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Background The contraceptive implant is a long-acting, effective method of contraception. Low uptake in Australia may be partially due to limited clinicians trained in implant procedures. Internationally, nurse-led implant procedures are accepted practice; however, this is not common in Australia. Aim An evaluation was undertaken to determine the effectiveness of implant training for nurses and consider the implications for clinical service delivery. Methods Participating nurses (n = 5) completed pre- and post-training surveys, and three were subsequently interviewed. Supervising doctors and nurses (n = 5) were also interviewed. A file audit was conducted to review implant procedures undertaken post-training. Findings Nurses undertook implant training to acquire new skills and meet patient demand. After the training, all nurses self-reported feeling ‘very confident’ in inserting the implant and at least ‘a little confident’ in removing the implant; the latter had minimal impact on removal success, as indicated in the file audit. Overall, nurses and supervising doctors and nurses felt that nurses could play a greater role in the provision of contraceptive implant procedures in Australia. Discussion Nurse-led procedures would increase access to the contraceptive implant for women, and have a positive impact on service delivery in different healthcare settings; however, funding constraints for nurses remain a significant barrier. Conclusion Nurses are well placed to undertake contraceptive implant procedures. This would increase access to this method of contraception for women. These findings may inform models of care that promote nurse-led contraceptive procedures in Australia.

Ridge augmentation for implant procedures has been shown to be highly successful. There are several techniques available to the dentist, but they require some degree of surgical expertise and experience. No particular technique has been shown to be superior. This article presents the indications, techniques, and complications of the various procedures for alveolar ridge augmentation. This information will educate the general dental practitioner of the techniques available and provide information on the surgical procedures that could be used to discuss with patients when they are being referred to a specialist.

Cleft lip and/or cleft palate defects often result in a functional deficiency in the patient’s chewing, speech ability, and aesthetic appearance, usually demanding multidisciplinary effort for addressing the aesthetic and functional patient’s requirements. This clinical report describes the planned oral rehabilitation of a 46-year-old woman with unilateral cleft lip defect based on the patient’s peculiarities and age. Due to limitations concerning bone grafts and implant procedures, as well as orthodontic treatment, the prosthodontic rehabilitation using the metal-ceramic fixed partial denture was chosen. The treatment adequately reestablished the aesthetic and functional activities, positively impacting the patient’s quality of life.

Objective: Treatment for pelvic organ prolapse (POP) can be surgical. The vaginal approach is a shorter procedure than the abdominal approach, with quicker resumption of activity for the p...

Explantation of an inflatable penile prosthesis (IPP) reservoir in the setting of acute infection can be challenging. We identified three such cases of infection and simultaneous extraction of multiple reservoirs among patients with the most recent prosthetic surgeries performed between March 2016 and November 2018. These cases were reviewed with particular emphasis on preoperative and operative management. All three patients underwent successful simultaneous explantation of all retained hardware with subsequent clinical improvement in their clinical status. Prior to surgery, none of the patients were aware of the presence of more than one reservoir. All three patients recovered well post operatively. A subset of prosthetics patients have undergone multiple implant procedures at various sites. Due to the importance of retrieving all foreign material in the setting of acute infection, the authors advocate for a low threshold to obtain cross-sectional imaging to identify the tissue plane and laterality of any retained components, with particular emphasis on creating an operative plan for reservoir retrieval.

Three-dimensional (3D) reconstruction by means of electroanatomic mapping (EAM) systems, allows for the understanding of the mechanism of focal or re-entrant arrhythmic circuits, which can be identified by means of dynamic (activation and propagation) and static (voltage) color-coded maps. However, besides this conventional use, EAM may offer helpful anatomical and functional information for tissue characterisation in several clinical settings. Today, data regarding electromechanical myocardial viability, scar detection in ischaemic and nonischaemic cardiomyopathy and arrhythmogenic right ventricle dysplasia (ARVC/D) definition are mostly consolidated, while emerging results are becoming available in contexts such as Brugada syndrome and cardiac resynchronisation therapy (CRT) implant procedures. As part of an invasive procedure, EAM has not yet been widely adopted as a stand-alone tool in the diagnostic path. We aim to review the data in the current literature regarding the use of 3D EAM systems beyond the definition of arrhythmia. This article is protected by copyright. All rights reserved.

