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La Radiologia Medica Jul 2024Microwave ablation (MWA) and conventional transarterial chemoembolization (cTACE) are locoregional treatments commonly performed in very early, early and intermediate...
PURPOSE
Microwave ablation (MWA) and conventional transarterial chemoembolization (cTACE) are locoregional treatments commonly performed in very early, early and intermediate stages of hepatocellular carcinoma (HCC). Despite combined locoregional approaches have shown encouraging results in obtaining complete tumor necrosis, their application in a single session is poorly described. Our aim was to evaluate the safety and efficacy of single-session MWA and cTACE treatment in 5-cm HCCs and its influence on liver function.
MATERIALS AND METHODS
All 5-cm HCCs treated by MWA and cTACE performed in a single-session in our Interventional Radiology unit between January 2020 and December 2022 were retrospectively recorded and analyzed. Patients with poor or missing pre- and post-treatment imaging were excluded. Technical success, clinical success, and complications rate were examined as primary endpoints. Pre- and post-treatment liver function laboratory parameters were also evaluated.
RESULTS
A total of 15 lesions (mean lesion diameter, 5.0 ± 1.4 cm) in 15 patients (11 men; mean age, 67.1 ± 8.9 years) were retrospectively evaluated. Technical and clinical success were 100% and 73%, respectively. Four (27%) cases of partial response and no cases of progressive or stable disease were recorded. AST and ALT values have found to be significantly higher in post-treatment laboratory tests. No other significant differences between pre- and post-treatment laboratory values were registered. AST and ALT pre- and post-treatment higher differences (ΔAST and ΔALT) were significantly associated with a lower clinical success rate.
CONCLUSION
MWA and cTACE single-session approach is safe and effective for 5-cm HCCs, without significant liver function impairment. A post-treatment increase in AST and ALT values may be a predictor for clinical failure.
PubMed: 38958915
DOI: 10.1007/s11547-024-01842-7 -
Odontology Jul 2024Hyaluronic acid (HA), known for diverse properties, was investigated for its potential in dental pulp therapy. This study investigated the potential of HA in dental pulp...
Hyaluronic acid (HA), known for diverse properties, was investigated for its potential in dental pulp therapy. This study investigated the potential of HA in dental pulp therapy by examining the physical properties and effects of zinc oxide eugenol (ZOE) pulpotomy materials containing varying HA concentrations on rat molar teeth. In vitro tests assessed compressive strength and hardness of ZOE materials blended with HA (0.5%, 1%, 3%) and HA gels (0.54%, 0.8%). 120 samples, encompassing the control group, underwent compressive strength testing, while 60 samples were designated for hardness assessment. In vivo experiments on rat molars studied histological effects of HA-containing ZOE on dental pulp over 1 week and 1 month. Gels with HA concentrations of 0.5%, 1%, and 0.54% were used in pulpotomy on 22 rats. Each rat underwent the procedure on four teeth, with one tooth serving as a control, totaling 88 teeth subjected to the intervention. In the analyses, SPSS 22.0 was used and the significance level was set at P = 0.05. Findings showed that HA at 0.5% maintained compressive strength, but higher concentrations decreased mechanical properties significantly (P = 0.001). Histological assessments indicated better outcomes with lower HA concentrations in terms of odontoblast layer continuity (P = 0.005 at 1 month) and pulp vitality (P = 0.001 at 1 week and P = 0.018 at 1 month). The study suggests HA holds promise for pulpotomy and regenerative endodontic treatments, but further research is needed to understand long-term clinical implications.
PubMed: 38958828
DOI: 10.1007/s10266-024-00973-7 -
Dental and Medical Problems 2024There are several publications that show the efficacy of surgical interventions in accelerating the rate of tooth movement in orthodontics. Consequently, possible... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There are several publications that show the efficacy of surgical interventions in accelerating the rate of tooth movement in orthodontics. Consequently, possible adverse effects must also be evaluated.
OBJECTIVES
The aim of the present study was to compare the perception of pain and root resorption between orthodontic treatment with a surgical acceleration intervention vs. conventional orthodontic treatment.
MATERIAL AND METHODS
An electronic search was conducted in the MEDLINE, Scopus, Web of Science (WoS), ScienceDirect, Cochrane Library, and Virtual Health Library (VHL) databases up to September 12, 2022. Randomized or non-randomized, controlled, parallel-arm or split-mouth clinical trials were included. Fixed-and random-effects meta-analyses were performed with regard to heterogeneity. The risk of bias (RoB) was assessed using the RoB 2.0 and ROBINS-I tools.
