Ligadura del trayecto fistuloso interesfinteriano. Nuestros resultados / Ligation of the intersphincteric fistulatract. Our results

Introducción: existen varias técnicas para el tratamiento quirúrgico de las fístulas anales, con variables resultados. La técnica de ligadura del trayecto fistuloso interesfinteriano (LIFT) consiste en la disección del espacio entre ambos esfínteres para localizar el trayecto fistuloso y proceder a su ligadura y sección. Objetivo: evaluar nuestros resultados con la técnica de LIFT para del tratamiento de las fístulas anales transesfinterianas. Diseño: retrospectivo, observacional de corte transversal. Materiales y métodos: Se incluyeron todos los pacientes con fístulas transesfinterianas tratados con LIFT desde enero de 2013 a diciembre 2020. El seguimiento postoperatorio se realizó hasta los 2 años. Resultados: se operaron 62 pacientes. El sexo predominante fue masculino. Hubo 47 pacientes con fístulas transesfinterianas bajas y 15 con fístulas transesfinterianas altas. En todos se identificó el trayecto fistuloso realizándose ligadura de ambos cabos del trayecto interesfinteriano y se procedió a un curetaje del trayecto a través del orificio externo. Cinco pacientes (8%) presentaron dehiscencia de piel a nivel de la incisión del espacio interesfinteriano, manejado en forma conservadora. Este grupo tuvo una cicatrización mas retardada de 4 semanas. Ocurrió recidiva en 22 (35,5%) pacientes. Conclusión: La técnica de LIFT parece una alternativa eficaz y segura para el tratamiento de las fístulas transesfinterianas bajas y altas ya que no altera la anatomía ni la continencia. (AU)

Introduction: there are various techniques for the surgical treatment of anal fistulas, with variable results. The ligation procedure of the intersphincteric fistulous tract (LIFT) consists of dissecting the space between both sphincters to locate the fistulous tract and proceed to its ligation and section. Objective: to evaluate our results with the LIFT procedure for the treatment of transsphincteric anal fistulas. Design: retrospective, cross-sectional observational study. Material and methods: all patients with transsphincteric fistulas treated with LIFT from January 2013 to December 2020 were included. Postoperative follow-up was carried out for up to 2 years. Results: sixty-two patients underwent surgery. The predominant sex was male. There were 47 patients with low transsphincteric fistulas and 15 with high transsphincteric fistulas. After identifying the fistulous tract in the intersphincteric groove, both ends were ligated and the tract was cut. Finally, curettage of the tract through the external orifice was performed. Five patients (8%) presented skin dehiscence at the level of the intersphincteric groove incision, managed conservatively. This group had a longer healing time of four weeks. Recurrence occurred in 22 (35.5%) patients. Conclusion: the LIFT procedure appears to be an effective and safe alternative for the treatment of low and high transsphincteric fistulas, since it does not alter the anatomy or continence. (AU)

Synthetic Hydroxyapatite Bone Graft Substitute In Sinus Augmentation - A Histological Analysis

Aim: Material And Method:To see the effect of synthetic Hydroxyapatite bone graft substitute in sinus augmentation. A lateral window was cut on the buccal aspect of the maxilla on the posterior region in the area of molar I/II and after carefully lifting the sinus membrane, bone graft was packed and a collagen membrane was placed on top of it. After a period of 8 months the site was re-entered to take bone sample for histological analysis using a trephine, at the same time, implant (Bioner Top DM, 4/10) was placed at the surgical site. The surgical site healed well. G-Bone hasResults: shown good bone growth histologically. The surgical site healed well. G-Bone has shown good bone growthConclusion: histologically.

