Limited cutaneous systemic sclerosis: Total rehabilitation with fixed prosthesis on dental implants

2021 ◽  
pp. 239719832110043
Author(s):  
Miguel Angel Garcés Villalá ◽  
Carolina Zorrilla Albert
Keyword(s):  
Systemic Sclerosis ◽  
Bone Loss ◽  
Dental Implants ◽  
Social Life ◽  
Connective Tissue Diseases ◽  
The Body ◽  
Calcinosis Cutis ◽  
Complex Disorders ◽  
Standardized Parameters

Introduction: Limited cutaneous systemic sclerosis with special manifestations (calcinosis cutis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) is part of the group of connective tissue diseases, these rare autoimmune systemic pathologies cause thickening and hardening of tissues in different parts of the body and can lead to complex disorders. Oral manifestations of systemic sclerosis may include limited ability to open the mouth, xerostomia, periodontal disease, enlarged periodontal ligament, and bone resorption of the jaw. Case Description: A 54-year-old Caucasian patient presented with oral pain, swallowing, phonation and chewing difficulties associated with dental instability, hygiene/handling difficulties and her main problem with microstomia, which prevented her from removing the skeletal prosthesis for 4 years, depriving her of social life. Gradual treatment with dental implants was diagnosed and planned to support a fixed total denture adapted to the ridge with self-cleaning characteristics. After implant insertion, panoramic radiographs with standardized parameters were taken to compare crestal bone levels at the time of prosthesis placement and with 10 years of follow-up. Conclusion: The average crestal bone loss of the 12 implants after the 10 years of follow-up was 1.26 mm for the maxilla and 1.17 mm for the mandible. The survival of the 12 support implants of two total fixed prostheses in a clinical/radiographic follow-up of 10 years was 100%. After 10 years of follow-up, the 12 implants inserted had a bone loss similar to that of healthy patients and no pathologies were registered, recovering function, aesthetics, and self-esteem. This therapy must be implemented before the interincisal distance decreases to 30 mm to allow intraoral surgical/prosthetic access. Implant-supported total fixed rehabilitation is a viable, predictable, and recommended therapy in patients with limited cutaneous systemic sclerosis.

scholarly journals Knee myopericytoma-case report and literature review

2020 ◽  
Vol 12 (6) ◽  
pp. 127-128
Author(s):  
Susana Rodrigues ◽  
Catrine Ferreira ◽  
Tiago Coelho ◽  
Diogo Gaspar ◽  
Jean Fallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Systemic Sclerosis ◽  
Middle Age ◽  
Subcutaneous Tissue ◽  
Connective Tissue Diseases ◽  
Systemic Lupus Erythematous ◽  
Systemic Lupus ◽  
Calcinosis Cutis ◽  
Substantial Morbidity

Calcinosis cutis is a rare disorder characterized by of deposition of insoluble calcium salts in the skin and subcutaneous tissue. Five subtypes of calcinosis cutis are described: dystrophic, metastatic, idiopathic, iatrogenic, and calciphylaxis.1 Of these subtypes, dystrophic calcinosis (DC) is the most common, and it is the most frequently seen in association with underlying autoimmune connective tissue diseases.2 Dermatomyositis, systemic sclerosis and less commonly systemic lupus erythematous were described to be complicated by DC. However, DC associated with rheumatoid arthritis (RA) is extremely rare.2 The condition causes substantial morbidity and is associated with pain and limitation of movement when the process involves areas close to joints or when ulceration occurs.2 We report a middle age Sudanese woman with good controlled RA who developed dystrophic calcinosis cutis.

scholarly journals Calcinosis cutis associated with systemic sclerosis: a rare case report

2020 ◽  
Vol 7 (8) ◽  
pp. 2803
Author(s):  
Surya Rao Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand Prasath Jayachandiran
Keyword(s):  
Systemic Sclerosis ◽  
The Body ◽  
Calcium Deposition ◽  
Pressure Sores ◽  
Connective Tissue Disorders ◽  
Calcinosis Cutis ◽  
Rare Case Report ◽  
The Face ◽  
Subcutaneous Tissues ◽  
Calcium Deposits

Calcinosis cutis is abnormal calcium deposition in the skin and subcutaneous tissues of the body. It is generally associated with autoimmune connective tissue disorders and in our case, it is systemic sclerosis. It most commonly occurs in the fingers presenting with pain and functional impairment. Here, we present a case of calcinosis cutis with systemic sclerosis in a teenage girl presented with bilateral gluteal pressure sores and multiple sites of calcium deposition like sacrum, upper limbs, knees and the face. We treated here with reconstructive surgery with Limberg flaps for the pressure ulcers with excision and primary closure of the other sites with calcium deposits. 

Subcutaneous calcinosis: Is it different between systemic sclerosis and dermatomyositis?

