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Hip fractures in patients with dementia: an emerging orthopaedic concern 痴呆患者髋部骨折:一个新兴的骨科问题
Q3 Dentistry Pub Date : 2024-01-01 DOI: 10.1615/jlongtermeffmedimplants.2023046658
Spyridon Sioutis, A. Zikopoulos, Vasilios Karabikas, E. Mitsiokapa, A. Tsatsaragkou, S. Katsanos, D. Mastrokalos, D. Koulalis, A. Mavrogenis
Hip fractures are a very common injury in the elderly population associated with an increased mortality rate. Currently, more and more elderly patients are diagnosed with dementia. Demented patients are more prone to falls and hip fractures compared to the general population because of conditions related to their disease such as instability, osteoporosis, poor muscle control and weakness. The coexistence of dementia and hip fractures is a difficult situation for both the patients and the treating physicians because of postoperative complications in this frail subgroup of patients and their inability to stand up and walk. To enhance the literature, we reviewed published studies of hip fracture patients suffering from dementia to discuss why they have more frequent hip fractures, to review their associated in-hospital complications, and to emphasize on their postoperative management to be able to reach the pre-injury activity level and optimal quality of life.
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引用次数: 0
Transfer of Guided Emergence Profile Developed Using Customized Provisional Implant Restoration and Cementation Using an Abutment Replica Technique: A Case Report. 使用定制临时种植体修复和基台复型技术固结所形成的导引出龈轮廓的转移:病例报告。
Q3 Dentistry Pub Date : 2024-01-01 DOI: 10.1615/JLongTermEffMedImplants.2024047947
Vinay Sivaswamy, S D Balaji Anand, Jacob Mathew Philip, C J Venkatakrishnan, M Narasimman, Helen Mary Abraham, B Pavithra

The long-term success of dental implants depends not only upon implant osseointegration, but also on the surrounding soft tissue health and profile. An ideal emergence profile contributes to the aesthetics of an implant restoration. It maintains long-term implant health by preventing potential food accumulation and forming a barrier against bacterial ingress. This article describes a method for obtaining an impression of implants that will capture the custom guided peri-implant soft tissue contours accurately, thus contributing to a final restoration with favorable aesthetics. We also describe a technique for reducing excess cement in a cement retained implant crown, thereby contributing to the health of the peri-implant tissues.

种植牙的长期成功不仅取决于种植体的骨结合,还取决于周围软组织的健康和外形。理想的种植体外形有助于种植修复的美观。它还能防止潜在的食物积存,形成防止细菌侵入的屏障,从而保持种植体的长期健康。本文介绍了一种获得种植体印模的方法,这种印模可以准确捕捉到定制引导下的种植体周围软组织轮廓,从而有助于获得美观的最终修复效果。我们还介绍了一种减少骨水泥固位种植体牙冠中多余骨水泥的技术,从而促进种植体周围组织的健康。
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引用次数: 0
Robotic Arm-Assisted Total Knee Arthroplasty: Anatomical Alignment and Mid-Term Outcomes from the First Cohort Originating in Greece. 机器人手臂辅助全膝关节置换术:源自希腊的首个队列的解剖对齐和中期疗效。
Q3 Dentistry Pub Date : 2024-01-01 DOI: 10.1615/JLongTermEffMedImplants.2023048690
Konstantinos Dretakis, Vasilios G Igoumenou, Symeon Naoum, Konstantinos Raptis, Christos Koutserimpas

Robotic arm-assisted total knee arthroplasty (RATKA) represents a haptic assistive robotic arm used for bone preparation. The purpose of this study was to present implant survivorship, complications and evaluate patients' satisfaction, clinical and functional outcome of RATKA with a minimum of 1-year follow-up. The Oxford Knee Score was recorded preoperatively and at last follow-up. Patients' satisfaction rates, as well as complications and re-operations were studied. Anatomical alignment including varus, valgus deformities and flexion, extension, pre-and postoperatively were evaluated. A total of 156 patients with mean age = 71.9 years were included in the study. The mean follow-up was 35.7 months, while one revision was performed due to infection. Statistically significant improvement of the Oxford Knee Score, as well as of the knee alignment deformities were recorded, while 99.4% of patients reported to be "very satisfied" or "satisfied" with the procedure. RATKA seems to be a safe, as well as reproductible procedure at short-and mid-term follow-up, while the accurate implant positioning may lead to favorable long-term outcomes.

