ObjectivesTo systematically review the effectiveness of one-phase treatment and two-phase treatment on the incidence of incisors trauma in patients with deep overjet, and to provide scientific basis for the selection of clinical treatment plans.MethodsPubMed, The Cochrane Library, Web of Science, CBM, CNKI, VIP and WanFang Data databases were searched to collect randomized controlled trials (RCTs) on the clinical effectiveness of one-phase treatment and two-phase treatment on the incidence of incisors trauma from inception to December 20th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 4 studies were included involving 613 patients. The results of meta-analyses showed that, there was no significant difference in the final overjet after one-phase treatment and two-phase treatment (functional appliance and headgear) (MD=–0.23, 95%CI –0.57 to 0.11, P=0.19). However, the new incidence of incisor trauma was significantly less for two-phase treatment group (functional appliance and headgear) (RR=0.69, 95%CI 0.48 to 0.99, P=0.05).ConclusionsPatients underwent two-phase treatment have lower incidence of dental trauma than one-phase treatment. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion
This case was an elderly male patient with symptomatic aortic valve calcification and severe aortic valve stenosis. Before the operation, the heart valve team had fully evaluated the patient’s suitability for transcatheter aortic valve replacement and approach. This patient had severe stenosis and plaques in the iliac artery, femoral artery, descending aorta, so the carotid artery approach transcatheter aortic valve replacement was chosen. After the operation, the patient’s symptoms improved significantly. So far, the patient was generally in good condition, without chest tightness, shortness of breath and other symptoms in daily activities. The current clinical application of the transcarotid approach is relatively small, but it is believed that with the publication of more clinical research results, the application of the transcarotid approach in transcatheter aortic valve replacement will become more and more common.
“Valve-in-valve” technique is an effective method to treat the bioprosthesis structural valve degeneration. In this paper, an 82-year-old male patient with severe aortic valve regurgitation had underwent surgical aortic valve replacement. He had a bioprosthesis structural valve degeneration which caused severe aortic stenosis more than 3 years after surgery. His symptoms of chest distress and short breath were aggravated progressively, and not relieved by conventional treatment. As the deterioration in his unstabled circulation system, an emergency transcatheter aortic valve replacement was conducted for him. The operation was finally successful, the symptoms were relived significantly after operation, and then the follow-up indicated that he had a good recovery.