Severe Descending Mediastinitis After Routine Dental Implant Surgery: A Case Report.

Severe descending mediastinitis after routine dental implant surgery: a case report.

Filed under: Rehab Centers

Eur J Oral Implantol. 2012; 5(4): 389-96
Capecchi M, Buongiorno V, Romagnoli A, Parri SN, Guiducci GM, Bressan E

Purpose: The aim of this article is to present a clinical case of severe descending mediastinitis following the insertion of three dental implants in the mandible. Materials and methods: A 64-year-old female was treated with an implant-supported rehabilitation for her mandibular missing teeth in positions 36, 45 and 46. Results: Three days after the dental implant surgery, the patient complained of malaise, shiver and fever (38°C) with dysphagia and swelling of the mouth floor. The following day the patient was admitted to the hospital with a diagnosis of larynx oedema. Due to the worsening clinical conditions on day 5, she was transferred to the Thoracic Surgery Division with a diagnosis of left neck phlegmon and underwent cervicotomy. A CT scan at day 9 showed mediastinal extension of the phlegmon with initial pleural reaction. The patient then underwent cervicotomy again for drainage. On day 16, she underwent videothoracoscopy to drain a left pleural effusion. The patient was discharged on day 31. Conclusions: Despite the fact that descending mediastinitis has a very high mortality rate, in the present case proper treatment was able to resolve this serious complication. It is likely that the early diagnosis and prompt treatment prevented neck and mediastinal infection diffusion. Clinicians should always keep in mind that a potential fatal infection complication may arise after routine dental implant surgery in the mandible.
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A 1-year prospective cohort study on mandibular overdentures retained by mini dental implants.

Filed under: Rehab Centers

Eur J Oral Implantol. 2012; 5(4): 367-79
Scepanovic M, Calvo-Guirado JL, Markovic A, Delgardo-Ruiz R, Todorovic A, Milicic B, Misic T

Aim: The aim of this 1-year prospective cohort study was to evaluate the outcomes and complications of immediately loaded mini dental implants used for stabilizing mandibular overdentures in edentulous patients wearing conventional complete dentures. Materials and methods: Thirty patients received mandibular conventional complete dentures that were subsequently retained by 4 immediately loaded mini dental implants placed in the interforaminal region. Overdenture success, implant success and biological and prosthetic complications were evaluated after the first year of service. Quality of life using the Oral Heath Impact Profile (OHIP)- EDENT test, satisfaction with dental prosthesis and chewing efficiency using questionnaires and a Visual Analogue Scale (VAS) were evaluated twice: after they had received mandibular complete dentures, and again after they had received mandibular overdentures. Results: After 1 year, no overdenture failed and 2 implants did not osseointegrate, resulting in a 98.3% success rate for loaded implants and 95.9% for total implants used (3 out of 123 were not loaded due to fracture). A flap surgical approach was performed in 7 patients, 3 implants fractured during insertion, 3 overdentures fractured, occlusion balancing was necessary for 11 dentures and relining for 8. Implant rehabilitation provided significant improvement in quality of life, stability, comfort, chewing and speaking ability while no significant differences were found in quality of maintenance of hygiene and for aesthetics. Conclusions: Mini dental implant retained overdentures can be a successful therapeutic procedure for treating mandibular edentulism that improves quality of life, patient satisfaction and chewing ability in patients wearing maxillary dentures. Longer follow-ups are needed to validate this therapy in the medium and long-term.
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Seven capital devices for the future of stroke rehabilitation.

Filed under: Rehab Centers

Stroke Res Treat. 2012; 2012: 187965
Iosa M, Morone G, Fusco A, Bragoni M, Coiro P, Multari M, Venturiero V, De Angelis D, Pratesi L, Paolucci S

Stroke is the leading cause of long-term disability for adults in industrialized societies. Rehabilitation’s efforts are tended to avoid long-term impairments, but, actually, the rehabilitative outcomes are still poor. Novel tools based on new technologies have been developed to improve the motor recovery. In this paper, we have taken into account seven promising technologies that can improve rehabilitation of patients with stroke in the early future: (1) robotic devices for lower and upper limb recovery, (2) brain computer interfaces, (3) noninvasive brain stimulators, (4) neuroprostheses, (5) wearable devices for quantitative human movement analysis, (6) virtual reality, and (7) tablet-pc used for neurorehabilitation.
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