Journal of long-term effects of medical implants最新文献

The total number of annual pacemaker implantations continues to grow globally, and help patients with heart rhythm disorders with an improved quality of life and reduced mortality. The first implantable pacemakers appeared in 1965, characterized by their bulkiness, short battery life, and a single pacing mode. Innovation led to the modern pacemaker: a smaller system with improved battery life and capacity, and innovation in lead technology. Certain arrhythmia conditions may also qualify for leadless pacemaker implantation, thus eliminating the spectrum of complications that could occur with leads. Adverse events can be divided into acute (perforation, lead dislodgement, infection) and long-term (lead fractures, device infection, insulation failure). Traditional long-term complications with leads occur in 10% of patients, compared with device-related adverse effects observed in 6.7% of leadless pacemakers. Furthermore, cardiac pacemaker implantation results in quality of life improvements across all age groups. Large cardiac rehabilitation studies have demonstrated the effectiveness of exercise in reducing the physical complications involved with pacemaker implantation. Of the three randomized controlled trials examined, all of them reported some benefit of exercise in the intervention group compared with the control. The following review aims to discuss the multitude of pacemaker options potentially available for the clinician, complications, their course of management, and the path forward with innovations arising out of previous research within the field.

Exploring variations in the oral microbiome that predict the early stages of oral diseases could lead to more accurate diagnosis and therapy before the disease manifests clinically. This study compared the bacterial profile around prosthesis on natural teeth and implants in a healthy oral cavity. Fifteen participants with prosthesis on natural teeth and 15 participants with implants were recruited. All participants were periodontally healthy. Plaque samples were collected and then subjected to PCR amplification with 16S rRNA gene sequencing. Using the BlastN program, the sequenced data were compared to reference bacterial gene sequences in the Human Oral Microbiome Database. Finally, bacterial species in both groups' samples were identified, and a phylogenetic tree was created to compare the bacterial profile around prosthesis on natural teeth and implants. Microorganisms identified were Streptococcus, Fusobacterium, Corynebacterium, Micrococcus, Aeromonas, Leptotrichia, and Dechloromonas species; around implants were Streptococcus, Fusobacterium, Corynebacterium, Prevotella, Eikenella, Nisseria, Rothia, Aeromonas, Leptotrichia, and Actinomyces species. On comparing the bacterial profile around prosthesis on natural teeth and implants in periodontally healthy individuals, pathogenic bacterial species including Fusobacterium nucleatum, Prevotella intermedia, and Eikenella corrodens were identified around implants.

A dental implant mimics the tooth and restores its function. It has flourished as a replacement of missing natural teeth that has a success rate over 90% over the years. However, this root-form implant has also been associated with some complications after its application. Crestal bone loss, one of the biggest challenges in dental implant placement, occurs around the dental implant neck within a few months post-loading. The aim of this study was to determine survival rates and to measure crestal bone changes after placement of a single crown prosthesis. Data collection was done in a private dental university setting. Data from approximately 296 cases were retrieved after analyzing 86,000 case sheets. The following parameters were evaluated based on dental records: age, sex, implant placement area, implant diameter and length, and presence or absence of exudate. Crestal bone loss was assessed radiographically. Excel tabulation and SPSS version 23 were used for data analysis. Chi-square testing was done to correlate various parameters used in this study. Incipient crestal bone loss was commonly observed. It was seen that the association between crestal bone loss and exudate was statistically significant (Chi-square, p < 0.05). Within the limits of this study, incipient crestal bone loss was observed in most dental implants irrespective of bone density, implant length, implant diameter, and implant placement area.

