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Heliyon Dec 2023The application of robotic surgery technologies in neurological surgeries resulted in some advantages compared to traditional surgeries, including higher accuracy and... (Review)
Review
The application of robotic surgery technologies in neurological surgeries resulted in some advantages compared to traditional surgeries, including higher accuracy and dexterity enhancement. Its success in various surgical fields, especially in urology, cardiology, and gynecology surgeries was reported in previous studies, and similar advantages in neurological surgeries are expected. Surgeries in the central nervous system with the pathology of millimeters through small working channels around vital tissue need especially high precision. Applying robotic surgery is therefore an interesting dilemma for these situations. This article reviews various studies published on the application of brain and spine robotic surgery and discusses the current application of robotic technology in neurological cases.
PubMed: 38046149
DOI: 10.1016/j.heliyon.2023.e22523 -
Journal of Maxillofacial and Oral... Sep 2023The aim of this systematic review was to systematically assess the papers comparing the surgical techniques of Alveolar Distraction Osteogenesis(ADO) and Autogenous Bone... (Review)
Review
AIM
The aim of this systematic review was to systematically assess the papers comparing the surgical techniques of Alveolar Distraction Osteogenesis(ADO) and Autogenous Bone grafting (ABG) for Vertical Ridge Augmentation in terms of bone gain, bone resorption and incidences of complications.
METHOLODOLOGY
The review was registered on PROSPERO with the ID : CRD42021237671. A broad electronic survey was conducted in the PubMed, Scopus, Web of Science, Cochrane Library, and Virtual Health Library databases of all studies published till 08/03/2022. Four studies fulfilled the criteria to carry out a meta-analysis a in which a total of 58 patients underwent ADO and 43 patients for ABG. A total of 133 implants were placed in the ABG group and 124 in the ADO group.
STATISTICAL ANALYSIS
DerSimonian-Laird estimator of variance was used for Random effect meta-analysis. The estimates of an intervention were expressed as the odds ratio (OR) and standard mean difference (SMD) in millimeters.
RESULTS
There was statistically significant difference in terms of bone height gain with SMD of - 0.78 (95% 0.04-1.55) in ABG. Bone resorption and complications were statistically insignificant with SMD of 0.52 (95% - 1.59 to 0.56) and OR 0.55 (95% 0.18-1.70), respectively.: CRD42021237671.
PubMed: 37534356
DOI: 10.1007/s12663-023-01943-2 -
Bioengineering (Basel, Switzerland) Jun 2022The aim of this review was to answer the following PICO question: "Do TMJ kinematic parameters (intervention and comparison) show efficacy for assessment of mandibular... (Review)
Review
The aim of this review was to answer the following PICO question: "Do TMJ kinematic parameters (intervention and comparison) show efficacy for assessment of mandibular function (Outcome) both in asymptomatic and TMD subjects? (Population)". PubMed, Scopus, Web of Science, Embase, Central databases were searched. The inclusion criteria were (1) performed on human, (2) English only, (3) on healthy, symptomatic or surgically altered TMJ, (4) measured dynamic kinematics of mandible or TMJ (5) with six degrees of freedom. To assess the Risk of Bias, the Joanna Briggs Institute tool for non-randomised clinical studies was employed. A pairwise meta-analysis was carried out using STATA v.17.0 (Stata). The heterogeneity was estimated using the Q value and the inconsistency index. Ninety-two articles were included in qualitative synthesis, nine studies in quantitative synthesis. The condylar inclination was significantly increased in female (effect size 0.03°, 95% CI: -0.06, 0.12, = 0.00). Maximum mouth opening (MMO) was increased significantly in female population in comparison with males (effect size 0.65 millimetres (0.36, 1.66). Incisor displacement at MMO showed higher values for control groups compared with TMD subjects (overall effect size 0.16 millimetres (-0.37, 0.69). Evidence is still needed, considering the great variety of devices and parameters used for arthrokinematics. The present study suggests standardising outcomes, design, and population of the future studies in order to obtain more reliable and repeatable values.
