ABSTRACT
Patients with plasma cell myeloma may initially present to their dentists or dental surgeons with toothache, loose teeth, or gingival masses. An X-ray of the jaw can reveal osteolyses. In addition, accumulation of monoclonal light chains in AL-amyloidosis can lead to macroglossia. It is prudent that the dentist or dental surgeon recognizes the underlying disease and refers the patient to the oncologist or hematologist for further workup to prevent the complications of plasma cell myeloma such as renal impairment, fractures, bone pain, infections, hypercalcemia, anemia, or heart failure. Another area where the dentist or dental surgeon is involved with patients suffering from plasma cell myeloma is prevention and therapy of osteonecrosis of the jaw, occurring after administration of bisphosphonates or denosumab for osteolytic bone disease. The case report presented here shows a patient complaining of toothache for whom recognition of a systemic disease by the dentist led to the diagnosis of plasma cell myeloma, highlighting the need for interdisciplinary cooperation. As recent years have seen many changes in the management of patients with plasma cell myeloma, an update for dentists and dental surgeons is warranted.
ABSTRACT
PURPOSE: The aim of the present study was to evaluate deviations between virtually planned and placed implants by the use of skeletally supported stereolithographic templates. MATERIALS AND METHODS: Ten consecutive patients were selected for virtual three-dimensional implant planning using the Facilitate(TM) software (Astra Tech AB, Mölndal, Sweden). Computer tomography images were obtained in the pre- and postoperative phase. Four deviation parameters (i.e. global, angular, depth, and lateral deviation) were defined and calculated between the planned and the placed implants, using the coordinates of their respective apical and coronal points. RESULTS: Deviations at the coronal positions appeared to be smaller (95% confidence interval: 0.15-1.0) as compared with apical positions (95% confidence interval: 0.14-1.1). But only the difference with regard to lateral measurements appeared to be statistically significant (p = .03). Except for depth (p = .01), no significant association between mesial or more distal locations could be detected concerning global (p = .07), lateral (p = .87), and angular (p = .56) values in mixed model analyses. Overall, there was a slight tendency for higher values for more distal locations. CONCLUSION: As slight deviations between planned and placed implants especially may occur even with skeletal-supported templates, the clinician should be aware not to overestimate advocated surgical safety by using static navigation tools.
Subject(s)
Dental Implantation, Endosseous/methods , Dental Implants , Surgery, Computer-Assisted , Tomography, X-Ray Computed , Aged , Aged, 80 and over , Computer-Aided Design , Dental Prosthesis Design , Dimensional Measurement Accuracy , Female , Humans , Imaging, Three-Dimensional , Male , Middle Aged , Pilot Projects , SoftwareABSTRACT
The two objectives of the present study were: to assess the healing after periradicular surgery using the Periotest device, and to compare the recorded Periotest values with the healing category determined after a one-year follow-up using radiographic and clinical criteria. In 43 patients with periradicular surgery, Periotest values could be recorded pre- and postoperatively, as well as after six and twelve months. Cases with a successful healing, as determined at the one-year follow-up, demonstrated a continuous decrease of the Periotest values over time, whereas one-year failures showed increasing Periotest values over the study period. In control teeth, the Periotest values remained unchanged for the whole study period. It appears that the Periotest measurements correlate with the postoperative healing mode following periradicular surgery, and therefore, allow an additional assessment of the healing outcome.
