BACKGROUND: Recently, in vitro studies demonstrated faster immune reconstitution after allogeneic peripheral blood stem cell transplantation (PBSCT) compared to bone marrow transplantation (BMT). In consequence, it can be expected that better immune reconstitution against cytomegalovirus (CMV) will lead to a reduced CMV-related morbidity and mortality after allogeneic PBSCT. METHODS: Forty seven patients who received allogeneic PBSCT were enrolled. CMV was routinely sought by at least weekly screening for CMV-related matrix protein pp65 antigenemia after engraftment (WBC >1,500/nL) was achieved. CMV antigenemia was treated with ganciclovir 5mg/kg twice daily i.v. as preemptive therapy for at least 10 days. After then, ganciclovir i.v. was switched to oral ganciclovir for maintenance therapy. RESULTS: CMV antigenemia was detected 8 (17%) out of 47 patients and CMV disease developed in only 1 case (2.1%). The medianperiod of time until the detection of CMV antigenemia was 51.5 days (range, 35~230). In 7 out of 8 cases, CMV antigenemia disappeared with ganciclovir treatment in 7 days. One patient with CMV disease (CMV interstitial pneumonitis) showed persistent CMV antigenemia for 3 months and expired due to restrictive lung disease. CONCLUSION: The incidence of CMV antigenemia and resistance to ganciclovir treatment was lower than the incidence of those reported in allogeneic BMT trials. These findings suggest that faster immune reconstitution against CMV after allogeneic PBSCT might have a stronger role in the prevention of emergence of CMV antigenemia and ganciclovir treatment than after allogeneic BMT.
Bone Marrow Transplantation ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Ganciclovir* ; Humans ; Incidence ; Lung Diseases ; Mass Screening ; Mortality ; Peripheral Blood Stem Cell Transplantation*

The submandibular displacement of a mandibular third molar residual root presents major challenges to oral and maxillofacial surgeons due to the proximity to critical anatomical structures such as the lingual nerve and sublingual artery. Preoperative imaging can approximate the location of the residual tooth root; however, accurately determining its exact position is difficult because of the dynamic nature of the mandible and the difficulty of realtime synchronization of imaging. This study presents the successful extraction of a residual mandibular third molar root in a 67-year-old female patient achieved using a magnetic field-based navigation system. The sublingually-displaced residual root was localized using the navigation system, marked using a virtual implant placement, and positioned by a hand piece using synchronized real-time sensor data. The root was successfully removed with a minimally-invasive approach. No complications occurred postoperatively, and follow-up showed no major issues. Due to the small size of the marker, ease of calibration, and independence from visual obstacles, magnetic field-based navigation systems are a promising tool for the removal of residual roots displaced into adjacent soft tissue.

The submandibular displacement of a mandibular third molar residual root presents major challenges to oral and maxillofacial surgeons due to the proximity to critical anatomical structures such as the lingual nerve and sublingual artery. Preoperative imaging can approximate the location of the residual tooth root; however, accurately determining its exact position is difficult because of the dynamic nature of the mandible and the difficulty of realtime synchronization of imaging. This study presents the successful extraction of a residual mandibular third molar root in a 67-year-old female patient achieved using a magnetic field-based navigation system. The sublingually-displaced residual root was localized using the navigation system, marked using a virtual implant placement, and positioned by a hand piece using synchronized real-time sensor data. The root was successfully removed with a minimally-invasive approach. No complications occurred postoperatively, and follow-up showed no major issues. Due to the small size of the marker, ease of calibration, and independence from visual obstacles, magnetic field-based navigation systems are a promising tool for the removal of residual roots displaced into adjacent soft tissue.

The submandibular displacement of a mandibular third molar residual root presents major challenges to oral and maxillofacial surgeons due to the proximity to critical anatomical structures such as the lingual nerve and sublingual artery. Preoperative imaging can approximate the location of the residual tooth root; however, accurately determining its exact position is difficult because of the dynamic nature of the mandible and the difficulty of realtime synchronization of imaging. This study presents the successful extraction of a residual mandibular third molar root in a 67-year-old female patient achieved using a magnetic field-based navigation system. The sublingually-displaced residual root was localized using the navigation system, marked using a virtual implant placement, and positioned by a hand piece using synchronized real-time sensor data. The root was successfully removed with a minimally-invasive approach. No complications occurred postoperatively, and follow-up showed no major issues. Due to the small size of the marker, ease of calibration, and independence from visual obstacles, magnetic field-based navigation systems are a promising tool for the removal of residual roots displaced into adjacent soft tissue.