机械臂辅助全膝关节置换术(RATKA)是一种用于骨准备的触觉辅助机械臂。本研究的目的是介绍植入物的存活率、并发症,并评估患者对RATKA至少1年随访的满意度、临床和功能结果。术前和最后一次随访时记录了牛津膝关节评分。对患者的满意度、并发症和再次手术进行了研究。对患者术前和术后的解剖对位情况进行了评估,包括膝关节屈曲、外翻畸形和屈伸。研究共纳入了 156 名患者,平均年龄为 71.9 岁。平均随访时间为 35.7 个月,其中一次因感染而进行了翻修。据统计,牛津膝关节评分和膝关节排列畸形均有明显改善,99.4%的患者对手术表示 "非常满意 "或 "满意"。在中短期随访中,RATKA 似乎是一种安全且可重复的手术,而准确的植入物定位可能会带来良好的长期疗效。
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引用次数: 0
The Impact of Patient Characteristics on Outcomes of Surgically Managed Vertebral Osteomyelitis in the United States: Insights from a National Database Study. 美国患者特征对手术治疗椎体骨髓炎结果的影响:全国数据库研究的启示
Q3 Dentistry Pub Date : 2024-01-01 DOI: 10.1615/JLongTermEffMedImplants.2023049402
Jennifer Kurowicki, Stuart Changoor, Daniel Coban, Neil Patel, Kumar Sinha, Ki Hwang, Arash Emami

This study was conducted to assess the patient characteristics, types of treatment, and outcomes of patients who are surgically treated for vertebral osteomyelitis (VO) in the United States. VO can be treated with or without surgical intervention. Surgically treated cases of VO are associated with significant morbidity and mortality, and incur major healthcare costs. There are few studies assessing the characteristics and outcomes of patients with VO who are treated surgically, as well as the overall impact of surgically managed VO on the healthcare system of the United States. Utilizing the Nationwide Inpatient Sample (NIS) database, 44,401 patients were identified who underwent surgical treatment for VO over a fifteen year period. Severity of comorbidity burden was calculated using the Deyo Index (DI). Surgical approach and comorbidities were analyzed in regard to their impact on complications, mortality rate, LOS, and hospitalization charges. The incidence of surgical intervention for patients who had VO increased from 0.6 to 1.1 per U.S. persons over the study period. Surgically treated patients had a mean age of 56 years, were 75.8% white, were 54.5% male, 37.9% carried Medicare insurance, and they had a mean DI of 0.88. Anterior/posterior approach (OR: 3.53), thoracolumbar fusion (OR: 2.69), thoracolumbar fusion (OR: 19.94), and anterior/posterior approach (OR: 64.73) were the surgical factors that most significantly predicted any complication, mortality, increased LOS, and increased hospital charges, respectively (P < 0.001). The mean inflation-adjusted total hospital cost increased from $20,355 to $39,991 per patient over the study period. VO has been steadily increasing in the United States. Incidence and inflation-adjusted costs nearly doubled. Anterior/posterior approach and thoracolumbar fusion most significantly predicted negative outcomes. VO is associated with lengthy and expensive hospital stays resulting in a significant burden to patients and the healthcare system.