Apport de la piézochirurgie et l'ostéotomie dans la surélévation sinusienne par voie crestale / Contribution of piezosurgery and osteotomy in crestal sinus lift

Dans la région postérieure maxillaire, après extractions dentaires, les crêtes subissent une résorption osseuse continue. Dans cette région s'ajoute un obstacle anatomique formé par le sinus maxillaire qui nécessite des conduites particulières avant et au moment de la pose d'implants. Parmi les techniques d'augmentation de volume osseux, la voie d'abord crestale

In the maxillary posterior region, after dental extractions, the ridges undergo continuous bone resorption. In this region, there is also an anatomical obstacle formed by the maxillary sinus, which requires special management before and at the time of implant placement. Techniques for bone augmentation include the crestal approach with osteotomes and piezo surgery

Six novel minimally invasive therapies for benign prostatic hyperplasia / 浙江大学学报·医学版

Benign prostatic hyperplasia (BPH) is the most common cause of lower urinary tract symptoms in men. When drug treatment is ineffective or conventional surgery is not suitable, novel minimally invasive therapies can be considered. These include prostatic urethral lift, prostatic artery embolisation, water vapor thermal therapy, Aquablation-image guided robotic waterjet ablation, temporary implantable nitinol device and prostatic stents. These novel therapies can be performed in outpatient setting under local anesthesia, with shorter operative and recovery times, and better protection of ejaculatory function and erectile function. General conditions of the patient and advantages and disadvantages of the each of these therapies should be fully considered to make individualized plans.

Facial lifting effect of SMAS multi-vector suspension / 中华医学美学美容杂志

Objective:To explore the rejuvenation effect of SMAS (Superficial musculoaponeurotic system) multi-vector suspension in the face and neck.Methods:From December 2019 to March 2023, the Plastic Surgery Department of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences implemented 34 cases of cheek rhytidectomy and 10 cases of cheek andneck rhytidectomy. Following general anaesthesia, liposuction is performed on the cheek and mandibular margins, and incisions are made anterior and posterior to the ear. At the end of the subcutaneous dissection, the SMAS in the region of the parotid gland is separated, and the SMAS is then secured by purse string multi-vector suture suspension. Intheend, excess skin is removed and the incision is reduced in tension.Results:All patients underwent successful surgeries and were satisfied with the postoperative follow-up results. The sagging soft tissues were effectively repositioned, resulting in natural facial and neck lift. There were no serious complications such as facial nerve injury, subcutaneous hematoma, incision infection, or skin flap necrosis.Conclusions:The utilization of MAS multi-vector suspension can significantly improve the relaxation of cheek and neck tissue, with fewer complications and satisfactory rejuvenation effect.

Ligation of intersphincteric fistula tract (LIFT) for the treatment of anal fistula: a prospective observational study

Background: The ligation of intersphincteric fistula fract (LIFT) technique avoids postoperative anal continence disturbances and preserves quality of life. Methods: A total of 70 patients with anal fistula (AF) were treated in the Day Surgery Unit. The LIFT technique was the primary treatment in 63 patients. The other had previously undergone placement of a loose seton (two-step approach). The mean follow-up was 66.8 months. Statistical analysis was performed using contingency tables, the chi-square test, and the Student T-test. Results: The use of LIFT was successful in 40 patients (57.1%). However, 6 patients (8.6%) presented persistence of postoperative intersphincteric fistula, being successfully treated by fistulotomy. There were no differences in this technique's success rate between high and low AF (p = 0.45). The success rate of one-step LIFT, however, was significantly higher (p = 0.03). No disturbances of continence were observed. Conclusions: The LIFT technique has a role in the treatment of AF, is suitable for ambulatory surgery, and has a low complications rate. A two-step approach is not always needed. (AU)

Elevación de seno maxilar sin injerto y colocación simultánea de implante dental / Graftless maxillary sinus lift with simultaneous dental implant placement

