Purpose: This study was conducted to identify the typical sites and patterns of peri-implant bone defects on conebeam computed tomography (CBCT) images, as well as to evaluate the detectability of the identified bone defects on panoramic images. Materials and Methods: The study population included 114 patients with a total of 367 implant fixtures. CBCT images were used to assess the presence or absence of bone defects around each implant fixture at the mesial, distal, buccal, and lingual sites. Based on the number of defect sites, the presentations of the peri-implant bone defects were categorized into 3 patterns: 1 site, 2 or 3 sites, and circumferential bone defects. Two observers independently evaluated the presence or absence of bone defects on panoramic images. The bone defect detection rate on these images was evaluated using receiver operating characteristic analysis. Results: Of the 367 implants studied, 167 (45.5%) had at least 1 site with a confirmed bone defect. The most common type of defect was circumferential, affecting 107 of the 167 implants (64.1%). Implants were most frequently placed in the mandibular molar region. The prevalence of bone defects was greatest in the maxillary premolar and mandibular molar regions. The highest kappa value was associated with the mandibular premolar region. Conclusion The typical bone defect pattern observed was a circumferential defect surrounding the implant. The detection rate was generally higher in the molar region than in the anterior region. However, the capacity to detect partial bone defects using panoramic imaging was determined to be poor.

From 1985 through 1994, 12 consecutive patients with Taussig-Bing anomaly underwent an arterial switch. Age at operation varied from 8 to 42 months (mean 21 months). Coarctation of the aorta was present in 6 patients (including 4 with hypoplasia of the aortic arch), interruption of the aortic arch in one, straddling mitral valve in one and subaortic stenosis in two. The relationship of the great arteries was D-transposition in 11 patients (oblique in 6 and anteroposterior in 5) and side-by-side in one. Eleven patients had previous palliative surgery. Pulmonary artery banding was done in 11 patients, Blalock-Hanlon in 3, carotid flap aortoplasty in 3, subclavian flap aortoplasty in 2, extended aortic arch anastomosis in 2 and ligation of PDA in 1. The Lecompte maneuver was adopted in all but one patient with side-by-side great vessels. Intraventricular reconstruction was done through the right ventricle in 11 patients and through the right atrium in one who underwent one-stage repair. There was one early death, which was related to thrombosis of the superior mesenteric artery. One patient with side-by-side great vessels died at home 6 months after the arterial switch operation. The suspected cause of death was myocardial infarction due to compression of the left coronary artery by the pulmonary artery. In the follow-up of 10 patients ranging from 1.8 to 9.4 years (average 6.3 years), one required reoperation for pulmonary stenosis. We conclude that two-staged arterial switch operation of Taussig-Bing anomaly with D-transposition can be performed with low mortality, but there seems to be some risk of the compression of the left coronary artery in the original Jatene method for Taussig-Bing anomaly with side-by-side great vessels.

Case 1 was a 2-year-old girl who underwent mitral valve replacement with a St. Jude Medical valve for severe mitral regurgitation 14 days following common atrioventricular canal defect correction. The postoperative course was uneventful, but an unilateral thrombosed leaflet of a St. Jude Medical valve was observed 3 times by echocardiography and fluoroscopy. Thrombolytic therapy with urokinase was done each time and the thrombus was successfully dissolved. Case 2 was a 1-year-old girl who underwent closure of ventricular septal defect and mitral valve replacement with a St. Jude Medical valve for ventricular septal defect, severe mitral regurgitation and pulmonary hypertension. Unilateral thrombosed leaflet of the St. Jude Medical valve and poor left ventricular function were found by echocardiography 11 days after the operation. Thrombolytic therapy with urokinase was successfully performed without any complications. Thrombolytic therapy with urokinase was considered to be effective treatment for unilateral thrombosed leaflet of a mechanical bileaflet valve prosthesis in a child. Poor left ventricular function might be one of the causative factors of unilateral thrombosed leaflet of a mechanical bileaflet valve prosthesis.