Our study is the first to report an especially high rate of grade 2 or worse radiation pneumonitis in patients treated with thoracic radiotherapy and simultaneous Osimertinib, despite total lung V5, V20 and MLD seeming unlikely to induce radiation pneumonitis.
The clinical effectiveness of the erbium-doped yttrium-aluminum-garnet (Er:YAG) laser in patients with peri-implantitis remains unclear. The aim of this meta-analysis was to investigate the efficacy and safety of Er:YAG laser (ERL) compared to subgingival mechanical debridement (SMD) for the treatment of peri-implantitis. A systematic electronic literature search was conducted to identify randomized clinical trials (RCTs), followed by a manual search. Results were expressed as weighted mean differences (WMDs) with accompanying 95 % confidence intervals (CIs). The primary outcome measurements were changes in clinical attachment level (CAL) and probing depth (PD). Secondary outcome measurements included changes in gingival recession (GR). The meta-analysis was performed with fixed-effect or random-effect model according to the heterogeneity assessed by I (2) test. Visual asymmetry inspection of the funnel plot, Egger's regression test, and the trim-and-fill method were used to investigate publication bias. At 6 months, significant difference in PD reduction (p = 0.018) was observed for Er:YAG laser compared to SMD treatment, while no significant differences were detected in CAL gain and GR change; at 12 months, no significant difference was observed for any investigated outcome. The findings of this meta-analysis suggest that use of the Er:YAG laser as alternative to SMD could potentially provide short-time additional benefits, while there is no evidence of long-time superior effectiveness. As all included studies were not at low risk of bias, and only four studies were included in the meta-analysis, future long-term and well-designed RCTs reporting clinical and microbiological outcomes, considering the cost/effectiveness ratio, and having a high methodological quality are needed to clarify the effectiveness of Er:YAG laser.
We performed a meta-analysis aimed to assess the clinical results after transalveolar sinus floor lift without bone grafting in the atrophic maxilla. A systematic electronic literature search was conducted in PubMed, Embase and The Cochrane Library, followed by a manual search. Two reviewers independently extracted study data and conducted quality assessments. Ten non-controlled studies including 1484 implants and eight controlled studies (5 RCTs and 3 prospective studies) including 817 implants (451 implants in the non-graft group) were enrolled in this study. The survival rate of implants via the graft-free method was 98% (95%CI 96% to 100%). There was no significant difference in the survival rate between the non-graft group and the graft group (RR: 1.02; p = 0.18). No statistically significant difference in marginal bone loss was detected between the groups at 12 months (0.57, p = 0.07) or 36 months (0.05, p = 0.61). The endo-sinus bone gain in the non-graft group was significantly lower than in the graft group at 12 months (−1.10, p = 0.0001) and 36 months (−0.74, p = 0.02). Hence, the available evidence suggests that predictable results could be acquired through transalveolar sinus floor lift without bone grafting, while there may be a trend toward more endo-sinus bone gain with bone grafts.
Sinus augmentation with a lateral window technique and delayed implant placement are the traditional treatment schedules when the residual alveolar bone height in atrophic posterior maxilla is less than 5 mm. This article presents a transcrestal window approach (TWA) to replace a missing first molar in an atrophic posterior maxillary ridge with 1 to 2 mm of residual bone height (RBH). Transcrestal sinus augmentation and delayed implant placement were performed. The antral pseudocyst that was located in the nasal wall of the maxillary sinus disappeared in the cone-beam computer tomography images taken after sinus elevation surgery. The 1-year follow-up visit showed that the implant was successful and the Periotest value was -4.8. This approach reduces discomfort to the patient. The TWA with an RBH of 1 to 2 mm is a minimally invasive method for maxillary sinus augmentation.
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