Introducción: La elevación de seno maxilar con implante dental simultáneo, sin el uso de substitutos óseos, ha retomado la teoría del potencial de neoformación ósea, que el coágulo de sangre alojado bajo la membrana de Schneider por sí solo presenta. Excluyendo así la necesidad de materiales exógenos. Objetivo: Exponer la efectividad de la elevación de seno maxilar con implante dental simultáneo, sin el uso de injerto, mediante la evaluación de la cantidad de ganancia ósea vertical. Presentación de casos: Caso 1: Paciente de 62 años, género femenino, que fue sometida a una elevación de seno maxilar sin injerto e implante dental simultáneo, con técnica de ventana lateral debido a altura ósea reducida de 5,24 mm. Luego del período de seguimiento tomográfico de 12 meses, después de la carga protésica, se logró una altura ósea vertical de 10,2 mm, lo que dio como resultado una ganancia ósea vertical de 4,96 mm. Caso 2: Paciente de 48 años, género femenino, que fue sometida a una elevación de seno maxilar sin injerto e implante dental simultáneo, con técnica transalveolar, mediante el uso de piezoeléctrico debido a una altura ósea reducida de 8,33 mm. Luego del período de seguimiento radiográfico de 4 meses, antes de la carga protésica, se logró una altura ósea vertical de 11,55 mm, lo que dio como resultado una ganancia ósea vertical de 3,19 mm. Conclusiones: Con base en estos 2 informes de casos, la elevación de seno maxilar e implante dental simultáneo sin injerto se asocian con la reducción de la morbilidad quirúrgica, menor probabilidad de procesos infecciosos y menor costo de la cirugía. Por lo tanto, puede considerarse una alternativa quirúrgica para la colocación de implantes en el maxilar posterior superior debido a deficiencias óseas verticales, independientemente de la técnica (lateral o transalveolar(AU)

Introduction: Maxillary sinus lift with simultaneous dental implantation without using bone substitutes, reapproaches the theory about the bone neoformation potential of the blood clot housed under the Schneider membrane, all by itself, thus excluding the need to use exogenous materials. Objective: Discuss the effectiveness of graftless maxillary sinus lift with simultaneous dental implant placement through an evaluation of the amount of vertical bone gain. Case presentation: Case 1: Female 62-year-old patient undergoing graftless maxillary sinus lift with simultaneous dental implantation by lateral window technique due to a reduced bone height of 5.24 mm. After a 12-month tomographic follow-up period subsequent to prosthetic loading, a 10.2 mm vertical bone height was achieved, resulting in 4.96 mm vertical bone gain. Case 2: Female 48-year-old patient undergoing graftless maxillary sinus lift with simultaneous dental implantation by transalveolar technique using a piezoelectric generator due to a reduced bone height of 8.33 mm. After a 4-month radiographic follow-up period, before prosthetic loading, an 11.55 mm vertical bone height was achieved, resulting in 3.19 mm vertical bone gain. Conclusions: According to these two case reports, graftless maxillary sinus lifting with simultaneous dental implantation is associated to reduced surgical morbidity, a lesser probability of infectious processes and lower surgical costs. It may therefore be considered to be a surgical alternative for implant placement in the posterior maxilla due to vertical bone deficiencies, regardless of the technique used (lateral or transalveolar(AU)

The efficacy and safety of prostatic urethral lift for benign prostatic hyperplasia: a systematic review and Meta-analysis / 中华泌尿外科杂志

Objective:The aim of this study was to evaluate the safety and efficacy of prostatistic urethral lift (PUL) in treating benign prostate hyperplasia(BPH) through systematic review and Meta-analysis.Methods:A systematic literature search on CNKI, Wanfang, VIP, PubMed, Web of Science, Cochrane Library and Chinese Clinical Trial Registry to identify the relevant studies and data before September 2021. Information was extracted from each eligible article. All statistical analyses of this Meta-analyses were performed with Review Manager 5.3 and Stata 15.0 software to conduct a Meta-analysis of the symptom improvement of BPH patients before and 3 months and 12 months after PUL. The main evaluation indicators included: International Prostate Symptom Score (IPSS), maximum urinary flow rate (Q max), post-void residual (PVR), and Quality of Life Scale (QOL), Sexual Health Inventory for Men (SHIM). The complication rate of PUL was systematically evaluated. Results:A total of 12 clinical studies were included, and 850 patients accepted the PUL. The results showed that IPSS decreased significantly at both 3 and 24 months after PUL surgery ( MD = -11.77, 95% CI -12.47—-11.07, P<0.05; MD = -9.71, 95% CI-10.76—-8.66, P<0.05), Q max (ml/s) increased to a certain degree ( MD = 3.87, 95% CI 3.37—4.37, P<0.05; MD = 3.68, 95% CI 2.97—4.40, P<0.05), QOL decreased significantly ( MD=-2.57, 95% CI -2.76—-2.38, P<0.05; MD = -2.14, 95% CI -2.38—-2.91, P<0.05), SHIM score was unaffected ( P>0.05), compared with preoperative baseline data. PUL could be performed under local anesthesia, the main perioperative complications reported in the included studies were dysuria (17%±6%), hematuria (14%±5%) and pelvic pain (8%±6%), all of which were transient. Conclusions:PUL in the treatment of BPH has significant short-term and long-term efficacy with low surgical risk and complication rate, and can preserve normal ejaculation function. It is a safe and effective minimally invasive surgery, which can be used for BPH patients with intolerance to general anesthesia surgery or normal sexual function demand.

