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BMC Oral Health Jun 2024In dentistry, glass-ionomer cements (GICs) are extensively used for a range of applications. The unique properties of GIC include fluoride ion release and recharge,...
BACKGROUND
In dentistry, glass-ionomer cements (GICs) are extensively used for a range of applications. The unique properties of GIC include fluoride ion release and recharge, chemical bonding to the tooth's hard tissues, biocompatibility, a thermal expansion coefficient like that of enamel and dentin, and acceptable aesthetics. Their high solubility and poor mechanical qualities are among their limitations. E-glass fibers are generally utilized to reinforce the polymer matrix and are identified by their higher silica content.
OBJECTIVES
The purpose of the study was to assess the impact of adding (10 wt% and 20 wt%) silane-treated E-glass fibers to traditional GIC on its mechanical properties (compressive strength, flexural strength, and surface hardness) and solubility.
METHODS
The characterization of the E-glass fiber fillers was achieved by XRF, SEM, and PSD. The specimens were prepared by adding the E-glass fiber fillers to the traditional GIC at 10% and 20% by weight, forming two innovative groups, and compared with the unmodified GIC (control group). The physical properties (film thickness and initial setting time) were examined to confirm operability after mixing. The evaluation of the reinforced GIC was performed by assessing the compressive strength, flexural strength, hardness, and solubility (n = 10 specimens per test). A one-way ANOVA and Tukey tests were performed for statistical analysis (p ≤ 0.05).
RESULTS
The traditional GIC showed the least compressive strength, flexural strength, hardness, and highest solubility. While the GIC reinforced with 20 wt% E-glass fibers showed the highest compressive strength, flexural strength, hardness, and least solubility. Meanwhile, GIC reinforced with 10 wt% showed intermediate results (P ≤ 0.05).
CONCLUSION
Using 20 wt% E-glass fiber as a filler with the traditional GIC provides a strengthening effect and reduced solubility.
Topics: Glass Ionomer Cements; Solubility; Flexural Strength; Compressive Strength; Hardness; Materials Testing; Glass; Surface Properties; Silanes; Microscopy, Electron, Scanning; Dental Stress Analysis; Pliability; Humans
PubMed: 38937723
DOI: 10.1186/s12903-024-04447-8 -
Burns : Journal of the International... Jun 2024A pressure of approximately 15-25 mmHg is used for effective compression therapy to prevent and treat hypertrophic scar formation in patients with burns. However,...
PURPOSE
A pressure of approximately 15-25 mmHg is used for effective compression therapy to prevent and treat hypertrophic scar formation in patients with burns. However, conventional facial compression garments present challenges owing to inadequate pressure distribution in curved areas such as the cheeks, around the mouth, and the slope of the nose. This study aimed to evaluate the utility of a custom-made 3D compression mask equipped with pressure sensors to treat facial burn scars.
METHODS
This single-blinded, prospective randomized controlled trial was conducted between May and October 2023, involving 48 burn scars in 12 inpatients with facial burns. We created the custom-made 3D compression mask equipped with pressure sensors, inner lined with biocompatible silicon, and a harness system using 3D printing technology, which can continuously monitor whether an appropriate pressure of 15-25 mmHg maintains. The biological scar properties, Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment Scale (POSAS) scores in patients with facial burns were assessed before applying the compression mask and garment and at 4 and 12 weeks after application.
RESULTS
Pre-application assessment of biological scar properties, VSS, and POSAS revealed no statistically significant differences between the 3D mask and control groups (p > 0.05 for all). Throughout the 12-week application, skin hydration and scar thickness significantly increased (p < 0.001) and reduced (p = 0.010), respectively, in the 3D mask group compared to the control group. Additionally, significant improvements in scar pliability (p = 0.004) and height (p = 0.009) of VSS, itching (p = 0.047), scar stiffness (p = 0.001), thickness (p = 0.011), and irregularity (p < 0.001) of POSAS-patient component, and scar thickness (p = 0.001), pliability (p = 0.012), and surface area (p = 0.027) of the POSAS-observer component were observed in 3D mask group throughout the 12-week application compared to the control group.
CONCLUSION
The customized 3D compression mask equipped with pressure sensors significantly improved scar thickness, skin hydration, and various assessment scale parameters throughout the 12-week application.
PubMed: 38937166
DOI: 10.1016/j.burns.2024.05.021 -
Urology Jun 2024To improve our previous simulation-based training module by using sustainable material to mold an anatomically accurate terrain and reproducing major vascular injuries...
Implementation and Validation of a High-Fidelity Simulation Model for Surgical Resident Training: Management of Acute Intraoperative Hemorrhage during Robot-assisted Surgery.
OBJECTIVES
To improve our previous simulation-based training module by using sustainable material to mold an anatomically accurate terrain and reproducing major vascular injuries encountered during robot-assisted nephrectomy.