Contains fulltext : 238907.pdf (Publisher’s version ) (Open Access) OBJECTIVES: this in vivo study reports on mechanical torque data as well as the biological evaluation up to 6 weeks after placement of implants with a unique wide knife thread design in a goat iliac crest model. We hypothesized that implants with this thread design would show substantial primary stability at a continuous level toward secondary stability. METHODS: 64 MegaGen Anyridge® implants were used with diameters 3.5 mm, 4.0 mm, 5.0 mm and 6.0 mm (n = 8). Implants were placed monocortically in the iliac crest of 16 healthy female Saanen goats, both on the right (for torque measurements) and left side (for histology/-morphometry). Torque-in at implant installation and torque-out at 2 and 6 weeks of implantation was measured, as well as bone-to-implant contact (BIC) and bone-area between the screw threads (BA). RESULTS: Histology showed intimate bone-to-implant contact with a maturating trabecular structure between 2 and 6 weeks. Torque values showed a dependency on implant diameter. For all implant diameters, torque-in values were similar to torque-out values at 2 weeks. At 6 weeks however, all torque-out values were significantly increased. BIC and BA percentages showed similar values for all diameters at both 2 and 6 weeks. CONCLUSIONS: These results prove the absence of a lag-phase in implant stability for MegaGen Anyridge® implants in the goat iliac crest model. The increased torque-out values at 6 weeks without increasing BIC and BA percentages correlate with the observed maturation of bone-to-implant contact quality over time. CLINICAL SIGNIFICANCE: It is a challenge to optimize implants with continuous primary stability and rapid transition into secondary stability to minimize the duration of the lag-phase. The results of this study prove the absence of a lag-phase in implant stability for MegaGen Anyridge® implants. Consequently, the data from this work are important for the treatment of individual patients 'translating' these findings into clinical implant procedures.

New biomaterials for biomedical applications have been developed over the past few years. This work summarizes the current cell lines investigations regarding nanosurface modifications to improve biocompatibility and osseointegration. Material surfaces presenting biomimetic morphology that provides nanoscale architectures have been shown to alter cell/biomaterial interactions. Topographical and biofunctional surface modifications present a positive effect between material and host response. Nanoscale surfaces on titanium have the potential to provide a successful interface for implantable biomedical devices. Future studies need to directly evaluate how the titanium nanoscale materials will perform in in vivo experiments. Biocompatibility should be determined to identify titanium nanoscale as an excellent option for implant procedures.

Objectives To present a comprehensive review of current literature available on Corona virus disease and dentistry, modifications required in dental and laboratory settings; and recommended disinfection protocols in current scenario. Special emphasis has been given to discuss guidelines for handling different prosthodontic procedures and implications of this pandemic on prosthodontic practice, education and research. Materials and methods Relevant literature pertaining to COVID-19 and dentistry was scrutinized on electronic search engines including PubMed, EMBASE and Cochrane. Guidelines given by various organizations, institutions, national and international regulatory bodies and Indian Prosthodontic Society were also consulted to gather information pertaining to the objectives of our review. Results and observations: A total of 160 articles including cross-sectional studies, in vitro study, narrative reviews, letters to the editor and opinions were found to be relevant in accordance with our search strategy. Documented literature revealed that Covid-19 pandemic has culminated in serious clinical, financial and psychological implications in the field of dentistry. Certain steps such as adoption of teledentistry, judicious use of protective equipment, use of rubber dams, pre-procedural rinses have been suggested unanimously. However, there is a dearth of evidence-based recommendations in literature. Data regarding consequences of delaying prosthodontic procedures and patients’ perspectives is also sparse. Conclusion The COVID-19 necessitates the need to adopt a balanced approach while treating patients and safeguarding the dental professionals at the same time. Risk-benefit ratio has to be assessed along with stringent following of guidelines and disinfection protocols to combat this unprecedented situation.

Repeatability and precision are major factors which have an influence on final implant treatment results. The aim of this study was to evaluate the repeatability of freehand implant procedures assisted with special plastic sleeves which are placed on the drill to guarantee the proper mesiodistal distance from the landmark&rsquo, s surface. Patient data required for implant treatment, including images of mandibles from CBCT scans and virtual models of soft tissues and teeth, were used to prepare complete virtual models of patient clinical conditions. The models were saved as STL files and 3D printed in five copies. Drilling procedures were done at positions 37, 46 and 47. Each model was scanned with pins in the osteotomies and compared using digital aligning of the models&rsquo, surfaces. The average deviation was &minus, 1.38 &plusmn, 1.4 mm. Average deviations on guide pins placed at position 37 were &minus, 0.46 &plusmn, 0.59 mm, at position 46 were &minus, 1.46 &plusmn, 0.88 mm (landmark&rsquo, s surface of both: distal tooth&rsquo, s surface), and at position 47 were the highest: &minus, 2.69 &plusmn, 1.62 mm (landmark&rsquo, s surface: surface of plastic sleeve). The following conclusion was drawn: Using universal plastic sleeves could improve implant procedure precision especially in the case of partially edentulous patients.