本研究旨在评估美国接受手术治疗的脊椎骨髓炎(VO)患者的特征、治疗类型和疗效。脊椎骨髓炎可通过或不通过手术干预进行治疗。经手术治疗的椎体骨髓炎病例具有显著的发病率和死亡率,并产生高昂的医疗费用。很少有研究对接受手术治疗的 VO 患者的特征和预后以及手术治疗 VO 对美国医疗系统的总体影响进行评估。利用全国住院病人抽样(NIS)数据库,我们确定了 44,401 名在 15 年间接受过手术治疗的 VO 患者。合并症负担的严重程度采用戴尤指数(Deyo Index,DI)进行计算。分析了手术方法和合并症对并发症、死亡率、住院时间和住院费用的影响。在研究期间,VO 患者的手术干预发生率从每美国人 0.6 例增加到 1.1 例。接受手术治疗的患者平均年龄为56岁,75.8%为白人,54.5%为男性,37.9%有医疗保险,平均DI为0.88。前/后入路(OR:3.53)、胸腰椎融合术(OR:2.69)、胸腰椎融合术(OR:19.94)和前/后入路(OR:64.73)分别是预测并发症、死亡率、住院时间延长和住院费用增加最显著的手术因素(P < 0.001)。在研究期间,每位患者经通货膨胀调整后的平均住院总费用从 20,355 美元增至 39,991 美元。在美国,VO 的发病率一直在稳步上升。发病率和通货膨胀调整后的费用几乎翻了一番。前路/后路方法和胸腰椎融合术对不良预后的影响最大。VO与漫长而昂贵的住院时间有关,给患者和医疗系统造成了巨大负担。
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引用次数: 0
Surface Modification of Magnesium Alloy AZ91D Using Nanopowder Mixed Electrical Discharge Machining for Biodegradable Implant. 使用纳米粉体混合放电加工技术对镁合金 AZ91D 进行表面改性,用于生物可降解植入物。
Q3 Dentistry Pub Date : 2024-01-01 DOI: 10.1615/JLongTermEffMedImplants.2024049752
Alok Kumar, Abhishek Singh

Powder-mixed electrical discharge machining (PMEDM) enhances the effectiveness of the electric discharge machining process. It has been used on the Mg alloy AZ91D to address biodegradation concerns in implants. By combining nano-conductive powder particles with the dielectric fluid, PMEDM creates a functional surface. Process parameters like pulse on time, pulse off time, peak current, and powder concentration are examined to optimize material removal rate (MRR), surface roughness (SR), and white layer thickness (WLT). The optimization of input parameters was completed using the Taguchi L9 technique and further analyzed using ANOVA technique that illustrates Ton and pulse-off time as more significant process parameters for powder mixed electric discharge machining as compared with electric potential and peak current. The optimal surface roughness value is found to be 2.215 μm at 3A pulse current and 15 μs Toff time which suggest the material to be suitable for implants.

混合粉末放电加工(PMEDM)提高了放电加工工艺的效率。它已被用于镁合金 AZ91D,以解决植入物中的生物降解问题。通过将纳米导电粉末颗粒与电介质流体相结合,PMEDM 可形成功能性表面。研究了脉冲开启时间、脉冲关闭时间、峰值电流和粉末浓度等工艺参数,以优化材料去除率(MRR)、表面粗糙度(SR)和白层厚度(WLT)。使用田口 L9 技术完成了输入参数的优化,并进一步使用方差分析技术进行了分析,结果表明与电动势和峰值电流相比,脉冲开启时间和脉冲关闭时间是粉末混合放电加工中更重要的工艺参数。在 3A 脉冲电流和 15 μs 关断时间条件下,最佳表面粗糙度值为 2.215 μm,这表明该材料适用于植入物。
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引用次数: 0
The History of Orthopedics in the Long Term: From General Medicine to Medical Specialties. 骨科的长期发展史:从普通医学到专科医学。
Q3 Dentistry Pub Date : 2024-01-01 DOI: 10.1615/JLongTermEffMedImplants.2024050866
Pavlos Altsitzioglou, Ioannis Zafeiris, Fotini Soucacos, Pantelis Limneos, Eleftheria Soulioti, Evanthia Mitsiokapa, Theodosios Saranteas, Andreas F Mavrogenis

