RESUMEN
Objective: To evaluate and compare prosthesis and implant survival in case of interim fixed complete dentures reinforced with fiber resin frameworks versus those that were not reinforced with any framework in case of immediately loaded full arch restorations in completely edentulous patients. Material and Methods: Thirty completely edentulous patients were randomly allocated into two parallel arm groups. Non-reinforced control group in which patients received non-reinforced all-on-four immediately loaded fixed complete denture and Fiber reinforced group in which patients received all-on-four fixed complete denture supported with glass-fiber reinforced resin framework. Prosthesis and implant survival were clinically evaluated after 4 months follow up period. Results: A statistically significant difference for prosthesis (p = 0.032) and implant survival (p = 0.031) was found between both groups. The fiber-reinforced group showed 100% prosthesis survival and 95% implant survival. On the other hand, the non-reinforced group showed 73.3% prosthesis survival and 81.1% implant survival. Conclusion: Based on the findings of this study, it can be concluded that strengthening the fixed full arch restorations with fiber reinforced frameworks can help overcoming the problem of interim prosthesis fracture during the osseointegration period when used for immediate loading in completely edentulous patients. It can also improve the survival of the immediately loaded implants. (AU)
Objetivo : Avaliar e comparar a sobrevivência de próteses e implantes no caso de próteses totais fixas provisórias reforçadas com estruturas de resina de fibra versus aquelas que não foram reforçadas com nenhuma estrutura no caso de restaurações de arcada completa com carga imediata em pacientes completamente desdentados. Material e Métodos : Trinta pacientes completamente desdentados foram alocados aleatoriamente em dois grupos de braços paralelos. Grupo controle não reforçado, no qual os pacientes receberam prótese total fixa (all-on-four) não reforçada, com carga imediata e grupo reforçado com fibra, no qual os pacientes receberam prótese total fixa (all-on-four), suportada com estrutura de resina reforçada com fibra de vidro. A sobrevivência da prótese e do implante foi avaliada clinicamente após 4 meses de acompanhamento. Resultados : Foi encontrada diferença estatisticamente significante para prótese (p=0,032) e sobrevivência do implante (p=0,031) entre os dois grupos. O grupo reforçado com fibra apresentou 100% de sobrevivência da prótese e 95% de sobrevivência do implante. Por outro lado, o grupo não reforçado apresentou 73,3% de sobrevivência da prótese e 81,1% de sobrevivência do implante. Conclusão: Com base nos achados deste estudo, pode-se concluir que o fortalecimento das restaurações fixas de arcada completa com estruturas reforçadas com fibras pode ajudar a superar o problema da fratura da prótese provisória durante o período de osteointegração quando usada para carga imediata em pacientes completamente desdentados. Também pode melhorar a sobrevivência dos implantes carregados imediatamente (AU).
Asunto(s)
Humanos , Masculino , Femenino , Implantes Dentales , Prótesis Dental , Restauración Dental Permanente , Dentadura CompletaRESUMEN
BACKGROUND: Hip and knee arthroplasty has been widely carried out in various levels of hospitals. The amount of hip and knee joint surgery has increased year by year. The surgical methods and techniques have reached a difficult time. Promoting the clinical pathway is an effective method to improve the treatment effect. OBJECTIVE: To systemically evaluate the difference between the clinical pathways and conventional pathways in total hip arthroplasty and total knee arthroplasty. METHODS: Clinical trials about the comparison of conventional and clinical pathways in total hip arthroplasty and total knee arthroplasty were searched in MEDLINE, Cochrane Library, EMbase, and CNKI. Study selection, data collection and evaluation of methodological quality were undertaken by two reviewers independently. The Cochrane Collaboration’s RevMan 5.0 was used for data analyses. RESULTS AND CONCLUSION: (1) Totally 17 clinical trials meeting research design criteria were included in this analysis, including 13 semi-randomized controlled trials and 4 randomized controlled trials. (2) The incidence of complications in the traditional method group was higher than that in the clinical pathway group [OR=0.63, 95%C/(0.53, 0.74), P < 0.000 01]. (3) Pain visual analogue scale score [MD=1.49, 95%C/(0.69, 2.85), P=0.001], postoperative Harris hip score [MD=19.31, 95%C/(-13.98, -4.92), P< 0.000 1], and 5-year prosthesis survival rate [OR=0.59, 95% Cl (0.36, 0.98), P=0.04] were better in the clinical pathway group than in the traditional method group. (4) There was no significant difference in postoperative mean deviation of mechanical axes of lower limbs after total knee arthroplasty in both groups [MD-0.0Q, 95%C/(-0.14, 0.14), P=0.99]. (5) Results showed that compared with traditional technique, hip and knee arthroplasty patients who entered the clinical pathway had better clinical efficacy, fewer complications and better joint function after operation.
RESUMEN
Thirty-one distal femoral and nine proximal tibial primary bone tumor patients who had prosthetic replacements were reviewed retrospectively. Average follow-up was thirty-eight months(range: 12- 109 months). There were thirty-two(osteosarcoma: 29, chondrosarcoma: 3) stage IIB lesions and eight 1B lesions(giant cell tumor). Twenty-nine patients were surviving at final follow-up. Overall prosthetic survival was 81%, 27% at 2 and 5 year respectively. Eleven prostheses were revised. The causes of revisions were infection(7), metal failure(2), fracture of host bone(1), and loosening(1). Eight revisions were successful, one was fair, and two patients needed an amputation. Prognostic factors which were analyzed for survival of prostheses were age, sex, location of primary lesion, percent of bone resected, and stage. Only the location of primary lesion showed statistical significance and diabolic pattern of survival curve was noted between two groups in resection length(40%). Average functional score was 26. The tibial side had worse prosthetic survival and a major threat to this procedure was due to infection.