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Materials (Basel, Switzerland) Aug 2021To evaluate marginal bone loss (MBL) in immediate implant procedures (IIP) placed in conjunction with platelet concentrates (PCs) compared to IIP without PCs. (Review)
Review
BACKGROUND
To evaluate marginal bone loss (MBL) in immediate implant procedures (IIP) placed in conjunction with platelet concentrates (PCs) compared to IIP without PCs.
METHODS
A search was performed in four databases. Clinical trials evaluating MBL of IIP placed with and without PCs were included. The random effects model was conducted for meta-analysis.
RESULTS
Eight clinical trials that evaluated MBL in millimeters were included. A total of 148 patients and 232 immediate implants were evaluated. The meta-analysis showed a statistically significant reduction on MBL of IIP placed with PCs when compared to the non-PCs group at 6 months ( < 0.00001) and 12 months ( < 0.00001) follow-ups. No statistically significant differences were observed on MBL of IIP when compared PCs + bone graft group vs. only bone grafting at 6 months ( = 0.51), and a significant higher MBL of IIP placed with PCs + bone graft when compared to only bone grafting at 12 months was found ( = 0.03).
CONCLUSIONS
MBL of IIP at 6 and 12 months follow-ups is lower when PCs are applied in comparison to not placing PCs, which may lead to more predictable implant treatments in the medium term. However, MBL seems not to diminish when PCs + bone graft are applied when compared to only bone grafting.
PubMed: 34443105
DOI: 10.3390/ma14164582 -
The Cochrane Database of Systematic... Aug 2012Encapsulation of a filtering bleb following trabeculectomy may lead to elevation of intraocular pressure, prompting further medical or surgical intervention. It has been... (Review)
Review
BACKGROUND
Encapsulation of a filtering bleb following trabeculectomy may lead to elevation of intraocular pressure, prompting further medical or surgical intervention. It has been suggested that needling of an encapsulated bleb may be effective in re-establishing drainage and lowering intraocular pressure.
OBJECTIVES
The objective of this review was to assess the effects of needling encapsulated blebs on intraocular pressure.
SEARCH METHODS
We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 1), MEDLINE (January 1950 to February 2012), EMBASE (January 1980 to February 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to February 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 14 February 2012.
SELECTION CRITERIA
We included randomised and quasi-randomised in which bleb needling was compared with any form of antiglaucoma medication in people with encapsulated trabeculectomy blebs. The primary outcome was mean intraocular pressure measured in millimetres of mercury at day one, one week, one month and at last available follow-up.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed trial quality and extracted data. Study authors were contacted for additional information.
MAIN RESULTS
One trial, which randomised 25 eyes to either needling or medical treatment, met the inclusion criteria. At one day post-treatment, mean intraocular pressure was lower in the needling group (16.28 mmHg, standard deviation 5.9) than the medical group (19.45 mmHg, standard deviation 3.75). The difference was not statistically significant. At all other follow-up points, mean intraocular pressure was consistently higher in the needling group than the medical group, although the differences were not statistically significant. However, only one needled bleb remained successful at the end of follow-up compared to 10 out of the 11 blebs managed conservatively. This difference was statistically highly significant.
AUTHORS' CONCLUSIONS
Evidence from one small trial suggests that needling of encapsulated trabeculectomy blebs is not better than medical treatment in reducing intraocular pressure.
Topics: Blister; Filtering Surgery; Glaucoma; Humans; Intraocular Pressure; Needles; Paracentesis; Randomized Controlled Trials as Topic; Trabeculectomy
PubMed: 22895936
DOI: 10.1002/14651858.CD003658.pub3 -
Journal of Clinical Medicine Nov 2022Background: Endosalpingiosis is assumed to be the second most common benign peritoneal pathology after endometriosis in women. Although recent studies indicate a...
