Base of fourth metatarsal stress fracture: tendency for prolonged healing.
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Adolescent↗
Biomedical subjects
Eran Dolev
Publications and source records attributed to Eran Dolev.
A long-term study of implants supporting overdentures as a model for implant success.
BACKGROUND: Implant-supported overdentures have been a common treatment for edentulous patients for the past 20 years, achieving good clinical results. The purpose of this study was to examine survival and success rates of implants supporting overdentures in the maxilla and mandible and to examine the influence of factors related to patients, implant procedure, implant data, and follow-up period on implant success. METHODS: During a 10-year period (1990 to 2000), 285 implants were placed in 62 patients to support 69 overdentures (seven patients had overdentures in both jaws). Patients ranged in age from 45 to 85 years (mean 64.5 years). The files of 61 patients, including 277 implants supporting 68 overdentures (14 maxillary and 54 mandibular), had measurable radiographic post-exposure follow-up (range 6.63 to 110.93 months, mean 37.93 months) for cervical bone loss (CBL) measurements. Bone loss was measured by radiographic examination in which the mean number of exposed threads in mesial and distal sides of the implant was considered. Implants were rehabilitated by overdentures with bar (N = 52) or ball (N = 16) attachments. RESULTS: Implant survival rate was 96.1% (11/285 did not survive) and total 10-year cumulative survival rate was 95.4% (maxilla, 83.5%, mandible, 99.5%). The success rate was 70.4% (maxilla, 41.9%; mandible, 80.8%) when using Albrektsson et al. success criteria. A logistic regression analysis showed that the maxilla (P <0.0001) and a short follow-up period (up to 5 years) (P = 0.017) were the most influencing factors enhancing CBL. CONCLUSIONS: 1) Survival of implants supporting overdentures was very high; 2) implants supporting overdentures in the maxilla had greater CBL than in the mandible; and 3) new criteria of implant success should be considered.
Aged↗
Drug-induced hypomagnesaemia : scope and management.
Nearly 50 medications have been implicated as inducing hypomagnesaemia, sometimes based on insufficient data regarding clinical significance and frequency of occurrence. In fact, clinical effects attributed to hypomagnaesemia have been reported in only 17 of these drugs. A considerable amount of literature relating to individual drugs has been published, yet a comprehensive overview of this issue is not available and the hypomagnesaemic effect of a drug could be either overemphasised or under-rated. In addition, there are neither guidelines regarding treatment, prevention and monitoring of drug-induced hypomagnesaemia nor agreement as to what serum level of magnesium may actually be defined as 'hypomagnesaemia'. By compiling data from published papers, electronic databases, textbooks and product information leaflets, we attempted to assess the clinical significance of hypomagnesaemia induced by each drug. A practical approach for managing drug-induced hypomagnesaemia, incorporating both published literature and personal experience of the physician, is proposed. When drugs classified as inducing 'significant' hypomagnesaemia (cisplatin, amphotericin B, ciclosporin) are administered, routine magnesium monitoring is warranted, preventive treatment should be considered and treatment of hypomagnesaemia should be initiated with or without overt clinical manifestations. In drugs belonging to the 'potentially significant' category, among which are amikacin, gentamicin, laxatives, pentamidine, tobramycin, tacrolimus and carboplatin, magnesium monitoring is justified when either of the following occurs: clinical manifestations are apparent; persistent hypokalaemia, hypocalcaemia or alkalosis are present; other precipitating factors for hypomagnesaemia coexist; or treatment is with more than one potentially hypomagnesaemic drug. No preventive treatment is required and treatment should be initiated only if hypomagnesaemia is accompanied by symptoms or clinically significant relevant laboratory findings. In those drugs whose hypomagnesaemic effect is labelled as 'questionable', including furosemide and hydrochlorothiazide, routine monitoring and treatment are not required.
Brain Diseases↗
Aesthetic versus surgical success of single dental implants: 1- to 9-year follow-up.
Anterior maxillary implantation is a challenging treatment. The authors examined the aesthetic and surgical success of a single dental implant in the anterior by studying 52 implants with a mean follow-up of 37.5 months. Marginal bone loss (MBL), aesthetic parameters, and examiners' satisfaction from the aesthetic outcome were examined. The total surgical survival and success rates as well as the average examiner's aesthetic satisfaction and success rates are presented. Implantation in the anterior has high surgical survival and success rates, as well as a considerably high aesthetic success rate. The high surgical success and survival rates cannot, however, predict aesthetic success.
