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Kozachenko VE, Arsenina OI, Makhortova PI, Popova AV, Popova NV, Komarova AV. [The use of distal occlusion correctors during treatment on an individual lingual bracket system in adult patients]. Stomatologiia (Mosk) 2023; 102:53-58. [PMID: 37622302 DOI: 10.17116/stomat202310204153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
A case of treatment of a 35-year-old patient with a retroposition of the lower jaw, distal occlusion of the posterior teeth, deep incisal overlap, narrowing of the deformity of the dentoalveolar arches, protrusion of the lower incisors, crowded position of the teeth, mismatch between the incisor lines, absence due to extraction of tooth 3.6, with impacted dystopic tooth 3.8 is presented. Fixed individual orthodontic appliances of the WIN («DW Lingual Systems GmbH» Germany) were used. It was found that the use of the Herbst apparatus in combination with the WIN lingual bracket system in adult patients helps to achieve optimal functional and aesthetic results. The use of a distal bite correction device is an additional support for the mesialization of the molars of the lower jaw.
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Affiliation(s)
- V E Kozachenko
- Central Research Institute of Dentistry and Maxillofacial Surgery», Moscow, Russia
| | - O I Arsenina
- Central Research Institute of Dentistry and Maxillofacial Surgery», Moscow, Russia
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - P I Makhortova
- Central Research Institute of Dentistry and Maxillofacial Surgery», Moscow, Russia
- Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russia
| | - A V Popova
- Central Research Institute of Dentistry and Maxillofacial Surgery», Moscow, Russia
| | - N V Popova
- Central Research Institute of Dentistry and Maxillofacial Surgery», Moscow, Russia
- Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russia
| | - A V Komarova
- Central Research Institute of Dentistry and Maxillofacial Surgery», Moscow, Russia
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Herzberg M, Dorn F, Trumm C, Kellert L, Tiedt S, Feil K, Küpper C, Wollenweber F, Liebig T, Zimmermann H. Middle Cerebral Artery M2 Thrombectomy: Safety and Technical Considerations in the German Stroke Registry (GSR). J Clin Med 2022; 11. [PMID: 35956233 DOI: 10.3390/jcm11154619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
There is ongoing debate concerning the safety and efficacy of various mechanical thrombectomy (MT) approaches for M2 occlusions. We compared these for MT in M2 versus M1 occlusions. Subgroup analyses of different technical approaches within the M2 MT cohort were also performed. Patients were included from the German Stroke Registry (GSR), a multicenter registry of consecutive MT patients. Primary outcomes were reperfusion success events. Secondary outcomes were early clinical improvement (improvement in NIHSS score > 4) and independent survival at 90 days (mRS 0−2). Out of 3804 patients, 2689 presented with M1 (71%) and 1115 with isolated M2 occlusions (29%). The mean age was 76 (CI 65−82) and 77 (CI 66−83) years, respectively. Except for baseline NIHSS (15 (CI 10−18) vs. 11 (CI 6−16), p < 0.001) and ASPECTS (9 (CI 7−10) vs. 9 (CI 8−10, p < 0.001), baseline demographics were balanced. Apart from a more frequent use of dedicated small vessel stent retrievers (svSR) in M2 (17.4% vs. 3.0; p < 0.001), intraprocedural aspects were balanced. There was no difference in ICH at 24 h (11%; p = 1.0), adverse events (14.4% vs. 18.1%; p = 0.63), clinical improvement (62.5% vs. 61.4 %; p = 0.57), mortality (26.9% vs. 22.9%; p = 0.23). In M2 MT, conventional stent retriever (cSR) achieved higher rates of mTICI3 (54.0% vs. 37.7−42.0%; p < 0.001), requiring more MT-maneuvers (7, CI 2−8) vs. 2 (CI 2−7)/(CI 2−2); p < 0.001) and without impact on efficacy and outcome. Real-life MT in M2 can be performed with equal safety and efficacy as in M1 occlusions. Different recanalization techniques including the use of svSR did not result in significant differences regarding safety, efficacy and outcome.
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Altenbernd J, Forsting M, Weber W, Fischer S. Thrombectomy of symptomatic isolated occlusions of posterior cerebral arteries in segment P1 and P2 in acute stroke treatment. Acta Radiol 2022; 63:802-809. [PMID: 33940961 DOI: 10.1177/02841851211014191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Interventional stroke treatments for occlusions of the posterior circulation are established procedures. However, there are limited data on the treatment of isolated symptomatic P1 and P2 occlusions, which we have examined in this study. PURPOSE To investigate the mechanical thrombectomy of distal posterior occlusions. MATERIAL AND METHODS Retrospectively, data from patients with isolated P1 and P2 occlusions treated with MT were evaluated. Successful reperfusions have been defined as modified thrombolysis in cerebral infarct (mTICI) Grade 2b-3. A good clinical outcome was defined as a 90-day modified Rankin score 0-2. RESULTS All 79 treated patients were primarily aspirated. Stent retrievers were used secondarily in nine patients. Successful reperfusion was achieved in 95% of patients. Of the patients, 57% had a favorable clinical outcome after 90 days. CONCLUSION Mechanical thrombectomy with first line aspiration of symptomatic P1 and P2 occlusions is a safe and effective procedure.
