Severe skeletal bimaxillary protrusion treated with micro-implants and a self-made four-curvature torquing auxiliary: A case report

BACKGROUNDBimaxillary protrusion is a clinically common dentofacial deformity, particularly among Chinese patients. This kind of malformation can severely affect facial esthetics and, even in mild cases, is difficult to correct without surgery. Unfortunately, many patients abandon treatment because of fear of surgery. Here, we describe a case of severe skeletal bimaxillary protrusion treated with nonsurgical orthodontic treatments, highlighting an alternative treatment option.CASE SUMMARYA 31-year-old woman wished to address a severe protrusion profile (approximately 8 mm overbite) and gummy smile. Cephalometric analysis and superimposition showed a severe skeletal class II pattern with a mandibular retrusion, and proclined and protrusive mandibular incisors. Panoramic radiograph showed a missing mandibular right third molar. A diagnosis of severe bimaxillary dentoalveolar protrusion was made. Taking into account the patient’s fear of orthognathic surgery, she accepted the proposed alternative treatment using micro-implants and a self-made four-curvature torquing auxiliary. The treatment allowed for maximal en masse anterior tooth retraction, proper relocation of incisors, and alleviation of the skeletal class II pattern. Esthetically, the patient’s lip protrusion was significantly decreased as was the overjet (from 10.5 mm to 1.8 mm), and the results remained stable throughout the 2-year follow-up.CONCLUSIONNonsurgical treatment using micro-implants and a four-curvature torquing auxiliary may benefit severe cases of skeletal bimaxillary protrusion in adults.     

综合治疗腰椎间盘突出症的疗效分析

目的探讨综合治疗腰椎间盘突出症（LIDP）的临床疗效。方法回顾性分析2002年1月-2007年12月经综合治疗的117例LIDP患者的临床资料。结果治愈84例,显效16例,好转11例,总有效率94.87%,未发现并发症。结论硬膜外麻醉、牵引、药物和手法推拿等综合治疗LIDP疗效满意,且安全、痛苦小、见效快,是一种理想且安全的治疗方法。     

经阴道入路治疗直肠前突64例临床分析

目的探讨治疗直肠前凸的手术方法。方法对64例直肠前凸患者应用经阴道入路治疗,观察其术后效果。结果本组痊愈53例（82.8%）,好转8例（12.5%）,无效3例（4.7%）。疗程18～26天,平均23天。术后随访6～24个月,无并发症及后遗症。结论经阴道入路治疗直肠前突方法简单,效果明确。     

Lateral augmentation of the sinus floor followed by regular implants versus short implants in the vertically deficient posterior maxilla: a systematic review and timewise meta-analysis of randomized studies

The aim of this study was to perform a timewise meta-analysis of randomized clinical trials (RCTs) comparing the outcomes of short implants (≤6 mm) versus lateral sinus floor augmentation followed by regular implants (≥10 mm) in the deficient posterior maxilla. Eleven RCTs with 1, 3, and 5 years of follow-up were reported in 21 articles. There was no significant difference in the implant loss rate at the patient level after 1 and 3 years between the two groups (risk ratio 0.50, P = 0.17; risk ratio 1.71, P = 0.51). After 5 years, the risk ratio was in favour of regular implants with augmentation and approached significance (3.28, P = 0.06). Excluding the results of two studies on ultrashort implants, the risk ratio for complications was in favour of short implants, but without significance (0.33, P = 0.08). Mean marginal bone loss was significantly lower at 1, 3, and 5 years for the short implants when compared to regular implants with augmentation. The residual osseointegration length of implants was between 3.4 mm and 5.9 mm in the short implants group and between 10.1 mm and 12.5 mm in the regular implants group after 5 years. In conclusion, short implants in the atrophic posterior maxilla demonstrate comparable outcomes to regular implants within the first 5 years. Patients who are fit for surgery should be informed about the risks and benefits of both options.     