2021 ◽  
pp. 239719832110532
Author(s):  
Antonia Valenzuela ◽  
Lorinda Chung
Keyword(s):  
Systemic Sclerosis ◽  
Connective Tissue ◽  
Juvenile Dermatomyositis ◽  
Treatment Options ◽  
Connective Tissue Diseases ◽  
Treatment Strategies ◽  
Normal Serum ◽  
Carbonate Apatite ◽  
Skin Damage ◽  
Calcinosis Cutis

Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. It is a manifestation of several autoimmune connective tissue diseases, most frequently with systemic sclerosis and juvenile dermatomyositis, followed by adult dermatomyositis. Autoimmune connective tissue disease–associated calcinosis is of the dystrophic subtype, which occurs at sites of damaged tissue in the setting of normal serum calcium and phosphate levels. In juvenile dermatomyositis, calcinosis is considered a marker of ongoing disease activity and possibly inadequate treatment, while in adult dermatomyositis, it is a hallmark of skin damage due to chronic rather than active disease. Calcinosis is associated with long disease duration in systemic sclerosis and dermatomyositis, anti-polymyositis/sclerosis autoantibodies in systemic sclerosis and NXP-2 and melanoma differentiation-associated gene 5 in dermatomyositis. Calcinosis in systemic sclerosis occurs most frequently in the hands, particularly the fingers, whereas in dermatomyositis, it affects mainly the trunk and extremities. The primary mineral component of calcinosis is hydroxyapatite in systemic sclerosis and carbonate apatite in dermatomyositis. Calcinosis in dermatomyositis and systemic sclerosis share some pathogenic mechanisms, but vascular hypoxia seems to play a more important role in systemic sclerosis, whereas the release of calcium from mitochondria in muscle cells damaged by myopathy may be a primary mechanism contributing to dermatomyositis-related calcinosis. Multiple treatment strategies for dermatomyositis and systemic sclerosis-related calcinosis have been used with variable results. Early aggressive treatment of underlying myositis in patients with dermatomyositis may improve long-term outcomes of calcinosis. A better understanding of the pathogenesis of calcinosis is needed to improve treatment options.

scholarly journals Treatment of Full and Partial Arches with Internal-Conical-Connection Dental Implants: Clinical Results after 5 Years of Follow-Up

2020 ◽  
Vol 10 (23) ◽  
pp. 8709
Author(s):  
Diego Lops ◽  
Riccardo Guazzo ◽  
Alessandro Rossi ◽  
Antonino Palazzolo ◽  
Vittorio Favero ◽  
...  
Keyword(s):  
Bone Loss ◽  
Dental Implants ◽  
Clinical Results ◽  
Marginal Bone Loss ◽  
Significant Difference ◽  
Distal Aspect ◽  
The Stability ◽  
Maxilla And Mandible ◽  
Implant Loading

The aim of the present investigation is to evaluate the implant therapy outcomes over a period of 5 years and to analyze several patient risk factors influencing the stability of the peri-implant tissues. Seventy-eight patients were consecutively treated between 2009 and 2017 and restored with implant-supported fixed prostheses. The following inclusion criteria were considered: partial or complete edentulism; residual bone volume of at least 3.3 mm in diameter and 8 mm in length; a favorable relationship between maxilla and mandible; at least a minimum 5 year follow-up for each implant included in the statistical analysis. Intraoral radiographs were taken at implant loading and every 12 months during the follow-up visits. They were subsequently stored on a personal computer and analyzed to determine the changes in bone level. Seventy-eight patients receiving 209 implants completed a minimum follow-up period of 5 years. One-hundred dental implants were inserted in the maxilla while 109 were placed in the mandible. Eleven (14.1%) out of 78 treated patients who received 29 (13.9%) dental implants were considered as drop-outs. On the whole, peri-implantitis was diagnosed in three implants. The average final pocket probing depth at implant level was 2.5 ± 1.2 mm. The average final bone loss after 5 years was 0.3 ± 0.4 mm, both at the mesial and distal aspect of the implant. The effects of the prosthesis type, sex and implant site did not statistically influence the marginal bone loss; on the contrary, a statistically significant difference regarding marginal bone loss was detected between smoker and non-smoker patients (p = 0.021). Implants with internal-conical abutment connection showed stable peri-implant bone levels at the medium-term follow-up. Nevertheless, further prospective long-term clinical studies are necessary to confirm these data.

scholarly journals Implant-prosthetic rehabilitation of patients with severe horizontal bone deficit on mini-implants with two-piece design—retrospective analysis after a mean follow-up of 5 years

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Lukas Wimmer ◽  
Pantelis Petrakakis ◽  
Karim El-Mahdy ◽  
Surian Herrmann ◽  
Dirk Nolte
Keyword(s):  
Bone Loss ◽  
Dental Implants ◽  
Treatment Option ◽  
Negative Impact ◽  
Height Loss ◽  
High Survival ◽  
Alveolar Crest ◽  
Crestal Bone Loss ◽  
Alternative Treatment Option

