RESUMO
OBJECTIVE: In patients with prostate cancer and high-risk pathological factors, adjuvant radiotherapy (ART) has been reported to be superior to observation for local disease control and progressionfree survival. But more than 30% of the patients do not present biochemical relapse (BR) and therefore the ART associated with the toxicity can be avoided. It has not been determined whether close observation with early salvage radiotherapy provides a similar result to ART. METHODS: Patients with localized prostate cancer treated with radical prostatectomy (RP) at the Institute of Cancerology (Medellín-Colombia), and those who had adverse predictors of biochemical relapse were included: extracapsular compromise, seminal vesicle involvement (pT3), and positive surgical margins (PSM) or not. Biochemical progression-free survival was compared between ART group and the observation group. RESULTS: Of 171 patients treated with RP, 55 had at least one adverse pathological factor. Of them, 33 (60%) were observed and 22 (40%) received ART. The median follow-up was 55 months (IQR: 37-89). Biochemical relapse occurred in 6 (18.2%) of the first group and 3 (13.6%) of the second group (p>0.05). Biochemical progression-free survival was 24.2% (95%CI: 11.5%-39.6%) in the observation group and 47.7% (95CI: 26.3%-66.4%) in the ART. CONCLUSIONS: After radical prostatectomy, the biochemical relapse in the patient with high-risk prostate cancer was similar in the observation group and in the ART group.
Assuntos
Prostatectomia , Neoplasias da Próstata/radioterapia , Neoplasias da Próstata/cirurgia , Conduta Expectante , Idoso , Colômbia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/sangue , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Radioterapia Adjuvante , Estudos RetrospectivosRESUMO
Introducción: el propósito de este estudio fue evaluar la variación en la posición de los tejidos blandos alrededor de implantes cortos de doble fase quirúrgica, seis meses posterior a la restauración con coronas individuales cementadas extraoralmente. Métodos:se hicieron mediciones clínicas y radiográficas sobre restauraciones individuales metal-cerámicas en 22 pacientes, soportadas por implantescortos Bicon® (30 implantes), al momento de instalar la restauración y a los 6 meses poscarga. Las mediciones clínicas hechas fueron: distancia margen gingival-borde incisal (MG-BI), distancia vértice de papila-punto de contacto mesial (VP-PCM), distancia vértice de papila-punto de contacto distal (VP-PCD), distancia vértice de papila-ángulo incisomesial (VP-AIM), distancia vértice de papila-ánguloincisodistal (VP-AID), distancia margen gingival-línea mucogingival (MG-LMG), y las mediciones radiográficas hechas fueron: distancia cresta ósea-punto de contacto mesial (CO-PCM), distancia cresta ósea-punto de contacto distal (CO-PCD). Resultados: no se encontraron cambios estadísticamente significativos en las variables enunciadas, a excepción de la distancia VP-PCD que registró la medida de2,55 mm al momento de la carga y de 1,49 mm a los 6 meses poscarga, y se reportó como una diferencia estadísticamente significativa(p = 0,003). Conclusión: los resultados muestran un comportamiento estable del tejido blando y del soporte óseo alrededor de los implantes, con un cambio favorable en la posición de las papilas y leve modificación hacia apical en la posición del margen gingival.
Introduction: the purpose of this study was to evaluate position change of the soft tissues surrounding double-stage surgery short implants six months after restoration with individual crowns extra-orally cemented. Methods: clinical and radiographic measurements were madeon metal-ceramic single restorations in 22 patients, supported by Bicon® short implants (30 implants in total), at the time of installing the restoration and 6 months after load. The clinical distances measured were: gingival margin-incisal border (GMIB), papillary vertex-mesial contact point (PV-MCP), papillary vertex-distal contact point (PVDCP), papillary vertex-incisomesial angle (PV-IMA), papillary vertex-incisodistal angle (PV-IDA), gingival margin-mucogingival line (GM-MGL), and the radiographic distances measured were: bone ridge-mesial contact point (BR-MCP), and bone ridgedistal contact point (BR-DCP). Results: no statistically significant differences were found in the aforementioned variables, except for the PVDCP distance which measured 2.55 mm at the time of installationand 1.49 mm six months afterwards, considered as a statistically significant difference (p = 0.003). Conclusion:the results show a stable behavior of soft tissue and bone support around the implants, with a favorable change in the position of the papillae and a slight apically modification in the position of gingival margin.
Assuntos
Humanos , Cimentação , Restauração Dentária Temporária , Retenção de DentaduraRESUMO
Introducción: este reporte clínico pretende presentar los resultados obtenidos con un sistema de implantes que modifica el protocolo convencional quirúrgico en cuanto a las revoluciones de fresado, no uso de irrigación, recolección del hueso nativo y opciones protésicas como la corona integrada al pilar, la cementación extraoral y la posición universal del pilar. En cuanto a su diseño se destaca el uso de implantes cortos, plataforma reducida, aletas laterales, conexión al pilar por cierrefriccional y superficie alterada. Métodos: se colocaron treinta implantes Bicon® de seis milímetros de longitud para restauración de diente único en veintidós pacientes. Se hizo el protocolo quirúrgico de acuerdo con las recomendaciones del fabricante y endos fases quirúrgicas. Se hizo la cirugía de destape de cada implante y se cementaron todas las restauraciones metal-cerámicas. Resultados: se reporta 100% de oseointegración de los implantes al momento de la cirugía de destape, con ausencia de movilidado dolor durante la función, ausencia de exudado y normalidad de los tejidos blandos periimplantares; se reporta ausencia de radiolucidez en la evaluación radiográfica. Conclusión: en este estudio podemos concluir que con el protocolo quirúrgico modificado y el diseño del implante Bicon® (Bicon Dental Implants, Boston, MA) se logró el 100% de éxito en la oseointegraciónde treinta implantes cortos al momento de la cirugía de destape, con superficie alterada y plataforma reducida, colocados para la restauración de diente único en diferentes zonas de la cavidad oral.
Introduction: the purpose of this clinical report is to present the collected results with an implant system that modifies the classical protocol regarding drilling speed, use of irrigation, native bone collecting and prosthetic options including crown integrated to the abutment, extraoral cementing of the crown and universal position of abutment screw. Regarding implant design, it´s important to highlight the use of short implants, with reduced platform, lateral wings instead of screw threads, abutmentconnection by means of friction and modified implant surface. Methods: 30 Bicon® implants, all six-mm of length, were placed in order to perform single tooth restorations in 22 patients. The surgical protocol was performed according to indications of themanufacturer in two surgical stages. The implants were uncovered and all metal-ceramic crowns were cemented. Results: the percentage of osseointegration success was 100% at the time of uncovering, without pain or mobility during function, no signs ofinfection and healthy appearance of peri-implant tissues. There were no radiographic changes at the x-ray evaluation. Conclusion: considering the limitations of this study, it can be concluded that with the modified surgical protocol and the structural design of the Bicon® Implant (Bicon Dental Implants, Boston, MA) a 100% osseointegration success was achieved on 30 implants with modified surface and reduced platform, placed in different areas of the oral cavity for single-tooth restoration.