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International Journal of Implant... Jul 2023The macrogeometry of a dental implant plays a decisive role in its primary stability. A larger diameter, a conical shape, and a roughened surface increase the contact... (Review)
Review
PURPOSE
The macrogeometry of a dental implant plays a decisive role in its primary stability. A larger diameter, a conical shape, and a roughened surface increase the contact area of the implant with the surrounding bone and thus improve primary stability. This is considered the basis for successful implant osseointegration that different factors, such as implant design, can influence. This narrative review aims to critically review macro-geometric features affecting the primary stability of dental implants.
METHODS
For this review, a comprehensive literature search and review of relevant studies was conducted based on formulating a research question, searching the literature using keywords and electronic databases such as PubMed, Embase, and Cochrane Library to search for relevant studies. These studies were screened and selected, the study quality was assessed, data were extracted, the results were summarized, and conclusions were drawn.
RESULTS
The macrogeometry of a dental implant includes its surface characteristics, size, and shape, all of which play a critical role in its primary stability. At the time of placement, the initial stability of an implant is determined by its contact area with the surrounding bone. Larger diameter and a conical shape of an implant result in a larger contact area and better primary stability. But the linear relationship between implant length and primary stability ends at 12 mm.
CONCLUSIONS
Several factors must be considered when choosing the ideal implant geometry, including local factors such as the condition of the bone and soft tissues at the implant site and systemic and patient-specific factors such as osteoporosis, diabetes, or autoimmune diseases. These factors can affect the success of the implant procedure and the long-term stability of an implant. By considering these factors, the surgeon can ensure the greatest possible therapeutic success and minimize the risk of implant failure.
Topics: Humans; Dental Implants; Dental Implantation, Endosseous; Osseointegration; Dental Prosthesis Design; Surgeons
PubMed: 37405709
DOI: 10.1186/s40729-023-00485-z -
World Journal of Emergency Surgery :... Jul 2023Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI)... (Review)
Review
Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues required to appropriately treat IAI that differs from the other etiologies of sepsis is the frequent requirement to provide physical source control. Fortunately, dramatic advances have been made in this aspect of treatment. Historically, source control was left to surgeons only. With new technologies non-surgical less invasive interventional procedures have been introduced. Alternatively, in addition to formal surgery open abdomen techniques have long been proposed as aiding source control in severe intra-abdominal sepsis. It is ironic that while a lack or even delay regarding source control clearly associates with death, it is a concept that remains poorly described. For example, no conclusive definition of source control technique or even adequacy has been universally accepted. Practically, source control involves a complex definition encompassing several factors including the causative event, source of infection bacteria, local bacterial flora, patient condition, and his/her eventual comorbidities. With greater understanding of the systemic pathobiology of sepsis and the profound implications of the human microbiome, adequate source control is no longer only a surgical issue but one that requires a multidisciplinary, multimodality approach. Thus, while any breach in the GI tract must be controlled, source control should also attempt to control the generation and propagation of the systemic biomediators and dysbiotic influences on the microbiome that perpetuate multi-system organ failure and death. Given these increased complexities, the present paper represents the current opinions and recommendations for future research of the World Society of Emergency Surgery, of the Global Alliance for Infections in Surgery of Surgical Infection Society Europe and Surgical Infection Society America regarding the concepts and operational adequacy of source control in intra-abdominal infections.
Topics: Female; Humans; Male; Surgeons; Abdominal Cavity; Intraabdominal Infections
PubMed: 37480129
DOI: 10.1186/s13017-023-00509-4 -
Ugeskrift For Laeger Dec 2023Introduction For many Danes, Christmas is a traditional celebration linked with food, and Christmas dinner might be the most important dinner of the year. Whether the...
