Objectives
The aim of Working Group 4 was to address topics related to biologic risks and complications associated with implant dentistry. Focused questions on (a) diagnosis of peri‐implantitis, (b) ...complications associated with implants in augmented sites, (c) outcomes following treatment of peri‐implantitis, and (d) implant therapy in geriatric patients and/or patients with systemic diseases were addressed.
Materials and methods
Four systematic reviews formed the basis for discussion in Group 4. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary.
Results
Bleeding on probing (BOP) alone is insufficient for the diagnosis of peri‐implantitis. The positive predictive value of BOP alone for the diagnosis of peri‐implantitis varies and is dependent on the prevalence of peri‐implantitis within the population. For patients with implants in augmented sites, the prevalence of peri‐implantitis and implant loss is low over the medium to long term. Peri‐implantitis treatment protocols which include individualized supportive care result in high survival of implants after 5 years with about three‐quarters of implants still present. Advanced age alone is not a contraindication for implant therapy. Implant placement in patients with cancer receiving high‐dose antiresorptive therapy is contraindicated due to the associated high risk for complications.
Conclusions
Diagnosis of peri‐implantitis requires the presence of BOP as well as progressive bone loss. Prevalence of peri‐implantitis for implants in augmented sites is low. Peri‐implantitis treatment should be followed by individualized supportive care. Implant therapy for geriatric patients is not contraindicated; however, comorbidities and autonomy should be considered.
Fifty-three cases of chronic lesion of the anterior cruciate ligament were followed up clinically and radiographically, and treated consecutively with an artificial Dacron Stryker ligament. An ...average of 29 months (range 12-53) after surgery, the authors report a high incidence of residual laxity (70.5%) and a 13% incidence of complications. There were no cases of evident synovitis, even if the authors do report a high percentage (85%) of periligamentous femoral osteolysis. Based on the results obtained, the authors believe that the Dacron Stryker ligamentous prosthesis is only indicated in cases where a biological ligament fails in patients engaged in competitive sports who request immediate activity for a limited period of time.
Posterior osteosynthesis in C1-C2 instability Bartolozzi, P; Salvi, M; Misasi, M
Archivio "Putti" di chirurgia degli organi di movimento,
1990, Letnik:
38, Številka:
2
Journal Article
This is a retrospective study of 8 cases of instability of the C1-C2 segment caused by R.A. or non-union and treated by posterior stabilization with wire loops and bone grafts. The authors reported ...good results in patients with mild recent neurological involvement and/or radiographic instability of the segment (posterior subluxation of the dens greater than 1/3 of the A-P diameter of C1 or tilting of the dens greater than 30 degrees). The death of a patient with non-union of the dens and severe neurological involvement due to respiratory palsy leads the authors to regard severe long-term neurological involvement (quadriparesis) a contraindication for this type of procedure.
The authors report their results on E.S.R. variations within the first month post-surgery in 38 traumatologic and orthopaedic patients, to evaluate the time of normalization and its attendibility in ...case of infection. Normalization was found within the first month postoperatively, without significant differences between orthopaedic and traumatologic patients. They think that the E.S.R. becomes significant on the control of postoperative subacute infection after the third postoperative day and propose E.S.R. evaluation after this period.
A new method of treatment of dislocated fractures and apophyseal fractures, using direct traction by pins on the bone fragments, and cast is presented. The authors describe the technique employed and ...report the results of the 22 cases treated.
Stress Fractures Conte, M.; Caputo, F.; Piu, G. ...
Orthopedic Sports Medicine
Book Chapter
Stress fractures (SFs), or fatigue fractures, are common overuse injuries of bone often suffered by elite and recreational athletes. They may occur anywhere in the body since all bones, but ...especially those of the lower limbs, are involved in most sports-related activities. Extrinsic and intrinsic factors influence the probability of SF development, some of these factors, such as physical conditioning, are well known, but others are still a matter of debate, such as anatomical conformation, gender, nutrition and equipment. The literature consists mostly of case series, with only a few analyses providing generally applicable evidence concerning risks and treatment. Pain is related to the particular activity. The clinical diagnosis of SFs is not always apparent from the patient’s history and physical examination, such that imaging (MRI, bone scan and CT scan) is crucial. In most patients, non-surgical treatment - consisting of rest and NSAIDs followed by a gradual return to sports activity once clinical symptoms are no longer present and there is radiographic evidence of recovery of bone fracture — is successful after 12 weeks. The timing of surgical treatment is not yet well established and depends on the SF site, symptoms duration, and activity level. Surgeons specializing in sports medicine should strive to recognize SFs as early as possible to achieve the best results for these patients and to reduce inactivity for elite and recreational athletes. Further studies are needed to prevent this common overuse injury and to establish a treatment algorithm aimed at allowing the athlete to return to his or her activity as quickly as possible and at reducing the risk of refracture.
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