Clinicopathological features and treatment strategies of intraductal papillary neoplasm of the bile duct / 中华消化外科杂志

Objective:To investigate the clinicopathological features and treatment strategies of intraductal papillary neoplasm of the bile duct (IPNB).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 40 patients with IPNB who were admitted to Peking Union Medical College Hospital from August 2000 to April 2020 were collected. There were 19 males and 21 females,aged (60±14) years. Patients underwent preoperative imaging examination and blood test for evaluation of tumor location, range and resectability. The treatment strategies of patients depended on preoperative examination and their own willingness. Observation indicators: (1) preoperative examinations and tests; (2) treatment; (3) pathological examination; (4) follow-up. Follow-up using outpatient examination, telephone interview and online diagnosis was performed to detect tumor recurrence and survival of patients up to April 2021. Count data were represented as absolute numbers and percentages. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). The Kaplan-Meier method was used to calculate the cumulative survival rate and draw survivla curve. Results:(1) Preoperative examinations and tests: 40 patients received preoperative imaging examination and blood test. Of 40 patients, 33 cases underwent abdominal ultrasonography, 31 cases underwent abdominal computed tomography (CT) examina-tion, 21 cases underwent magnetic resonance imaging (MRI), 15 cases underwent endoscopic retrograde cholangiopancreatography (ERCP), 8 cases underwent position emission tomography CT examination, 6 cases underwent endoscopic ultrasonography; some patients underwent multiple examinations. The main imaging features of IPNB were bile duct dilatation, and intraluminal tumor. Enhanced CT scan showed tumor reinforcement. Preoperative blood tests showed of the 40 patients, 21 cases with abnormal liver function, 17 cases with increased bilirubin, 9 cases with increased carcinoembryonic antigen, and 24 cases with increased CA19-9. (2) Treatment: 35 of 40 patients underwent surgery, 5 patients underwent ERCP and biopsy and didn′t undergo surgery based on their willings. Of 35 patients with surgeries,20 cases underwent hemihepatectomy or lobectomy, 8 cases underwent pancreatico-duodenectomy, 7 cases underwent bile duct tumor resection. The operation time was (262±91)minutes, and volume of intraoperative blood loss was 300 mL(range, 50?2 000 mL). Postopera-tive complications occurred in 6 of 35 patients, including 3 cases with Grade Ⅰ complications and 3 cases with Grade Ⅱ complication according to Clavien-Dindo classi-fication system. (3) Pathological examination: 40 patients were diagnosed as IPNB by pathological examinations. There were 19 and 21 patients with extrahepatic and intrahepatic lesions, respectively. There were 20 benign lesions (15 cases of low or intermediate-grade intraepithelial neoplasia and 5 cases of high-grade intraepithelial neoplasia) and 20 malignant lesions of invasive carcinoma. There were 18 cases with mucus secretion and 22 cases without mucus secretion or information. Five of 35 patients with surgeries had positive margin and the rest of 30 patients had negative margin. A total of 154 lymph nodes were dissected in 21 patients, including 3 positive lymph nodes. (4) Follow-up: 35 of 40 patients were followed up for (53±35)months. Seventeen of 35 patients survived without tumor, and 3 patients survived with tumor of which the time to tumor recurrence were 12, 17, 37 months. Fifteen patients died, with the time interval to death of (30±19)months. The 1-, 3-, and 5-year cumulative survival rates of 35 patients were 88.6%, 73.6%, and 50.7%, respectively.Conclusions:IPNB is rare, with the main imaging features as bile duct dilatation, and intraluminal tumor. The tumor is reinforce-ment after enhanced scan. Surgery is the main treatment for IPNB and lymph node metastasis is rare.

