scholarly journals Association of Type of Splint, Rationale for Splinting and Survival of Splint, Based on Different Clinical Scenarios with Long Term Follow Up in Chennai Population

2021 ◽  
Vol 10 (30) ◽  
pp. 2260-2265
Author(s):  
Siddharth Narayan ◽  
Sankari Malaiappan

BACKGROUND The revival of older treatment modalities like splinting requires the assessment of newer patient centric parameters like survival, compliance, anaesthetics apart from changing the biomaterials employed alone. The purpose of this study was to assess the association between type of splint, chief complaint and survival of splint based on different clinical scenarios with long term follow-up. METHODS The present study was a prospective university based clinical trial with convenience sampling to include clinical scenarios which required splinting in a Chennai Dental College. Ninety-five adult patients were included in the study comprising 50 men and 45 women, aged between 19 - 65 years where parameters like demographic distribution, type of splint, location of the splint, patient compliance and survival were included. The primary end point of the present study was recall of patients periodically every month till 6 - 8 months to assess the duration of survival of splints and associate the same with age, gender, patient compliance, type of splint and rationale for splinting. RESULTS Among the 95 patients included (524 teeth splinted together), all patients completed the treatment protocol, stainless steel wire composite splints were given to 70 patients while composite mesh splints were used in 20 patients. A likelihood ratio of 0.024 (P < 0.05) was seen while associating composite mesh splints, rationale for use, survival time and patient compliance. CONCLUSIONS Within the limits of the present study, a conclusion was made that one must emphasise on the importance of retaining natural teeth based on appropriate clinical scenarios where maximum benefit could be obtained among compliant patients. KEY WORDS Periodontal Splints, Survival Rate, Patient Compliance, Rationale for Splinting, Tooth Fractures, Tooth Reimplantation

1996 ◽  
Vol 17 (1) ◽  
pp. 41-42 ◽  
Author(s):  
Christopher L. Tisdel ◽  
Marion C. Harper

The efficacy of a short leg walking cast in the treatment of chronic plantar heel pain was assessed for 32 patients with 37 involved extremities treated over a 2-year period. All patients had failed numerous other treatment modalities and had been symptomatic for an average of 1 year. Long-term follow-up for 24 patients with 28 involved extremities revealed complete resolution of pain for 7 extremities (25%), improvement for 17 (61%), and no improvement for 4 (14%). Ten (42%) patients were completely satisfied with cast treatment, 3 (12%) were satisfied with reservations, and 11 (46%) were dissatisfied. Casting appears to be a reasonable option for patients with recalcitrant heel pain and should be offered before surgical intervention.


2017 ◽  
Vol 45 (5) ◽  
pp. 649-654 ◽  
Author(s):  
Isabelle Francisca Petronella Maria Kappen ◽  
Gerhard Koendert Pieter Bittermann ◽  
Dirk Bitterman ◽  
Aebele Barber Mink van der Molen ◽  
William Shaw ◽  
...  

2018 ◽  
Vol 97 (10-11) ◽  
pp. E36-E43
Author(s):  
Vikram Shetty ◽  
Akshaya Kulkarni ◽  
Suman Banerjee

Rhinosporidiosis is a rare, chronic, granulomatous infection of the mucous membranes that mainly involves the nose and nasopharynx; it occasionally involves the pharynx, conjunctiva, larynx, trachea and, rarely, the skin. The characteristic clinical features of this disease include the formation of painless polyps in the nasal mucosa or the nasopharynx that bleed easily on touch. At our center, excision of the lesion with a Le Fort I osteotomy is carried out in patients (1) in whom two or more previous attempts at excision of biopsy-proven rhinosporidiosis arising from the nasal mucosa was carried out or (2) in whom the rhinosporidiosis arises from the nasophayrngeal mucosa and/or extranasal sites. In this article we retrospectively present 7 cases in which, according to our inclusion criteria, complete excision of the lesion was carried out with a Le Fort I osteotomy. Excellent visualization of the entire maxillary and ethmoidal air cells after the down-fracture of the maxilla helped in the total removal of the lesions. Most of these lesions had multiple points of origin through the nasal, maxillary, and ethmoidal mucosa; the excellent visualization enabled direct cauterization of all these points of origin. The mean follow-up period was 7.96 years, and all patients were disease-free by the time the study was prepared. This article presents details of the treatment protocol and technique followed at our center for the treatment of nasopharyngeal rhinosporidiosis and the details of long-term follow-up. Through this study we hope to prove the efficacy of Le Fort I osteotomy in the definitive management of nasopharyngeal rhinosporidiosis.


2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Simonetta Franco ◽  
Simona Miccoli ◽  
Luisa Limongelli ◽  
Angela Tempesta ◽  
Giorgio Favia ◽  
...  

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is the most serious side effect in patients receiving bisphosphonates (BPs) for neoplastic disease and osteoporosis. The aim of this study is to propose a new dimensional stage classification, guiding the surgical treatment of BRONJ patients, and to evaluate the success rate of this new management. From 2004 to 2013, 203 neoplastic and osteoporotic patients with 266 BRONJ lesions were referred to the Odontostomatology Unit of the University of Bari. All patients underwent surgery after suspension of BPs therapy and antibiotic treatment. The surgical procedure was complemented by piezosurgery and followed by the application of hyaluronate and amino acids. The new dimensional staging suggests the choice of the surgical approach, and allows the prediction of postoperative complications and soft and hard tissues healing time, guiding the surgical treatment protocol. This protocol could be a successful management strategy for BRONJ, considering the low recurrences rate and the good stabilisation of the surgical sites observed after a long-term follow-up.