Introduction For many Danes, Christmas is a traditional celebration linked with food, and Christmas dinner might be the most important dinner of the year. Whether the correct meal includes roast pork or roast duck is a deeply personal question. Methods We asked all patients who were admitted to the surgical gastrointestinal emergency clinics of the Capital Region in Denmark on Christmas Eve and Christmas Night what they have had for Christmas dinner. Results A total of 30 patients presented to the hospital, and 17 of these were successfully included. 71% had eaten roast duck and 65% had eaten roast pork. This result was non-significant compared with the general Danish population tested with chi-square (p = 0.955). Conclusion We found no significance in the ingestion of roast duck and roast pork between patients at surgical gastrointestinal emergency clinics and the Danish background population. Funding none. Trial registration none.
Topics: Animals; Humans; Ducks; Meals; Pork Meat; Surgeons; Swine; Gastrointestinal Diseases; Emergency Room Visits
PubMed: 38084623
DOI: No ID Found -
Ugeskrift For Laeger Dec 2023Introduction The use and consumption of "products", such as cosmetic procedures and confectionery, is on a rise in the Danish population. However, it has never been...
Introduction The use and consumption of "products", such as cosmetic procedures and confectionery, is on a rise in the Danish population. However, it has never been evaluated if the same tendency can be observed among the providers of these products. In view of the upcoming Christmas, we decided to investigate this delicate matter. Methods This study was a survey-based cross-sectional study examining demographics, professional backgrounds, as well as frequency and preferences regarding confectionery and cosmetic procedures among confectioners and plastic surgeons. Results A total of 90 persons answered the questionnaire. Results showed that consumption of confectionery was high among both confectioners and plastic surgeons, and that the use of cosmetic procedures was higher among both confectioners and plastic surgeons than among the background population. Both groups preferred to know the person who provided "the product" within their respective area. Conclusion Most plastic surgeons do not need to know their confectioner but would like to know their cosmetic procedure provider. So, if you, as part of the department management, or simply as a well-meaning colleague, want to treat your staff/colleagues, you can safely order cake from a random confectioner but not cosmetic procedures from a random surgeon! Funding none. Trial registration not relevant.
Topics: Humans; Surgery, Plastic; Cross-Sectional Studies; Operating Rooms; Surveys and Questionnaires; Surgeons
PubMed: 38084615
DOI: No ID Found -
Journal of Robotic Surgery Dec 2023Surgical flow disruptions are unexpected deviations from the natural progression which can potentially compromise the safety of the operation. Separation of the surgeon... (Review)
Review
Surgical flow disruptions are unexpected deviations from the natural progression which can potentially compromise the safety of the operation. Separation of the surgeon from the patient and team members is the main contributor for flow disruptions (FDs) in robot-assisted surgery (RAS). FDs have been categorised as communication, coordination, surgeon task considerations, training, equipment/ technology, external factors, instrument changes, and environmental factors. There may be an association between FDs and task error rate. Intervention to counter FDs include training, operating room adjustments, checklists, teamwork, communication improvement, ergonomics, technology, guidelines, workflow optimisation, and team briefing. Future studies should focus on identifying the significant disruptive FDs and the impact of interventions on surgical flow during RAS.
Topics: Humans; Robotic Surgical Procedures; Workflow; Ergonomics; Operating Rooms; Surgeons
PubMed: 37815757
DOI: 10.1007/s11701-023-01728-2 -
Ugeskrift For Laeger Dec 2023Introduction The woven Christmas heart is a cherished tradition and an iconic symbol of Danish Christmas. The common approach is to weave Christmas hearts by hand,... (Randomized Controlled Trial)
Randomized Controlled Trial
Introduction The woven Christmas heart is a cherished tradition and an iconic symbol of Danish Christmas. The common approach is to weave Christmas hearts by hand, however, as surgery is moving towards a minimally invasive approach, we wished to assess whether Christmas hearts could be weaved in a minimally invasive approach. Methods A single-blinded randomized crossover trial. All participants had to weave three Christmas hearts; one by hand, one laparoscopic, and one by a robotic approach within eight minutes. The hearts were assessed visually by a Danish Christmas expert and designer. Two trained surgeons received additional attempts, with no time limit, at weaving Christmas hearts by a laparoscopic and by a robotic approach. Results The study showed that it was possible to weave Christmas hearts by a minimally invasive approach. However, Christmas hearts woven by hand were significantly more elegant (p less-than 0.001 for both), as well as significantly faster to weave (p less-than 0.001 for both) than hearts woven by a laparoscopic or robotic approach. Furthermore, experienced surgeons tended to weave more elegant Christmas hearts than inexperienced surgeons (p = 0.051). Conclusion Minimally invasive approaches to surgery can be used to weave Christmas hearts, however, these approaches did not lead to more elegant or faster weaving of the Christmas hearts. Furthermore, surgical experience and experience with minimally invasive surgical approaches led to more elegant Christmas hearts. Funding none. Trial registration none.