The use of seton as a bridge to definitive ligation of the intersphincteric fistula tract procedure for fistula-in-ano: a systematic review and meta-analysis

Background: There is still controversy over the usefulness of seton placement prior to the ligation of the intersphincteric fistula tract (LIFT) surgery in the management of anal fistula. Objective: To evaluate the impact of preoperative seton placement on the outcomes of LIFT surgery for the management of fistula-in-ano. Design: systematic review and meta-analysis. Data Sources: A search was performed on the MEDLINE (PubMed), EMBASE, Scopus, Web of Science, Cochrane Library and Google Scholar databases. Study Selection: Original studies without language restriction reporting the primary healing rates with and without seton placement as a bridge to definitive LIFT surgery were included. Intervention: The intervention assessed was the LIFT with and without prior seton placement. Main Outcome Measures: The main outcome was defined as the primary healing rate with and without the use of seton as a bridge to definitive LIFT surgery. Results: Ten studiesmet the criteria for systematic review, all retrospective,with a pooled study population of 772 patients. There were no significant differences in the percentages of recurrence between patients with and without seton placement (odds ratio [OR] 1.02; 95% confidence interval [CI] 0.73-1.43: p=0.35). The I2 value was 9%, which shows the homogeneity of the results among the analyzed studies. The 10 included studies demonstrated a weighted average overall recurrence of 38% (interquartile range [IQR] 27-42.7%), recurrence with the use of setonwas 40%(IQR26.6-51.2%), and without its use, the recurrence rate was 51.3% (IQR 31.3-51.3%) Limitations: The levels of evidence found in the available literature were relatively fair, as indicated after qualitative evaluation using the Newcastle-Ottawa scale and the Attitude Heading Reference System (AHRS) evidence levels. Conclusions: Our meta-analysis suggests that the placement of seton as a bridge treatment prior to LIFT surgery does not significantly improve long-term anal fistula healing outcomes. Ligation of the intersphincteric fistula tract surgery can be performed safely and effectively with no previous seton placement. International prospective register of systematic reviews-PROSPERO registration number: CDR42020149173. (AU)

Lifting facial não cirúrgico com fios de polidioxanona: revisão de literatura / Non-surgical facelift with polydiaxanone threads: literature review

O objetivo deste estudo foi realizar uma revisão de literatura acerca do lifting facial não cirúrgico com fios de PDO, abordando os diferentes tipos, suas indicações, a degradação no organismo, pla no de inserção, contraindicações, vantagens e possíveis complicações. As buscas foram realizadas nas bases de dados Pubmed, Bireme, Scielo, Sumários de Revistas Brasileiras e BVS, selecionan do-se artigos relevantes disponibilizados entre 2005 e 2020. Sendo os descritores utilizados em português e inglês para busca: "Harmonização Facial", "Fios de Sustentação", "Lifting Facial". Após aplicação dos critérios de inclusão e exclusão, dos 44 artigos encontrados, foram selecionados 16 para esse estudo. O uso dos fios de sustentação facial consiste em um método minimamente inva sivo, indolor, de caráter ambulatorial, anestesia local e efeito imediato. Diante dos possíveis riscos que acompanham o lifting cirúrgico, as pessoas estão buscando por alternativas menos invasivas, como os fios de sustentação. Apesar de não poderem ser considerados como alternativa a cirurgia reparadora convencional, os pacientes muitas vezes acabam optando pelo lifting com fios por se sentirem mais seguros, mesmo com resultados mais modestos. Observou-se que a utilização dos fios de PDO tem demostrado eficácia no rejuvenescimento facial quando bem indicados, apesar da possibilidade de ocorrência de efeitos adversos, normalmente pequenos e passageiros... (AU)

