ABSTRACT
This narrative review describes up-to-date treatment options for peri-implantitis and proposes a treatment protocol and flowchart based on the current scientific evidence. Peri-implantitis treatment should be based on the phased treatment protocol for periodontitis, which is a continuous flow of decisions for extraction, nonsurgical and surgical treatments with step-by-step re-evaluation. The protocol's goals are to fulfill the success criteria for peri-implantitis treatment (probing depth of ≤5 mm, and absence of bleeding on probing, suppuration, and progressive bone loss) and to halt disease progression. Fixtures with peri-implantitis can initially be classified as failed or failing. A failed implant needs to be removed. In contrast, nonsurgical and surgical treatments can be applied to a failing implant. Nonsurgical treatment should be the initial treatment for failing implants; however, sole nonsurgical treatment was regarded as inefficient for peri-implantitis. Recent studies have found that the adjunctive use of antibiotics to nonsurgical debridement increased the success of nonsurgical treatment for peri-implantitis. Surgical treatments can be classified into resective, access, and reconstructive surgeries. The technique should be selected according to the patient's bone defect configuration, which relate to regenerative potential. Various combinations of decontamination methods (e.g., mechanical, chemical, and pharmacological approaches) are required to achieve absolute surface decontamination. Clinicians should select an appropriate surface decontamination strategy according to the purpose of surgery. After signs of disease disappear and its progression is halted through active peri-implantitis treatment, it is necessary to enroll patients into maintenance programs. Compliance of patients with the maintenance program reduces the recurrence of peri-implantitis and sustains clinical success after treatment. Maintenance visits should include professional plaque control and hygiene care reinforcement for patients, and their interval should be set according to individual peri-implantitis risk. Clinicians should remind that peri-implantitis treatment is not a single procedure, but rather a continuing cycle of treatment and re-evaluation.
ABSTRACT
Through-focus scanning optical microscopy (TSOM) method based on use of a library, which is composed of simulated defocused images of nanosized silicon lines on the top of a monocrystalline silicon substrate, is demonstrated. The images are simulated using Finite-Differences in Time-Domain (FDTD) method taking into account optical aberrations of the experimental setup, which are measured experimentally. Consideration of the optical aberrations allows us to reduce the discrepancy between experimental and simulated defocused images of the samples under study to the value of ≈2%in contrast to ≈10% when the aberrations are not taken into account. It results in ≈5% recognition accuracy for critical dimension (CD) values in the range 40-150 nm.
ABSTRACT
OBJECTIVES: Ectopic inferior parathyroid adenomas (PAs) are frequently located in the anterior mediastinum, quite often in the thymus gland. Correct preoperative localization is particularly helpful for surgical planning. Clinical follow up has shown that most intrathymic adenomas were visualized on pinhole views and located closer to the thyroid than expected. We reviewed the typical appearance of intrathymic PA on pinhole views. METHODS: We retrospectively reviewed sestamibi pinhole parathyroid imaging performed on 163 patients with primary hyperparathyroidism and final diagnoses established by surgery, histology, intraoperative PTH monitoring, and clinical follow up. Studies showing focal increased activity in the lower pole region of the thyroid were selected and divided into 2 groups, group A (foci that are visually not separable from the thyroid) and group B (foci that are completely separated from the thyroid), and correlated with the final diagnoses. RESULTS: Of the 163 patients, 102 had 103 clearly abnormal foci in the lower pole region (bilateral lower pole foci in one study). There were 93 foci in group A and 10 foci in group B. Of the 93 foci in group A, there were 80 normally situated inferior PA, 6 descended superior PA, 3 intrathyroidal PA, one hyperplastic parathyroid gland, one thyroid adenoma, one unidentified, and one intrathymic PA. Of the 10 foci in group B, 3 were eutopic inferior PA and 7 were intrathymic PA. CONCLUSION: Focal increased activity completely separated from the lower pole of thyroid (regardless of the distance of separation) on sestamibi pinhole images indicates a high probability of intrathymic parathyroid adenoma.