RESULTS
A total of 1,395 articles were initially retrieved, 40 studies were finally included in the review and 15 studies were eligible for quantitative analysis. The meta-analysis showed a significant difference in pain perception between acceleration surgery vs. conventional orthodontics at 24 h (p = 0.040); however, this difference was not significant at 7 days (p = 0.080). Overall, the patients who underwent any acceleration procedure presented significantly less resorption as compared to those who were applied conventional treatment (p < 0.001). A similar significant difference was found in retraction movements (p < 0.001) and alignment movements (p = 0.030).
CONCLUSIONS
In the first 24 h, surgical interventions for the acceleration of tooth movement produce a greater perception of pain as compared to conventional orthodontic treatment, but the perception is similar after 7 days. Acceleration surgery results in less root resorption - in alignment movements, and especially in retraction movements.
Topics: Humans; Tooth Movement Techniques; Root Resorption; Orthodontics
PubMed: 38958635
DOI: 10.17219/dmp/161553 -
ACS Applied Bio Materials Jul 2024Polysaccharides (PSAs) are carbohydrate-based macromolecules widely used in the biomedical field, either in their pure form or in blends/nanocomposites with other... (Review)
Review
Polysaccharides (PSAs) are carbohydrate-based macromolecules widely used in the biomedical field, either in their pure form or in blends/nanocomposites with other materials. The relationship between structure, properties, and functions has inspired scientists to design multifunctional PSAs for various biomedical applications by incorporating unique molecular structures and targeted bulk properties. Multiple strategies, such as conjugation, grafting, cross-linking, and functionalization, have been explored to control their mechanical properties, electrical conductivity, hydrophilicity, degradability, rheological features, and stimuli-responsiveness. For instance, custom-made PSAs are known for their worldwide biomedical applications in tissue engineering, drug/gene delivery, and regenerative medicine. Furthermore, the remarkable advancements in supramolecular engineering and chemistry have paved the way for mission-oriented biomaterial synthesis and the fabrication of customized biomaterials. These materials can synergistically combine the benefits of biology and chemistry to tackle important biomedical questions. Herein, we categorize and summarize PSAs based on their synthesis methods, and explore the main strategies used to customize their chemical structures. We then highlight various properties of PSAs using practical examples. Lastly, we thoroughly describe the biomedical applications of tailor-made PSAs, along with their current existing challenges and potential future directions.
PubMed: 38958361
DOI: 10.1021/acsabm.3c01199 -
Dental and Medical Problems 2024Dentists, through inappropriate antibiotic prescription, may contribute to the global problem of antibiotic resistance (AR).
BACKGROUND
Dentists, through inappropriate antibiotic prescription, may contribute to the global problem of antibiotic resistance (AR).
OBJECTIVES
Understanding dentists' antibiotic prescription patterns, source of knowledge, and the driving forces behind their prescription practices may be crucial for the effective implementation of the rational use of antibiotics (RUA) in dentistry.
MATERIAL AND METHODS
Active members of the Turkish Dental Association were invited to participate in an electronic survey comprising questions focusing on their role, knowledge and perceptions regarding RUA, the perceived barriers to adapting RUA in daily dental work, and the actual antibiotic prescription practices. The potential impact of age, gender, professional experience, and the mode of dental practice was also evaluated. Dentists' prescription practices for periodontal disease/conditions were evaluated as well.
RESULTS
Based on 1,005 valid responses, there was consensus on the necessity of RUA (99.1%); however, its implementation was low. The main barriers were dentists' own safety concerns (74.4%), strong patients' demands (42.2%) and the fact that prescribing antibiotics became a professional habit (35.8%). Different educational background resulted in clear variances in everyday prescription practices.
CONCLUSIONS
The implementation of RUA was not sufficient and the perceived barriers had an impact on daily prescribing habits. Support for dental professionals through the efficient dissemination of evidencebased clinical guidelines and decision-making aids is likely to require additional help from professional organizations in order to actively combat AR.
Topics: Humans; Anti-Bacterial Agents; Practice Patterns, Dentists'; Surveys and Questionnaires; Male; Female; Adult; Middle Aged; Turkey; Health Knowledge, Attitudes, Practice; Attitude of Health Personnel; Inappropriate Prescribing
PubMed: 38958119
DOI: 10.17219/dmp/159490 -
Journal of the Indian Society of... Apr 2024Many practitioners have questioned whether the construction method of pediatric zirconia crowns impacts the periodontal health and clinical performance of severely... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
Many practitioners have questioned whether the construction method of pediatric zirconia crowns impacts the periodontal health and clinical performance of severely decayed primary molars. The objective of this study was to compare the periodontal health and clinical performance of primary molars restored with custom-made zirconia crowns (CZCs) and prefabricated zirconia crowns.
