Dental Implants have become the standard care of rehabilitation of missing teeth. This article intends to review the success criteria for implants from 1979 till date. Earlier days implant success was evaluated by immobility and peri-implant radiolucency. But currently, the width of the attached gingiva, co-existing medical conditions, smoking, and width of the implant also play a role in evaluating implant success. Genetic and immunological markers have also been identified.
A patient attending for treatment of a restorative nature may present for a variety of reasons. The success is built upon careful history taking coupled with a logical progression to diagnosis of the problem that has been presented. Each stage follows on from the preceding one. A fitting treatment plan should be formulated and should involve a holistic approach to what is required.
This is a report of 14 patients who suffered from oral cancer and underwent radical excisions of the oral cancer lesion with functional neck dissection at the Department of Oral and Maxillofacial Surgery in Annasawmy Mudaliar General Hospital, Bangalore, between 2010 and 2011. Eleven males and 3 females were involved, with the average age of 68.7 years. All patients had positive cervical lymph nodes proven by clinical and ultrasound examination. Level IB was positive in all cases and Level II of the neck was found additionally involved in five cases. A functional neck dissection in patients with a clinically positive node neck achieved better disease-free survival with minimal postoperative co-morbidity.
Background:The systemic effects attributable to the injection of dental local anesthetic solutions have been the subject of discussion for many years.Aim and Objective:The aim of the present study was to investigate the biochemical and hemodynamic effects of adrenaline in lignocaine local anesthetic solutions when used in clinical doses in patients undergoing third molar surgery under general anesthesia.Materials and Methods:Of the total 30 patients, 15 were given local anesthetic solution containing adrenaline and the other 15 were given the same without adrenaline. Hemodynamic and biochemical parameters were recorded at considerable intervals. The changes from the pre-local anesthetic (baseline) values with each treatment were compared by analysis of variance and Student's t-test. The changes within each treatment were compared by the paired t-test.Results and Conclusion:This study shows that exogenous adrenaline administration in clinical doses produces systemic effects even in conditions where the endogenous release of the catecholamines would be expected to be considerable.
Aim:To evaluate the efficacy of elective neck dissection versus the “wait and watch” policy in the treatment of early squamous cell carcinoma of tongue.Materials and Methods:This is a retrospective study of 21 patients with surgical treatment between April 2009 and July 2011. The patients were divided into two groups, with Group 1 consisting of patients who underwent wide excision glossectomy with elective neck dissection and Group 2 consisting of patients who underwent glossectomy without the neck being surgically addressed. The selection of patients was done by the random double-blinded method and the review was done by a single reviewer. All patients were examined for an average period of 1 year postoperatively.Results:Twenty-one cases were treated, among which there were 17 T1 and 4 T2 carcinomas. All the patients had primary carcinoma involving only the tongue with no clinical neck palpable neck nodes. Eleven patients underwent wide excision of primary tumor with elective neck dissection (Group 1) and 10 patients underwent only resection of primary tumor without the neck being surgically addressed (Group 2). In Group 1, there were no recurrences, and in Group 2, there were two patients who developed subsequent cervical node metastasis with one patient undergoing further surgery to address the positive neck and the other patient was lost to follow-up.Conclusions:Regional recurrence was the most common cause of failure after surgical treatment of oral tongue carcinoma. Elective neck dissection significantly reduced mortality due to regional recurrence and also increased the overall survival. Our study suggests that elective neck dissection is a treatment strategy of choice for stages I and II carcinoma of the oral tongue. A prospective, randomized study is worthwhile to further evaluate the benefit of elective neck dissection in the treatment of early carcinoma of the tongue with a larger pool of patients and a lengthier follow-up period.
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