Although interest in buttocks implant procedures is growing around the world, it remains a technically demanding procedure. The intramuscular plane is thought to be superior to other planes of dissection. Asymmetry and visibility of the implants remain frequent complications when the surgeon works without any reference points to guide the procedure. The XYZ method helps the surgeon to obtain symmetry, to significantly reduce implant visibility and to decrease other complications associated with buttocks implants. The method uses the surface anatomy of the boney frame of the pelvis to perform a geometric plane to detach the muscle.

Sensor-Based Navigation and CRT ImplantationIntroduction Cardiac resynchronization therapy (CRT) implant procedures are often complex and prolonged, resulting in substantial ionizing radiation (IR) exposure to the patient and operator. We assessed the impact of lower-dose fluoroscopy settings and a sensor-based electromagnetic tracking system (MediGuide™, MDG) on reducing IR exposure during CRT implantation. Methods A single-center 2-group cohort study was conducted on 348 consecutive patients, age 66.4 ± 11.0 years, 80.4% male, with CRT implant procedures from 2013 to 2015. Patients were arbitrarily assigned to MDG (N = 239) versus no MDG (N = 109) guidance. Lower-dose fluoroscopy settings were adopted in January 2015 (3 instead of 6 fps; 23 instead of 40 nGy/pulse; N = 101). Results Overall, MDG was associated with an 82.1% reduction in IR exposure (393 μGray·m2 vs. 2191 μGray·m2, P < 0.001). Lower-dose fluoroscopy resulted in a 59.5% reduction in IR-exposure without MDG (1055 μGray·m2 vs. 2608 μGray·m2, P < 0.001) and 81.8% reduction with MDG (108 μGray·m2 vs. 595 μGray·m2, P < 0.001). Low-dose fluoroscopy combined with MDG was associated with a 95.9% lower exposure to IR when compared to standard fluoroscopy without MDG (108 μGray·m2 vs. 2608 μGray·m2, P < 0.001). Procedures with MDG were shorter (96 minutes vs. 123 minutes, P < 0.001) and associated with a trend towards a higher success rate (94.6% vs. 89.0%, P = 0.062), with fewer coronary sinus cannulation failures (2.1% vs. 6.4%, P = 0.040). Conclusion Low-dose fluoroscopy settings are highly effective (>50%) in reducing IR exposure during CRT implant procedures. When combined with MDG, >95% reduction in IR exposure is achieved. Moreover, MDG shortens procedural duration and may improve acute procedural outcomes.

The field of dentistry lacks satisfactory tools to help visualize planned procedures and their potential results to patients. Dentists struggle to provide an effective image in their patient's mind of the end results of the planned treatment only through verbal explanations. Thus, verbal explanations alone often cannot adequately help the patients make a treatment decision. Inadequate attempts are frequently made by dentists to sketch the procedure for the patient in an effort to depict the treatment. These attempts however require an artistic ability not all dentists have. Real case photographs are sometimes of help in explaining and illustrating treatments. However, particularly in implant cases, real case photographs are often ineffective and inadequate. The purpose of this study is to develop a mobile application with an effective user interface design to support the dentist–patient interaction by providing the patient with illustrative descriptions of the procedures and the end result. Sketching, paper prototyping, and wire framing were carried out with the actual user's participation. Hard and soft dental tissues were modeled using three dimensional (3D) modeling programs and real cases. The application enhances the presentation to the patients of potential implants and implant supported prosthetic treatments with rich 3D illustrative content. The application was evaluated in terms of perceived ease of use and perceived usefulness through an online survey. The application helps improve the information sharing behavior of dentists to enhance the patients' right to make informed decisions. The paper clearly demonstrates the relevance of interactive communication technologies for dentist–patient communication., Highlights • Presents a case study using user-centered development methodology • The quality of doctor patient interaction is an important driver of satisfaction. • Several patients are annoyed with bloody photos, particularly in implant cases. • Rich visual content by mobile devices has positive effect on user experience. • Actual users' participation into design is effective to reduce system complexity.

