Robert W. Berg

Cesarean scar pregnancies: experience of 60 cases.

To evaluate the management, clinical courses, and outcomes of cesarean scar pregnancies diagnosed in the first trimester.

A technique for retrieval of cement-retained implant-supported prostheses

Predictable retrievability of cement-retained prostheses has been a clinical concern. This article presents a technique that describes an implant restoration design which will allow predictable removal of cement-retained implant-supported prostheses.

A digital radiographic artifact: A clinical report

Digital dental radiographic imaging is considered to be as diagnostically accurate as conventional film-based radiography. In addition, many digital radiographic systems offer various image enhancements that may aid in image interpretation. However, neither type of radiographic imaging technique perfectly correlates radiographic diagnoses with clinical findings. Moreover, visual digital enhancements may provide information that is diagnostically misleading. This report presents a completed patient treatment evaluation with both enhanced and unenhanced digital radiography. The outcome suggests that clinicians should be careful with the interpretation of digital radiographic images, as this can potentially result in false-positive diagnoses.

A Complete Denture Impression Technique Survey of Postdoctoral Prosthodontic Programs in the United States

Purpose The purpose of the study was to survey program directors of postdoctoral prosthodontic programs in the United States regarding their programs’ complete denture impression techniques. The key objectives of the survey were to identify the current trends in complete denture impression making and to determine which techniques and materials are taught in US postdoctoral prosthodontic programs. Materials and Methods An online survey was sent to all program directors of US postdoctoral prosthodontic programs. The survey comprised two sections: preliminary impressions and final impressions. The survey contained 22 questions that would take approximately 5 minutes to complete. All responses remained anonymous throughout the survey. Results The response rate for the survey was 87%. A majority of the programs did not separately border mold the tray prior to making the preliminary impressions (82%). The impression material of choice for the preliminary impression was irreversible hydrocolloid (88%). Selective pressure was the predominantly used impression philosophy (80%). All programs border molded the custom tray, and 95% recorded the borders in sections. The material of choice for border molding the custom tray was modeling plastic impression compound (71%). The most commonly used impression material for the final impressions was polyvinylsiloxane (PVS) (42%), and the second most commonly used impression material was polysulphide (32%). The most common technique for locating the posterior palatal seal was marking intraorally and transferring onto the final impression (65%). Most programs routinely advised their patients not to wear their existing dentures for at least 24 hours before the final impressions were made (83%). Conclusions Based on the results of this study, the following conclusions can be drawn: (1) The most commonly used material for the preliminary impression was irreversible hydrocolloid and for the final impression was PVS. (2) Modeling plastic impression compound was used by most programs to border mold the custom trays. (3) Selective pressure was the predominantly used impression philosophy. (4) A majority of the programs made a special consideration for excessive movable (flabby) tissue. (5) Most programs routinely advised their patients to not wear their existing dentures for at least 24 hours before the final impressions were made.

Interim Prosthetic Phase of Multidisciplinary Management of Cleidocranial Dysplasia: “The Bronx Approach”

This case report presents treatment of two patients with the usual characteristics of Cleidocranial Dysostosis. A multidisciplinary approach using the disciplines of prosthodontics, orthodontics, and oral surgery was effected. Exfoliation of the patients deciduous teeth and failure of permanent anterior tooth eruption led to emotional, social, and self-esteem issues in both patients. Due to the psychosocial issues confronting these two patients, esthetics was addressed prior to active intervention with orthodontics and after some surgical intervention. The use of two interim overdenture prostheses with magnetic retention is described.

Term singleton pregnancy after conservative management of a complicated triplet gestation including a heterotopic cornual monochorionic twin pair.

The use of assisted reproductive techniques has been linked to several potential obstetric complications. In particular, a strong association exists between assisted reproductive techniques and the risk of multifetal pregnancies.1 This association has been established for both dichorionic as well as monochorionic multiple gestations.2,3 In addition, a substantially increased risk for both ectopic and heterotopic pregnancies has been observed among pregnancies that result from assisted reproductive techniques.4,5 Obviously, the first-trimester sonographic evaluation plays a major role in the identification and management of these complications. We report a case in which the early sonographic evaluation of a pregnancy resulting from assisted reproductive techniques led to the detection of a triplet gestation, which consisted of an intrauterine singleton and a heterotopic right cornual monochorionic twin pair. In addition to describing the meticulous 2and 3-dimensional sonographic evaluation used, this case highlights the substantial clinical

Evaluation of human peri-implant soft tissues around alumina-blasted/acid-etched standard and platform-switched abutments.

