836 resultados para Optimal DVR placement
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A good catheter implantation technique is important to allow effective peritoneal access function and long-term technique survival. Studies regarding results obtained by nephrologists in comparison with different techniques have been limited. The aim of this study was to investigate the rate of early catheter-related complications and catheter survival in two Brazilian centers, according to two different percutaneous methods of catheter implantation performed by nephrologist team. Adult incident patients recruited from January 2006 to July 2013 having undergone first peritoneal dialysis (PD) catheter implantation were included in the analysis. Mechanical and infectious early complication rates were defined as time to the first event occurring up to 3 months. Four hundred and forty-five consecutive Tenckhoff catheters were implanted by nephrologist team percutaneously after antibiotic prophylaxis in an operating room: trocar was used in 349 (78.4 %) and Seldinger technique (ST) in 99 (21.6 %). The ST was significantly associated with a lower rate of leak (16.3 vs 3 %, p = 0.03) and outflow failure due to tip catheter migration (22.6 vs 10.1 %, p = 0.04), while early infectious complication rates were similar between the two groups (p = 0.59). Long-term catheter survival was higher in Seldinger group (log-rank, p = 0.031). By Cox multivariate analysis, adjusted for age, sex, and diabetes, the ST remained independently associated with better catheter survival [HR 0.681 (0.462-0.910), p = 0.04]. As conclusion, our experience showed better PD outcomes with the ST than trocar method of catheter implantation by nephrologist.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Because of the functional and esthetic requirements of patients, different techniques have been proposed to reduce the time between dental implant placement and interim restoration fabrication. This article describes a modified indexing technique by using a surgical template for open-tray impression and definitive cast development during immediate loading procedures. This technique does not use a complete impression of the oral cavity and, therefore, is more comfortable, less time consuming, and less expensive. It also allows the fabrication of interim restorations with the optimal shape for developing an adequate emergence profile.
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An optimal control framework to support the management and control of resources in a wide range of problems arising in agriculture is discussed. Lessons extracted from past research on the weed control problem and a survey of a vast body of pertinent literature led to the specification of key requirements to be met by a suitable optimization framework. The proposed layered control structure—including planning, coordination, and execution layers—relies on a set of nested optimization processes of which an “infinite horizon” Model Predictive Control scheme plays a key role in planning and coordination. Some challenges and recent results on the Pontryagin Maximum Principle for infinite horizon optimal control are also discussed.
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Some problems of Calculus of Variations do not have solutions in the class of classic continuous and smooth arcs. This suggests the need of a relaxation or extension of the problem ensuring the existence of a solution in some enlarged class of arcs. This work aims at the development of an extension for a more general optimal control problem with nonlinear control dynamics in which the control function takes values in some closed, but not necessarily bounded, set. To achieve this goal, we exploit the approach of R.V. Gamkrelidze based on the generalized controls, but related to discontinuous arcs. This leads to the notion of generalized impulsive control. The proposed extension links various approaches on the issue of extension found in the literature.
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Pós-graduação em Engenharia Mecânica - FEIS
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Forced orthodontic eruption (FOE) is a non-surgical treatment option that allows modifying the osseous and gingival topography. The aim of this article is to present a clinical case of a FOE, which resulted in an improvement of the amount of available bone and soft-tissues for implant site development. Patient was referred for treatment of mobility and unesthetic appearance of their maxillary incisors. Clinical and radiographic examination revealed inflamed gingival tissue, horizontal and vertical tooth mobility and interproximal angular bone defects. It was chosen a multidisciplinary treatment approach using FOE, tooth extraction, and immediate implant placement to achieve better esthetic results. The use of FOE, in periodontally compromised teeth, promoted the formation of a new bone and soft-tissue in a coronal direction, without additional surgical procedures, enabling an esthetic, and functional implant-supported restoration.
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Introduction: The demand for optimal esthetics has increased with the advance of the implant dentistry and with the desire for easier, safer and faster technique allowing predictable outcomes. Thus, the aim of this case report was to describe a combined approach for the treatment of a periodontally compromised tooth by means of atraumatic tooth extraction, immediate flapless implant placement, autogenous block and particulate bone graft followed by connective tissue graft and immediate provisionalization of the crown in the same operatory time. Case Report: A 27-year-old woman underwent the proposed surgical procedures for the treatment of her compromised maxillary right first premolar. The tooth was removed atraumatically with a periotome without incision. A dental implant was inserted 3 mm apical to the cement-enamel junction of the adjacent teeth enabling the ideal tridimensional implant position. An osteotomy was performed in the maxillary tuber for block bone graft harvesting that allowed the reconstruction of the alveolar buccal plate. Thereafter, an autogenous connective tissue graft was placed to increase both the horizontal and vertical dimensions of the alveolar socket reaching the patient functional and esthetic expectations. Conclusion: This treatment protocol was efficient to create a harmonious gingival architecture with sufficient width and thickness, maintaining the stability of the alveolar bone crest yielding excellent aesthetic results after 2-years of follow-up. We suggest that this approach can be considered a viable alternative for the treatment of periodontally compromised tooth in the maxillary esthetic area enhancing patient comfort and satisfaction.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Pós-graduação em Engenharia Elétrica - FEIS
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The aim of this study was to measure changes in buccal alveolar crestal bone levels after immediate placement and loading of dental implants with Morse taper prosthetic abutments after tooth extraction. This study followed the STROBE guidelines regarding prospective cohort studies. The sample comprised 12 patients with a mean age of 45 years, in whom a central or upper lateral incisor was indicated for extraction. Prior to extraction, computed tomography (CT) analysis was carried out to assess the presence of the buccal bone crest. CT scans were performed at 24 h and at 6 months after immediate implant placement and immediate loading. The distance from the most apical point of the implant platform to the buccal bone crest was assessed at the two time points. The buccal bone crest height was evaluated at three points in the mesio-distal direction: (1) the centre point of the alveolus, (2) 1 mm mesial to the centre point, and (3) 1 mm distal to the centre point. The values obtained were subjected to statistical analysis, comparing the distances from the bone crest to the implant platform for the two time points. After 6 months there was a statistically significant, non-uniform reduction in height at the level of the crest of the buccal bone in the cervical direction. It is concluded that the buccal bone crest of the immediate implants that replaced the maxillary incisors underwent apical resorption when subjected to immediate loading.