A thorough literature search was done in PubMed and Google Scholar as well as in physical books in libraries to summarize the literature on the history and evolution of medicine and orthopedics. The philosophical ideas that emerged in ancient Greece served as a foundation for the development of medicine. In the 5th century BC, the schools of Knidos and Kos emerged as influential centers for the development of medical thinking. The field of orthopedics can be traced back to early human civilizations. Ancient Egyptians perpetuated the tradition of employing splinting techniques. Hippocrates provided insights for the diagnosis, correction and treatment of many musculoskeletal entities. The field of medicine experienced a period of limited advancement during the Middle Ages. The Renaissance provided for the foundation of modern orthopedics and important contributions to the understanding and implementation of antisepsis. The discovery of x-ray and advancements in infection control and anesthesia have shown substantial progress in the domain of orthopedics and have contributed to the development of orthopedic subspecialization. Orthopedic surgery holds a historical lineage deeply entrenched in ancient practices and early human civilizations. Physicians specializing in orthopedics should be aware of the historical origins of their discipline and continue to evolve through further subspecialization and enhanced research.

我们在 PubMed 和 Google Scholar 以及图书馆的实体书中进行了全面的文献检索,以总结有关医学和骨科的历史和演变的文献。古希腊出现的哲学思想是医学发展的基础。公元前 5 世纪,克尼多斯(Knidos)和科斯(Kos)学派成为具有影响力的医学思想发展中心。骨科领域可以追溯到人类早期文明。古埃及人延续了使用夹板技术的传统。希波克拉底为许多肌肉骨骼疾病的诊断、矫正和治疗提供了真知灼见。在中世纪,医学领域经历了一个进步有限的时期。文艺复兴时期奠定了现代骨科的基础,并对防腐的理解和实施做出了重要贡献。X 射线的发现以及在感染控制和麻醉方面的进步显示了骨科领域的巨大进步,并促进了骨科亚专业的发展。骨科手术的历史源远流长,在古代实践和早期人类文明中根深蒂固。骨科专业医生应了解其学科的历史渊源,并通过进一步的亚专业化和加强研究继续发展。
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引用次数: 0
Comparison of the Volume and Histological Properties of Newly Formed Bone after the Application of Three Types of Bone Substitutes in Critical-Sized Bone Defects. 临界大小骨缺损应用三种骨替代物后新形成骨的体积和组织学特性比较
Q3 Dentistry Pub Date : 2024-01-01 DOI: 10.1615/JLongTermEffMedImplants.2023046281
Shiva Esfandiari, Reza Amid, Mahdi Kadkhodazadeh, Aida Kheiri

This study aimed to compare the volume and quality of the newly formed bone following application of two types of xenografts and one synthetic material in bone defects in rabbit calvaria from histological and micro-CT aspects. Four 8-mm defects were created in 12 rabbit calvaria. Three defects were filled with bone substitutes and one was left unfilled as the control group. The newly formed bone was evaluated histologically and also by micro-CT at 8 and 12 weeks after the intervention. The percentage of osteogenesis was comparable in histomor-phometric assessment and micro-CT. Histological analysis showed that the percentage of the newly formed bone was 10.92 ± 5.17%, 14.70 ± 11.02%, 11.47 ± 7.04%, and 9.45 ± 5.18% in groups bovine 1, bovine 2, synthetic, and negative control, respectively after 8 weeks. These values were 33.70 ± 11.48%, 26.30 ± 18.05%, 22.92 ± 6.30%, and 14.82 ± 8.59%, respectively at 12 weeks. The difference in the percentage of the new bone formation at 8 and 12 weeks was not significant in any group (P > 0.05) except for bovine 1 group (P < 0.05). Micro-CT confirmed new bone formation in all groups but according to the micro-CT results, the difference between the control and other groups was significant in this respect (P < 0.05). All bone substitutes enhanced new bone formation compared with the control group. Micro-CT assessment yielded more accurate and different results compared with histological assessment.