This study evaluated the histometric characteristics of the peri-implant mucosa of human subjects that received textured implant abutments with conventional (implant and abutment with same diameter) or platform-switched (implant diameter wider than that of the abutment) configurations. Wider and longer connective tissue around platform-switched implants was observed compared to that with conventional abutments. Despite the different dimensions between the two abutment types, the abutment-soft tissue interaction was similar for both groups at the histometric level.

Greig Cephalopolysyndactyly Syndrome Diagnosis Based on Prenatal Sonographic Features Coupled With Comparative Genomic Hybridization

Limb deformities are frequent features found during prenatal sonographic screening for malformations. Some anomalies of the hand such as the clenched hands and overlapping fingers in trisomy 18 or the outwardly turned feet in fibular hemimelia are pathognomonic. Others, such as preaxial and postaxial polydactyly, are part of a long list of skeletal anomalies and syndromes. We present a case with several skeletal anomalous features, which clustered around a rare syndrome involving a deletion in the GLI-Kruppel family member 3 (GLI3) gene of chromosome 7. The diagnosis presented a challenge to all involved. It started with the sonographic description of the features of the fetus. The genetic diagnosis was achieved by a comparative genomic hybridization (CGH) microarray.

Evaluation of human periimplant soft tissues around nonsubmerged machined standard and platform-switched abutments.

Purpose:This study evaluated the effect of the platform-switching phenomenon, the use of a smaller diameter abutment on a larger diameter implant platform. Clinical and histological outcomes of the periimplant mucosa around titanium abutments in a nonsubmerged implant were evaluated. Materials and Methods:Ten healthy adult patients, ranging from 27 to 65 years, participated in the study. A minimum of 2 endosseous implants with immediate abutment connection was placed per patient, 1 conventional and 1 platform-switched abutment. All sites for implant placement had an adequate zone of keratinized mucosa before surgical intervention. Results:No clinical signs of inflammation were observed in the periimplant soft tissue mucosa, and healing was uneventful throughout the study period. Histological findings showed abnormally thick stratified squamous epithelium for both groups with few inflammatory cells in the connective tissue and none on the surface of the epithelium. Conclusion:Histological findings for both conventional and platform-switched implant-abutment configurations showed a similar composition of the soft tissue. These findings were in direct agreement with previous studies.

P02.11: Conservative management of a complicated heterotopic triplet pregnancy with a cornual monochorionic twin pair

A 29 year old G5 P0040 presented for evaluation of a multifetal gestation at 8 postmenstrual weeks. The patient had an extensive obstetrical history significant for prior right tubal pregnancy and right salpingectomy, two 1st trimester miscarriages, and a subsequent IVF pregnancy resulting in a simultaneous bilateral, ovarian heterotopic pregnancy, which was managed by laparoscopic resections and left salpingectomy. The index pregnancy was assisted by IVF/ET. Two frozen embryos were transferred. Ultrasound detected a heterotopic triplet gestation. 2D ultrasound and 3D reconstruction were instrumental in depicting the location of the three embryos. This was significant for an intrauterine singleton, and a right cornual monochorionic diamniotic twin pair. Extensive counseling was performed regarding the different management options. Given that this was a highly desired pregnancy and that a normally implanted intrauterine singleton was seen, selective reduction of the cornual twin pair was performed by transcervical ultrasound guided KCl injection. Following the procedure, serial clinical and sonographic evaluation were performed. This surveillance revealed increased amount of fluid accumulating in the cul-de-sac, suggesting bleeding from the cornual pregnancy. The patient therefore, underwent laparotomy in which evacuation of the hemiperitoneum and cornual pregnancy were followed by closure of the cornual gestations’ bed. During the surgery, caution was exercised using gentle handling of the uterus to maintain the intrauterine singleton embryo intact. Ultrasound demonstrated a reasonably large distance from it to the affected cornua which was interpreted as a positive prognostic factor. After recovery, outpatient surveillance confirmed an otherwise uncomplicated prenatal course. Scheduled cesarean delivery was performed at 37 weeks. This unusual case highlights the efforts to conservatively manage this extremely rare and complicated heterotopic pregnancy.