Clinical outcomes of rigid and non-rigid telescopic double-crown-retained removable dental prostheses: An analytical review

PURPOSE: The objective of this literature review was to analyze the cumulative survival rates (CSRs) of rigid and non-rigid double-crown-retained removable dental prostheses.MATERIALS AND METHODS: Screening of the literature published from January 1995 to December 2019 was performed by using electronic data base (Pubmed) and manual search. The CSRs of rigid and non-rigid double crown removable dental prostheses were investigated.RESULTS: A total of 403 articles were reviewed and 56 relevant articles of them were selected. Subsequently, 25 articles were included for data extraction. These articles were classified according to rigid and non-rigid type double crowns and further subdivided into teeth, implants, and teeth-implant combination types. The CSRs of rigid type double crown ranged from 68.9% to 95.1% of 5 to 10 years in tooth abutments, 94.02% to 100% over a 3-year mean observation periods in implant abutments, and 81.8% to 97.6% in tooth-implant combination. Non-rigid type double crowns had various CSR ranges from 34% to 94% maximum during 10 years observation in teeth abutment. The CSRs of non-rigid type had over 98% in implant abutments, and ranged from 85% to 100% in tooth-implant combination.CONCLUSION: The CSRs of double crowns varies according to types. With accurate evaluation of the remaining teeth and plan of the strategic implant placement, it could be successful treatment alternatives for partially or completely edentulous patients.

Survival of individual teeth after non-surgical endodontic treatment / 대한구강보건학회지

OBJECTIVES: The present study aimed to estimate the survival rate of teeth after non-surgical root canal treatment and to investigate the effect of income on the tooth survival rate. METHODS: The study included 1,414.668 endodontically treated teeth from 1,193.666 persons enrolled in the National Health Insurance Service in 2002. A survival analysis of the teeth was performed using the Kaplan-Meier method. The survival rates were calculated using a follow-up period of 11 years after the root canal treatment. RESULTS: In the present study, the 11-year cumulative survival rate of teeth after non-surgical endodontic treatments was 86.90%. The survival rates of teeth tended to decrease for the posterior teeth; the maxillary teeth showed a lower survival rate than that of the mandibular teeth. The teeth with the highest survival rates were the mandibular left lateral incisor, maxillary right incisor, mandibular right lateral incisor, and maxillary left central incisor, in that order. The lowest survival rates were shown by the mandibular second molar, maxillary second molar, maxillary first molar, and mandibular first molar, in that order. The survival rate of the first molar (#16, #26, #36, #46) was higher in the low-income group than in the high-income group (P<0.001). CONCLUSIONS: This study represents the outcome pattern of root canal treatment among South Korean individuals. These study findings can be used as comparative data for clinical decision making about endodontic treatment.

Factors associated with the survival and marginal bone loss of dental implants: a 5-year retrospective study

PURPOSE: The purpose of this study was to compare the long-term survival rate and peri-implant marginal bone loss related to multiple risk factors including the clinician's experience. MATERIALS AND METHODS: Four hundred twenty implants in 146 patients, who had involved a supportive periodontal therapy program every 3 to 6 months and had follow up data for at least 5 years, were selected as the study group. Peri-implant marginal bone loss, data of demographic, implant and surgical characteristics were collected from peri-apical radiographs and chart review. Implant survival was regarded as the remaining with radiographic marginal bone level in excess of 50% of the fixture length for any reason. RESULTS: The cumulative survival rate after 5 years of loading was 94.9%. In binary logistic regression analysis, smoking status (P = 0.033) and presence of spontaneous cover screw exposure (P < 0.001) were significantly related to 5-year survival of implants. In stepwise multiple regression analysis, smoking status (P < 0.001), type of abutment connection (P < 0.001) and implant surface (P = 0.033) were significantly related to peri-implant marginal bone level. And the year of resident was not statistically related to 5-year implant survival in simple logistic regression analysis (P = 0.171). CONCLUSION: Smoking status, spontaneous cover screw exposure, type of abutment connection and implant surface might influence the implant success. There was no significant correlation between the year of resident and implant failure.