Topics: Humans; Cardiac Surgical Procedures; Laparoscopy; Minimally Invasive Surgical Procedures; Robotic Surgical Procedures; Surgeons; Cross-Over Studies
PubMed: 38084616
DOI: No ID Found -
Aesthetic Surgery Journal Sep 2023
Topics: Humans; Rhytidoplasty; Hematoma; Surgeons
PubMed: 37437181
DOI: 10.1093/asj/sjad225 -
Ugeskrift For Laeger Feb 2024Sister Mary Joseph nodule (SMJN) is a rare clinical finding in patients with metastatic adenocarcinoma. This is a case report of a 69-year-old man, who presented with a...
Sister Mary Joseph nodule (SMJN) is a rare clinical finding in patients with metastatic adenocarcinoma. This is a case report of a 69-year-old man, who presented with a cutaneous element by his umbilicus at his GP. He was referred to a dermatologist, then a plastic surgeon. The element was a metastasis from adenocarcinoma originating from his caecum. It is important for doctors to know of SMJN as a rare presentation of metastatic cancer, and to clinically examine the patient for an abdominal starting point, when presented with a cutaneous tumour at the position of the umbilicus.
Topics: Male; Humans; Aged; Adenocarcinoma; Skin Neoplasms; Surgeons; Umbilicus
PubMed: 38445337
DOI: 10.61409/V07230477 -
Revista Do Colegio Brasileiro de... 2023
Topics: Humans; Artificial Intelligence; Surgeons
PubMed: 38088637
DOI: 10.1590/0100-6991e-20233696EDIT01-en -
Medicina (Kaunas, Lithuania) Jul 2023: Robotic surgery has been widely adopted in general surgery worldwide but access to this technology is still limited to a few hospitals. With the recent introduction of... (Review)
Review
: Robotic surgery has been widely adopted in general surgery worldwide but access to this technology is still limited to a few hospitals. With the recent introduction of new robotic platforms, several studies reported the feasibility of different surgical procedures. The aim of this systematic review is to highlight the current clinical practice with the new robotic platforms in general surgery. : A grey literature search was performed on the Internet to identify the available robotic systems. A PRISMA compliant systematic review was conducted for all English articles up to 10 February 2023 searching the following databases: MEDLINE, EMBASE, and Cochrane Library. Clinical outcomes, training process, operating surgeon background, cost-analysis, and specific registries were evaluated. : A total of 103 studies were included for qualitative synthesis after the full-text screening. Of the fifteen robotic platforms identified, only seven were adopted in a clinical environment. Out of 4053 patients, 2819 were operated on with a new robotic device. Hepatopancreatobiliary surgery specialty performed the majority of procedures, and the most performed procedure was cholecystectomy. Globally, 109 emergency surgeries were reported. Concerning the training process, only 45 papers reported the background of the operating surgeon, and only 28 papers described the training process on the surgical platform. Only one cost-analysis compared a new robot to the existing reference. Two manufacturers promoted a specific registry to collect clinical outcomes. : This systematic review highlights the feasibility of most surgical procedures in general surgery using the new robotic platforms. Adoption of these new devices in general surgery is constantly growing with the extension of regulatory approvals. Standardization of the training process and the assessment of skills' transferability is still lacking. Further studies are required to better understand the real clinical and economical benefit.
Topics: Humans; Robotics; Robotic Surgical Procedures; Hospitals; Surgeons; Cholecystectomy
PubMed: 37512075
DOI: 10.3390/medicina59071264