A retrospective study (1994-1999) of 441 ITI(r) implants in 114 patients followed-up during an average of 2.3 years.

OBJECTIVE: Implantation is a common practice in the oral rehabilitation of edentulous patients, affording good results in extensive patient series. The aim was to determine the average success rate and analyze the causes of implant failure. MATERIAL AND METHODS: In the present retrospective study (1994-1999) a total of 441 ITI(r) implants were performed in 114 patients (58 females (51%) and 56 males (49%) aged 44.5 years on average; range 12-82 years), with a mean follow-up of 2.3 1.3 years. Data recorded included patient age and sex, smoking habit, oral hygiene, the number, length, diameter and type of implants, their location and the prostheses fitted. RESULTS: After 2.3 1.3 years of follow-up, the implant success rate was 96.2%. In 7 patients a total of 15 implants failed during the osseointegration period, while in two patients a total of two implants failed following dentures placement. The failures were mainly attributed to over-drilling during the surgical procedure, or to an overloading upon tightening in the osseointegration period. No significant relation was observed between implant loss and the rest of the clinical parameters studied, with the sole exception of implant length (failure increasing with shorter lengths)(chi-square; p = 0.001).

Estudio clínico retrospectivo (1994-99) de 441 implantes ITI en 114 pacientes, con un seguimiento medio de 2,3 años / A retrospective study (1994-1999) of 441 ITI implants in 114 patients followed-up during an average of 2,3 years

Introducción: Estudio clínico retrospectivo (1994-99), en pacientes tratados con implantes ITI® y rehabilitación prostodóncica. El objetivo del estudio fue determinar el porcentaje de éxito y el análisis causal de los fracasos. Material y métodos: Se colocaron 441 implantes ITI® en 114 pacientes, 58 mujeres (51 por ciento) y 56 hombres (49 por ciento), con una edad media fue de 44,5 ñ 13,27 años y, tras la carga, serealizó el seguimiento de los mismos durante un tiempo medio de 2,3 ñ 1,3 años. Se tuvo en cuenta la edad, el sexo, el hábito de fumar y la higiene oral de los pacientes, así como el número, longitud, diámetro, tipo y localización de los implantes. También se recogieron datos sobre las prótesis realizadas. Resultados: Después de un período medio de seguimiento de 2,3ñ1,3 años, obtuvimos un porcentaje de éxito de los implantes del 96,2 por ciento. Fallaron, en 7 pacientes, 15 implantes durante el período de osteointegración, y en 2 pacientes, 2 implantes, tras la colocación de sobredentaduras. Los fracasos fueron atribuidos principalmente a sobreinstrumentación en el proceso quirúrgico o a sobrecarga por apretamiento en el período de osteointegración. No observamos ninguna relación significativa entre la pérdida de implantes y el resto de parámetros clínicos estudiados, con excepción de la longitud, ya que observamos más fracasos entre los implantes de menor longitud (2; p=0,001) (AU)

Oral rehabilitation using osseointegrated implants in a patient with idiopathic torsion dystonia.

Idiopathic torsion dystonia is a motor syndrome characterized by dystonic movements and postures in the absence of other neurologic deficits. The condition involves prolonged spasms of muscle contraction that distort the body into typical postures. Such distortions involving the head and the neck make conventional denture use in edentulous patients very difficult. The present paper reports on a patient with idiopathic torsion dystonia who was treated with a mandibular overdenture supported by endosteal implants, which enabled the establishment of a stable occlusion and improved the dynamics of the masticatory muscles for chewing.

[Massive pericardial effusion and cardiac tamponade as the presentation form of hypothyroidism]. / Derrame pericárdico masivo y taponamiento cardíaco como forma de presentación de hipotiroidismo.