Background: Endosalpingiosis is assumed to be the second most common benign peritoneal pathology after endometriosis in women. Although recent studies indicate a significant association with gynecologic malignancies, many underlying principles remain unclear. This work aimed to systematically describe the intraoperative appearance of endosalpingiosis. Methods: Data and intraoperative videos of patients with histologically verified endosalpingiosis were retrospectively reviewed. The main outcome measures were macroscopic phenotype and anatomical distribution. Additionally, a systematic review searching PubMed (Medline) and Embase was conducted. Results: In the study population (n = 77, mean age 40.2 years (SD 16.4)), the mean size of lesions was 3.6 mm and the main visual pattern was vesicular (62%). The most frequent localization was the sacrouterine ligaments (24.7%). In the systematic review population (n = 1174 (210 included studies overall), mean age 45.7 years (SD 14.4)), there were 99 patients in 90 different studies with adequate data to assess the appearance of the lesions. The mean size of the lesions was 48.5 mm, mainly with a cystic visual pattern (49.5%). The majority of the lesions affected the ovaries (23.2%), fallopian tubes (20.4%), or lymph nodes (18.5%). Comparing this study to the literature population, the main differences concerned the size (p < 0.001) and main visual patterns (p < 0.001) of lesions. Conclusions: The usual intraoperative findings of endosalpingiosis appeared less impressive than described in the literature. In our study population, lesions of a few millimeters in size with a vesicular appearance were mostly seen, most frequently in the sacrouterine ligament area. Intraoperative recognition by the gynecologic surgeon and histologic diagnosis should play an important role in further understanding this entity, scientifically and clinically.
PubMed: 36498581
DOI: 10.3390/jcm11237006 -
Journal of Indian Prosthodontic Society 2020To evaluate different methods, techniques, and concepts documented in the literature to assess iris positioning accurately to the related dimensions needed to effectuate... (Review)
Review
AIM
To evaluate different methods, techniques, and concepts documented in the literature to assess iris positioning accurately to the related dimensions needed to effectuate maxillofacial rehabilitation of ocular prosthesis.
SETTINGS AND DESIGN
This systematic review was conducted as per the PRISMA guidelines which is the most opted reporting protocol.
MATERIALS AND METHODS
Two electronic databases PubMed and Cochrane Library) were searched for manuscripts published from 1969 till September 30, 2019. An electronic search (of peer review restricted to English language dental literature was conducted to identify the relevant scientific article on iris positioning in maxillofacial prostheses. Two observers independently read the abstracts and selected 17 full text articles fulfilling the inclusion criteria.
STATISTICAL ANALYSIS USED
No meta-analysis was conducted due to heterogeneity of data obtained.
RESULTS
All the 17 documented articles related to determination of the iris positioning to perform maxillofacial prosthetic rehabilitation depicting the use of a strip of plastic template, a Boley's gauge, a millimeter ruler, a pupillometer, window light, an ocular locator with fixed caliper, inverted anatomic tracings, a transparent graph grid were reviewed systematically.
CONCLUSION
Currently, there is no evidence in the form of a systematic review of the available literature discussing the best technique available for perfectly matching the iris positioning. However, the latest techniques making use of digital technology such as digital photography, is believed to be more precise for iris positioning in the ocular prosthesis.
PubMed: 33487961
DOI: 10.4103/jips.jips_374_19 -
BMC Oral Health Apr 2023Ridge resorption following tooth extraction may be reduced by alveolar ridge preservation (ARP). Previous randomized clinical trials and systematic reviews have... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Ridge resorption following tooth extraction may be reduced by alveolar ridge preservation (ARP). Previous randomized clinical trials and systematic reviews have suggested that autogenous tooth bone graft (ATB) can be an effective alternative material for ARP. However, the results are heterogeneous. Therefore, our research aimed to evaluate the efficacy of ATB in ARP.