本研究旨在从组织学和显微 CT 方面比较兔小腿骨缺损中应用两种异种移植物和一种合成材料后新形成骨的体积和质量。在 12 只兔子的小腿上创建了 4 个 8 毫米的缺损。三处缺损用骨替代物填充,一处未填充作为对照组。干预后 8 周和 12 周,对新形成的骨进行组织学评估和显微 CT 评估。在组织计量学评估和显微 CT 中,成骨的比例相当。组织学分析表明,8 周后,牛 1 组、牛 2 组、合成组和阴性对照组新形成骨的百分比分别为 10.92 ± 5.17%、14.70 ± 11.02%、11.47 ± 7.04% 和 9.45 ± 5.18%。12 周后,这些数值分别为 33.70 ± 11.48%、26.30 ± 18.05%、22.92 ± 6.30% 和 14.82 ± 8.59%。除牛 1 组(P < 0.05)外,其他各组在 8 周和 12 周时新骨形成的百分比差异均无显著性(P > 0.05)。显微 CT 证实所有组都有新骨形成,但根据显微 CT 结果,对照组与其他组在这方面差异显著(P < 0.05)。与对照组相比,所有骨替代物都能促进新骨形成。与组织学评估相比,显微 CT 评估得出的结果更准确,差异也更大。
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引用次数: 0
Efficacy of Ozonated Olive Oil Gel in the Management of Peri-Implant Mucositis. 臭氧橄榄油凝胶治疗植牙期粘膜炎的疗效
Q3 Dentistry Pub Date : 2024-01-01 DOI: 10.1615/JLongTermEffMedImplants.2023047323
Apurva Choudhary, Arvina Rajasekar

Peri-implant mucosistis is similar to gingivitis, the former affects the mucosa around implants without bone loss. The aim of this study was to determine the effectiveness of ozonated olive oil gel in the management of peri-implant mucositis. A randomized controlled clinical trial was conducted among 50 patients with peri-implant mucositis within the age group of 25-50 years. They were randomly divided into two groups with 25 participants in each group based on the intervention [Group A (Ozonated olive oil gel), Group B (Chlorhexidine gel)]. Silness and Loe plaque index (PI) and Loe and Silness gingival index (GI) were recorded at baseline and after 4 weeks. Paired t-test and independent t-test was used to test the significance. Within the groups, there was a statistically significant reduction in PI and GI from baseline (P < 0.05). However, the difference in PI and GI between both the groups was statistically insignificant (P > 0.05). Ozonated olive oil gel was equally effective to chlorhexidine gel in the management of peri-implant mucositis.

种植体周围粘膜炎与牙龈炎相似,前者会影响种植体周围的粘膜,但不会造成骨质流失。本研究旨在确定臭氧橄榄油凝胶在治疗种植体周围粘膜炎方面的效果。这项随机对照临床试验在 50 名年龄在 25-50 岁之间的种植体周围粘膜炎患者中进行。根据干预措施[A 组(臭氧橄榄油凝胶)、B 组(洗必泰凝胶)],他们被随机分为两组,每组 25 人。在基线和 4 周后记录 Silness 和 Loe 牙菌斑指数(PI)以及 Loe 和 Silness 牙龈指数(GI)。采用配对 t 检验和独立 t 检验进行显著性检验。在各组内,PI 和 GI 与基线相比均有统计学意义上的显著降低(P < 0.05)。然而,两组之间的 PI 和 GI 差异在统计学上不显著(P > 0.05)。在治疗种植体周围粘膜炎方面,臭氧橄榄油凝胶与洗必泰凝胶具有同等疗效。
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引用次数: 0
Correlation between Primary Stability of Dental Implants and Bone Density: A Retrospective Analysis. 牙科植入物的原始稳定性与骨密度之间的相关性:回顾性分析
Q3 Dentistry Pub Date : 2024-01-01 DOI: 10.1615/JLongTermEffMedImplants.2023049708
S Padmaja, Arvina Rajasekar

Dental implants have gained popularity in recent years. The most important variable in determining the effectiveness of the implant's primary stability is bone density. The success of the implant depends on proper procedure and implant stability. With this background, the aim of the present study was to study the correlation between primary stability and bone density. The present retrospective study was conducted among 2,440 patients who had undergone implant treatment in the Department of Implantology, Saveetha Dental College and Hospitals, Chennai, from June 2021 to February 2022. Data regarding patient's age, gender, implant location, bone density, and primary stability were taken into consideration. Association between primary stability and bone density was assessed using the Chi-square test. Of the subjects, 33.42% had D2 bone density in the lower posterior region; 13.98% had D3 density in the lower posterior region. Primary stability of 30-40 Ncm was seen in the majority of the subjects; 32.64% who had primary stability of 30-40 Ncm had D2 bone density. There was a statistically significant association between implant site and bone density (p = 0.04) and primary stability and bone density (p = 0.03). Within the limitations of the study, it can be concluded that there is a strong association between implant primary stability and bone density.

