Bicortical Screw and Needle Welded Together as Effective Implant Technique for Immediate Load of SINGLE Tooth in Aesthetic Zone Characterized by Severe Bony Reabsorption: Cases Report

After a long period of time in which submerged implants were used just with delayed load, scientific evidence has led to immediate loading, finally re-evaluating the long lasting experience gotten with one-piece implants. In aesthetic area, if bone is deep and wide, immediate load can be performed with any type of implants, with scarce risk of failure. Situations in which bone is scarce are frequent and impose to choose between performing a suitable technique compatible with immediate loading or renouncing to immediate loading. In our experience, implant technique based on the welding-in-mouth of a titanium needle to main implant is regularly destined to success, because the needle implant, deeply anchored to bone, compensates the lateral forces that normally push the tooth forward. The long lasting experience accrued since over 30 years in our professional offices leads us to suggest this technique as a standard solution while dealing with bone reabsorption in the aesthetic area. We are certain that further studies will confirm our conclusions.

Olecranon fixation with two bicortical screws

Aims The aim of this study is to report the results of a case series of olecranon fractures and olecranon osteotomies treated with two bicortical screws. Methods Data was collected retrospectively for all olecranon fractures and osteotomies fixed with two bicortical screws between January 2008 and December 2019 at our institution. The following outcome measures were assessed; re-operation, complications, radiological loss of reduction, and elbow range of flexion-extension. Results Bicortical screw fixation was used to treat 17 olecranon fractures and ten osteotomies. The mean age of patients being treated for olecranon fracture and osteotomy were 48.6 years and 52.7 years respectively. Overall, 18% of olecranon fractures were classified as Mayo type I, 71% type II, and 12% type III. No cases of fracture or osteotomy required operative re-intervention. There were two cases of loss of fracture reduction which occurred in female patients ≥ 75 years of age with osteoporotic bone. In both cases, active extension and a functional range of movement was maintained and so the loss of reduction was managed non-operatively. For the fracture fixation cohort, at final follow-up mean elbow extension and flexion were -5° ± 5° and 136° ± 7°, with a mean arc of motion of 131° ± 11°. Conclusion This series has shown that patients regain near full range of elbow flexion-extension and complication rates are low following bicortical screw fixation of olecranon fractures and osteotomy. Cite this article: Bone Joint Open 2020;1-7:376–382.

Olecranon fixation with two bicortical screws

Aims The aim of this study is to report the results of a case series of olecranon fractures and olecranon osteotomies treated with two bicortical screws. Methods Data was collected retrospectively for all olecranon fractures and osteotomies fixed with two bicortical screws between January 2008 and December 2019 at our institution. The following outcome measures were assessed; re-operation, complications, radiological loss of reduction, and elbow range of flexion-extension. Results Bicortical screw fixation was used to treat 17 olecranon fractures and ten osteotomies. The mean age of patients being treated for olecranon fracture and osteotomy were 48.6 years and 52.7 years respectively. Overall, 18% of olecranon fractures were classified as Mayo type I, 71% type II, and 12% type III. No cases of fracture or osteotomy required operative re-intervention. There were two cases of loss of fracture reduction which occurred in female patients ≥ 75 years of age with osteoporotic bone. In both cases, active extension and a functional range of movement was maintained and so the loss of reduction was managed non-operatively. For the fracture fixation cohort, at final follow-up mean elbow extension and flexion were -5° ± 5° and 136° ± 7°, with a mean arc of motion of 131° ± 11°. Conclusion This series has shown that patients regain near full range of elbow flexion-extension and complication rates are low following bicortical screw fixation of olecranon fractures and osteotomy. Cite this article: Bone Joint Open 2020;1-7:376–382.

Biomechanical Evaluation of Sagittal Split Ramus Osteotomy Fixation Techniques in Mandibular Setback

The objective of this study was to evaluate and compare the biomechanical behavior of internal fixation techniques in bilateral sagittal split ramus osteotomies (BSSROs) for mandibular setback. Artificial polyurethane mandibles were used in this study. The distal segment of the mandible was repositioned in an 8-mm setback position. All mandibles were divided into three groups: Group 1 had a straight plate with a four-hole monocortical fixation, Group 2 had a curved plate with a four-hole monocortical fixation, and Group 3 had a three–inverted L-type bicortical screw fixation. Vertical loads were applied on the incisal edge by a material testing system. The resistance force at 1, 3, 5, and 10 mm of displacement was analyzed. From the experimental results, Group 1 showed significantly lower results than Groups 2 and 3. No significant difference was observed between Groups 2 and 3 at 1, 3, and 5 mm of displacement. However, at 10 mm of displacement, the resistance force of Group 3 was greater than that of Group 2. For BSSROs, this study concluded that curved plate fixation exhibited the same rigidity as the inverted-L bicortical screw fixation did at ≤5 mm displacement.