Bone resorption after maxillary reconstruction with the vascularized free iliac flap

The aim of this study was to evaluate the resorption of the iliac bone after maxillary reconstruction with a vascularized free iliac flap. Twenty-seven patients with maxillary defects who underwent maxillary reconstruction with the vascularized free iliac flap between January 2017 and January 2021 were included. Computed tomography (CT) images taken at 1 week, approximately 6 months, and 1 year after the surgery were used for evaluation. The total iliac bone thickness and height, cortical bone thickness, and cancellous bone density were measured in the CT images. Compared with 1 week after the surgery, the total thickness and height of the iliac bone were reduced significantly 1 year after the surgery, and the cortical bone thickness and cancellous bone density were reduced significantly at 6 months and 1 year after the surgery. Compared with 6 months after the surgery, cancellous bone density was reduced significantly 1 year after the surgery. In conclusion, during the first year after maxillary reconstruction with a vascularized free iliac flap, there was significant resorption of iliac bone, including the total iliac bone thickness and height, the cortical bone thickness, and the cancellous bone density.     

Protruding tumorous angiolymphoid hyperplasia with eosinophilia (ALHE) of the scalp accompanied by arterial occlusion

We report a case of an extraordinarily large tumorous form of ALHE developing on the occiput of a 57-year-old Japanese male. Histologically, it was characterized by increased numbers of small blood vessels, fibrosis, and lymph follicle formations with massive eosinopilia in the dermis in addition to an occluded artery in the deep dermis.     

Outcomes following osteotome-mediated sinus floor elevation with Bio-Oss Collagen or no grafting material: a one-year single-blind randomized controlled trial

The objective of this single-blind randomized controlled trial was to test the hypothesis of no difference in implant treatment outcome and patient-reported outcome measures (PROMs) following osteotome-mediated sinus floor elevation with Bio-Oss Collagen (test) compared with no grafting material (control) after 1 year of implant loading. Forty healthy patients (27 female, 13 male) with a mean age of 49 years (range 24–74 years) were randomly allocated to the test or control group. Outcome measures included survival of the suprastructures and implants, peri-implant marginal bone loss, complications, and PROMs; the latter included the Oral Health Impact Profile-14 and a self-administered questionnaire with visual analogue scales to assess the peri-implant tissue, implant crown, function of the implant, total implant treatment outcome, and oral health-related quality of life. Mean differences were expressed with the standard deviation and 95% confidence interval. The level of significance was 0.05. Survival of the suprastructures and implants was 100% with both treatment modalities. No significant difference in any of the outcome measures was observed between the test and control groups. High patient satisfaction and a significant improvement in quality of life were observed with both treatment modalities. Consequently, no significant difference in implant treatment outcome between the test and control groups was revealed after 1 year of implant loading. Neither of the treatment modalities can therefore be considered better than the other.     

A clinical and radiographic case series of implants placed with the simplified minimally invasive antral membrane elevation technique in the posterior maxilla

The aim of the present case series was to evaluate a simplified minimally invasive transalveolar sinus elevation technique utilizing calcium phosphosilicate (CPS) putty for hydraulic sinus membrane elevation. The simplified minimally invasive antral membrane elevation technique is based on the application of hydraulic pressure via a viscous bone graft that acts as an incompressible fluid.In this retrospective study, 21 patients (mean age: 48.5 ± 12 years) consecutively treated with the simplified minimally invasive transalveolar sinus elevation technique were evaluated. 28 tapered implants were placed in posterior maxillary sites with less than 6 mm of residual bone height as determined radiographically on cone beam volumetric tomographs. No sinus membrane perforations were noted and none of the patients complained of symptoms of sinusitis post-operatively (0%). The mean gain in bone height post-operatively was 10.31 ± 2.46 mm (p < 0.001). All implants successfully integrated (100% success rate) and were loaded with cement-retained prostheses.The proposed technique is a simple, efficacious, minimally invasive approach for sinus elevation that can be recommended for sites with at least 3 mm of residual height.