Winter supplementation level economics in a forage-based calf backgrounding system were analyzed by combining 6 studies. In each study, British-breed calves were backgrounded on corn residue with high (HI) or low (LO) winter supplementation level treatments, grazed through the summer, and finished. Within study, cattle were assigned randomly to treatment with identical implant procedures and finishing diets. Feedlot performance values were adjusted to an equal fat thickness. During winter backgrounding, HI gained 0.35 kg/d (P 0.19) during finishing, but HI had 0.08 kg greater ADG (P = 0.06) and 35 kg greater final BW (P

Tissue response represents an important feature in biocompatibility in implant procedures. This review article highlights the fundamental characteristics of tissue response after the implant procedure. This article also highlights the tissue response in compromised osseous conditions. Understanding the histologic events after dental implants in normal and abnormal bone reinforces the concept of case selection in dental implants.

The Japanese society for dialysis therapy (JSDT) launched the second edition of ‘Guidelines for Vascular Access Construction and Repair for Chronic Hemodialysis’ concerning the vascular access in 2011. The indication of long-term catheters is strictly limited in these guidelines because of possible high risks of infections including sepsis and obstruction of catheters with thrombus. In Japan, the long-term catheters would be needed more frequently to prepare the very rapid demographic change within a decade, under the condition that the material and structure of these catheters will be more resistant against the complications.

Introduction: Although multiple defects of the atrial septum are not uncommon, there remain limited data regarding the use of multiple devices in these patients. A variety of approaches to transcatheter closure have been used, and in this paper we describe the experience from two operators in a single centre. Methods: From September 2002 to September 2012, 673 transcatheter atrial septal defects (ASD) and patent foramen ovale (PFO) closure procedures were performed and retrospectively examined in a registry analysis. Results: Of these, 22 patients had multiple discrete defects, and four different approaches to closure were used. In 4 patients (18.2%) one device was used percutaneously to close multiple defects. Eleven patients (50%) had two devices inserted during the same procedure while two patients (9%) had two devices inserted as staged procedures. One patient (4.5%) had three devices inserted over two procedures. Four patients (18.2%) were found not to be suitable for percutaneous closure during the procedure and were referred for surgical closure. Conclusion: Our experience with the implant procedures, and clinical follow up of patients, shows that patients with multiple defects can be effectively treated with transcatheter device techniques including single device closure, multiple devices in one procedure and multiple devices in staged procedures and also with surgical repair.

BACKGROUND Cardiac resynchronization therapy (CRT) implant procedures are often complex and prolonged, resulting in significant ionizing radiation (IR) exposure to the patient and operator. We report our early experience working with a novel sensor-based electromagnetic tracking system (MediGuide™, MDG, St. Jude Medical Inc., St. Paul, MN, USA), in terms of procedural IR exposure reduction. METHODS AND RESULTS Information regarding patient demographics, procedural details, procedural duration, and IR exposure were prospectively collected on 130 consecutive CRT procedures performed between January 2013 and January 2014. Sixty procedures were performed with MDG guidance, and 70 were performed without MDG guidance. Despite a nonsignificant trend toward shorter procedure duration with the use of MDG (120 minutes vs 138 minutes with non-MDG, P = 0.088), a 66% reduction in total IR exposure (median 769 μGray · m(2) vs 2,608 μGray · m(2), P 90% reduction in IR dose required to cannulate the coronary sinus (median 80 μGray · m(2) vs 922 μGray · m(2), P < 0.001), and to a lesser extent from a reduction in IR dose required for LV lead placement (median 330 μGray·m(2) vs 737 μGray · m(2), P = 0.059). In addition, a significant learning curve effect was observed with a significantly shorter procedural duration for the last 15 cases compared to the first 15 cases (median 98 minutes vs 175 minutes, P < 0.001). CONCLUSION The nonfluoroscopic MDG positioning system is associated with a dramatic reduction in exposure to IR during CRT implant procedures, with a 90% decrease in the IR dose required to cannulate the coronary sinus. A steep learning curve was quantified.

General dental practices are increasingly using implant procedures to replace all the teeth in one arch in one day. Dental nurses need to know about how this is carried out so they can support dentists and patients; such knowledge can also improve their career opportunities