Clinical evaluation of 287 CAD/CAM zirconia ceramic restorations:A 3-year follow up / 实用口腔医学杂志

Objective:To evaluate the clinical performance of CAD/CAM zirconia all-ceramic restorations.Methods:287 all-ce-ramic Zirconia restorations in 206 patients were included in a 3-year prospectively survey with California Dental Association Standard (CDA)as a reference.The effects and the related factors such as restoration type,tooth region,fiber reinforced composite application on survival rate were analyzed.Kaplan-Meier survival analysis and Log-Rank test were used for data analysis.Results:Chipping frac-tures in 5 restorations,intense gingivitis at 4 restorations and periapical inflammation for 3 restorations were observed during the obser-vation period.The 3-year cumulative survival rate (CSR)of CAD/CAMzirconia restorations was 95.7%,The differences among the CSR of single crowns(96.3%),linked crowns (93.6%)and fixed partial dentures(95.7%)were not statistically significant(P >0.05).The difference was not statistically significant(P >0.05)between the CSR of the anterior region group(94.5%)and posterior region group(96.3%)as well as difference(P >0.05)between the CSR of fiber reinforced composite group (95.0%)and without fiber reinforced composite group(96.1%).Conclusion:The cumulative survival rate of CAD/CAM zirconia all-ceramic restorations is high.Chipping fracture is the main reason of failure.Restoration type,tooth region and fiber reinforced composite have no significant effect on the survival of zirconia restorations.

A 15-year clinical retrospective study of Branemark implants / 대한치과보철학회지

PURPOSE: This study was to compare the cumulative survival rate (CSR) of Branemark machined surface implants and TiUnite(TM) imlants and to analyze association between risk factors and the CSR of the implants. MATERIALS AND METHODS: A retrospective study design was used to collect long-term follow-up clinical data from dental records of 156 patients treated with 541 Branemark machined and TiUnite(TM) implants at Korea University Guro hospital in South Korea from 1993 through 2008. Machined implant and TiUnite(TM) implant were compared by CSR. Exposure variables such as gender, systemic disease, location, implant length, diameter, prosthesis type, opposing occlusion type, date of implant placement, type of edentulous space, abutment type, existence of splinting with natural teeth, and existence of cantilever were collected. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR (alpha=.05). RESULTS: Patient ages ranged from 16 to 75 years old (mean age, 51 years old). Implants were more frequently placed in men than women (94 men versus 63 women). Since 1993, 264 Branemark machined implants were inserted in 79 patients and since 2001, 277 TiUnite(TM) implants were inserted in 77 patients. A total survival rate of 86.07% was observed in Branemark and Nobel Biocare TiUnite(TM) during 15 years. A survival rate of machined implant during 15 years was 82.89% and that of TiUnite(TM) implant during 5 years was 98.74%. The implant CSR revealed lower rates association with several risk factors such as, systemic disease, other accompanied surgery, implant location, and Kennedy classification. CONCLUSION: Clinical performance of Branemark machined and TiUnite(TM) implant demonstrated a high level of predictability. In this study, TiUnite(TM) implant was more successful than machined implant. The implant CSR was associated with several risk factors.

A Retrospective study of the Cumulative Survival Rate and change of peri-implant marginal bone around implants associated with maxillary sinus augmentation / 대한치과보철학회지

STATEMENT OF PROBLEM: Insertion of endosseous implants in the atrophic maxilla is often complicated because of lack of supporting bone. Augmentation of the floor of the maxillary sinus with autogenous bone & bone substitute graft has been proven to be a reliable treatment modality, at least in the short term. The aim of this study is to evaluate the factors of implant survival rate associated with maxillary sinus lift with grafts. MATERIAL AND METHODS: The sinus floor was augmented with bone grafts derived from modified Caldwell-luctechnique (71 subject, 93 sinus, 180 implants), the autogenous bone or autogenous + Bio-oss. Before implant installation the width and height of the alveolar crest were increased in the first stage procedure in 10 patients while in the other 61 patients augmentation and implant installation could be performed simultaneously width and height of the alveolar crest > 4 mm) or delayed installation. RESULTS: In all case bone volume was sufficients for implant insertion. 14 of 180 inserted implants were lost during follow up and the healing period Patient received implant supported overdenture (5 patients) or fixed bridge (62 patients). CONCLUSION: Within the limit of the result of this study, we conclude that bone grafting of the floor of the maxillary sinus floor with bone for the insertion of implants might be a reliable treatment modality and the autogenous bone graft and delayed installation method might be the factors for good results.