METHODS
Twenty primary molars indicated for crown restorations were selected from ten patients (5-9 years old) randomly. Each patient received two pediatric zirconia crowns constructed by two different methods: one custom-made and one prefabricated. The primary molars were divided into two groups: Group 1: primary molars received CZCs and Group 2: primary molars received prefabricated zirconia crowns (PZCs).
RESULTS
After a 12-month follow-up, there was no statistically significant difference between the periodontal health of primary molars restored with custom-made and prefabricated zirconia crowns. The clinical performance of primary molars restored with CZCs was statistically significantly higher than those restored with PZCs in terms of retention and fracture resistance (P ≤ 0.05).
CONCLUSIONS
The construction method of pediatric zirconia crowns does not significantly affect the periodontal health of primary molars; however, clinical performance is significantly affected in terms of retention and fracture resistance.
CLINICAL SIGNIFICANCE
A CZC is an excellent alternative option, especially for primary molars whose permanent successors still have a long time to erupt. The PZC is a quick and easy restoration, but the technique is sensitive.
Topics: Humans; Zirconium; Crowns; Molar; Tooth, Deciduous; Follow-Up Studies; Child, Preschool; Child; Dental Prosthesis Design; Male; Female; Dental Caries
PubMed: 38957914
DOI: 10.4103/jisppd.jisppd_39_24 -
Journal of the Indian Society of... Apr 2024Dental caries results from an ecologic shift within the dental biofilm from a balanced population of microorganisms to an acidogenic, aciduric, and cariogenic... (Comparative Study)
Comparative Study Randomized Controlled Trial
INTRODUCTION
Dental caries results from an ecologic shift within the dental biofilm from a balanced population of microorganisms to an acidogenic, aciduric, and cariogenic microbiological population developed and maintained by frequent consumption of fermentable dietary carbohydrates. Total caries removal (TCR) of deep lesion may result in pulpal exposure requiring more invasive treatment. Hence, current pediatric dentistry has shifted to minimally invasive treatment that avoids more complex, time-consuming procedure, and the child's discomfort.
AIM
The aim of this study is to evaluate and compare clinical performance and radiographic changes after complete and incomplete caries removal procedures.
MATERIALS AND METHODS
The study was conducted on 60 primary molars in children aged 6-9 years. Selected 60 primary molars were randomly divided into two groups. Group 1 (PCR): infected dentin was removed, while the affected dentin was maintained on the pulpal wall. Group 2 (TCR): both infected and affected dentin were removed through low-speed carbide bur and hand excavator. Teeth were evaluated at 4 and 6 months clinically and radiographically.
RESULTS
The proportion was compared using Fisher's exact test. The Statistical Package for the Social Sciences version 21 was used for analysis. The level of significance was kept at 5%.
CONCLUSION
The clinical and radiographic success rates of ICR and CCR in primary teeth with deep carious lesions were high and did not differ significantly, indicating that the retention of carious dentin does not interfere with pulp vitality. Thus, ICR is a reliable minimally invasive approach that might replace the CCR in primary teeth when correctly indicated.
Topics: Humans; Tooth, Deciduous; Dental Caries; Child; Molar; Dental Pulp; Male; Female; Dental Cavity Preparation; Dentin
PubMed: 38957913
DOI: 10.4103/jisppd.jisppd_116_24 -
Journal of the Indian Society of... Apr 2024Pharmacological methods, specifically sedatives, have gained popularity in managing the behavior of children during dental appointments. (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
Comparative evaluation of intranasal dexmedetomidine, intranasal midazolam, and nitrous oxide for conscious sedation of anxious children undergoing dental treatment: A randomized cross-over trial.
BACKGROUND
Pharmacological methods, specifically sedatives, have gained popularity in managing the behavior of children during dental appointments.
AIM
The aim of this study was to compare 1 m/kg intranasal dexmedetomidine, 0.3 mg/kg intranasal midazolam, and nitrous oxide in evaluating the level of sedation, behavior of the child, onset of sedation, physiologic signs, and adverse effects.
MATERIALS AND METHODS
In this cross-over trial, 15 children aged 6-8 years were randomized to receive intranasal atomized dexmedetomidine, intranasal atomized midazolam, and inhalation nitrous oxide at three separate visits. After administering the sedative agent, a single pulpectomy was performed during each appointment, and the outcomes were recorded. The washout period between each visit was 1 week.
RESULTS
All three sedative agents were equally effective in controlling overall behavior. Dexmedetomidine showed lower sedation level scores (agitated; score 9) than the other groups. There was a statistically significant difference in the onset of sedation, with dexmedetomidine having the longest onset of 36.2 ± 9.47 min. Coughing and sneezing were predominantly observed after administration of intranasal midazolam. Oxygen saturation levels were statistically lower in the intranasal midazolam group during local anesthesia administration and post-treatment.
