The Use of a Dehydrated, Deepithelialized Amnion-Chorion Membrane in Guided Bone Regeneration Involving Staged Implant Placement: Case Series with a 5-Year Follow-up.

Barrier membranes are critical to the success of guided bone regeneration (GBR). Though not directly involved in bone regeneration, barrier membranes hold bone graft materials at the surgical site during the slow process of bone regeneration and prevent the infiltration of fibrotic gingival tissues that would compromise new bone formation. Many options are available on the market, but membranes derived from placental tissues are gaining rapid adoption due to their unique biologic and handling properties. In this case series, a dehydrated human deepithelialized amnion-chorion membrane (ddACM) was used in combination with freeze-dried bone allograft (FDBA) for two-stage GBR procedures. Data from 1-year and 5-year follow-up appointments are presented, as well as predictable indications for the use of ddACM. Using ddACM with FDBA for GBR cases led to predictable bone regeneration with osseointegrated implants at 5-year postoperative visits.

Accidental Overdose Deaths in Oklahoma, 2002-2017: Opioid and Methamphetamine Trends.

To evaluate trends related to accidental overdose deaths in Oklahoma, with a focus on opioids and methamphetamine. All accidental drug overdose deaths in the state of Oklahoma from 2002 to 2017 were reviewed. Opioids were grouped into the following categories: all opioids, prescription opioids, synthetic opioids and heroin. Age-adjusted death rates for methamphetamine and each opioid category were calculated and analyzed. Accidental overdoses accounted for 9,936 deaths during the study period. Of these, opioids were seen in 62.9%, with prescription opioids comprising 53.8%, synthetic opioids 10.3% and heroin 2.8%. Synthetic opioids, despite a recent upward nationwide trend, showed a slight overall decrease (-6.8%) from 2009 to 2017. In contrast, methamphetamine showed a 402.2% increase from 2009 to 2017 and an overall increase of 1,526.7%. Methamphetamine was involved in the most overdoses (1,963), followed by oxycodone (1,724). Opioid-related deaths were most common among white individuals (90.3%) and showed a slight male predilection (56.9%). With the intent of assessing the opioid epidemic as it relates to accidental overdoses in Oklahoma, this study suggests that opioid-related overdoses have slowed in recent years amidst a sharp increase in methamphetamine deaths.

Indications for Simultaneous Implantation and Bone Augmentation Using the Allograft Bone Ring Technique.

Dental implant therapy often requires bone augmentation to facilitate stable implantation with a predictable outcome. Traditionally, this is accomplished through guided bone regeneration (GBR), which is a series of surgical procedures that use barrier membrane technology to direct the growth of new hard and soft tissues in sites with insufficient volumes for the purpose of placing dental implants. GBR and implant placement can be performed in either one or two surgeries. This article will focus on a novel simultaneous approach that utilizes a custom milled cancellous allograft bone ring that is stabilized through the graft preparation and apical threads of the dental implant. Indications include simultaneous implant placement in a deficient sinus as well as horizontal and vertical four-, three-, two-, and one-wall defects.

Small cell carcinoma of the renal pelvis and ureter: clinicopathologic and immunohistochemical features.

CONTEXT: Small cell carcinoma (SCC) of the renal pelvis and/or ureter is very rare, with only case reports published in the literature. OBJECTIVE: To describe the clinicopathologic and immunohistochemical findings in the largest series to date. DESIGN: A review of a regional cancer registry identified 10 cases diagnosed as SCC from 930 patients with renal pelvic and/or ureteral cancer from 1971 to 1998. The original slides, demographics, treatment, and clinical outcome were reviewed. Representative sections were immunostained for AE1/AE3, cytokeratin 7, cytokeratin 20, CD56, synaptophysin, chromogranin, and thyroid transcription factor 1. RESULTS: Of the 10 cases, 5 were pure SCC, 2 were mixed (SCC and urothelial carcinoma), 2 were reclassified as poorly differentiated squamous carcinoma, and 1 was reclassified as urothelial carcinoma. The patients with SCC had an age range of 50 to 80 years (median, 72 years) with a female to male ratio of 2.5:1. All patients had non-organ confined disease. Five of 7 patients died of disease; 4 of those 5 had been clinically followed (median survival, 23 months) and 1 was diagnosed at autopsy. The SCC cases revealed positive staining of the SCC component as follows: AE1/AE3 (7 of 7), CD56 (7 of 7), synaptophysin (6 of 7), thyroid transcription factor 1 (5 of 7), chromogranin (4 of 7), and cytokeratin 7 (1 of 7). None were positive for cytokeratin 20 (0 of 7). CONCLUSIONS: SCC of the renal pelvis/ureter is seen in a predominately female population in Sweden, is clinically aggressive, and has poor survival when presenting at an advanced stage in patients only treated by surgery. An immunostain panel serves as a useful adjunct in classifying these tumors.

It's time we listened to our teeth: the SoundBite hearing system.

The SoundBite hearing system (Sonitus Medical, San Mateo, Calif) allows people with single-sided deafness to wear an intraoral device and a small microphone in the deaf ear to regain lost hearing. A piezoelectric activator in a small removable unilateral oral appliance conducts sound through the bone via the teeth to the good ear. The goal of this article is to introduce the SoundBite, a new bone-conduction hearing device, to dentists and orthodontists.

Three-dimensional technology improves the range of orthodontic treatment with esthetic and removable aligners.

The orthodontic field continues to evolve with advances in technology. New three-dimensional technology has given the clinician the opportunity to perform comprehensive full-treatment plans. This case report illustrates diagnostic and treatment planning aspects of virtual treatments, in addition to successful orthodontic treatment results with removable aligners.

Utilizando o Sistema Invisalign / Using the Invisalign System

Invisalign« é um novo método de tratamento ortodôntico que utiliza a programação virtual da movimentação dentária pretendida para criar uma série de aparelhos transparentes, removíveis e estéticos, que podem tratar um agrande variedade de má-oclusão. Nesse artigo apresentamos dois casos com apinhamento na região de incisivos inferiores. O primeiro caso foi tratado com reduções interproximais e o segundo caso com a extração de um incisivo inferior. Enquanto esses casos ilustram tratamentos limitados, casos mais complexos poderão ser tratados utilizando-se o Sistema Invasalign. Esperamos apresentar exemplos desses casos mais complexos em um próximo artigo