Multilateral analysis of Renova(R) implant placement and its Survival rate / 대한치주과학회지

PURPOSE: Given the predictability of dental implant procedure from the studies of successful osseointegration, implant dentistry is often the treatment of choice to replace missing teeth in edentulous patient instead of the fixed prosthesis or removable denture. The Renova(R) dental implant has a RBM(Resorbable Blast Media) surface, internal hex prosthetic connection and a tapered design. At this study gives the analysis of the implant and the short term survival rate of the implant. MATERIAL AND METHODS: In this study, a multilateral analysis was performed on the subjects undergoing placement with Renova(R) implant between August 2006 and February 2008 in Yonsei University dental hospital. 96 implants were placed in 56 patients and they were surveyed for cumulative survival rate. Among them 78 implants in 44 patients were surveyed for the rest analyses. RESULT: 1. The cumulative survival rate was 96.88% of 96 implants in 56 patients. 2. The mean marginal bone loss was 0.803mm and the marginal bone loss in augmentation group has higher value than the marginal bone loss in non augmentation group. 3. The health scale for the implants were 87% in success group, 9% in satisfactory survival group, 1% in compromised survival group, and 3% in failure group. 4. Two implants placed in poor bone posterior area by 2-stage failed during prosthetic procedure. CONCLUSION: Renova(R) dental implant showed high cumulative survival rate in installation on partial edentulous ridge and could be a predictable implant system.

A Retrospective study on Branemark TiUnite(R) implant for mandibular posterior single tooth replacement / 대한치주과학회지

The purpose of this study was to evaluate 6 years cumulative survival rate (CSR, %) of mandibular posterior single tooth implants replaced with Branemark TiUnite(R) implant system. The findings from this study were as followed ; 1. The 112 (111 persons) single implants that were placed in the mandibular posterior region were successful except 4 cases and showed 96.42% CSR. 2. The 55 (55 persons) single implants that were placed in the mandibular first molar region were successful except 2 cases and showed 96.36% survival rate. And, among the 57 (56 persons) single implants replacing the mandibular second molar, 2 failed showing 96.49% survival rate. There was no significant statistical difference. 3. Among the total 112 implants, 5.0mm wide diameter implants were placed in 96 cases(85.7%) showing 96.9% survival rate. 4.0mm standard diameter implants were placed in 16 cases showing 93.8% survival rate. There was no significant statistical difference. 4. Long implants above 10.0mm length were placed 103 cases(91.0%) and showed 96.1% survival rate. Short implants within 8.5mm length were placed 9 cases and showed 100% survival rate. There was no significant statistical difference. 5. 37 implants placed in typeI,II bone quality were showed higher survival rate(100%) than that of 52 implants placed in typeIII, IV bone quality(92.3%). But, there was no significant statistical difference. In conclusion, Branemark TiUnite(R) implant showed successful results when replacing manbibular single molar.

Retrospective study on ITI SLA (sand-blasted, large-grit, acid-etched) implant for mandibular posterior single tooth replacement / 대한치주과학회지

The purpose of this study was to evaluate cumulative survival rate (CSR, %) of mandibular posterior single tooth implants replaced with ITI SLA (sand-blasted, large-grit, acid-etched) implant system and compare the CSR between first and second molar. The findings from the results were as follows; 1. Total of 158 implants were inserted into 147 patients. 68 patients were males, 79 patients were females and their mean age was 47.8 years. 98 implants were placed in first molar area and 60 implants were placed in second molar area. In terms of diameter, implants with wide diameter over 4.8mm dominated (91.1%). Implants with length over 10mm were used (96.2%). 2. In the two cases, there was a slight transient numbness which recovered within 1-2 months. Nine SynOcta screw type abutments demonstrated screw loosening. There were ten cases of crown fallen-out from decementation. 3. Only one failed out of 158 implants. The CSR was 99.4%. The CSRs for first molar and second molar were 99% and 100%, respectively. From the results, it was concluded that single tooth replacement implant in the mandibular posterior area, might be considered as the effective treatment modality comparable to the conventional crown and bridge.

