Breast augmentation with silicone implants: the role of surgical drainage—report on 502 consecutive patients

Breast augmentation is one of the most frequently performed cosmetic surgery procedures worldwide. We report on a series of 502 consecutive cosmetic breast augmentations by a single surgeon, using both the submuscular and submammary approaches. A vacuum drain was placed in the surgical pocket at the end of the procedure. The drain fluid collection was recorded immediately after the surgery and the following day before removal. A tenfold increase in the amount of fluid collection was noted in the drain’s reservoir. Thirteen patients presented with minor wound healing problems at the second postoperative follow-up, which were treated conservatively; two of them had the implant removed and replaced after 2 months. There were only two capsular contractions at 1-year follow-up. We focus our discussion on the drainage in the early postoperative period and conclude that the routine use of a surgical drainage reduces the risk for complications. Based on our findings, we advocate that short-term routine use of a surgical drain is advisable.     

Factors influencing survival of reconstructions. Consensus report of Working Group 2

Abstract: In order to evaluate the level of evidence of factors influencing the survival of reconstructions, systematic reviews of the relevant literature were prepared by a group of rapporteurs. The review papers were circulated to the members of the group before the conference and formed the basis for group and panel discussions. Subsequently, modifications were added to the review papers, and suggestions for consensus statements concerning the following topics were prepared and again critically reviewed in the group and in the plenum: Impact of (i) periodontal disease on the survival of tooth-supported reconstructions, (ii) post-surgical factors as supportive therapy on the survival of implant supported reconstructions, (iii) technical and/or biological complications on the survival of different types of reconstructions, (iiii) material choice for reconstructions on the survival of single crowns and fixed dental prostheses.     

安徽省学生近20年常见病患病情况分析

目的了解安徽省学生视力低下、龋齿、贫血的患病状况及变化趋势,为开展学生常见病防治工作提供参考。方法对1985,1995,2000,2005年4个不同时期安徽省学生体质健康调研资料7～22岁学生视力低下、龋齿、贫血等常见病的患病状况进行分析。结果20a间,学生贫血患病率明显下降,从1985年的55.5%下降到2005年的5.3%;龋患率1985年至2000年明显上升,从32.1%上升到42.6%,2000年以后呈下降趋势,达18.8%;近视率逐年上升并居高不下,从1985年的23.0%上升到2005年的55.2%,尤其是高中生和大学生,高达70%～80%。结论通过开展学生常见病防治工作,学生贫血患病率和龋患率明显下降,但学生近视率逐年上升并居高不下,应引起有关部门的重视。     

Dentition planning with image-based occlusion analysis

Purpose To develop an easy-to-use, dentition planning method which is based on three-dimensional (3D) computer planning technology to replace conventional plaster-cast occlusion planning techniques. Methods The optimal dental occlusion is defined according to the condition of centric occlusion, i.e. after bringing occlusal surfaces of mandibular and opposing maxillary arches into identical 3D position. This identical position of occlusal surfaces represents the common reference frame for the 3D manipulation of all graphical elements. The planning procedure involves the following steps: (1) the optimal occlusal surface is approximated as triangle and localized both on the maxilla and mandible; (2) the original volumetric model is resampled according to the occlusal orientations; (3) the program reads in the models of ideal upper and lower dental arches from files, reshapes those to the patient anatomy and visualizes the local alignment on separate panels for mesiodistal and faciolingual inclinations. The final goal of the proposed method is to combine the requirements of functional and aesthetic designs and create an input for orthodontics, implantology and maxillofacial surgery. Results In the present study the optimal dental occlusion is created by image resampling after bringing the occlusal surfaces of mandibular and opposing maxillary arches into identical 3D position. This identical position of occlusal surfaces represents the common reference frame for manipulation of all graphical elements. Conclusions The proposed graphical environment was able to fit the elements of the ideal dentition curve to patient computed tomography under predefined centric occlusion. Rotation and scaling transformations of teeth were possible in the reformatted volumetric views about any of the axes of the teeth’s own reference space.     