2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Anuj Mahajan ◽  
Prashanth Adiga ◽  
Vivek Pai ◽  
Keerthi Raj

Abstract Background Malignant renal masses in paediatric age group are mostly Wilms’ tumour. RCC is very rare in this age group, papillary variant being the most common. Sarcomatoid variation occurs in 5% of adult RCC, while it is extremely rare in children. No treatment protocol exists in the management of paediatric RCC. Case presentation Here, we present a case of 10-year-old female who presented with left flank mass. Radical nephrectomy was done which showed clear cell carcinoma with sarcomatoid variant on histopathological examination. Conclusion RCC with sarcomatoid variation can occur in children. However, further studies and long-term follow-up are needed for formulating a treatment protocol and prognostication factors for the same.


2017 ◽  
Vol 20 (2) ◽  
pp. 189-199 ◽  
Author(s):  
Alison Major ◽  
Conor O’Halloran ◽  
Andrea Holmes ◽  
Stephanie Lalor ◽  
Rebecca Littler ◽  
...  

Case series summary Feline tuberculosis is an increasingly recognised potential zoonosis of cats. Treatment is challenging and prognosis can vary greatly between cases. Pulmonary infection requires extended courses of antibiotics, but methodologies for sensitively monitoring response to treatment are currently lacking. In this case series, we retrospectively examined the serial computed tomography (CT) findings in nine cats that had been diagnosed with tuberculosis. Changes in pathology (where applicable to tuberculosis) were correlated with the clinical presentation of each of the cats, the treatment protocol, and previous and contemporary diagnostic investigations. This study found that changes in CT findings during the medium- to long-term management of feline tuberculosis were highly variable between cats. The majority of cats had reduced pathology at re-examination during anti-tuberculous therapy, but pathology only resolved in a minority of cases. In some cases recurrence of pathology detected by CT imaging preceded clinical deterioration, allowing for rapid therapeutic intervention. Relevance and novel information When considered in combination with clinical findings, CT studies can aid in decision making regarding tapering of antibiotic protocols, or reintroduction of therapy in cases of recurrence or reinfection. This series also highlights that, in some cases, persistent abnormalities can be detected by CT, so complete resolution of CT pathology should not always be a goal in the management of feline tuberculosis.


2021 ◽  
Vol 12 ◽  
pp. 215145932110399
Author(s):  
Michele Novi ◽  
Giuseppe Porcellini ◽  
Alessandro Donà ◽  
Luigi Tarallo ◽  
Gianmario Micheloni ◽  
...  

Background During the last decades, the growing number of shoulder replacement has increased the associated complications. Periprosthetic fractures have a low incidence but can be a severe clinical condition, especially in elderly population. There are still no guidelines to define the best treatment protocol for post-operative periprosthetic humeral fractures. Factors associated to these fractures and consequently the decision-making for the best treatment seem to be patient-related but also correlated with the type of implant. The aim of this study is to analyze the patient’s risk factors, fracture pattern, implant type and treatment, evaluating the outcome with a long-term follow-up. Methods A retrospective study was performed on more than 2700 shoulder prostheses implanted over 10 years in two specialized centers, identifying 19 patients who underwent surgery for post-operative periprosthetic fracture. Gender, age, comorbidities, type of prosthetic implant, type of fracture, and cortical index of each patient were evaluated. All patients underwent surgery and were evaluated with a mean follow-up of 5 years with radiographic controls and functional assessment with the Constant–Murley score. Results Complete healing was achieved in 18 of 19 patients. All patients presented a lower Constant–Murley score than the pre-fracture score, there were no significant differences between prosthetic implants, and the cortical index was lower than the threshold level in more than 60% of cases. Conclusion The results of this study showed that a correct preoperative planning is essential to evaluate the type of implant and possible signs of stem mobilization. With a stable stem, it is preferable to maintain it and proceed to a synthesis. The decision process is more complex in periprosthetic fractures with a reduced cortical index, when some radiolucency lines are present in stems with high primary stability, because it is not always indicative of an unstable stem. Level of Evidence Therapeutic III


2017 ◽  
Vol 44 (3) ◽  
pp. 202-209 ◽  
Author(s):  
Isabelle Francisca Petronella Maria Kappen ◽  
Dirk Bittermann ◽  
Laura Janssen ◽  
Gerhard Koendert Pieter Bittermann ◽  
Chantal Boonacker ◽  
...  

2016 ◽  
Vol 14 (4) ◽  
pp. 577-579 ◽  
Author(s):  
Antonio Luiz de Vasconcellos Macedo ◽  
Vladimir Schraibman

ABSTRACT The intraoperative identification of certain anatomical structures because they are small or visually occult may be challenging. The development of minimally invasive surgery brought additional difficulties to identify these structures due to the lack of complete tactile sensitivity. A number of different forms of intraoperative mapping have been tried. Recently, the near-infrared fluorescence imaging technology with indocyanine green has been added to robotic platforms. In addition, this technology has been tested in several types of operations, and has advantages such as safety, low cost and good results. Disadvantages are linked to contrast distribution in certain clinical scenarios. The intraoperative near-infrared fluorescent imaging is new and promising addition to robotic surgery. Several reports show the utility of this technology in several different procedures. The ideal dose, time and site for dye injection are not well defined. No high quality evidence-based comparative studies and long-term follow-up outcomes have been published so far. Initial results, however, are good and safe.


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