Effect of the early exposure of cover screws on the survival rate of implants / 대한치주과학회지

The early exposure of cover screws is a common complication of 2-stage implant technique. The exposure of cover screws between stage I and II surgery may cause inflammation in the soft tissues surrounding the implants, and lead to peri-implantitis or marginal bone loss. The purpose of this study was to evaluate the effect of the early exposure of cover screws on implants placed using 2-stage technique. Two hundred and nineteen implants in 77 patients were examined for cumulative survival rate, radiographic marginal bone level change, cause and frequency of the early exposure. The results were as follows: 1. Twenty-five implants showed early exposure of cover screws with a frequency of 11.4%. 2. Cumulative survival rate of the implants with early cover screw exposure was 88.0%, and that of the implants without cover screw exposure was 96.9%. 3. At the time of stage II surgery and 1 year after loading, the marginal bone loss was greater around the implants with early exposure of cover screws than around the implants without cover screw exposure(p 0.05).

The distribution of xive implant patients and the type of implant site and survival rate in mandible / 대한치주과학회지

This study is an analysis of distribution of patients who installed Xive implant in Yonsei University Hospital and types of implant site for about 2 years recall check and cumulative survival rate. 41 implant were used in this study. It shows the conclusion below. 1. Patients at the age of 40s and 50s were 60% of all implant cases and average number of implant was 2.4(man), and 1.9(woman). All cases were operated on mandible, 3 implants on anterior region and 38 implants on posterior region. 2. The major cause of tooth loss is dental caries(48.8%), followed by periodontal disease. 3. Most distribution of bone qaulity for mandibular implant site was type II(65.8%) and bone quantity was type B(75.6%). 4. The majority of implants were those of 11, 13mm in length(95%) and regular diameter in width(64%). 5. The 41(19 persons) Xive implants that were placed in the mandibular anterior and posterior region were all survival and showed a 100% 2 year cumulative survival rate. The results provided us with basic data on patient type, implant distribution, bone condi- tion, and survival rate. We wish that our results coupled with other research data helps assist in the further study for better implant success rates, etc.

A Two-year Retrospective Study on the Clinical Success of the Korean Implant Systems / 대한치주과학회지

The purpose of this study was to evaluate the success rate of Korean implant systems. A total of 245 implants were placed in 112 patients using different implant systems from February 1988 until June 2002. Data on implant systems, implant positions, surface treatments, guided bone regeneration procedure, marginal bone levels, and states of surrounding gingiva were collected. A follow-up evaluations were done after 1 year and 2 year of loading. Clinical parameters such as probing depth was evaluated at the last follow-up. The marginal bone loss after 1 year of loading was measured on periapical radiographs. Clinical comparisons were performed to evaluate implants loss in relation to the implant systems, implant positions, surface treatments, and guided bone regeneration procedure. There was no clinical difference of success rate in implant systems, implant positions, and surface treatments. Mean marginal bone resorption from the time of loading to 1 year follow-up was 0.31mm in Korean implant systems and 0.41mm in other implant systems. The cumulative survival rate of Korean implant systems and other implant systems at the 2-year of loading was 95.6% and 97.3% respectively. From these results, it was concluded that Korean implant systems could be successfully used in clinical dentistry.

Analysis of the Factors of Influence on the Therapeutic Effect of Primary Hepatic Carcinoma after Interventional Therapy / 实用放射学杂志

Objective To evaluate the factors of influence on the prognosis and survival rate in patients of primary hepatic cellular carcinoma(HCC) after interventional therapy.Methods 258 cases of HCC were treated with interventional therapy,the data of these cases and the survival rate were analysed.Results The prognosis in patients with HCC was relation to the hepatic function,therapeutic methods and accumulation of iodized oil by analysis of Cox Regression.The cumulative survival rate was different in HCC with different pathological type,different grade of hepatic function,with or without tumor embolus in portal vein,different cumulation of iodized oil and different therapetic methods,there was significance in statistics between most of them.Conclusion Cox Regression model can be used to analyse synthetically the factors that significantly affected the survival period in the patients with HCC.