Analysis of risk factors of 19 fractured implants / 中华口腔医学杂志

Objective@#To analyze the incidence and possible risk factors of 19 fractured implants out of 8 468 implants in 3 184 cases.@*Methods@#During the 22-year clinical practice, clinical records of 18 patients with 19 fractured implants in 3 184 cases with 8 468 implants were analyzed to determine the following factors: location of the fractured implants, prosthodontics option, date of implant fracture, dimensions of fractured implants, complications prior to implant fracture and parafunctional habit. An evaluation of fractured implants was performed to identify possible factors that may predispose an implant to a higher risk of fracture.@*Results@#Overall, the average duration of service of the implants was (7.0±4.5) years. Implant fracture occurred in 7 Camlog implants, 7 Nobel replace implants, 3 Ankylos implants and 2 Brånemark implants. No Thommen implant fractures were recorded. Amongst the 19 fractured implants, 8 occurred at the thinnest wall portion of the implant neck, 8 at the end of screw and 3 at the self-tapping thread region. All fractures were observed after functional loading. Furthermore, 9/19 (47.4%) of fractures occurred in the maxilla, indicating similar incidence rates in both arches (P=0.065). Most of fractures (16/19) occurred in the molar region and 18/19 in single implant-supported restorations. Totally 17 cases had received metal occlusal restorations. In 6 cases (35.5%), previous bone destruction apically extending to the level of implant fracture was documented before any clinical signs of fracture. Three fractured implants were removed and simultaneously re-implanted with larger-diameter implants, while the rest of the cases were left to heal, followed by a second-stage surgery.@*Conclusions@#Within the limitation of this analysis, the study demonstrated that appropriate implant-abutment connection design, implant diameter, prosthetic strategy and bone resorption are crucial to the long-term performance of implants. There is no significant difference of fractures rates in both archs.

Clinical evaluation of socket shield technique in maxillary anterior region / 中华口腔医学杂志

Objective@#To evaluate the preliminary clinical outcome of socket shield technique in maxillary anterior region.@*Methods@#Nine patients were treated with socket shield technique in Peking University School and Hospital of Stomatology from February 2012 to December 2015 were enrolled in this study. Ten implants were placed and restored immediately. After 12-48 months' follow-up (averaged 32 months), the peri-implant hard and soft tissue were clinically evaluated.@*Results@#No implants were lost during the observation period, resulting a cumulate 32-month survival. The pink esthetic score (PES) was 13.5. Mesial and distal bone loss were 0.17 mm and 0.22 mm respectively.@*Conclusions@#To achieve good esthetic results, socket shield technique may be an option for maxillary anterior region immediate implant placement.

A retrospective study of six fractured platform-switching abutments / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To explore the reasons for platform-switching abutment fracture, the treatment and prevention methods.</p><p><b>METHODS</b>Between March 2009 and December 2014, all of the fractured platform-switching abutments were evaluated. The fracture rate of platform-switching abutments was calculated and the gender, age, implant site, implant size, abutment size, prosthetic type, loading time and crown materials were analyzed.</p><p><b>RESULTS</b>A total of 2 487 platform-switching implants were placed during this period and 6 abutments were fractured. The fracture rate was 0.24% (6/2 487). All of the 6 fractured abutments were placed in molar region. All occlusal planes were made of metal material. Five patients were male. All the fracture abutments could not be removed and the implants had to be removed and reimplanted.</p><p><b>CONCLUSIONS</b>Without special abutment removing instruments, it is difficult to remove the fractured platform-switching abutment. In molar region, platform-switching implant system should be carefully used. Increasing implants number and splinting crowns with porcelain occlusal planes might reduce the abutment fracture risk.</p>

A 10-year retrospective analysis of clinical results of implant-retained/ supported prostheses in full edentulous patients / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the 10-year clinical results of implant prostheses in edentulous patients.</p><p><b>METHODS</b>Between August 1994 and November 2009, 762 implants were placed in 127 patients (162 jaws) with the mean age of (56.0 ± 10.9) years in Peking University, School and Hospital of Stomatology. Sinus lift, guide bone regeneration (GBR) and onlay graft were used according to the indications of bone defect types. Overdentures and fixed bridges were delivered.Overdentures were retained/supported by ball, magnet, telescopic crown or milled bar. Clinical evaluation included peri-implant soft tissue health status, prostheses functional status and complications.Radiographic evaluations were conducted at operation day, 3 months post-operatively, right after prostheses delivery, and annually afterwards. Clinical data were collected and analyzed.</p><p><b>RESULTS</b>Of the 127 patients, 116 were edentulous mandible and 46 edentulous maxilla, with a mean follow-up period 109.2 months(45-228 months). Thirteen implants were lost and the 10-year implant cumulative survival rate was 97.8% and the prostheses success rate was 100.0%. The prevalence of peri-implantitis was 3.8% (29/762). Sixty-seven point nine percent of the patients underwent implant placement without bone graft.Sinus lift technique and guided bone regeneration technique were the most often used with 84.8% (39/46) in the upper jaws and 6.2% (10/162) in the total jaws respectively. Seventy-one percent of the cases(115/162) was overdentures. Telescopic, milled-bar, and magnetic retained/supported overdentures were the most commonly used with 34.8% (40/115) , 27.0% (31/115) , and 20.0% (23/115) respectively. The implant-supported fixed prostheses included adhesive retained fixed bridges and screw retained fixed bridges with the ratio of 19.1% and 80.9% respectively. The prevalence of 10-year post-prosthodontic complications was 53.5% (68 cases). The most common complications were prosthetic and uperstructure complications.</p><p><b>CONCLUSIONS</b>The 10-year implant-retained/supported prostheses was a successful modality in edentulous cases.Sinus lift technique and guided bone regeneration technique are the most commonly used techniques with predictable clinical results. Telescopic crowns milled bar and magnet with 4-6 implants retained/supported overdenture were the most often used retention systems and telescopic crown overdenture had more advantages in terms of long-term maintenance and satisfaction.</p>