METHODS
A systematic search was conducted in Cochrane Library, Embase, MEDLINE and Scopus for studies published from inception to 31 November 2021. We searched searched for randomized, non-randomized controlled trials and case series reporting on ATB use for ARP. The primary outcome was the ridge width difference pre- and post-surgery, measured in millimetres (mm) measured on CBCT (cone beam computed tomography). The secondary outcomes were the histological results. We followed the PRISMA2020 recommendations for reporting our systematic review and meta-analysis.
RESULTS
The analysis included eight studies for the primary and six for the secondary outcomes. The meta-analysis revealed a positive ridge preservation effect with a pooled mean difference ridge width change of -0.72 mm. The pooled mean residual graft proportion was 11.61%, and the newly formed bone proportion was 40.23%. The pooled mean of newly formed bone proportion was higher in the group where ATB originated from both the root and crown of the tooth.
CONCLUSIONS
ATB is an effective particulate graft material in ARP. Complete demineralization of the ATB tends to decrease the proportion of newly formed bone. ATB can be an attractive option for ARP.
TRIAL REGISTRATION
The study protocol was registered on PROSPERO (CRD42021287890).
Topics: Humans; Alveolar Process; Tooth Socket; Alveolar Ridge Augmentation; Tooth Extraction; Osteogenesis; Alveolar Bone Loss
PubMed: 37076844
DOI: 10.1186/s12903-023-02930-2 -
The Angle Orthodontist Jul 2019To identify the scientific evidence that demonstrates which of the transverse maxillary treatments has the least effect on periodontal tissues.
OBJECTIVES
To identify the scientific evidence that demonstrates which of the transverse maxillary treatments has the least effect on periodontal tissues.
MATERIALS AND METHODS
PubMed (MEDLINE), Cochrane Library, Scopus, Web of Science, Virtual Health Library, Google Scholar, and OpenGrey were searched without restrictions. A hand search was also carried out in the reference lists of the articles selected. The related articles tool in the PubMed database was checked for each article included. Risk of bias assessment was performed using Cochrane Collaboration's Risk of Bias tool for randomized clinical trials and the ROBINS-I tool for nonrandomized studies of interventions. The GRADE tool was used to assess the quality of the evidence.
RESULTS
After examination of the full texts, three studies were finally included. Two studies used a Haas expander with different protocols, and one study used a Haas expander compared with a quad-helix appliance. These studies evaluated periodontal parameters and periodontal indices by clinical examination with a millimeter probe, and one study examined computed tomography images. After quality assessment, two studies were considered as having a "low" risk of bias. One study was scored as having a moderate risk of bias. The evidence was graded as moderate quality for alveolar bone level, tooth displacement, and inclination and very low for all other outcomes.
CONCLUSIONS
There were no significant differences to enable a sound conclusion about which type of maxillary expansion has the least periodontal side effects.
Topics: Humans; Maxilla; Palatal Expansion Technique; Periodontium
PubMed: 30741576
DOI: 10.2319/060218-419.1 -
Modern Rheumatology Jul 2023Rice body (RB) formation is an uncommon inflammatory process seen in systemic disorders. In this study, we aimed to assess characteristic features of RBs in pediatric...
OBJECTIVES
Rice body (RB) formation is an uncommon inflammatory process seen in systemic disorders. In this study, we aimed to assess characteristic features of RBs in pediatric patients.
METHOD
We retrospectively evaluated pediatric patients who underwent joint/extremity magnetic resonance imaging. A systematic literature review was conducted for articles including children with RBs.
RESULTS
We found 24 patients (median age 6.1 years; F/M = 2.4) with RBs [23 with juvenile idiopathic arthritis (JIA) and one with arthralgia]. The most prevalent location for RBs was the knee joint (75%). RBs were most frequently seen as diffuse multiple millimetric structures. In three out of five patients with follow-up magnetic resonance imaging, resolution or regression of RBs was observed without surgical intervention. Our literature search identified 13 pediatric patients with RBs. Most (84.6%) had JIA, and the knee joint (71.4%) was the most commonly affected joint. Surgery was preferred in our 3 patients (12.5%) and 10 literature patients (83.3%) in the treatment.