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Affiliation(s)
- Jens Altenbernd
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
- Department of Radiology and Neuroradiology, Gemeinschaftskrankenhaus Herdecke, Germany
| | - Michael Forsting
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Werner Weber
- Department of Radiology and Neuroradiology, Knappschaftskrankenhaus Bochum, Germany
| | - Sebastian Fischer
- Department of Radiology and Neuroradiology, Knappschaftskrankenhaus Bochum, Germany
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Drakopoulou M, Giannopoulou A, Zampakis P, Messinis L, Theofanopoulos A, Constantoyannis C, Panagiotopoulos VE. Suction thrombectomy using a microcatheter as a salvage method for acute distal occlusion during cerebral aneurysm embolization: A case report. Brain Circ 2022; 8:112-116. [PMID: 35909705 PMCID: PMC9336589 DOI: 10.4103/bc.bc_5_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/05/2022] Open
Abstract
The aneurysm coiling process presents a risk of thromboembolic complications, mostly in patients with ruptured aneurysms, given the fact that they cannot receive antiplatelet therapy. Management strategies include medical anticoagulation or antiplatelet therapy, intra-arterial thrombolysis, and mechanical thrombectomy using direct aspiration first-pass technique or stent retrievers. We report our own experience of using an Excelsior SL-10 Microcatheter (Stryker, Fremont, California, USA) with an internal diameter of 0.0165”, originally designed for coil delivery, for contact aspiration of a thrombotic occlusion of a distal anterior cerebral artery during coiling of a broad-based trilobar anterior communicating artery aneurysm. The clot was removed under continuous manual aspiration, and complete recanalization has been accomplished. Mechanical thrombectomy through microcatheter aspiration may be a safe and feasible treatment option for acute distal artery occlusions, especially in the case of tortuous distal vessels during embolization of cerebral aneurysms.
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Affiliation(s)
- Maria Drakopoulou
- Department of Neurosurgery, University Hospital of Patras, Patras, Greece
| | | | - Petros Zampakis
- Department of Neuroendovascular Surgery and Interventional Neuroradiology, University Hospital of Patras, Patras, Greece
| | - Lambros Messinis
- Department of Neuropsychology, University Hospital of Patras, Patras, Greece
| | | | | | - Vasileios Evangelos Panagiotopoulos
- Department of Neurosurgery, University Hospital of Patras, Patras, Greece.,Department of Neuroendovascular Surgery and Interventional Neuroradiology, University Hospital of Patras, Patras, Greece
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Losev FF, Popova NV, Arsenina OI, Vagner VD, Gavrilova MV. [Quantitative objective and subjective assessment of the quality of treatment of patients with distal occlusion]. Stomatologiia (Mosk) 2022; 101:70-76. [PMID: 35640182 DOI: 10.17116/stomat202210103170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of the study is to evaluation of the quality of orthodontic treatment by comparing the severity of signs of distal occlusion before the start of orthodontic treatment and after its completion. MATERIAL AND METHODS Quantitative assessment of the severity of distal occlusion in 83 patients aged 17 to 30 years before and after orthodontic treatment. Depending on the chosen treatment algorithms, the patients were divided into 3 groups. The first group - 34 people - treatment included the use of a functional non-removable orthodontic device (FNT). The second group - 21 people - the treatment was accompanied by the removal of individual teeth of the upper jaw and the retraction of a group of front teeth of the upper jaw. Patients of the 3rd group - 28 people - underwent combined orthodonto-surgical treatment. The severity of distal occlusion was assessed using 3D cephalometric analysis data. To obtain a subjective assessment of the quality of orthodontic treatment, patients were asked to fill out questionnaires before and after orthodontic treatment. RESULTS The severity of distal occlusion decreased as much as possible as a result of treatment of the first group in 23.07% of patients and the third group (16.63%), which is interpreted by the formulation «significant improvement» of the dental anomaly. Patients of the first and third groups had a high degree of satisfaction with the result of treatment, according to the quantitative assessment of the questionnaire. The severity of distal occlusion in the second group was reduced to a lesser extent (55.5%), compared with the first and third groups, which is interpreted as «moderately improved». Patients noted an average degree of satisfaction with the result of treatment, as the implemented treatment plan did not meet their expectations in the aesthetic aspect. CONCLUSION The use of FNT for the extension and normalization of the position of the lower jaw is justified in the case of refusal of patients from combined orthodonto-surgical treatment, as it allows to fully solve the functional, aesthetic and psychological problems of patients, which contributes to improving their quality of life.