CONCLUSION
0.3 mg/kg intranasal midazolam is as effective as nitrous oxide sedation for controlling behavior and providing adequate sedation in pediatric dental patients. However, 1 m/kg dexmedetomidine did not provide the same level of sedation and had a significantly longer onset. 0.3 mg/kg intranasal midazolam is an effective alternative to nitrous oxide sedation in anxious children.
Topics: Humans; Nitrous Oxide; Midazolam; Child; Administration, Intranasal; Cross-Over Studies; Hypnotics and Sedatives; Dexmedetomidine; Conscious Sedation; Male; Female; Dental Anxiety; Anesthesia, Dental; Anesthetics, Inhalation; Dental Care for Children; Child Behavior; Pulpectomy
PubMed: 38957912
DOI: 10.4103/jisppd.jisppd_104_24 -
Journal of the Indian Society of... Apr 2024Dental caries is a multifactorial disease that manifests itself in primary and permanent dentitions. Pit and fissure sealants have become the most effective noninvasive... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Dental caries is a multifactorial disease that manifests itself in primary and permanent dentitions. Pit and fissure sealants have become the most effective noninvasive treatment for addressing teeth with deep pits and fissures in children. The purpose of the present study was to evaluate the behavior of the child when administering the pit and fissure sealant using the rubber dam and MiniDam.
METHODOLOGY
Fifty-two children in the age range of 9-12 years were randomly allocated into two groups: Group I, rubber dam and Group II, MiniDam. The children were randomly assigned into two groups with 26 members in Group 1 (rubber dam isolation) and 26 members in Group 2 (MiniDam isolation). Children's anxiety was assessed using the modified Venham scale and heart rate. The children's pain intensity was assessed using Memojis Pain Scale. The data collected were tabulated and statistically analyzed using SPSS software. The level of significance was established at 0.05.
RESULTS
Intergroup comparison of heart rates showed a statistically significant difference for both the groups at various intervals (P value 0.05), that is, before placing the dam, with the dam, and during treatment. Pain and anxiety scores showed a statistically significant difference in both the groups before and after the procedure (P < 0.05).
CONCLUSIONS
The use of MiniDam can offer a better option for the pit/fissure sealant procedure due to its unique qualities, including simplicity of placement, improved behavior management, and less chair time in children.
Topics: Humans; Pit and Fissure Sealants; Child; Rubber Dams; Dental Anxiety; Male; Female; Child Behavior; Pain Measurement; Heart Rate; Dental Caries
PubMed: 38957909
DOI: 10.4103/jisppd.jisppd_127_24 -
Journal of the Indian Society of... Apr 2024The escalating concern over Internet gaming disorder (IGD) among children underscores the urgency of comprehending its determinants and links to mental health,...
BACKGROUND
The escalating concern over Internet gaming disorder (IGD) among children underscores the urgency of comprehending its determinants and links to mental health, particularly for interventions targeting school-aged children.
AIM
This study aimed to evaluate the prevalence and determinants of IGD and its association with depression, anxiety, and behavior among 8-12-year-old children attending private schools in Salem city.
SETTINGS AND DESIGN
A cross-sectional study involving 780 children aged 8-12 years from Salem district was conducted. Schools were randomly sampled, and data were collected through a self-administered questionnaire.
MATERIALS AND METHODS
Data were gathered from children without genetic, systemic, or mental disorders and brain trauma. The questionnaire, adapted from Alhamoud M A et al. (2022), encompassed sections on sociodemographic characteristics, gaming behavior, and scales for assessing IGD, depression, and anxiety. Administration occurred during school hours with a 30-35 min completion time.
STATISTICAL ANALYSIS USED
Data analysis utilized SPSS v23.0, including descriptive statistics, ANOVA, Chi-square tests for intergroup comparisons, and Pearson's correlation coefficient to determine associations.
RESULTS
The prevalence of IGD in Salem district was 1.2%, with higher rates of anxiety and depression observed among older children, particularly males.
CONCLUSIONS
A positive correlation was evident between IGD, anxiety, and depression. Urgent preventive measures have to be warranted to curb the rising trend of IGD, such as limiting screen time and promoting outdoor activities to enhance children's overall health.
Topics: Humans; Child; India; Male; Cross-Sectional Studies; Prevalence; Female; Depression; Internet Addiction Disorder; Anxiety; Surveys and Questionnaires; Schools; Video Games; Behavior, Addictive
PubMed: 38957906
DOI: 10.4103/jisppd.jisppd_27_24