CONCLUSION
Our results showed that RBs were most commonly detected in the knee joint, and most cases were secondary to JIA. Although surgery is used as a treatment option, we observed that RBs can occasionally disappear during follow-up without surgical intervention.
Topics: Humans; Child; Retrospective Studies; Rheumatic Diseases; Arthritis, Juvenile; Knee Joint; Magnetic Resonance Imaging
PubMed: 35819010
DOI: 10.1093/mr/roac075 -
The Spine Journal : Official Journal of... Feb 2021The introduction and integration of robot technology into modern spine surgery provides surgeons with millimeter accuracy for pedicle screw placement. Coupled with... (Meta-Analysis)
Meta-Analysis
BACKGROUND CONTEXT
The introduction and integration of robot technology into modern spine surgery provides surgeons with millimeter accuracy for pedicle screw placement. Coupled with computer-based navigation platforms, robot-assisted spine surgery utilizes augmented reality to potentially improve the safety profile of instrumentation.
PURPOSE
In this study, the authors seek to determine the safety and efficacy of robotic-assisted pedicle screw placement compared to conventional free-hand (FH) technique.
STUDY DESIGN/SETTING
We conducted a systematic review of the electronic databases using different MeSH terms from 1980 to 2020.
OUTCOME MEASURES
The present study measures pedicle screw accuracy, complication rates, proximal-facet joint violation, intraoperative radiation time, radiation dosage, and length of surgery.
RESULTS
A total of 1,525 patients (7,379 pedicle screws) from 19 studies with 777 patients (51.0% with 3,684 pedicle screws) in the robotic-assisted group were included. Perfect pedicle screw accuracy, as categorized by Gerztbein-Robbin Grade A, was significantly superior with robotic-assisted surgery compared to FH-technique (Odds ratio [OR]: 1.68, 95% confidence interval [CI]: 1.20-2.35; p=.003). Similarly, clinically acceptable pedicle screw accuracy (Grade A+B) was significantly higher with robotic-assisted surgery versus FH-technique (OR: 1.54, 95% CI: 1.01-2.37; p=.05). Furthermore, the complication rates and proximal-facet joint violation were 69% (OR: 0.31, 95% CI: 0.20-0.48; p<.00001) and 92% less likely (OR: 0.08, 95% CI: 0.03-0.20; p<.00001) with robotic-assisted surgery versus FH-group. Robotic-assisted pedicle screw implantation significantly reduced intraoperative radiation time (MD: -5.30, 95% CI: -6.83-3.76; p<.00001) and radiation dosage (MD: -3.70, 95% CI: -4.80-2.60; p<.00001) compared to the conventional FH-group. However, the length of surgery was significantly higher with robotic-assisted surgery (MD: 22.70, 95% CI: 6.57-38.83; p=.006) compared to the FH-group.
CONCLUSION
This meta-analysis corroborates the accuracy of robot-assisted pedicle screw placement.
Topics: Humans; Pedicle Screws; Robotic Surgical Procedures; Robotics; Spinal Fusion; Spine; Surgery, Computer-Assisted; Zygapophyseal Joint
PubMed: 32976997
DOI: 10.1016/j.spinee.2020.09.007 -
International Orthopaedics May 2014The purpose of this review is to provide a better understanding of biomechanical changes induced by reverse shoulder arthroplasty (RSA), discuss the different techniques... (Review)
Review
PURPOSE
The purpose of this review is to provide a better understanding of biomechanical changes induced by reverse shoulder arthroplasty (RSA), discuss the different techniques of radiographic assessment of upper limb lengthening after RSA and determine the ideal soft tissue tension that provides the best functional outcome without increasing the risk of complications.
METHODS
Inclusion criteria were articles in which the primary interest was the technique of measuring upper-extremity lengthening after complications related to lengthening and its role in postoperative function; those written in English, French or German; and those that provided evidence levels I-IV relevant to search terms.
