Local risk factors for one-year dental implant loss and late loss in 287 failed implants caused by peri-implantitis or infection after prosthesis loading: a retrospective study.

The purpose of this paper was to retrospectively assess the local factors that are likely to be associated with the risks for one-year dental implant loss.A retrospective study was designed and implemented. The sample consisted of patients who underwent an implant loss or removal caused by peri-implantitis or infection after prosthesis loading. The chi-squared test and generalised estimating equations (GEE) were used to explore the potential risk factors for one-year implant loss. A total of 279 patients with 287 failed implants were enrolled in this study. Immediate implant placement exhibited a 3.373 (95% CI: 1.652 to 6.886) significantly increased risk to experience one-year implant loss than early and late implant placement (p = 0.001). In addition, implants loaded during a healing period fewer than two months after implant placement were at 18.139 (95% CI: 8.925 to 36.866) significantly higher risk of one-year implant loss when compared with those that loaded within more than two months after implant placement (p < 0.001). Smokers were 1.866 (OR = 1.866,95% CI: 0.993 to 3.510) times as high risk for one-year implant loss as non-smokers, but there were no significant statistical differences (p = 0.053). Immediate implant placement and early implant loading were considered risk factors for one-year implant loss.

[Different concentration of lidocaine used for an exodontia of the impacted mandibular third molar].

PURPOSE: To investigate the anesthesia outcomes of 1% lidocaine with 1∶100 000 epinephrine (EPI) for inferior alveolar nerve, lingual nerve and buccal nerve block, compared with 2% lidocaine with 1∶100 000 EPI. METHODS: A study with a cross-over design, with each patient also serving as their own control, was implemented to estimate the clinical outcomes. Predictor variable was 1% lidocaine with 1∶100 000 EPI versus 2% lidocaine with 1∶100 000 EPI. Outcome variables were patients' responses to pain on injection, onset time of anesthetizing, efficacy of anesthesia, and the time to sensation return for the lower lip and tongue. Patients reported pain level at every experimental stage with a 10-point Numerical Rating Scale(NRS). Three weeks later, the patients were tested with the alternate drug combinations. The same outcomes were assessed. A verification of treatment difference was performed using SPSS 17.0 software package. RESULTS: Twenty-one patients were recruited and completed the study protocol. Sixty-two percent of the patients were women and 38% were men with a median age of 24 years [interquartile range (IQR), 20-30 yr]. Patients reported significantly lower pain scores with 1% lidocaine (1.09,95%CI，0.77-1.41) on injection, compared with 2% lidocaine (1.66, 95%CI, 1.33-1.99) (P=0.010). Patients undergoing 1% lidocaine with 1∶100 000 EPI (52-63 s) had a markedly quicker onset time of anesthetizing than those using 2% lidocaine with 1∶100 000 EPI (259-335 s, P=0.000). The efficacy of anesthesia between 2 groups was not significantly different (P=0.751). Among the patients with the pain values of 1~3, there were 9 patients(100%) perceiving slight pain when splitting teeth was performed in 1% lidocaine group, while 4 patients(57%) felt slight pain when elevating soft flaps was performed and 3 patients(43%) perceived mild pain when splitting teeth was performed in 2% lidocaine group (P=0.019). The time to sensation return for the lower lip and tongue was significantly different between the 2 drug formulations (P=0.000), with an extended period of average 61 min (52-69 min) in 2% lidocaine group. CONCLUSIONS: 1% lidocaine with EPI plays a similar role in clinical outcomes for inferior alveolar nerve, lingual nerve and buccal nerve block as 2% lidocaine with EPI, which produces lower pain on injection as well as a relatively short time to sensation return. The reasons for slight pain during surgical operation are a relative lower efficacy of anesthesia on the inferior alveolar nerve in 1% lidocaine group, and on the buccal nerve anesthesia in 2% lidocaine group.

[Clinical analysis of impacted supernumerary teeth in 115 patients].

