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Prospective study of 429 hydroxyapatite-coated cylindric omniloc implants placed in 121 patients.
Int J Oral Maxillofac Implants. 2003 Jan-Feb;18(1):82-92.
McGlumphy EA, Peterson LJ, Larsen PE, Jeffcoat MK.
PURPOSE: Controversy over the long-term clinical effectiveness of hydroxyapatite
(HA)-coated dental implants still persists, despite numerous clinical studies documenting
high survival rates. The Ohio State University College of Dentistry undertook a 5-year
prospective study of 429 HA-coated cylindric implants placed into 121 patients to determine
the long-term clinical performance of the implants. MATERIALS AND METHODS: All study
subjects were patients screened and evaluated in the university's dental clinic by one
of the principal investigators and one member of the surgical team. A total of 429
HA-coated implants were placed in 121 patients. The Ohio State University Human Subjects
Committee approved and reviewed this study. RESULTS: At the time of this report,
375 implants had completed 5 years of clinical follow-up. Beyond the 5-year limit
of the study, 282 implants had completed 6 years and 114 implants had completed 7
years of clinical monitoring. The cumulative survival rate was 96% at 5 years and
95% at 7 years of follow-up. Mean combined mesial/distal bone loss was 1.2 mm in
the mandible and 1.4 mm in the maxilla after 5 years of functional loading. Implant
failures were most commonly associated with short implants or angled abutments.
DISCUSSION: Prospective clinical data are extremely valuable for clinicians evaluating
the reliability of dental implant systems. In the present study, the implants achieved
100% osseointegration with minimal marginal bone loss, and 96% of the implants remained
in function at 5 years. CONCLUSION: The HA-coated cylindric implants in this study
provided a predictable means of oral rehabilitation.
Effect of prophylactic amoxicillin on endodontic flare-up in asymptomatic, necrotic teeth.
J Endod. 2001 Jan;27(1):53-6.
Pickenpaugh L, Reader A, Beck M, Meyers WJ, Peterson LJ.
The purpose of this prospective, randomized, double-blind, placebo-controlled study was
to determine the effect of prophylactic amoxicillin on the occurrence of endodontic
flare-up in asymptomatic, necrotic teeth. Seventy patients participated and had a clinical
diagnosis of an asymptomatic, necrotic tooth with associated periapical radiolucency.
One hour before endodontic treatment, patients randomly received either 3 g of
amoxicillin or 3 g of a placebo control in a double-blind manner. After endodontic
treatment, each patient received: ibuprofen; acetaminophen with codeine (30 mg);
and a 5 1/2-day diary to record pain, swelling, percussion pain, and number and
type of pain medication taken. The results demonstrated 10% of the 70 patients
had a flare-up characterized by moderate-to-severe postoperative pain or swelling
that began approximately 30 h after endodontic treatment and persisted for an
average of 74 h. Of the seven patients who had flare-ups, 4 were in the
amoxicillin group and 3 were not. Prophylactic amoxicillin did not significantly
(p = 0.80) influence the endodontic flare-up. We concluded that a prophylactic
dose of amoxicillin before endodontic treatment of asymptomatic, necrotic teeth
had no effect on the endodontic flare-up.
Contemporary management of deep infections of the neck.
J Oral Maxillofac Surg. 1993 Mar;51(3):226-31.
Peterson LJ.
Odontogenic infections rarely lead to involvement of the lateral and retropharyngeal spaces.
When this does occur, the microbiology of the infection is similar to the typical
odontogenic infection, ie, Streptococcus and oral anaerobes including Peptostreptococcus,
Bacteroides, and Fusobacterium. There is an increased incidence of Fusobacterium seen in
the more severe infections, as well as a higher incidence of Streptococcus milleri.
Many patients who have deep cervical infections also have some compromise in their
host defense mechanism, such as diabetes. The signs and symptoms of deep cervical
space infections are similar to those of the severe submandibular space infection,
but also includes sialorrhea, respiratory distress, odynophagia, and dysphagia.
Lateral soft-tissue radiographs of the neck are useful in assisting with the
diagnosis of retropharyngeal infections, and CT scans can provide definitive
information regarding lateral pharyngeal space involvement. Treatment includes
the use of high-dose intravenous bacteriocidal antibiotics. The recommended
antibiotics are penicillin-metronidazole, ampicillin-sulbactam, or clindamycin.
Certain cephalosporins may also be useful in selected patients.
Early surgical intervention is also indicated. Aggressive incision and drainage
of all of the involved spaces is necessary to assure early resolution of the infection.
Continual airway monitoring and the
establishment of surgical airways is the final portion of the treatment triad.
Use of cricothyroidostomy in oral and maxillofacial surgery.
J Oral Maxillofac Surg. 1987 Oct;45(10):873-8.
Feinberg SE, Peterson LJ.
Surgical entry into the upper airway is not only important in emergency situations but
also in the treatment of certain elective maxillofacial procedures. The procedure of
choice by which surgical access is gained has traditionally been a tracheostomy.
Although a cricothyroidostomy is easier and quicker to perform, with a higher degree
of safety, it has generally been relegated to only emergency situations. The purpose
of this paper is to present the anatomy, indications, and surgical technique of
cricothyroidostomy. It is concluded that cricothyroidostomy, and not tracheostomy,
is the preferred procedure for surgical establishment of an upper airway,
either in elective maxillofacial surgical procedures, or in an emergency situation.
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