近年来,种植牙越来越受欢迎。决定种植体主要稳定性效果的最重要变量是骨密度。种植体的成功取决于正确的操作和种植体的稳定性。在此背景下,本研究的目的是研究主要稳定性与骨密度之间的相关性。本回顾性研究的对象是 2021 年 6 月至 2022 年 2 月期间在钦奈萨维耶塔牙科学院和医院种植科接受过种植治疗的 2440 名患者。研究考虑了患者的年龄、性别、种植体位置、骨密度和初次稳定性等数据。基底稳定性与骨密度之间的关系采用卡方检验进行评估。受试者中,33.42%的人后下部骨密度为D2;13.98%的人后下部骨密度为D3。大多数受试者的初级稳定性为 30-40 Ncm;初级稳定性为 30-40 Ncm 的受试者中有 32.64% 的骨密度为 D2。种植部位与骨密度(p = 0.04)、初次稳定性与骨密度(p = 0.03)之间存在统计学意义上的显著关联。在研究的限制条件下,可以得出这样的结论:种植体初级稳定性与骨密度之间存在密切联系。
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引用次数: 0
Design and Stability Analysis of an Adaptive Neuro-Fuzzy Inference System (ANFIS)-Based Pacemaker Controller in MATLAB Simulink. 基于 MATLAB Simulink 的自适应神经模糊推理系统 (ANFIS) 起搏器控制器的设计与稳定性分析
Q3 Dentistry Pub Date : 2024-01-01 DOI: 10.1615/JLongTermEffMedImplants.2023043889
Asghar Dabiri Aghdam, Nader Jafarnia Dabanloo, Fereidoun Nooshiravan Rahatabad, Keivan Maghooli

We present the design and stability analysis of an adaptive neuro-fuzzy inference system (ANFIS)-based controller of a pacemaker in MATLAB Simulink. ANFIS uses learning and speed properties of fuzzy and neural networks. Based on body states and preprogrammed situations of patients (age and sex, etc.), heart rate and amplitude of pacing pulse are changed. Output signal that is fed backed from heart is compared to the reference fuzzy bases ANFIS signals. After designing ANFIS based controller, the stability of the proposed system has been tested in both the time (step response) and trequency (Bode diagram and Nichols chart) domains. In our previous study, the step response analyzed and compared with other works. For frequency domain, all the possible frequency analysis methods have been tested but because of nonlinear properties of ANFIS, after linearization, just the Bode diagram achieved good results. The step response results in time domain is compared with previous work's results including optimum heart pulse rate for each particular patient. In the frequency domain, the Bode diagram stability analysis showed gain and phase margin as follows: GM (dB) = 42.1 and PM (deg) = 100.

我们在 MATLAB Simulink 中介绍了基于自适应神经模糊推理系统(ANFIS)的起搏器控制器的设计和稳定性分析。ANFIS 利用模糊和神经网络的学习和速度特性。根据患者的身体状态和预设情况(年龄和性别等),改变心率和起搏脉冲的振幅。从心脏反馈的输出信号与参考模糊基础 ANFIS 信号进行比较。在设计了基于 ANFIS 的控制器后,我们在时域(阶跃响应)和频域(Bode 图和 Nichols 图)对所提议系统的稳定性进行了测试。在我们之前的研究中,对阶跃响应进行了分析,并与其他研究成果进行了比较。在频域方面,我们测试了所有可能的频率分析方法,但由于 ANFIS 的非线性特性,在线性化之后,只有 Bode 图取得了良好的结果。时域的阶跃响应结果与之前的工作结果进行了比较,包括每个特定病人的最佳心脏脉搏率。在频域,Bode 图稳定性分析显示增益和相位裕度如下:GM (dB) = 42.1,PM (deg) = 100。
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引用次数: 0
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Journal of long-term effects of medical implants
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