Abstract Background As a consequence of tooth loss due to trauma or extraction, a reduced alveolar crest volume limits the deployment of standard implants in certain patient cases. For this reason, minimal-invasive treatment with mini-dental implants (MDI) might be an option to allow implant treatment even in cases with severe horizontal bone loss without augmentation measures. The aim of this retrospective cohort study was to investigate clinical and radiological implant, as well as patient-related parameters after treatment with MDI. Results Clinical and radiological records of 19 female (82.6%) and 4 male patients (17.4%) (N = 23), who received 52 mini-dental implants with a two-piece design in a single surgical center between November 2011 and October 2018, were retrospectively analyzed. Implants were submitted to conventional loading on different types of screwed superstructures. Crestal bone loss was measured on standardized periapical radiographs. Patient-related outcome parameters (PROMs) were recorded during follow-up period. Mean clinical and radiological follow-up was 69.6 months (5.8 years) and 51.6 months (4.3 years), respectively. Three implants were lost in two patients, leading to an implant survival rate of 94.2%. Mean radiological crestal bone loss was 1.6 mm. Both amount of peri-implant recession and crestal bone loss were significantly correlated (r = 0.65; p < 0.001). Likewise, a significant correlation was observed between deeper probing depths and increased peri-implant bone loss (r = 0.41; p = 0.012). Alveolar ridges with a reduced alveolar crest width were significantly correlated with higher peri-implant bone loss as well (r = − 0.33; p = 0.011). No prosthetic complications were reported during follow-up. Extent of midfacial recession and papilla height loss had a significant negative impact on most of the PROMs. Conclusions Treatment with MDI seems to be a successful alternative treatment option, especially for elderly patients with reduced crest width at implant sites. Due to the good clinical results and high survival and success rates, this treatment option was associated with high patient satisfaction. Despite the promising results, particular consideration should be given to appropriate treatment planning in these patients due to the strong correlation between peri-implant soft-tissue parameters, crestal bone loss, and reduced alveolar crest width.

scholarly journals A Clinical and Radiographic Evaluation of Zirconia Dental Implants: 10-Year Follow-Up

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Andrea Enrico Borgonovo ◽  
Susanna Ferrario ◽  
Carlo Maiorana ◽  
Virna Vavassori ◽  
Rachele Censi ◽  
...  
Keyword(s):  
Bone Loss ◽  
Dental Implants ◽  
Clinical Success ◽  
Radiographic Evaluation ◽  
Success Rates ◽  
Marginal Bone Loss ◽  
Single Tooth ◽  
Zirconia Implants

Purpose. The aim is to evaluate the survival and success rates, as well as the marginal bone loss (MBL) and periodontal indexes, of zirconia implants with 10-year follow-up. Materials and Methods. 10 patients were selected and 26 one-piece zirconia implants were used for the rehabilitation of single tooth or partially edentulous ridge. After 10 years, a clinical-radiographic evaluation was performed in order to estimate peri-implant tissue health and marginal bone loss. Results. The survival and success rates were 100%. The average marginal bone loss from baseline to 120 months after surgery was 0.92 ± 0.97 mm. Conclusion. One-piece zirconia dental implants are characterised by high biocompatibility, low plaque adhesion, and absence of microgap that can be related to the clinical success of these implants.

scholarly journals Effect of Opposite Tooth Condition on Marginal Bone Loss around Submerged Dental Implants: A Retrospective Study with a 3-Year Follow-Up

2021 ◽  
Vol 18 (20) ◽  
pp. 10715
Author(s):  
Odontuya Dorj ◽  
Hsi-Kuei Lin ◽  
Eisner Salamanca ◽  
Yu-Hwa Pan ◽  
Yi-Fan Wu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bone Loss ◽  
Dental Implants ◽  
Marginal Bone Loss ◽  
Bone Level ◽  
Natural Teeth ◽  
Marginal Bone Level

Background: The objective of this study was to evaluate the effects of opposite tooth conditions on change in marginal bone level (MBL) around submerged dental implants. Materials and methods: The study included healthy patients with one or two implants. Structures opposite implants were either natural teeth (NT) or fixed restorations (FRs). MBLs were measured on digital periapical radiographs at the mesial and distal aspects of each implant. Results: Sixty implants were inserted by the 3-year follow-up. Mean MBLs for NT were 0.21 ± 0.33 mm before prosthetic loading and 0.30 ± 0.41 mm 3 years later (p = 0.001). Mean MBLs with FRs were 0.36 ± 0.45 mm before loading and 0.53 ± 0.50 mm 3 years later (p < 0.001). Changes in mean MBL from the 6-month follow-up to the 1- and 3-year follow-ups were statistically significant (p < 0.01) for implants opposite NT. However, changes in mean MBL from the 6-month follow-up to the 1-year (p = 0.161) and 3-year follow-ups (p = 1.000) were not significant for implants opposite FRs. Between baseline and the 3-year follow-up, MBL change was relatively small and did not differ regarding NT and FRs. Conclusion: Bone loss was greater if submerged dental implants were opposed by FRs. MBLs around submerged implants continued to change after 3 years if NT opposed implants.

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