PURPOSE: To retrospectively analyze the clinical characteristics of impacted supernumerary teeth in 115 patients. METHODS: One hundred and fifteen patients with im-pacted supernumerary teeth who were admitted to the Department of Oral and Max-illofacial Surgery of Hefei Stomatological Hospital were selected randomly. The age, sex, number of teeth, location, direction, clinical manifestation, anaes-thesia method and operation time were analyzed retrospectively, T test and Chi-square test were used to determine the statistical differences with SPSS 19.0 software package. RESULTS: Among 115 patients, there were 176 impacted supernu-merary, most of them were in mixed dentition period (66.96%), the sex ratio was 2.29:1, and Most patients (59.1%) had one supernumerary tooth, followed by two supernumerary teeth(33.9%). Most supernumerary teeth were located in the middle of the maxilla (68.2%). Inverted ones were the most common (52.8%). The most common symptoms were delayed eruption, displacement, crowding, torsion and space of the adjacent teeth. 92.2% of patients underwent general anesthesia. The dee-per the locations of impacted supernumerary were, the longer the operation time was. CONCLUSIONS: There are regional characteristics of supernumerary teeth in Hefei City, which can provide a reference for clinical diagnosis and treatment.

Primary tumor prevalence has an impact on the constituent ratio of metastases to the jaw but not on metastatic sites.

This article provides an overview of metastases to jaws (MJ), mainly concerning the differences between American and Chinese patients, and exploring the relationship between the primary tumors' prevalence (PTP) and constituent ratio of MJ. Information concerning of 399 MJ cases in 215 papers, including one new case in our hospital, was subjected to statistic analysis. The main clinical features of MJ, such as constituent ratio of PTP and that of MJ, metastatic sites, treatments, and prognosis were summarized. Breast, lung, kidney, prostate and thyroid (in descending order) were the leading primary sites of MJ. Furthermore, the constituent ratio of MJ was found to be correlated with that of PTP in all subjects including American and Chinese subjects in our study. As to metastatic sites in the mandible, a specific "M" shaped pattern appeared regardless of the tumor type or constituent ratios of MJ were in all subjects. Almost all subjects received traditionally palliative treatments, and the prognosis was quite poor. The PTP had a significant impact on the constituent ratio of MJ. However, it was the properties of the microenvironment rather than characteristics or constituent ratios of tumor cells, that decided the metastatic sites in various tumor subjects.

Metastatic tumors to the oral and maxillofacial region: a retrospective study of 19 cases in West China and review of the Chinese and English literature.

PURPOSE: The aim of this article was to obtain an overview of metastatic tumors to the oral and maxillofacial (OMF) region, especially the differences in the constituent ratios of primary cancers between the United States and China. PATIENTS AND METHODS: Clinical findings of 19 cases encountered in West China Hospital of Stomatology were summarized and the English and Chinese literature were reviewed and analyzed. The main clinical features of OMF metastases were summarized, with an emphasis on primary cancers' constituents. RESULTS: The lung, breast, kidney, liver, and prostate were the top 5 common primary sites of cancer. However, there was a significant difference in the primary cancers' constituents between United States and China (P < .001). The breast, kidney, prostate cancers, and melanoma of skin were more frequent primary cancers in United States than in China, whereas that of the lung, thyroid, liver, esophagus, and the stomach were more common in China than in United States. The proportions of the OMF metastatic lesions originating in the lung, kidney, liver, thyroid, and esophagus in all OMF metastatic tumors were higher than the corresponding primary cancers' prevalent proportions. CONCLUSIONS: The frequency of developing OMF metastasis is not always consistent with primary cancers' prevalence, which suggests that different cancers have different potentiality to develop OMF metastasis. Cancers of the kidney, liver, lung, thyroid, and esophagus were more likely to spread to the OMF region. In general screening of primary cancer, it would be helpful to take into account the metastatic potentiality of different cancers and primary cancers' prevalence in different countries in the case of occult primary.