regarding the following: 1) degree of subcrestal positioning of the implant, 2) changes of marginal hard‐tissue height over time, and 3) whether marginal hard‐tissue could be detected on the implant platform at the follow‐up visit. Results: The mean marginal loss of hard tissues was 0.11 ± 0.30 mm for Group A and 0.08 ± 0.22 mm for Group B. Sixty‐nine percent of the implants in Group A and 77% of the implants in Group B demonstrated hard tissue on the implant platform. There were no statistically significant differences between the groups regarding marginal peri‐implant hard‐tissue loss. Conclusion: The present study fails to demonstrate that grafting of the remaining osseous wound defect between the bone crest and the coronal aspect of the implant has a positive effect on marginal peri‐implant hard‐tissue changes.     

Afternoon nap, meal ingestion and circadian variation of acute myocardial infarction

A two-peaked circadian variation in acute myocardial infarction has been demonstrated, with a morning peak attributed to physiological changes produced by nocturnal sleep. To investigate the causes of the secondary peak, we compared meal habits and circadian variation in patients with acute myocardial infarction who were accustomed to afternoon naps (group A) to those who were not (group B). One hundred and fifty two patients formed group A and 65 group B. The main meal was lunch in group A (77%) and dinner in group B (74%). Both groups displayed a significant circadian variation, (group A: x2=51.3, group B: x2=60.4, both p < 0.0001), but the secondary peak occurred earlier (2pm-4pm) in group A, than in group B (6pm-8pm). We conclude that ingestion of the main daily meal, followed by a period of physical inactivity, with or without sleep, is a trigger for acute myocardial infarction.     

Descemet's membrane substrate from human donor lens anterior capsule

Background: To study the potential use of human donor anterior lens capsule as a Descemet's membrane substrate. Methods: Anterior lens capsules were recovered from the lenses of 30 cornea donors. Human corneal endothelial cells were recovered from the remaining corneal sclera rims of 15 donor corneas used for penetrating keratoplasty. Samples were sorted into three groups. Group 1 consisted of 10 samples in which the endothelial cells were allowed to grow on anterior lens capsules. In Group 2 human corneal endothelial cells grew on a collagen membrane and in Group 3 on polystyrene culture plates. Cell density, morphology and adherence of the cell–capsule complex were evaluated at 1, 4, 7 and 14 days with a phase‐contrast microscope, a scanning electron microscope and by histology. Cell viability was quantified by a microscopic live–dead assay. Expression of zonula occludens‐1, Na⁺/K⁺‐adenosine triphosphatase, tissue transglutaminase and vimentin were investigated by immunohistochemistry. Results: A mean diameter of 10.05 ± 0.13 mm of anterior capsule was obtained as a substrate for cell culture. Endothelial cell density of Group 1 was measured at 2455.4 ± 283.8 cells/mm², which was also comparable with the cell density of the control group. Cell viability was 95% or superior in all groups and multiple cellular interconnections developed between growing cells. Immunohistochemical analysis demonstrated strongly positive staining for all investigated proteins. Electron microscopy confirmed the adherence and monolayer growth of the endothelial cells. Conclusions: Human donor anterior lens capsule might therefore be a potential scaffold for the ex vivo expansion of human corneal endothelial cells.