Background Radiation exposure is a major concern in cardiac device implantation, especially cardiac resynchronization therapy (CRT) procedures. The RadPad™ (Worldwide Innovations & Technologies, Inc., Kansas City, MO, USA), a radiation-attenuating adhesive drape, has been shown to be beneficial in several clinical settings involving fluoroscopy, but less is known about the actual benefits in CRT procedures. Methods Consecutive CRT implants performed with and without a RadPad™ drape over a 10-month period were analyzed. Two thermoluminescent dosimeters (TLDs) were attached to each implanting physician at several locations (adjacent to eyes, center abdomen [outside lead apron], left and right index fingers, and dorsum of the right foot). Results were corrected for background using control TLDs, and normalized to dose-area product (DAP). Results Thirty-six patients (31 male), 16 with and 20 without the RadPad™, were included in the study. No technical problems were caused by the presence of the radiation-absorbing drape. Time required to position the drape never exceeded 30 seconds, no acute skin reactions were noted, and no radiation-absorbing drape became displaced. Despite a trend toward longer fluoroscopy times and higher DAPs in the radiation-absorbing drape group, radiation exposure was significantly reduced: 65% in the case of the hands and body (P < 0.001), and 40% the eyes (P < 0.01). Conclusion The use of a radiation-absorbing drape results in a significant reduction in radiation dose to the implanting physician during CRT procedures. Not only is the dose to the hands reduced, but also the eye and body doses are significantly reduced. The routine use of radiation-absorbing drapes should be considered for all CRT implant procedures in the light of these findings.

Surgical implants are widely used in the medical field but their long-term performance is limited due to failure of integration with tissues. This manuscript describes very well-known problems associated with implants and discusses novel solutions used in tissue engineering and regenerative medicine that can be implemented in this uncommonly discussed medical area.General and medical literature describing modifications of medical and surgical implants, biofunctionalization, tissue engineering and regenerative medicine.Procedures for surgical implantation have grown substantially in the last few decades and provided improved quality of life for patients, regardless of area of implantation and device type and purpose.In general, implants fail because of lack of long-term integration with the surrounding tissues. Implant manufacturers have not addressed implant failure from the point of view of biointegration. In addition, some medical practitioners are inclined to treat implant failure by using anti-infection methods to prevent bacterial adhesion. However, both approaches are conceptually limited, as discussed in this manuscript.Implantation in the future will not be limited to medically needed procedures but also to a growing number of cosmetic body transformation procedures, which may include perceived 'improved implant functions' over natural tissues or organs. An additional trend is that implant procedures are being progressively performed in younger individuals.Current implants generally do not allow the physician to have controlled long-term access to internal tissues in contact with the implants, for example to release specific compounds when medically needed to the problem area.

Since the introduction of the sutureless Perceval® (Sorin Group, Saluggia, Italy) in Europe after CE mark in 2012, the "sutureless approach" is becoming more and more popular. Sutureless implantation in general is easy, fast and safe, but bears several potential pitfalls. This might result in inferior functional results affecting also clinical outcomes. In our center, more than 300 implant procedures have been performed up to date by mainly two senior surgeons. The technique is in the process of spreading to all surgeons performing aortic valve procedures. Proctored activities are completed at our and other institutions, and wetlab activities are conducted in collaboration with the manufacturer's research and development laboratory. This article was written to give a step-by-step advice for surgeons who want to start a sutureless program or even have made limited experience with this approach wanting to reconfirm their technique. The focus is kept on surgical aspects regarding indication, access, intra-operative exposure and implantation of the prosthesis.

This article reviews the various anatomical facts significant for preoperative planning of implant procedures in the mandible and the maxilla. This planning includes the precise evaluation of distinct anatomical factors, such as the position of the mandibular canal, the maxillary sinus, the width of the cortical plates, the existing bone density , appropriate implant selection and planning the most appropriate implant position in the existing clinical condition.

Objective To describe an innovative miniature visualization surgical endoscope and endoscopic techniques applicable to dental implant procedures. Materials and Methods A newly developed modular dental implant endoscope is introduced, and the first impressions from its use in different implant procedures are reported. Results Details of the device that combines an endoscope, irrigation cannulas, and a surgical microinstrument channel are presented. The advantages of using it in dental implant procedures are described, and examples of how miniature visualization and surgical endoscopic techniques can be applied to increase the success of implantation are outlined. The new modular implant endoscope accurately identified all microanatomical and pathological structures, and simplified dental implant procedures. Conclusion Endoscopy should be considered not only for intraoperative observation and assessment of implant sites, but also should be applied for active assistance during implant placement procedures.