Adolescent↗
The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival.
BACKGROUND: Grafting of the maxillary sinus floor has been performed successfully over the last decade. The ultimate goal of this procedure is to allow surviving implants to support a functional prosthesis. Surgical complications of the procedure are rarely reported and their impact on implant survival has been investigated even to a lesser extent. The purpose of this study was to evaluate the prevalence of surgical complications of the sinus graft procedure and their impact on implant survival. METHODS: The study consisted of 70 patients who underwent 81 sinus graft procedures using the lateral wall approach from 1995 to 2000. A total of 212 screw-shaped implants were placed in the grafted sinuses and were restored by fixed prosthesis. Mean follow-up period for the implants was 43.6 months. Intra- and postoperative complications were thoroughly documented regarding clinical signs, times of occurrence, and treatment regimens. RESULTS: Perforation of the Schneiderian membrane was the major intraoperative complication, observed in 36 of the 81 sinuses (44%). Of the 70 patients, seven (10%) suffered from postoperative complications, specifically related to the sinus graft procedure, which included an uncommon cyst formation and an infection. Membrane perforations were strongly associated with the appearance of postoperative complications (specific and non-specific to the procedure) (P < 0.001). However, no association was found between membrane perforations or postoperative complications and implant survival. CONCLUSIONS: Intraoperative complications may lead to postoperative complications. Surgical complications did not significantly influence implant survival.
Adult↗
Maxillary nerve block--a new approach using a computer-controlled anesthetic delivery system for maxillary sinus elevation procedure. A prospective study.
OBJECTIVE: The maxillary (or second division) nerve block is an effective method of achieving profound anesthesia of a hemimaxilla. This block can be used for procedures involving the maxillary sinus, including the maxillary sinus elevation procedure. The purpose of this study was to evaluate a computer-controlled anesthetic delivery system (Wand) for maxillary nerve block injection to attain maxillary sinus anesthesia for sinus floor elevation procedure. METHOD AND MATERIALS: The study population consisted of 61 healthy adult patients, ranging in age from 40 to 72 years (mean 45 years), who received 76 maxillary nerve blocks (17 having both right and left maxillary blocks) by means of the Wand system via the greater palatine nerve approach, for sinus floor elevation procedure. Two patients (3%) were excluded from the study due to the inability to negotiate the greater palatine foramen. For each block, two cartridges of 2% lidocaine hydrochloride with adrenaline (1:100,000) were administered, using a 27-gauge--long needle. After ensuring the anesthetized areas (waiting time 2.5 minutes), the sinus elevation procedure was performed. Parameters recorded were the success or failure of anesthesia, positive (blood) aspiration, bony obstructions in the greater palatine canal, and complications. RESULTS: The use of this technique increased the ability to more easily locate the greater palatine foramen. A local infiltration (at the incisor region) was needed in 13 (17%) of the blocks, and seven (9.2%) sites required an extra infraorbital block injection in addition to the maxillary nerve block. One block had a positive aspiration. There were no bony obstructions demonstrated in the canal interfering with the injection, and no complications were recorded. CONCLUSION: The Wand appears to offer a number of advantages over the hand-held syringe when the greater palatine block technique for the maxillary nerve block is used. It is suggested that, when indicated, and with the required knowledge and respect for the associated anatomy, this technique should be considered with greater ease and more confidence.
Adult↗
[The thalidomide story: a new chapter].
Thalidomide, a medication the use of which was banned about forty years ago due to its teratogenic effect, has returned into use due to its anti-angiogenic and immunomodulatory virtues. It is used now as a novel treatment in several malignant diseases as well as in the treatment of various inflammatory conditions. Recently it has been found that thalidomide may antagonize corneal blood vessels growth which is a late results of exposure to mustard gas. The story of thalidomide, which is very unusual, may serve as the snake symbol in medicine, to remind us about the possible double face of every medication, of which every physician should be aware.
Humans↗
Reflections on military medicine.
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Adult↗
Use of natural substances in the treatment of renal stones and other urinary disorders in the medieval Levant.