PubMed: 35877320
DOI: 10.3390/bioengineering9070269 -
Journal of Clinical Medicine Feb 2020Ultrasound can penetrate deep into tissues and interact with human tissue via thermal and mechanical mechanisms. The ability to focus an ultrasound beam and its energy... (Review)
Review
Ultrasound can penetrate deep into tissues and interact with human tissue via thermal and mechanical mechanisms. The ability to focus an ultrasound beam and its energy onto millimeter-size targets was a significant milestone in the development of therapeutic applications of focused ultrasound. Focused ultrasound can be used as a non-invasive thermal ablation technique for tumor treatment and is being developed as an option to standard oncologic therapies. High-intensity focused ultrasound has now been used for clinical treatment of a variety of solid malignant tumors, including those in the pancreas, liver, kidney, bone, prostate, and breast, as well as uterine fibroids and soft-tissue sarcomas. Magnetic resonance imaging and Ultrasound imaging can be combined with high intensity focused ultrasound to provide real-time imaging during ablation. Magnetic resonance guided focused ultrasound represents a novel non-invasive method of treatment that may play an important role as an alternative to open neurosurgical procedures for treatment of a number of brain disorders. This paper briefly reviews the underlying principles of HIFU and presents current applications, outcomes, and complications after treatment. Recent applications of Focused ultrasound for tumor treatment, drug delivery, vessel occlusion, histotripsy, movement disorders, and vascular, oncologic, and psychiatric applications are reviewed, along with clinical challenges and potential future clinical applications of HIFU.
PubMed: 32046072
DOI: 10.3390/jcm9020460 -
Journal of Neuroscience Methods Jun 2020In recent years, multiple noninvasive imaging modalities have been used to develop a better understanding of the human brain functionality, including positron emission... (Review)
Review
In recent years, multiple noninvasive imaging modalities have been used to develop a better understanding of the human brain functionality, including positron emission tomography, single-photon emission computed tomography, and functional magnetic resonance imaging, all of which provide brain images with millimeter spatial resolutions. Despite good spatial resolution, time resolution of these methods are poor and values are about seconds. Scalp electroencephalography recordings can be used to perform the inverse problem in order to specify the location of the dominant sources of the brain activity. In this paper, EEG source localization method, diagnosis of brain abnormalities using common EEG source localization methods, investigating the effect of the head model on EEG source imaging results have been studied. In this review we present enough evidence that provides motivation for consideration in the future research using EEG source localization methods.
Topics: Brain; Brain Diseases; Brain Mapping; Electroencephalography; Humans; Magnetic Resonance Imaging
PubMed: 32353472
DOI: 10.1016/j.jneumeth.2020.108740 -
Journal of Dentistry Sep 2014The purpose of the present review was to test the null hypothesis of no difference in the implant failure rates, postoperative infection, and marginal bone loss for... (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVES
The purpose of the present review was to test the null hypothesis of no difference in the implant failure rates, postoperative infection, and marginal bone loss for patients being rehabilitated using dental implants with immediate nonfunctional loading (INFL) compared to immediate functional loading (IFL), against the alternative hypothesis of a difference.
METHODS
An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. The estimates of relative effect were expressed in risk ratio (RR) and mean difference (MD) in millimeters.
RESULTS
1059 studies were identified and 11 studies were included, of which 7 were of high risk of bias, whereas four studies were of low risk of bias. The results showed that the procedure used (nonfunctional vs. functional) did not significantly affect the implant failure rates (P=0.70), with a RR of 0.87 (95% CI 0.44-1.75). The wide CI demonstrates uncertainty about the effect size. The analysis of postoperative infection was not possible due to lack of data. No apparent significant effects of non-occlusal loading on the marginal bone loss (MD 0.01mm, 95% CI -0.04-0.06; P=0.74) were observed.
CONCLUSIONS
The results of this study suggest that the differences in occlusal loading between INFL and IFL might not affect the survival of these dental implants and that there is no apparent significant effect on the marginal bone loss.
CLINICAL SIGNIFICANCE
There has been a controversy concerning whether dental implants should be subjected to immediate functional or nonfunctional loading. As the philosophies of treatment may alter over time, a periodic review of the different concepts is necessary to refine techniques and eliminate unnecessary procedures. This would form a basis for optimum treatment.