人工肱骨头置换术治疗高龄复杂肱骨近端骨折

目的探讨和分析采用人工肱骨头置换术治疗复杂肱骨近端骨折的适应证、手术技术要点和早期疗效。方法对12例肱骨近端四部分骨折伴肱骨头脱位的高龄患者,早期手术行人工肱骨头置换。手术采用三角肌胸肌间入路,先复位大小结节,确定假体高度,骨水泥固定假体保持30°左右的后倾,大小结节再复位固定,必要时取骨折的肱骨头自体骨植骨,术后早期功能锻炼。结果术后平均随访16．6个月,术后未发生感染、神经损伤、关节脱位和假体周围骨折。采用Neer评分系统评定人工关节功能,平均为84．4分,90分以上(优)3例,80～89分(满意)7例,70～79分(不满意)2例,满意率为83．3%。12例患者疼痛方面平均得分为33．5分,功能方面为25．6分,运动方面为16．5分,解剖重建方面为8．8分。结论在正确选择手术适应证、掌握手术技术以及合理的术后康复等前提下,人工肱骨头置换术是治疗高龄患者复杂肱骨近端骨折的有效方法,尤其在减轻创伤后肩关节疼痛方面效果最为显著。但在恢复肩关节活动度方面仍欠满意,需加强对患者术后关节康复训练的指导工作。     

超声洁治和局部用甲硝唑治疗轻、中度种植体周围炎

目的：评价用碳纤维工作头的超声洁牙机和25％甲硝唑凝胶治疗种植体周围炎的疗效。方法：将27颗患轻中度种植体周围炎的种植牙随机分为洁牙机治疗组和甲硝唑治疗组，在基线、1、2、6和12周时检查种植体的临床和生物学指标。结果： 两种治疗方法均可使菌斑指数、龈沟出血指数、龋下微生物的酶活性检查等指标改善。治疗期间未发现任何不良反应。结论；碳纤维头超声洁治和局部用25％甲硝唑凝胶是治疗牙种植体周围炎的安全有效的方法。     

Endoscopically controlled sinus floor augmentation. A preliminary report.

Sinus augmentation has been advocated to be a surgical technique with predictable results in peri‐implant surgery. Endoscopic surgery of the maxillary sinus so far has been used as diagnostic procedure. In this paper, the use of endoscopy is described as a low invasive adjunctive technique in sinus floor augmentation. After preparation of the mucoperiosteum, bone grafts can be placed under endoscopic control between sinus floor and mucoperiosteum. A laterobasal approach via a small osteotomy and a transalveolar approach are possible for mucosal elevation and graft placement. First clinical results are reported. Endoscopic sinus lift may contribute to a reduction of perioperative morbidity, reduction of oroantal fistulae and control of graft position. The less invasive technique may allow to extend the indication for sinus augmentation.     

Polylactic acid (PLA) root replica in ridge maintenance after loss of a vertically fractured incisor

Abstract A periodontally affected tooth was prepared for a special treatment: Calcium hydroxide was introduced into the apical half of the root canal whereas its cervical part was filled with glass ionomer cement. The tooth was shortened subgingivally. After 6 weeks of epithelization over the residual root a palatal full-thickness flap was mobilized. The root was carefully extracted and chairside copy-milled from the biodegradable polylactic acid (PLA) material. The PLA-replica was implanted immediately into the socket and the flap was sutured. Aim of the treatment was to prevent the ridge collapse of the extraction area. Ridge height could be preserved during the 21 months of observation. With time the radiographic density of the cancellous bone increased in the implanted area, indicating that a PLA-replica is replaced by host's bone tissue.     

Pixel value modification using RVG-4 automatic exposure compensation for instant high-contrast images

The RVG-4 permits automatic exposure compensation (AEC). The purpose of this investigation was to determine the effects of AEC on image contrast. Images were made either with or without a dental QA jaw phantom using a fixed image projection geometry. Exposures were 6.3 through 27.3 μC/kg using an X-ray generator operated at 70 kVp. Region of interest pixel value distributions were measured at tissue thicknesses in this phantom, and the average pixel values and signal-to-noise ratios (SNR) were calculated. The use of AEC without an object in place resulted in a disproportionate relationship between pixel value and exposure with a marked reduction in SNR. The use of AEC on under- and over-exposed images of the phantom simultaneously enhanced image contrast and reduced SNR. Thus, AEC provides a convenient and quick method for achieving high-contrast images with sub-optimal exposures, however, this could lead to inappropriate patient dosages if the function is used for over-exposed images. AEC reduces the SNR and produces disproportionate pixel values relative to exposure.     

Cavernous sinus thrombosis following odontogenic and cervicofacial infection

Summary Cavernous sinus thrombosis (CST) is rarely seen clinically as a complication of infectious processes since the discovery of penicillin. At the present time, dental abscess is an uncommon cause of CST. We now report our experiences with a 60-year-old diabetic male, who developed CST 38 days after extraction of an infected upper third molar tooth. The importance of eradicating regional cervicofacial foci of infection is stressed.