RESULTS
Seven articles met our inclusion criteria. Postoperatively, changes in humeral length varied from minus five to five millimetres, and changes in upper-extremity length varied from 15 mm to 27 mm. The acromiohumeral distance averaged 23 mm. Humeral and arm shortening increased the risk of dislocation and led to poor anterior active elevation. The type of surgical approach did not play a role in postoperative function. Subclinical neurological lesions were frequent.
CONCLUSIONS
Studies in this systematic review indicate that deltoid tensioning by restoring humeral length and increasing the acromiohumeral distance is critical for adequate postoperative function and to prevent dislocation. Excessive arm lengthening should be avoided, with zero to two centimetres of lengthening being a reasonable goal to avoid postoperative neurological impairment.
Topics: Arthroplasty, Replacement; Biomechanical Phenomena; Bone Lengthening; Humans; Humerus; Shoulder Joint
PubMed: 24271331
DOI: 10.1007/s00264-013-2175-z -
Journal of Neurosurgery. Spine Feb 2024Postoperative C5 palsy (C5P) is a known complication in cervical spine surgery. However, its exact pathophysiology is unclear. The authors aimed to provide a review of...
OBJECTIVE
Postoperative C5 palsy (C5P) is a known complication in cervical spine surgery. However, its exact pathophysiology is unclear. The authors aimed to provide a review of the current understanding of C5P by performing a comprehensive, systematic review of the existing literature and conducting a critical appraisal of existing evidence to determine the risk factors of C5P.
METHODS
A systematic search of PubMed/MEDLINE (January 1, 2019, to July 2, 2021), EMBASE (inception to July 2, 2021), and Cochrane (inception to July 2, 2021) databases was conducted. Preestablished criteria were used to evaluate studies for inclusion. Studies that adjusted for one or more of the following factors were considered: preoperative foraminal diameter (FD) at C4/5, posterior spinal cord shift at C4/5, preoperative anterior-posterior diameter (APD) at C4/5, preoperative spinal cord rotation, and change in C2-7 Cobb angle. Studies were rated as good, fair, or poor based on the Quality in Prognosis Studies (QUIPS) tool. Random effects meta-analyses were done using methods outlined by Cochrane methodologists for pooling of prognostic studies. Overall quality (strength) of evidence was based on Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methods for prognostic studies. The protocol for this review was published on the PROSPERO (CRD264358) website.
RESULTS
Of 303 potentially relevant citations of studies, 12 met the inclusion criteria set a priori. These works provide moderate-quality evidence that preoperative FD substantially increases the odds of C5P in patients undergoing posterior cervical surgery. Pooled estimates across 7 studies in which various surgical approaches were used indicate that the odds of C5P approximately triple for each millimeter decrease in preoperative FD (OR 3.05, 95% CI 2.07-4.49). Preoperative APD increases the odds of C5P, but the confidence is low. Across 3 studies, each using different surgical approaches, each millimeter decrease in preoperative APD was associated with a more than 2-fold increased odds of C5P (pooled OR 2.51, 95% CI 1.69-3.73). Confidence that there is an association with postoperative C5P and posterior spinal cord shift, change in sagittal Cobb angle, and preoperative spinal cord rotation is very low.
CONCLUSIONS
The exact pathophysiological process resulting in postoperative C5P remains an enigma but there is a clear association with foraminal stenosis, especially when performing posterior procedures. C5P is also related to decreased APD but the association is less clear. The overall quality (strength) of evidence provided by the current literature is low to very low for most factors. Systematic review registration no.: CRD264358 (https://www.crd.york.ac.uk/prospero/).
Topics: Humans; Paralysis; Spinal Cord; Risk Factors; Prognosis; Cervical Vertebrae; Multivariate Analysis; Decompression, Surgical
PubMed: 37976498
DOI: 10.3171/2023.9.SPINE221352