Topics: Alveolar Bone Loss; Dental Implants; Dental Restoration Failure; Humans; Immediate Dental Implant Loading; Surgical Wound Infection; Survival Analysis
PubMed: 24995809
DOI: 10.1016/j.jdent.2014.06.010 -
The International Journal of Oral &... Dec 2023Alveolar ridge split (ARS) is ridge augmentation to mitigate ridge width loss that typically follows tooth extraction. This study aimed to determine the efficacy of ARS... (Meta-Analysis)
Meta-Analysis
PURPOSE
Alveolar ridge split (ARS) is ridge augmentation to mitigate ridge width loss that typically follows tooth extraction. This study aimed to determine the efficacy of ARS on alveolar ridge horizontal dimensional changes and the survival rates of implants placed into the same sites.
MATERIALS AND METHODS
An electronic and manual search was conducted for English articles published up to January 1, 2021. The PICO (problem, intervention, comparison, outcome) model for quantitative studies was established to address the following two focused questions: (1) What are the effects of the ARS technique on increasing alveolar width and implant survival?; and (2) what are the factors that influence the efficacy of the ARS technique? The outcome measures in this systematic review and meta-analysis were mean alveolar ridge gain-horizontal (buccolingual) in millimeters from baseline (initial presentation) to final assessment (minimum of 12 weeks after ARS), implant survival rate, and patient-reported complication rate. The risk of bias was evaluated using the ROBINS-I assessment tool for non-randomized interventional studies. Weighted means were calculated, and pooled effects and 95% confidence intervals (95% CI) were depicted on forest plots. Publication bias was assessed by funnel plot and Rosenthal Statistics. A sensitivity analysis was undertaken to assess the primary outcome.
RESULTS
Overall, 35 studies met the inclusion criteria and were included in the systematic review. The mean alveolar ridge gain for ARS was 3.06 mm (95% CI: 3.01 to 3.12 mm). A mean gain of 2.99 mm (95% CI: 2.93 to 3.04 mm) was found after sensitivity analysis, excluding one article with a high risk of bias. There were no significant differences in ridge width in the group with bone graft (mean difference [95% CI] of 2.97 mm [2.91 to 3.03 mm]) and in the group without bone graft (mean difference [95% CI] of 3.06 mm [2.92 to 3.20 mm]). The ARS technique demonstrated a 98.17% implant survival rate in 4,446 implants, 4,103 of which were placed at the time of ARS with a 97.72% implant survival rate, and 343 placed in a delayed approach with a 99.14% implant survival rate. The risk of bias was low in 14.2%, low to moderate in 68.5%, moderate in 11.4%, and severe/moderate in 5.7% of the included studies.
CONCLUSIONS
ARS shows a high implant survival rate in narrow alveolar ridges, adequate horizontal alveolar ridge dimensional gain regardless of adding grafting material, and minimal patient-reported complications.
Topics: Humans; Dental Implantation, Endosseous; Dental Implants; Alveolar Ridge Augmentation; Alveolar Process; Bone Transplantation
PubMed: 38085739
DOI: 10.11607/jomi.9972 -
Journal of Oral and Maxillofacial... Aug 2012To determine the impact of secondary versus primary closure techniques on the frequency and severity of pain, facial swelling, trismus, infectious complications, and... (Meta-Analysis)
Meta-Analysis Review
Secondary versus primary closure techniques for the prevention of postoperative complications following removal of impacted mandibular third molars: a systematic review and meta-analysis of randomized controlled trials.
PURPOSE
To determine the impact of secondary versus primary closure techniques on the frequency and severity of pain, facial swelling, trismus, infectious complications, and postoperative bleeding after impacted mandibular third molar extraction.
MATERIALS AND METHODS
Randomized controlled trials were identified through MEDLINE, EMBASE, and CENTRAL, ongoing trial registers, meeting abstracts, doctoral and masters theses, and manual searching of the reference lists of eligible studies. Study selection, data extraction, risk of bias, and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) rating of confidence in effect estimates were undertaken independently in duplicate.
RESULTS
Of 1,721 identified citations, 14 studies proved eligible. Pain and facial swelling at postoperative days 3 and 7 and infectious complications at day 7 did not differ between techniques. Patients receiving secondary closure had less trismus (in millimeters) at postoperative days 3 (mean difference, 3.72; 95% confidence interval, 1.42 to 6.03, P = .002) and 7 (mean difference, 2.35; 95% confidence interval, 0.37 to 4.33; P = .02). Four randomized controlled trials reported bleeding: in 2, there was no bleeding in either group; the numbers of bleeding events with primary and secondary closures were 22 and 16 and 5 and 15, respectively, in the other 2. Because of the risk of bias and inconsistency in results, the evidence warranted, at best, low confidence in the estimates of effect across all outcomes.