Laparoscopic proctosigmoidectomy for cavernous hemangioma of the colorectum / 中华普通外科杂志

Objective To study the clinical characteristic and treatment of colorectal cavernous angioma and laparoscopic proctosigmoidectomy in colorectal cavernous angioma. Methods Clinical data of 8 colorectal cavernous angioma cases were analyzed. Results Cavernous hemangioma located in the rectum in 4 cases,in the proctosigmoid in 3 cases,and in the proctosigmoid and descending colon in one case.Under definite diagnosis,all cases underwent laparoscopic colorectomy,the postoperative recovery was satisfactory,and there was no postoperative mortality. Conclusions Colorectal cavernous angioma is rare,and usually be misdiagnosed.It commonly involves sigmoid and rectum.Laparoscopic proctosigmoidectomy is an effective way to deal with the disease.

Analysis to Vomiting Treating in Fuqingzhu Nvke / 国际中医中药杂志

FU Shan, the famous doctor of Qing dynasty, had features in diagnosing and treating vomiting. His therapeutic experiences were recorded in his book Fuqingzhu Nvke. From his book we can see that he is treating vomiting basically from kidney and heart, associated by regulating the functions of spleen and stomach, calming the liver and harmonizing somach, and supplementing qi and blood.

Nosocomial Infection Knowledge of Nurses in Graduating Class / 中华医院感染学杂志

OBJECTIVE To investigate the nosocomial infection knowledge nurses in graduating class. METHODS 286 nurses of graduating class were investigated by questionnaires. RESULTS The students were lacked of knowledge about nosocomial infection and 61.70% nurses of graduating class had never participated in the training of nosocomial infection knowledge (the average score only 58.67). They were interested in the disinfection and sterilization of infection diseases. And they wanted to get it through clinical infection control group (81.56% students selected this educational methods). CONCLUSIONS It is necessary to strengthen the training and education of nosocomial infection. And adjust the training mode and content according object.

Clinical study of alveolar vertical distraction osteogenesis for implant / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical result of alveolar vertical distraction osteogenesis for implant.</p><p><b>METHODS</b>19 cases with severe vertical alveolar defects (more than 10 mm defect) underwent vertical distraction procedure before implant placement. 15 cases were male and 4 cases were female. The alveolar bone defects were caused by tumor resection in 10 cases, by trauma in 8 cases, and due to congenital defect in 1 case. The vertical defects in all cases were over 10 mm. X-ray examination were taken prior to operation and in 1 week, 2 week, 4 week, the end of active distraction and before removing distractor. Implants were placed in 17 cases after removing distractors. The prosthesis were finished 6 month later.</p><p><b>RESULTS</b>11 cases out of 19 had implant prosthesis. 6 cases had implant in the jaw but waiting for the prosthesis. Altogether 65 dental implants were placed, 2 cases did not receive further implant treatment because of cost problem. The study showed that new bone formed after distraction in all 19 cases. Average gained height of new bone was 13 mm.</p><p><b>COMPLICATIONS</b>Unexpected mandible fracture in 2 cases, infection in 1 case.</p><p><b>CONCLUSIONS</b>Alveolar vertical distraction is a good alterative for severe alveolar defects. The distractor should be further developed and modified.</p>

A clinical and histological study of Bio-Oss in combination with guided bone regeneration membrane technique / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the reliability of Bio-Oss particles as bone grafts in combination with membrane-technique.</p><p><b>METHODS</b>6 small biopsy specimens were retrieved without causing iatrogenic damage in 6 patients (implant sites). The Donath's hard tissue section and micro grinding technique was adopted, and Leval Laczko staining method was used.</p><p><b>RESULTS</b>The histological results showed Bio-Oss particles were easily distinguished from the newly formed bone, but new bone was formed among different particles of Bio-Oss, no connective tissue was found. Intimate contact between newly formed bone and particles of the graft was present.</p><p><b>CONCLUSIONS</b>Bio-Oss appears to be highly biocompatible and osteoconductive. It can be used success fully as a bone substitute in combination with guided bone regeneration membrane technique.</p>

Perioperative Treatment for Elderly Patients with Cardiopulmonary Diseases Undergoing Laparoscopic Cholecystectomy / 中国微创外科杂志

Objective To report our experience on laparoscopic cholecystectomy(LC) for elderly patients with cholecystitis and cardiopulmonary diseases.Methods Totally 225 elderly patients,who had undergone laparoscopic cholecystectomy in our hospital between January 2000 and June 2008,were retrospectively analyzed. Results Among the cases,LC were completed in 222 patients,the other 3 were converted to open surgery.No bile duct injury or biliary leakage occurred.After the operation,7 cases developed pulmonary infection,and 3 cases showed urinary infection,all of them were cured by antibiotics.Three cases suffered from cardiac ischemia without further damage.Conclusions With strict enrollment criteria,careful preoperative preparation,skillful operation,and intensive intra-and postoperative monitor,the LC is safe for elderly patients as a minimally invasive surgery.