Dental nurses have a central role in implant placement, from explaining the stages of the process to patients and addressing patient concerns to assisting during the procedure itself and providing postoperative care and advice to maximise success rates

The aim of this study is to measure radiation dose to the fingertips of occupationally exposed workers handling stranded iodine-125 seeds during prostate implants. The doses were measured by thermoluminescence dosimetry at the nail of the index finger of both hands in three hospitals in the Netherlands. In all hospitals, measurements were carried out during the preparation of stranded IBt seeds, type Intersource((R)) 1251L. The fingertip doses per procedure (mean +/- SD) to the fingertip for workers from the three hospitals were estimated to be 0.29 +/- 0.15 mSv (n=6)

Vaginal mesh implants are currently suspended in the NHS pending the findings of a major government review. Jonathan Gornall goes in search of the obstetrician who invented mesh and uncovers how the original evidence was mired in a multimillion pound deal, industry funded research, and undisclosed conflicts of interest

The Association of Dental Implantology Audit (ADIA) website enables dentists and nurses to record all the data regarding implant procedures specific to individual patients and clinicians. The ADIA now has over 300 regular users who benefit from the system.

Fluoroscopy-guided medical procedures are generally diagnostic in nature and involve low dose and minimal risk to the patient. However, an increasingly larger percentage of procedures offer a therapeutic benefit to the patient. Such interventional procedures are very often technically difficult, but offer a less-invasive alternative to higher-risk surgical procedures. Although infrequent, severe skin injury can result from these procedures that involve total fluoroscopy time in excess of 1 h. The purpose of this study was to evaluate fluoroscopy time and peak skin dose (PSD) for lengthy fluoroscopy procedures, and to determine the variables that may best predict PSD.

Short implant procedures may suffer from fixture instability, if incorrectly planned and performed, and from an esthetically compromised rehabilitation, due to increased interarch distance and increased crown-implant ratio. Several procedures have been proposed to achieve alveolar ridge augmentation with different success and complication rates: onlay grafts, alveolar sandwich osteotomies, titanium micromesh, alveolar distraction, and alveolar nerve transposition. The edentulous posterior mandible suffers from the presence of a compact cortical layer, which tends to limit graft osteogenesis, because of a low permeability to the osteogenic elements (microvessels and cells). This report introduces a variant to the endochondral onlay bone graft, in which an external cortical layer is placed above a biologically active core of cancellous bone and platelet-rich plasma. This solution provides easy 3-dimensional conformation of the graft, enhancing its mechanical stability. The presence of the biologically active core provides better vascular support and a valid interface between graft and the osteogenetic cell lines.

To compare the efficacy of the Ahmed S2 Glaucoma Valve with the Baerveldt 250-mm(2) Glaucoma Implant in the treatment of adult glaucoma.Comparative case series.Fifty-nine eyes of 59 patients who received the Ahmed S2 Glaucoma Valve and 133 eyes of 133 patients who received the Baerveldt 250-mm(2) Glaucoma Implant by the Indiana University Glaucoma Service from 1996 to 2003.Eyes that had previous drainage implant procedures were excluded from both groups. If both eyes of a single patient received an implant, the second eye to undergo implantation was excluded from the study.Kaplan-Meier survival with success defined as intraocular pressure (IOP)5 mmHg and22 mmHg and at least 20% reduction from preoperative IOP (with or without antiglaucoma medications) and without loss of light perception. Secondary outcome measures included intraocular pressure, visual acuity, number of glaucoma medications, and surgical complications.The 2 groups were similar with regards to age, gender, race, neovascular glaucoma diagnosis, number of prior ocular surgeries, preoperative IOP, and number of preoperative glaucoma medications. Mean durations of follow-up were 20.0 months for Ahmed eyes and 22.9 months for Baerveldt eyes. Cumulative successes in the Ahmed group were 0.73 at 1 year and 0.62 at 2 years, whereas cumulative successes in the Baerveldt group were 0.92 at 1 year and 0.85 at 2 years (Kaplan-Meier survival functions: P = 0.03, log rank test). Male gender, African descent, neovascular glaucoma, and Ahmed implantation were found to be significant predictors of failure. At last follow-up visit, eyes in the Ahmed group had a significantly higher mean IOP (19.8+/-9.5 vs. 15.8+/-7.9 mmHg, P = 0.003, t test) and more antiglaucoma medications (1.4+/-1.2 vs. 0.9+/-1.1 medications, P = 0.008, Mann-Whitney test) than eyes in the Baerveldt group. Two methods for avoiding hypotony after Baerveldt 250-mm(2) implantation had similar outcomes.Our study suggests that the Ahmed S2 Glaucoma Valve may be less effective at lowering IOP than the Baerveldt 250-mm(2) Glaucoma Implant.