The aim of this study is to perform a literature review about non-surgical facial lifting with PDS threads, addressing its variety of types, indications, organism degradation, insertion plan, contrain dications, advantages and possible complications.The researches were conducted in the Pubmed, Bi reme, Scielo, Sumários de Revistas Brasileiras and BVS data bases, selecting relevant articles available between 2005 and 2020. After applying the inclusion and exclusion criteria, of the 44 articles found, 16 were selected for this study. Being used the following descriptors in Portuguese and English for research purposes: "Facial Harmonization", "Supporti Threads", "Face Lift". The use of facial support threads consists in a minimally invasive, painless, outpatient method, local anesthesia and imme diate effect. Faced with the possible risks that accompany the surgical facelift, people are looking for less invasive alternatives, such as the support wires. Although they cannot be considered as an alternative to conventional reparative surgery, patients often end up opting for a facelift because they feel safer, even with more modest results. It was observed that the use of PDO threads has been shown to be effective in facial rejuvenation when well indicated, despite the possibility of adverse effects, usually small and transient... (AU)

Lifting labial: uma revisão de literatura / Lip Lift: A Literature Review

Introdução: o lifting labial consiste em remover cirurgicamente uma porção do lábio superior caracterizado como longo, achatado, sem definição das colunas filtrais e com diminuição da borda do vermelhão, o que acontece em paralelo ao avanço da idade. Sendo assim, várias técnicas foram criadas ao longo do tempo por cirurgiões a fim de fornecer ao paciente um lábio mais jovem e atraente. Objetivos: explanar as dimensões e características dos lábios, as indicações do lifting labial e as técnicas cirúrgicas. Método: foi realizado um levantamento na literatura científica nas bases de dados PubMed/Medline. O critério de inclusão adotado foi artigos com disponibilidade do texto integral do estudo e clareza no detalhamento metodológico utilizado. Além disso, um livro foi adicionado para comple-mentar informações necessárias. Os descritores utilizados para seleção dos artigos foram: lifting labial (lip lifting); morfologia dos lábios (lip morphology); lábios ideais (ideal lips). Resultados: lábios envelhecidos tendem a perder a sensualidade por consequência de al-guns fatores como o alongamento do lábio branco, a perda das definições do lábio e das co-lunas do filtro, o achatamento do lábio vermelho e o surgimento de rugas, que resultam em buscas por técnicas clínicas que ajudam a amenizar essas condições e melhorar a autoes-tima dos pacientes. Conclusão: para alcançar resultados satisfatórios com essa técnica, é necessário que o profissional domine o conhecimento sobre as dimensões do terço inferior da face de acordo com idade, sexo e raça, que tenha domínio sobre as técnicas cirúrgicas mais eficazes e as indicações de acordo com a individualidade do paciente.

Introduction: the lip lift consists of surgically removing a portion of the upper lip when it is characterized as long, flat, with no definition of the filter columns, and with a reduction in the vermilion border, which happens in parallel with advancing age. Therefore, surgeons have created several techniques to provide the patient with a younger and more attractive lip. Objectives: explain the dimensions and characteristics of the lips, the indications for lip lifting, and some surgical techniques. Method: a survey was carried out in the scientific literature on the PubMed/Medline databases. The inclusion criterion adopted was articles with the full text of the study and clarity in the methodological details used. Also, a book was added to complement necessary information. The descriptors to select articles were lip lifting, lip morphology, and ideal lips. Results: aged lips tend to lose their sensuality with the lengthening of the white lip, the loss of definitions, thinning of the red lip, and the appearance of wrinkles, which demand searches for techniques that help soften these con-ditions and improve the patient's self-esteem. Conclusion: to achieve satisfactory results with this technique, the professional needs to master the knowledge about the dimensions of the lower third of the face according to age, sex, and race. Also, the professional needs to master the most effective surgical techniques and the indications according to the patient's individuality. Keywords: Lip lift. Morphology of the lips. Characteristics of young lips. Lip aging.

