Rehabilitación de un paciente desdentado total con sobredentadura

Con el advenimiento de los implantes y con ellos la opción de las sobredentaduras, la pasividad comienza a jugar un papel fundamental para darle mejor pronóstico a la rehabilitación y prolongar la vida útil de los implantes. Dentro de este análisis es que se presenta el caso clínico de un paciente portador de prótesis completa superior e inferior, tratado dentro del marco de la Carrera de Especialista en Prostodoncia de la Universidad Nacional de Cuyo. El tratamiento propuesto al paciente fue: dos implantes en el maxilar inferior con una sobredentadura retenida por pilares esféricos y cuatro implantes superiores con una sobredentadura retenida por una barra, la cual feruliza los implantes. La barra superior fue colada seccionada en cuatro partes, unidas en boca y luego soldadas mediante tecnología láser. De esta forma se busca obtener pasividad para evitar aflojamiento de tornillos de fijación, fractura de tornillos o implantes, reabsorción de los tejidos óseo perimplantarios o pérdida de la oseointegración de los implantes.

A Transmembrane Form of the Prion Protein Contains an Uncleaved Signal Peptide and Is Retained in the Endoplasmic Reticululm

Although there is considerable evidence that PrPSc is the infectious form of the prion protein, it has recently been proposed that a transmembrane variant called CtmPrP is the direct cause of prion-associated neurodegeneration. We report here, using a mutant form of PrP that is synthesized exclusively with the CtmPrP topology, that CtmPrP is retained in the endoplasmic reticulum and is degraded by the proteasome. We also demonstrate that CtmPrP contains an uncleaved, N-terminal signal peptide as well as a C-terminal glycolipid anchor. These results provide insight into general mechanisms that control the topology of membrane proteins during their synthesis in the endoplasmic reticulum, and they also suggest possible cellular pathways by which CtmPrP may cause disease.

Segurança biológica de implantes mamários de silicone: interrelação entre processos esterilizantes e biocompatibilidade

Os implantes mamários de silicone têm sido empregados, tanto nas cirurgias de aumento das mamas, quanto na reconstrução do tecido mamário após mastectomia. A segurança biológica dos implantes de silicone merece estudo relacionado aos processos de esterilização empregados, pois podem constituir-se em fator de comprometimento da estrutura química do polímero e, conseqüentemente, da biocompatibilidade. Este estudo consistiu na avaliação da biocompatibilidade de implantes mamários de silicone após terem sido submetidos aos processos de esterilização por calor seco, radiação gama e óxido de etileno. O parâmetro avaliado foi a viabilidade celular, empregando o método de difusão em agar e de captura do vermelho neutro. As amostras compreenderam implantes de silicone gel lisos, texturizados e revestidos com poliuretano e implantes texturizados pré-cheios com solução salina. Também foi realizado o teste de endotoxinas bacterianas pelo método do LAL e determinação da taxa de migração do gel de silicone (teste de bleed). Os três métodos de esterilização mostraram-se igualmente eficientes pela comprovação da condição de esterilidade dos implantes através de metodologia descrita na Farmacopéia Americana 27 edição. Os níveis de endotoxinas bacterianas dos implantes, também atenderam aos requisitos dos compêndios oficiais. Na avaliação da biocompatibilidade todos os implantes, independente dos processos de esterilização utilizados, apresentaram ausência de citotoxicidade. Os resultados do teste de bleed mostraram uma maior taxa de migração de gel para os implantes de superfície lisa em comparação com os implantes de superfície texturizada e revestida com poliuretano, quando esterilizados por calor seco. Ao comparar a taxa de migração do gel para os implantes de superfície lisa esterilizados por calor seco e óxido de etileno, obteve-se uma maior taxa de migração para aqueles implantes esterilizados por óxido de etileno. As diferentes avaliações realizadas neste estudo abrangeram aspectos biológicos, químicos e físicos relevantes para garantir um produto de boa qualidade e que, por assegurar a manutenção da característica de biocompatibilidade, resulta na segurança biológica deste tipo de implante.

Fixed Mydriatic Pupil Associated with an Intraocular Pressure Rise as a Complication of the Implant of a Phakic Refractive Lens (PRL)

We describe a case report of a patient that was implanted with a posterior chamber phakic intraocular lens (Phakic Refractive Lens, PRL) for the correction of moderate myopia and who developed postoperatively a fixed mydriasis compatible with an Urrets-Zavalia Syndrome (UZS). Specifically, a sudden acute increase of IOP in the left eye was observed in the immediate postoperative period. After IOP stabilization, the refractive result was good, but a fixed and mydriatic pupil appeared. This condition led the patient to experience visual discomfort, halos, and glare associated with high levels of higher-order aberrations in spite of the good visual result. A tinted-contact lens was fitted in order to minimize those symptoms. The UZS should be considered as a possible complication after implantation of posterior chamber phakic intraocular lenses.