The management of abdominal wall repair continues to present a challenging problem, especially in the repair of major defects. Many abdominal wall defects can be repaired by primary closure; however, if the defect is large and there is a tension on the closure of the wound, the use of prosthetic materials becomes indispensable. Many studies have been performed with various materials and implant techniques, without the comparison of their degrees of success, based on sound meta-analysis and/or inclusive epidemiologic studies. This review covered the effectiveness of recent advances in prosthetic materials and implant procedures used in repair of abdominal wall, based on biomechanical properties and economic aspects of reconstructed large abdominal wall defects and hernias in animals. The presented results in this review helped to reach treatment algorithms that could maximize outcomes and minimize morbidity.

The aim of this article is to investigate the potential risk of a critical life-threatening hemorrhage due to the perforation of the lingual cortical plate and arterial trauma of the terminal branches of the sublingual artery. In fact, in many cases, implants are placed in the mandibular interforaminal region, and this area is also often involved in oral surgery as a bone donor site.One hundred dry skull Caucasian mandibles and 100 computed tomographies (CTs) of the mandible of Caucasian patients were examined. The entrances of the lingual vascular canals were analyzed. Positions and dimensions of the entrances are reported.In 80% of the dry skull mandibles, at least 1 lingual canal was found, and the CT scan detected the presence of at least 1 lingual vascular canal in up to 60% of patients.A CT examination should routinely be performed before any surgical approach to the interforaminal region.

Implantation of cardiac implantable electronic devices (CIEDs), including pacemakers, implantable cardioverter-defibrillators, and biventricular pacemakers/cardioverter-defibrillators, is becoming increasingly common with new implants now exceeding 1.5 million per year globally. As a result, health care providers in all disciplines are caring for an increasing number of patients with CIEDs. Although the risk of complications associated with implantation of CIEDs is relatively low, the sequela can be catastrophic. Management requires an understanding of an individual patient's indication for CIED implant, the steps of implant procedures, device function, and natural history of each complication.

Preoperative assessment of maxillary sinus anatomy can prevent complications associated with sinus grafting or implant procedures. The purpose of this study was to measure the frequency, numbers, locations, orientations, and heights of maxillary sinus septa.Reconstructed cone-beam computed tomographic images of 1,012 sinuses were analyzed using NewTom VG software (NNT 2.21, ImageWorks, Elmsford, NY). This cross-sectional study included patients who underwent radiography at the department of radiology. The presence, numbers, locations, orientations, and heights of septa were analyzed. To establish multiple predictors in this study, groups were defined according to different radiographic features of the septa. Differences between male and female groups and between edentulous and dentulous groups were tested with χ(2) tests and the level of significance was set at 5%.The sample consisted of 506 patients (168 men and 338 women; average age, 35.1 yr). A significantly (P.05) greater occurrence rate of 57.4% was observed in the edentulous group compared with the rate of 39.7% observed in the dentulous group.The difference in the prevalence of maxillary sinus septa between the edentulous and dentulous groups was statistically significant (P.05), and the septa exhibited variable characteristics. It is essential and effective to analyze computed tomographic images of sinuses to evaluate the characteristics of septa before performing surgical procedures.

The Keller Funnel, an FDA Class 1 device, in 2009 provided plastic and cosmetic surgeons a new tool for inserting silicone implants in augmentation or reconstruction procedures. Conceived by plastic surgeon Kevin Keller, MD, the device was designed to simplify the delivery of the implant into the breast pocket, to reduce incision lengths to equal that of saline implant procedures, and to offer a minimal or no-touch technique to lessen the introduction of contaminants. The development and success of the implant delivery device, the Keller Funnel, happened like many emerging enterprises with part ingenuity, part serendipity, and a lot of energy.

The aim was to develop a morphometric and anatomically accurate atlas (statistical shape model) of calcaneus. The model is based on 18 left foot and 18 right foot computed tomography studies of 28 male individuals aged from 17 to 62 years, with no known foot pathology. A procedure for automatic atlas included extraction and identification of common features, averaging feature position, obtaining mean geometry, mathematical shape description and variability analysis. Expert manual assistance was included for the model to fulfil the accuracy sought by medical professionals. The proposed for the first time statistical shape model of the calcaneus could be of value in many orthopaedic applications including providing support in diagnosing pathological lesions, pre-operative planning, classification and treatment of calcaneus fractures as well as for the development of future implant procedures.