Tratamiento protésico y quirúrgico del maxilar atrófico / Prosthetic and surgical treatment of the atrophic maxilla

RESUMEN: Proponer un plan de tratamiento con técnicas quirúrgicas y protocolos protésicos predecibles representa un gran desafío profesional, especialmente en pacientes con un maxilar atrófico. Entre las alternativas terapéuticas, la prótesis híbrida sobre cuatro implantes dentales correctamente distribuidos permite formar un área de distribución de carga, la cual guarda relación con las necesidades biomecánicas del elemento protésico.

ABSTRACT: Proposing a treatment plan with surgical techniques and predictable prosthetic protocols means a great professional challenge, especially in patients with an atrophic maxilla. Among the therapeutic alternatives, the hybrid prosthesis on four correctly distributed dental implants, allows to form a load distribution area, which is related to the biomechanical needs of the prosthetic element.

Manejo multidisciplinario de rinosinusitis bacteriana aguda posterior a elevación de seno maxilar: reporte de caso rehabilitado a tres años de seguimiento / Multidisciplinary management of acute bacterial rhinosinusitis after maxillary sinus lift: three years follow-up: case report

La cirugía de elevación de seno maxilar se considera como la técnica de aumento óseo más predecible. Sin embargo, no está exenta de complicaciones las cuales deben ser manejadas adecuadamente. Se presenta un caso clínico rehabilitado, con un seguimiento de 3 años, en el cual se realizó un manejo multidisciplinario y resolutivo de complicaciones asociadas a la técnica quirúrgica de elevación de membrana sinusal vía ventana lateral. Frente a una infección postoperatoria, como la presentada en el caso, hay que considerar iniciar un tratamiento antibiótico en el momento adecuado para impedir el agravamiento del cuadro clínico o un cambio de esquema en caso de resistencia antimicrobiana.

Maxillary sinus lift surgery is considered the most predictable bone augmentation technique. However, this procedure is not without complications, which must be handled properly. We present a rehabilitated clinical case, with a 3-year follow-up, in which a multidisciplinary and resolutive management of complications associated with the surgical technique of sinus lift procedure, using lateral window approach, was performed. In case of postoperative infection, such as the one presented in this report, it is necessary to consider starting an antibiotic treatment at the adequate moment to prevent the aggravation of the illness or change the pharmacological treatment in case of antimicrobial resistance.

Physical fitness and physical activity level in school going adolescent children

Background: Adolescence is transitional phase between childhood and adulthood characterized by marked acceleration in growth. The objective of this study was to evaluate differences between the boys and girls in physical fitness and the variation in their physical activity at school going children at Pune.Methods: The study was carried out at various schools in Pune city. Government, government aided (semi government), and private schools were selected according to different zones of the city using random sampling method. A self-administered youth physical activity questionnaire (Y PAQ) has been given for testing their level of physical activity. Physical fitness test such as curl-up test, 90° push-up test, trunk lift, back saver sits, and reach test were performed for analysing the physical fitness of the students.Results: A total of 296 students, 142 boys (aged 13.47±0.04 years) and 154 girls (aged 13.40±0.03 years) were included in the study. The average/mean comparison demography between boys and girls for curl-up test showed 21.61±10.00 and 15.21±7.24 repetitions/min respectively. The average of 900 push-ups test between boys and girls were 12.72±7.31 and 5.12±3.25 repetitions/min respectively. The average/mean of Trunk lift test was 5.67±2.56 in boys and 5.12±2.45 inches in girls respectively.Conclusions: The study concluded that there was lower fitness level as per calculation of healthy fitness zone seen amongst the school going children and also there were lower levels of their physical activity in day to day life. Also, study results show significant difference among the boys and girls in their physical fitness level.