CONCLUSIONS
Although differences between primary and secondary closure techniques after impacted mandibular third molar extraction are likely to be small, available evidence provides only low confidence in the effect estimates. The results do not support a preference for either approach.
Topics: Edema; Humans; Mandible; Molar, Third; Pain, Postoperative; Postoperative Complications; Postoperative Hemorrhage; Randomized Controlled Trials as Topic; Surgical Wound Infection; Tooth Extraction; Tooth, Impacted; Trismus; Wound Closure Techniques
PubMed: 22695015
DOI: 10.1016/j.joms.2012.03.017 -
Journal of the American Dental... Aug 2012The authors conducted a systematic review of all published randomized controlled trials in which investigators compared the effectiveness of splint therapy with that of... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The authors conducted a systematic review of all published randomized controlled trials in which investigators compared the effectiveness of splint therapy with that of minimal or no treatment in patients with temporomandibular disorders (TMDs).
TYPES OF STUDIES REVIEWED
The authors searched MEDLINE, Embase and the Cochrane Central Register of Controlled Trials for studies published from inception of each database through August 2011. In eligible studies, investigators enrolled adult patients with TMDs and assigned them randomly to splint therapy or a control group receiving minimal or no treatment.
RESULTS
Of 1,567 potentially eligible studies, 11 proved eligible and were included. Moderate-quality evidence suggests that splint therapy reduced pain in the temporomandibular joint (TMJ) area (standardized response mean = -0.93, 95 percent confidence interval [CI], -1.33 to -0.53; risk difference for having continued pain = -0.35, 95 percent CI, -0.21 to -0.46; mean change on the 100-millimeter visual analog scale = -11.5 mm, 95 percent CI, -16.5 mm to -6.6 mm). Low to very low quality of evidence showed no significant differences between the splint therapy and control groups in terms of quality of life or depression. None of the trial reports described effect on function.
CONCLUSIONS
Although overall results are promising for the reduction of pain, establishing the role of splints for patients with TMDs will require large trials with stronger safeguards against bias.
Topics: Humans; Occlusal Splints; Randomized Controlled Trials as Topic; Temporomandibular Joint Disorders
PubMed: 22855899
DOI: 10.14219/jada.archive.2012.0289 -
Journal of the American Dental... Sep 2016Periodontal defect on the distal aspect of mandibular second molars is a common complication after mandibular third-molar extraction. Researchers have proposed different... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Periodontal defect on the distal aspect of mandibular second molars is a common complication after mandibular third-molar extraction. Researchers have proposed different procedures, but no evidence has shown that a single effective method can prevent or treat this complication.
METHODS
The authors conducted a systematic review and meta-analysis to answer this clinical question: what is the effect of regenerative periodontal therapy on the periodontal tissue healing of the distal site of the mandibular second molar after impacted mandibular third-molar extraction compared with extraction alone without using any biomaterials during a follow-up period of at least 6 months? The authors conducted an electronic search for randomized controlled trials using MEDLINE, Embase, and other databases, and they assessed the quality of selected articles.
RESULTS
Among the 1,083 eligible articles found in the initial search, 7 studies fit all of the selection criteria. All of these studies had a follow-up period lasting at least 6 months. The authors found that regenerative periodontal therapy was significantly more effective in gaining clinical attachment level or reducing probing depth at the distal site of the mandibular second molar than extraction without therapy (weighted mean difference of clinical attachment level gain, 1.94 millimeters [95% confidence interval {CI}, 1.56-2.31]; weighted mean difference of probing depth reduction, 1.67 mm [95% CI, 1.15-2.19]).
CONCLUSIONS AND PRACTICAL IMPLICATIONS
The results of our systematic review and meta-analysis demonstrated that regenerative periodontal therapy effectively prevents the periodontal defect associated with impacted mandibular third-molar extraction. Clinicians should consider performing guided tissue regeneration when the defect is anticipated.
Topics: Guided Tissue Regeneration, Periodontal; Humans; Molar, Third; Periodontal Diseases; Tooth Extraction
PubMed: 27085787
DOI: 10.1016/j.adaj.2016.03.005