PURPOSE The main aim of this study was to investigate the loss of maxillary teeth opposing mandibular implant-supported prostheses (ISPs) placed at dental clinics. MATERIALS AND METHODS Participating dentists were asked to provide information on implant procedures they had undertaken between January 1, 1990, and December 31, 2009. Data were requested for procedures in which implants were inserted into only one side of the mandible in posterior regions and no implants were inserted in other regions. RESULTS Data on a total of 383 patients were analyzed. Participants in this study consisted of 170 men and 213 women ranging from 20 to 78 years of age (mean age, 51.0 years). Natural teeth were divided into three groups: opposing teeth (teeth opposing ISPs), control teeth (teeth of the same type as the opposing teeth but on the other side of the maxilla), and other teeth. The mean observation period was 72 months. One hundred six teeth were lost during the observation period. Fourteen opposing teeth were lost (1.72%, 14/816), 15 control teeth were lost (1.84%, 15/816), and 77 other teeth were lost (0.98%, 77/7,891). The percentage of opposing teeth lost was significantly higher than that of other teeth. However, there was no difference in the rates of loss of opposing and control teeth. CONCLUSION ISPs in posterior mandibular regions are not a risk factor for the loss of opposing teeth.

Background Liver transplantation surgery is carried out in only a few selected centres in the UK. This study was performed with a view to identifying potential training opportunities available for the general and specialist higher surgical trainee, and also to assess the outcome following liver transplant surgery according to the grade of the surgeon performing the procedure. Methods Data on 111 liver transplants with caval preservation undertaken consecutively in a single unit during a 32-month period were collected and analysed. The transplant procedures were grouped into those performed by consultants and those performed by supervised trainees. Survival was estimated by the Kaplan–Meier method. The Cox regression model was used to examine the influence of grade of the surgeon on survival. χ2 and independent sample t tests were used to identify significant preoperative, intraoperative and postoperative variables. Results Trainees carried out 34 recipient hepatectomies (31 per cent), 47 implant procedures (42 per cent) and all 143 retrieval operations. The mean time taken by a supervised trainee to carry out a recipient hepatectomy and implantation was 183 and 44 min compared with 165 and 46 min for a consultant (P = 0·22 and P = 0·44 respectively). The mean intraoperative red cell requirement was 8 units for both consultants and trainees (P = 0·85). The overall patient survival rate was 88 per cent at 3 years and the grade of the surgeon made no difference to survival or the occurrence of complications (P > 0·05). Conclusion The outcome following liver transplantation with caval preservation did not differ according to the grade of the surgeon performing the procedure. Extensive training opportunities are available to learn hepatobiliary and vascular surgical techniques in liver transplantation surgery.

Many implant practitioners have been taught to use one implant system by a specific manufacturer. However, to successfully treat a patient, implant clinicians must learn to utilize the strengths of various systems when the patient’s condition warrants it. The purpose of this paper is to illustrate how an edentulous patient with atrophied bone was treated with multiple-model implant procedures. Her treatment included different root form implants, bone spreading augmentations, endosseous submerged blades, tricortical support Diskimplants, and a custom-made ramus blade implant.

Disadvantages of existing balloon expandable or self-expanding transcatheter platforms for mitral valve-in-valve include the potential for malposition during deployment and for LV outflow tract obstruction Controlled mechanical valve expansion, the option to reposition, and stable hemodynamics throughout the procedure make the LOTUS valve an attractive option for mitral valve-in-valve Correct sizing remains a critical aspect of all trancatheter valve implant procedures, including valve-in-valve implants.

Statement of problem. The process of removing excess cement from subgingival margins after cementation of restorations to implant abutments may lead to scratching of the abutments or incomplete cement removal. Purpose. The purpose of this study was to investigate and to compare the surfaces of abutments after the removal of three cements (glass ionomer, resin, and zinc phosphate) by use of three instruments (gold coated scaler, rigid plastic scaler, and stainless steel explorer). Material and methods. Six investigators removed zinc phosphate, glass ionomer, and resin cements with explorers, gold coated scalers, and rigid plastic scalers with a model simulating clinical conditions. The surface of Branemark abutments with cemented restorations were examined with a microscope at 20× for scratches and cement remnants. Results. Statistical analysis of the results were inconclusive about which combination of instrument and cement worked most effectively. Conclusion. A surprising amount of cement remnants and scratching of abutments was observed. Although the six investigators were experienced in prosthodontic and implant procedures, there was variation in the results of their cement removal. (J Prosthet Dent 1997;78:43-7.)

Whereas implanters of cardiovascular implantable electronic devices (CIED) consider implant procedures successful when lead measurements are adequate and the incision has healed without complication, patients often base their final opinion of the procedure on the cosmetic outcome. Fortunately, optimization of cosmetic results is strongly linked to minimization of wound complications as well as simple refinement of techniques and strategies throughout the peri-implant period.