We report a 43 years old female, admitted due to fatigability, asthenia and diffuse abdominal pain. On admission, obesity, slowness of thinking, bradycardia, distention of jugular veins and ascites were observed on physical examination. Laboratory showed undetectable thyroid hormone levels, a chest X ray showed bilateral pleural effusion and an enlarged heart. An echocardiography showed a massive pericardial effusion with collapse of the right atrium and dilatation of both caval veins. A pericardial tap was performed, draining 350 ml. Thyroid hormone substitution was started and after 12 months of follow up, the heart size decreased and a control echocardiogram showed a minimal pericardial effusion.

[Incidence of radicular cysts in a series of 125 chronic periapical lesions. Histopathologic study]. / Incidence des kystes radiculaires dans une série de 125 lésions périapicales chroniques. Etude histopathologique.

The incidence of radicular cysts in 125 chronic periapical lesions was studied in 36 cases of periapical surgery (28.8%), and to 89 tooth extractions (71.2%). Histopathology revealed 18 radicular cysts (14.4%) and 107 lesions corresponding to chronic apical periodontitis (C.A.P.) or granulomas (85.6%). Cholesterol clefts, a fibrous capsule and presence of a cavity were more common in the cysts, significant differences being observed with respect to chronic apical periodontitis.

[Fibrinolytic treatment of thrombus of the right atrium causing severe pulmonary embolism]. / Tratamiento fibrinolítico de un trombo en la aurícula derecha que causa una embolia pulmonar grave.

A case of acute pulmonary embolism and right atrial thrombus "in transit" treated with recombinant tissue plasmin activator is described. An early echocardiographic study in acute pulmonary embolism can detect right atrial thrombus in 15% of the time. It is well known that this finding is associated with poor prognosis, but the best treatment is controversial. The present case, in accordance with other previous reports, suggests the use of systemic fibrinolytic therapy in patients with right atrial thrombus and pulmonary embolism in course.

Dental health in patients infected by human immunodeficiency virus (HIV). A study of 94 cases.

The dental health of 94 HIV-positive patients was investigated by the sum of carious, missing and filling teeth (DMF index), plaque (Silness and Löe) and bleeding point indices (Lenox and Kopczyk). Blood parameters were evaluated, including total lymphocytes, CD4+ lymphocytes, beta-2-microglobulin, platelets, the Quick index, and immunoglobulins (IgG, IgM and IgA). Patient oral parameters were contrasted with risk group (intravenous drug users homo- and heterosexuals) and controls. An evaluation was also made of differences in dental condition as a function of CD4+ cell number, according to the latest CDC classification (1992). HIV-positive intravenous drug users were found to present poorer DMF, plaque and bleeding point indices than the rest of the patients. No relationship was observed between CD4+ cell numbers in blood and dental condition, thus suggesting that the deteriorated dental health observed is a consequence of factors inherent to the risk groups involved rather than of the altered blood parameters.

Periodontal disease in HIV seropositive patients and its relation to lymphocyte subsets.

This study was performed to determine the type of periodontal pathology found in a group of HIV+ patients and its relation to serum levels of CD4. The sample consisted of 101 individuals: intravenous drug users (84%), homosexuals (7%), and heterosexuals (10%). Each patient was examined clinically and radiographically. Periodontal clinical parameters included gingival index and probing depth and loss of attachment on four sites per tooth. Severity of disease was defined as the most severe lesion found: gingivitis, or early, moderate, or advanced periodontitis. CD4 counts were determined on 64 of these patients. Associations between severity of the disease and gender and CD4 counts were analyzed using the Mantel Haenszel chi square test, while associations between severity and age and CD4/CD8 ratio were analyzed using the Kruskal-Wallis test. No disease was found in 14.8% of the sample, gingivitis was found in 21.8%, early periodontitis in 43.6%, moderate periodontitis in 10.9%, and advanced periodontitis in 8.9%. Linear gingival erythema (LGE) was seen in 17.8% of all patients and necrotizing periodontitis (NUP) in 4.9%. No statistically significant differences were observed between the severity of the disease and CD4 counts.