The coronavirus disease 2019 (COVID-19) pandemic has led to important restrictions in social life of civilians worldwide and there were lower admission rates mainly in surgical departments in many hospitals. This study presents how COVID-19 pandemic affected admissions at the orthopaedic and trauma surgery department of a major trauma center. A retrospective study was conducted that recorded all patients examined at the outpatient orthopaedic clinic and the emergency orthopaedic department, as well as patients admitted to the orthopaedic surgery clinic and patients that underwent operative procedures between March 23 and May 4, 2020 (first lockdown period) and between March 23 and May 4, 2019 (control period). In addition, all patients with hip fractures that required hospitalization and underwent hip surgery were identified during the same time periods. During lockdown period 1 compared with the lock-down period 2 were observed: 70% and 61% decrease in the number of patients examined at the outpatient clinic and the emergency orthopaedic department respectively. The number of patients admitted to the orthopaedic surgery clinic declined by 41%, whereas operative procedures decreased by 22%. Regarding hip fractures timing to surgery during the first period was significantly less compared with second lockdown period, however, hospitalization days remained almost unchanged over the two time lockdown periods. Restrictions during the first lockdown period due to COVID-19 pandemic caused an important decrease in the number of patients and theaters in all orthopaedic departments in one of the major trauma centers in Athens. However, the incidence of hip fractures in elderly was not significantly decreased. Further similar studies are needed to identify variations and patterns of these parameters in other trauma centers.

To assess up to date patient and doctor perceived costs of dental implant surgery among the Indian population as there is a lack of information regarding patients' awareness of dental implants. Two online questionnaire forms were sent over the internet to the Indian population and the Indian dentists and dental students regarding the knowledge, attitude and perception regarding the dental implant surgery for rehabilitation of a single missing tooth. Statistical analysis was then carried out using SPSS software version 23.0. Thirty-eight percent (P < 0.05) of the participants questioned the thought that implants require the same care as fixed prostheses, and thought it was a better option due to a major percent expecting an additional payment > 10,000 indian rupees. The expectations that patients have for an implant-supported set are high in contrast to their willingness to make additional payments. There are still misconceptions regarding costs, and these must be resolved individually in practice.

This study investigated the effect of bone grafting on hard and soft tissue alterations after immediate implant insertion in mandibular molar sites. This randomized, double-blind clinical trial consisted of 30 healthy patients (17 women and 13 men aged 22-58 years) who required immediate implant installation to replace a first or second mandibular molar. Only subjects with a buccal gap between 2 and 4 mm were selected. The participants were randomly allocated to two groups. In the experimental group, the gap was augmented by an allograft, whereas in the control group no graft was applied. Marginal bone level, probing depth, keratinized gingival width, and bleeding on probing were assessed at the time of implant placement (T0), 1 month (T1), and 3 months (T2) after surgery. There was no significant difference in hard and soft tissue parameters between the grafted and nongrafted sites at any of the durations (P < 0.05). Bone level decreased significantly in both groups (P < 0.05). However, the amount of probing depth and the frequency of cases showing bleeding on probing did not alter over the experiment either in the test or in the control group (P > 0.05). Bone grafting simultaneously with immediate implant installation had no significant effect on hard and soft tissue outcomes when the buccal gap size was between 2 and 4 mm. Therefore, the use of a bone substitute is not mandatory up to the jumping distance of 4 mm in immediate implant surgery.

Dental implants are being utilized by numerous dentists to replace missing teeth by restoring the function of teeth without compromising the aesthetics. An implant is attached to the bone through the process of osseointegration, which is the connection between bone and artificial implant. For a dental implant to be successful long-term stable osseointegration is required. Early dental implant failure (EDIF) usually occurs within the first four months of implant placement. Osseointegration is dependent on the serum levels of vitamin D. Vitamin D is a secosteroid hormone synthesized by skin cells under the influence of UV radiation or is ingested through a diet or supplemental medication. Low levels of vitamin D negatively affect bone formation thus, affecting the longevity of implant. Vitamin D facilitates bone metabolism, alveolar bone resorption thus, preventing tooth loss. The relationship between bone formation and vitamin D levels have been observed in animal models. According to numerous studies conducted on rodents, vitamin D has been found to increase bone formation around implants. Vitamin D serum levels can be influenced by a variety of factors such as malnutrition, insufficient sun exposure, pigmented skin, obesity and advanced age. As vitamin D levels decrease with increasing age, osteoporosis and periodontal diseases are often diagnosed within the elderly population. Vitamin D is involved in the wound healing process and involves numerous different cells and calcium signaling pathways. This review paper will investigate the relationship between serum vitamin D levels and its impact on wound healing and EDIF.