Urinary disorders were common in the ancient world, especially in the Mediterranean region. In semi-arid zones and countries with unreliable water sources, renal stones and other urinary problems occur with greater frequency. A lack of water and correspondingly high levels of calcium saturation are among the main reasons for the formation of calcium sediments in the urinary tract, and it is hardly surprising, therefore, that many generations of physicians and healers have been called upon to treat these disorders, or at least alleviate the pain associated with them. Down the ages, many natural substances have been used for this purpose. This article focuses on 62 plants, 9 animal-based remedies, 1 mineral preparation and 4 medicinal substances of different or uncertain origin, traced in a recent survey of relevant historical literature (both medical and non-medical). Many of these materials, used to treat urinary disorders in the Levant between the 8th and the 18th centuries, had already been in use since the classical period, and several are still used today in traditional medicine.
History, Ancient↗
Bioterrorism and how to cope with it.
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Amino Alcohols↗
Smoking and complications of onlay bone grafts and sinus lift operations.
PURPOSE: To compare the incidence of complications related to onlay bone grafts (OBGs) and sinus lift operations (SLOs) among smokers and nonsmokers. MATERIALS AND METHODS: Data from 143 operations performed during the years 1995 to 2003 were analyzed. There were 64 OBGs and 79 SLOs. Patients were divided into 3 groups: nonsmokers, mild smokers (up to 10 cigarettes per day), and heavy smokers (more than 10 cigarettes per day). Duration of smoking (less or more than 10 years) was recorded. OBG complications were classified as minor (hematoma, swelling, inflammation, or temporary paresthesia) or major (graft exposure or mobility). For the SLO, perforations of the schneiderian membrane were the main intraoperative complication; postoperative complications mostly consisted of swelling, acute or chronic sinus infection, or bleeding. RESULTS: Of smokers having OBG, 50% experienced complications, compared to 23.1% of nonsmokers. Major complications were observed in one third of the smokers, compared to only 7.7% in nonsmokers. There was also a tendency toward complications in former smokers, although this relationship was not statistically significant. There was no relationship between SLO complications and smoking or a past smoking habit. DISCUSSION: In the present study, smokers demonstrated significantly higher postoperative complications following OBG operations. Smoking did not influence the results in the SLO group. There was no statistically significant difference between complications and past smoking. This finding indicates that the risk of complications can be reduced up to the normal nonsmoker complication rate when smoking ceases. CONCLUSIONS: This study established a relationship between OBG complications and smoking in this patient population. A higher incidence of complications was found in the smoking group. There was no significant influence of smoking on SLO complications.
Analysis of Variance↗
Implant marginal bone loss in maxillary sinus grafts.
PURPOSE: The marginal bone loss (MBL) around implants placed in maxillary sinus grafts was evaluated. MATERIALS AND METHODS: The study consisted of 70 patients who had undergone 81 sinus-graft procedures (total 212 screw-type implants). Complete radiographic records were available for 160 implants, which were used to calculate MBL (follow-up 6 to 56.5 months). Habits (smoking, bruxism), surgical phase parameters (preoperative residual bone, grafting material, implant characteristics, and complications), and prosthetic parameters (crown-implant ratio, marginal fit, and opposite-arch restoration) were recorded for each patient and statistically analyzed regarding MBL. RESULTS: Cumulative survival and overall radiographic success rates were 95.5% and 83.7% for 4.5 years, respectively. Smoking, small implant surface area, and a delayed implantation approach were related to enhanced MBL, with mean MBL values of 0.24 mm/y (P < .011), 0.21 mm/y (P < .031), and 0.31 mm/y (P = .052), respectively. In residual bone of < or =4 mm, the relation to enhanced MBL was stronger (P < .018) for delayed implantation. DISCUSSION: Survival and radiographic success rates compare well with other reports. However, most studies modify success criteria regarding MBL. Smoking may be a primary risk factor regarding implant success. Implants with greater surface area values could compensate for problematic bone characteristics (e.g., in grafted maxillary sinuses). The effect of delayed implantation on MBL was surprising and may prompt simultaneous implantation whenever primary stability can be achieved. CONCLUSIONS: Smoking and implant surface area affected MBL in this patient population. Criteria for long-term implant success should be revised to a standard.
Adult↗