Success and survival rate of the implant with crestal sinus lift using S-reamer and gel-type graft material: A retrospective study by more 5-years follow check up / 대한치과보철학회지

PURPOSE: The purpose of this retrospective study was to evaluate the method using the S-reamer and gel-type graft material by the success rate and survival rate.MATERIALS AND METHODS: Implantation period was from 2008 to 2014, Follow check up year is 2019. There were 59 patients and 117 implants. All implants were placed in the posterior maxilla with the sinus lift. The patients population consisted of 34 men and 25 women, ranging from 19 to 75 years. The residual bone heights were from 1 mm to 6 mm. Sinus was perforated with S-reamer without membrane tearing and gel type bone graft material was used for membrane lifting and filling the space. all implants were placed simultaneously. Panoramic X-ray was taken. After 5 – 6 months healing period, final prostheses were restored. After more 5-years implant surgery, Panoramic X-ray was obtained and X-ray analysis and clinical examination were performed. Success criteria was referred to a Buser's success critera. All implants were classified to success implant, survival implant, failed implant. A success implant was satisfying success criteria, a survival implant was a implant that was acute infection with suppuration and bone loss, a failed implant was a implant that was mobile, removed.RESULTS: Five implants were removed, and 4 implants had infected with bone loss. Survival rate was 95.7% and success rate was 92.3%.CONCLUSION: This retrospective study presented that this method with S-reamer and gel-type graft material was a successful treatment without membrane tear in the condition of 1-6 mm residual bone height.

Retrospective study on transcrestal sinus floor elevation with simultaneous implantation of short implants / 华西口腔医学杂志

OBJECTIVE@#To explore the changes in bone height of the maxillary sinus floor at different sinus ridge heights after transcrestal sinus floor elevation (tSFE) with the simultaneous implantation of short implants.@*METHODS@#A total of 74 Bicon short implants were implanted into 37 patients during the same period of maxillary sinus elevation. The residual bone height (RBH)<4 mm group has 43 sites, and the RBH≥4 mm group has 31 sites. After 5 years of follow-up observation, the implant survival rate and the change in bone height achieved in the maxillary sinus over time were measured and analyzed via clinical examination and X-ray imaging.@*RESULTS@#In the 74 implantation sites, the elevation height of the sinus floor was (6.64±1.32) mm and the bone height of the sinus floor was (3.35±1.29) mm 5 years after loading. No statistical difference was observed in the bone resorption of the implant neck between the RBH<4 mm and RBH≥4 mm groups. Meanwhile, a statistical difference was noted in the bone height obtained in the maxillary sinus between the two groups.@*CONCLUSIONS@#When RBH in the maxillary posterior tooth area was <4 mm, the simultaneous implantation of Bicon short implants with tSFE can achieve a high implant survival rate and bone gain in the maxillary sinus, but does not increase the absorption of the alveolar ridge bone.

Development of tilted implant for free end of maxillary posterior teeth / 华西口腔医学杂志

Vertical bone insufficiency in the maxillary posterior teeth is a common clinical situation. At present, the bone insufficiency in the maxillary posterior teeth is mainly overcome by bone grafting through maxillary sinus floor elevation. Compared with traditional axial implantation, tilted implantation can better avoid bone grafting, reduce complications, shorten the treatment cycle, reduce the treatment cost for patients, and gradually be promoted in clinical settings. This article reviews the concept, biomechanics, clinical evaluation, and digital trend of tilted implants of maxillary posterior teeth.

Ligadura interesfinteriana del trayecto fistuloso (LIFT) como alternativa de tratamiento a una fístula perianal compleja / Ligation of intersphincteric fistula tract (LIFT) as an alternative treatment for complex perianal fistula

Resumen Introducción: Las técnicas quirúrgicas para la fístula perianal compleja han tenido altas tasas de recidiva asociado al riesgo de incontinencia fecal. La técnica de LIFT (Ligadura Interesfintérica del trayecto fistuloso) ha logrado menores tasas de recidiva con casi nulo riesgo de incontinencia según reportes inter-nacionales. Sin embargo, aún no está consolidada como técnica estándar para esta patología. Objetivo: Presentar los resultados (éxito clínico e incontinencia según escala de Wexner) de nuestros pacientes con fístula perianal compleja operados con técnica de LIFT. Materiales y Método: Estudio descriptivo de cohorte prospectiva no aleatoria, con pacientes operados por fístula perianal compleja en el Hospital del Salvador, entre los años 2015 al 2017. Resultados: Se incluyen 22 pacientes operados. En un 77% se obtiene éxito terapéutico en la primera cirugía y hasta un 90% con una segunda cirugía más simple. Ninguno de los pacientes modificó su Wexner preoperatorio. Conclusiones: En pacientes con fístula perianal compleja la técnica de LIFT es una alternativa que ofrece igual o mejores tasas de curación clínica con bajo riesgo de incontinencia fecal.