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Affiliation(s)
- F F Losev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - N V Popova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - O I Arsenina
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - V D Vagner
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - M V Gavrilova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Markov NM, Ivanov VV, Krechina EK, Pogabalo IV, Rumshiskaya AD, Rozhnova EV. [Relationship between masticatory muscles activity and motor cortex activation during treatment of patients with distal malocclusion]. Stomatologiia (Mosk) 2019; 98:71-79. [PMID: 31322599 DOI: 10.17116/stomat20199803171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The processes of neuroplasticity of the motor cortex of the brain were evaluated in the treatment of 20 (12 women and 8 men) patients aged 18-35 years (22.5±1.5 years) with distal occlusion using functional magnetic resonance imaging (fMRI), as well as comparison of surface myography (EMG) data to assess the adaptive capabilities of the tooth-jaw system and the central nervous system against the background of orthodontic correction. Correction of distal occlusion was carried out using ceramic braces 'Damon' (f. 'Ormco', USA). The advancement of the lower jaw forward with bite enhancement was carried out using the Twin force device ('Ortho Orgonizers GmbH', Germany). The study was conducted in five stages: 1) before orthodontic correction; 2) before installing the Twin force device; 3) after anterior displacement of the lower jaw and bite enhancement on the Twin force device; 4) after removing the brackets; 5) 1.5 months after the treatment. FMRI proved to be a useful tool for orthodontic treatment efficacy assessment and neuromuscular adaptation of maxillofacial structures to changing functional status.
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Affiliation(s)
- N M Markov
- Central Research Institute of Dentistry and Maxillofacial Surgery of Ministry of Health of the Russian Federation, Moscow, Russia
| | - V V Ivanov
- The first Moscow State University I. M. Sechenova Ministry of the Russian Federation, Moscow, Russia
| | - E K Krechina
- Central Research Institute of Dentistry and Maxillofacial Surgery of Ministry of Health of the Russian Federation, Moscow, Russia
| | - I V Pogabalo
- Central Research Institute of Dentistry and Maxillofacial Surgery of Ministry of Health of the Russian Federation, Moscow, Russia
| | - A D Rumshiskaya
- Medical and Rehabilitation Center of Ministry of Health of the Russian Federation, Moscow, Russia
| | - E V Rozhnova
- The first Moscow State University I. M. Sechenova Ministry of the Russian Federation, Moscow, Russia
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Altenbernd J, Kuhnt O, Hennigs S, Hilker R, Loehr C. Frontline ADAPT therapy to treat patients with symptomatic M2 and M3 occlusions in acute ischemic stroke: initial experience with the Penumbra ACE and 3MAX reperfusion system. J Neurointerv Surg 2017; 10:434-439. [PMID: 28821628 PMCID: PMC5909737 DOI: 10.1136/neurintsurg-2017-013233] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 07/20/2017] [Accepted: 07/25/2017] [Indexed: 11/21/2022]
Abstract
Background After a series of positive studies for mechanical thrombectomy in large vessel occlusion acute ischemic stroke, the question remains, can symptomatic patients with distal vessel occlusion benefit from mechanical thrombectomy? Purpose To assess the safety and efficacy of the 3MAX reperfusion system as frontline therapy for M2 and M3 occlusions. Methods This study retrospectively collected data on 58 patients treated for M2 and M3 occlusions between January and September 2016. Of these 58 patients, 31 had an isolated M2 or M3 occlusion. Eligible patients were treated with 3MAX by adirect first pass aspiration (ADAPT) technique within 6 hours following stroke onset. Effectiveness was defined by functional independence (90-day modified Rankin Scale core 0–2) and revascularization to modified Thrombolysis in Cerebral Infarction (mTICI) 2b–3 scores adjudicated by a core laboratory, while complication rates were used to determine safety of the device and the procedure. Results Patients with an isolated M2 or M3 occlusion had a mean age of 68.6±13.3 years (range 18–90 years), a median National Institutes of Health Stroke Score of 15 (IQR 9–19), and ASPECTS score of 9 (IQR 8–10). After intervention, 100% (31/31) of patients were revascularized to mTICI 2b–3; 77.4% (24/31) of patients showed revascularization to mTICI 3. Aspiration alone led to revascularization in 83.9% (26/31) of patients. At 90 days, 96.8% (30/31) of patients had achieved functional independence. The incidence of symptomatic intracranial hemorrhage was 0% (0/31). Conclusions Results suggest that the 3MAX reperfusion system is safe and effective in achieving successful revascularization and functional independence for patients with acute ischemic stroke secondary to M2 and M3 occlusions using ADAPT, either as frontline monotherapy, or in combination with adjunctive devices.
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Affiliation(s)
- Jens Altenbernd
- Department of Radiology and Neuroradiology, Klinikum Vest Knappschaftskrankenhaus Recklinghausen, Recklinghausen, Germany
| | - Oliver Kuhnt
- Department of Radiology and Neuroradiology, Klinikum Vest Knappschaftskrankenhaus Recklinghausen, Recklinghausen, Germany
| | - Svenja Hennigs
- Department of Radiology and Neuroradiology, Knappschaftskrankenhaus Bottrop, Bottrop, Germany
| | - Ruediger Hilker
- Department of Neurology, Klinikum Vest Knappschaftskrankenhaus Recklinghausen, Recklinghausen, Germany
| | - Christian Loehr
- Department of Radiology and Neuroradiology, Klinikum Vest Knappschaftskrankenhaus Recklinghausen, Recklinghausen, Germany
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