Applying scanning electron microscopy for the ultrastructural and clinical analysis of periprosthetic capsules in implant-based breast reconstruction

La reconstruction en deux étapes par expanseur et implant est la technique la plus répandue pour la reconstruction mammmaire post mastectomie. La formation d’une capsule périprothétique est une réponse physiologique universelle à tout corps étranger présent dans le corps humain; par contre, la formation d’une capsule pathologique mène souvent à des complications et par conséquent à des résultats esthétiques sous-optimaux. Le microscope électronique à balayage (MEB) est un outil puissant qui permet d’effectuer une évaluation sans pareille de la topographie ultrastructurelle de spécimens. Le premier objectif de cette thèse est de comparer le MEB conventionnel (Hi-Vac) à une technologie plus récente, soit le MEB environnemental (ESEM), afin de déterminer si cette dernière mène à une évaluation supérieure des tissus capsulaires du sein. Le deuxième objectif est d‘appliquer la modalité de MEB supérieure et d’étudier les modifications ultrastructurelles des capsules périprothétiques chez les femmes subissant différents protocoles d’expansion de tissus dans le contexte de reconstruction mammaire prothétique. Deux études prospectives ont été réalisées afin de répondre à nos objectifs de recherche. Dix patientes ont été incluses dans la première, et 48 dans la seconde. La modalité Hi-Vac s’est avérée supérieure pour l’analyse compréhensive de tissus capsulaires mammaires. En employant le mode Hi-Vac dans notre protocole de recherche établi, un relief 3-D plus prononcé à été observé autour des expanseurs BIOCELL® dans le groupe d’approche d’intervention retardée (6 semaines). Des changements significatifs n’ont pas été observés au niveau des capsules SILTEX® dans les groupes d’approche d’intervention précoce (2 semaines) ni retardée.

Does immediate loading affect clinical and patient-centered outcomes of mandibular 2-unsplinted-implant overdenture? : a 2-year within-case analysis

Objective To provide 2-year clinical- and patient-oriented data with regard to mandibular overdenture assisted by 2 immediately loaded unsplinted implants. Material and methods In this pre-post design, Phase-I clinical trial, 18 edentate individuals (62.4 ± 7.7 years) received a new set of complete denture. Then, following standard procedures, 3 threaded implants (OsseoSpeed TX™, Dentsply Implants, Mölndal, Sweden) were placed in the mandible in each patient, and locator abutments (Zest Anchors LLC, Escondido, U.S.A.) were inserted on the right and left side implants. The midline implant served as a control for within-patient comparison. The immediate loading was conducted within 24 h of surgery. Data were collected at baseline (T0), 12 (T1) and 24 (T2) months after immediate loading. The clinical outcomes included implant survival rate, crestal bone level changes and implant stability. These criteria were assessed through clinical and radiographic examinations as well as resonance frequency analysis. Patient-centered outcomes included patient satisfaction and oral health-related quality of life measured using validated questionnaires. Brunner-Langer approach was used for statistical analysis. Results Implant survival rate for immediate loaded implants was 91.7% at 2-year follow-up. None of the unloaded implants failed. There was no statistically significant difference at baseline and follow-ups with regard to clinical outcomes between loaded and unloaded implants. Patient satisfaction and quality of life improved (p < 0.0001) from baseline to 2-year follow-up. Conclusion Immediate loading protocol did not negatively affect clinical outcomes, satisfaction and quality of life of patients wearing 2-unsplinted-implant mandibular overdenture for 2 years. This conclusion requires confirmation by randomized control trials. Clinical significance statement Mandibular overdenture assisted by two immediately-loaded unsplinted implants is successful treatment based on 2-year clinical and patient-based outcomes.

Oral bacterial microflora associated with total acrylic dentures: implant supported vs mucus supported

Poster presented at the 1st International Congress of CiiEM - From Basic Sciences to Clinical Research. 27-28 November 2015, Egas Moniz, Caparica, Portugal.

Oral fungal microflora associated with implant-supported VS. mucous-supported dentures

Poster presented at the 1st International Congress of CiiEM - From Basic Sciences to Clinical Research, 27-28 November 2015, Egas Moniz, Caparica, Portugal.

Does immediate loading affect clinical and patient-centered outcomes of mandibular 2-unsplinted-implant overdenture? : a 2-year within-case analysis

Objective To provide 2-year clinical- and patient-oriented data with regard to mandibular overdenture assisted by 2 immediately loaded unsplinted implants. Material and methods In this pre-post design, Phase-I clinical trial, 18 edentate individuals (62.4 ± 7.7 years) received a new set of complete denture. Then, following standard procedures, 3 threaded implants (OsseoSpeed TX™, Dentsply Implants, Mölndal, Sweden) were placed in the mandible in each patient, and locator abutments (Zest Anchors LLC, Escondido, U.S.A.) were inserted on the right and left side implants. The midline implant served as a control for within-patient comparison. The immediate loading was conducted within 24 h of surgery. Data were collected at baseline (T0), 12 (T1) and 24 (T2) months after immediate loading. The clinical outcomes included implant survival rate, crestal bone level changes and implant stability. These criteria were assessed through clinical and radiographic examinations as well as resonance frequency analysis. Patient-centered outcomes included patient satisfaction and oral health-related quality of life measured using validated questionnaires. Brunner-Langer approach was used for statistical analysis. Results Implant survival rate for immediate loaded implants was 91.7% at 2-year follow-up. None of the unloaded implants failed. There was no statistically significant difference at baseline and follow-ups with regard to clinical outcomes between loaded and unloaded implants. Patient satisfaction and quality of life improved (p < 0.0001) from baseline to 2-year follow-up. Conclusion Immediate loading protocol did not negatively affect clinical outcomes, satisfaction and quality of life of patients wearing 2-unsplinted-implant mandibular overdenture for 2 years. This conclusion requires confirmation by randomized control trials. Clinical significance statement Mandibular overdenture assisted by two immediately-loaded unsplinted implants is successful treatment based on 2-year clinical and patient-based outcomes.

Non-destructive measurement of U-235 retained in absolute air filters /

"April 15, 1964."