Introduction: Surgical techniques for complex perianal fistula have high recurrence and fecal incontinence rates. The technique of LIFT (ligation of the intersphincteric fistula tract) has achieved lower rates of recurrence with almost no risk of incontinence according to international reports. However, it is not yet consolidated as a standard technique for this pathology. Objective: To present the results (clinical success and incontinence according to the Wexner scale) of our patients with complex perianal fistula operated with the LIFT technique. Materials and Method: Descriptive study of a non-randomized prospective cohort, with patients operated for complex perianal fistula at the Hospital del Salvador, between 2015 and 2017. Results: 22 operated patients are included. In 77%, therapeutic success is obtained in the first surgery and up to 90% with a second surgery. None of this patients modified their preoperative Wexner. Conclusions: In patients with complex perianal fistula, the LIFT technique is an alternative that offers high cure rates with low risk of fecal incontinence.

The Ligation of Intersphincteric Fistula Tract Technique: A Preliminary Experience

PURPOSE: Surgery is the only treatment for anal fistula. Many surgical techniques have been described. The aim of this study was to communicate the authors' preliminary experience in the use of a recently proposed, simplified technique. METHODS: This was a prospective study of 28 patients admitted from January 13, 2016 through July 20, 2017. Patients were managed with the ligation of intersphincteric fistula tract (LIFT) technique and results were observed and documented, including recurrence rate, incontinence rate, and other postoperative complications. RESULTS: A total of 28 patients were studied. The mean operation time was 31 minutes (range, 23–44 minutes), and there were no intra- and postoperative complications. The overall complete healing rate was 85.7%, and the recurrence rate was 14.2%. Follow-up was conducted at 1, 3, and 6 months. CONCLUSION: Many surgical techniques have been described for the treatment of anal fistula. The correct choice of surgical technique out of available procedures is the most important factor for proper treatment and reducing the risk of recurrence or incontinence. In the authors' experience, the LIFT technique is simple and easy to learn, and is a good choice for the treatment of simple anal fistula; however, a tailored surgery remains the gold standard for this condition.

Application of multi-point and multi-level suspension and fixation through palpebral margin incision in midface lift / 中华整形外科杂志

Objective@#To explore the clinical effect of the multi-point, multi-level suspension as well as fixation using midfacial soft-tissue spaces for midface lifting.@*Methods@#A total of 65 patients with aging midface were admitted at the First Affiliated Hospital of Fujian Medical University from October 2017 to February 2019. Among them, 47 patients underwent primary blepharoplasty and midface lifting. Eighteen patients, including 5 patients with lower eyelid retraction or ectropion after blepharoplasty, underwent secondary midface lifting after blepharoplasty. The preseptal space was separated under orbicularis oculi muscle by palpebral margin incision. The orbicularis retaining ligament and the tear trough ligament were severed through preperiosteal plane. The preseptal space was connected with premaxillary space and prezygomatic space. The malar fat pad and superficial fascia were vertically suspended and fixed on the periosteum of infraorbital ridge by selected medial, middle and lateral points. The orbicularis oculi muscle was suspended and superolaterally fixed at lateral orbital periosteum. Therefore, the midface could be lifted by multi-point, multi-level suspension and fixation.@*Results@#All incision healed in the first stage. Eyelid separation occurred to 1 patient, around 1 month after the operation. Tarsal strip lateral canthoplasty was performed for repair. Local protuberance of lateral lower eyelid occurred to another patient shortly after the operation, but improved after 3 months by lid massaging. No other complication was observed in the rest of the cases. All patients were followed up for 1 to 8 months and the results were satisfactory.@*Conclusions@#It is simple and practicable to utilize midfacial soft-tissue spaces. This method could benefit patient of less trauma, bleeding, and complications, and good clinical effect. It is a good choice for rejuvenation of the midface, especially for secondary midface rejuvenation after blepharoplasty, or complicated with lower eyelid retraction and ectropion.