METHODS
The simulator was built with a pump, gauge, and valve linked via silicone tubing. Artificial blood was made from cornstarch, water, and red dye, and pumped through 3D-Med artificial vessels with the dimensions of an average renal artery. Silicone was used to emulate the pliability of organic tissue and mold an anatomically accurate terrain. Eight urologic residents participated in the pilot simulation. We employed validated assessment tools including Non-Technical Skills for Surgeons and Objective Structured Assessment of Technical Skills forms to guide debrief sessions moderated by an expert physician after individual performance evaluations.
RESULTS
The apparatus demonstrated high reproducibility across all simulation scenarios, enhancing resident problem-solving skills. Residents' pre-simulation surveys revealed significant concern regarding their acute hemorrhage management. Residents' post-simulation survey demonstrated average realism scores increased from 4.375 to 4.75. Residents also felt the simulator enhanced learning, offering valuable practice and knowledge applicable to their surgical specialty.
CONCLUSIONS
The management of acute hemorrhage during robot-assisted surgery remains a space for additional surgical education and training. Our simulation successfully provided a reliable, reproducible training for residents to practice their technical and non-technical skills in managing acute hemorrhage.
PubMed: 38936623
DOI: 10.1016/j.urology.2024.06.055 -
Sensors (Basel, Switzerland) Jun 2024Smart wearable devices are extensively utilized across diverse domains due to their inherent advantages of flexibility, portability, and real-time monitoring. Among...
Smart wearable devices are extensively utilized across diverse domains due to their inherent advantages of flexibility, portability, and real-time monitoring. Among these, flexible sensors demonstrate exceptional pliability and malleability, making them a prominent focus in wearable electronics research. However, the implementation of flexible wearable sensors often entails intricate and time-consuming processes, leading to high costs, which hinder the advancement of the entire field. Here, we report a pressure and proximity sensor based on oxidized laser-induced graphene (oxidized LIG) as a dielectric layer sandwiched by patterned LIG electrodes, which is characterized by high speed and cost-effectiveness. It is found that in the low-frequency range of fewer than 0.1 kHz, the relative dielectric constant of the oxidized LIG layer reaches an order of magnitude of 104. The pressure mode of this bimodal capacitive sensor is capable of detecting pressures within the range of 1.34 Pa to 800 Pa, with a response time of several hundred milliseconds. The proximity mode involves the application of stimulation using an acrylic probe, which demonstrates a detection range from 0.05 mm to 37.8 mm. Additionally, it has a rapid response time of approximately 100 ms, ensuring consistent signal variations throughout both the approach and withdrawal phases. The sensor fabrication method proposed in this project effectively minimizes expenses and accelerates the preparation cycle through precise control of laser processing parameters to shape the electrode-dielectric layer-electrode within a single substrate material. Based on their exceptional combined performance, our pressure and proximity sensors exhibit significant potential in practical applications such as motion monitoring and distance detection.
PubMed: 38931691
DOI: 10.3390/s24123907 -
BMC Oral Health Jun 2024Low mechanical properties are the main limitation of glass ionomer cements (GICs). The incorporation of elastomeric micelles is expected to enhance the strength of GICs... (Comparative Study)
Comparative Study
BACKGROUND
Low mechanical properties are the main limitation of glass ionomer cements (GICs). The incorporation of elastomeric micelles is expected to enhance the strength of GICs without detrimentally affecting their physical properties and biocompatibility. This study compared the chemical and mechanical properties, as well as the cytotoxicity, of elastomeric micelles-containing glass ionomer cement (DeltaFil, DT) with commonly used materials, including EQUIA Forte Fil (EF), Fuji IX GP Extra (F9), and Ketac Molar (KT).
METHOD
Powder particles of GICs were examined with SEM-EDX. Setting kinetics were assessed using ATR-FTIR. Biaxial flexural strength/modulus and Vickers surface microhardness were measured after immersion in water for 24 h and 4 weeks. The release of F, Al, Sr, and P in water over 8 weeks was analyzed using a fluoride-specific electrode and ICP-OES. The toxicity of the material extract on mouse fibroblasts was also evaluated.
RESULTS
High fluoride levels in the powder were detected with EF and F9. DT demonstrated an initial delay followed by a faster acid reaction compared to other cements, suggesting an improved snap set. DT also exhibited superior flexural strength than other materials at both 24 h and 4 weeks but lower surface microhardness (p < 0.05). EF and F9 showed higher release of F, Al, and P than DT and KT. There was no statistically significant difference in fibroblast viability among the tested materials (p > 0.05).
CONCLUSIONS
Elastomeric micelles-containing glass ionomer cement (DT) exhibited satisfactory mechanical properties and cytocompatibility compared with other materials. DT could, therefore, potentially be considered an alternative high-strength GIC for load-bearing restorations.
Topics: Glass Ionomer Cements; Animals; Mice; Materials Testing; Micelles; Fibroblasts; Hardness; Elastomers; Flexural Strength; Aluminum; Fluorides; Strontium; Polycarboxylate Cement; Cell Survival; Microscopy, Electron, Scanning; Surface Properties; Pliability; Kinetics; Spectroscopy, Fourier Transform Infrared; Stress, Mechanical; Time Factors; Biocompatible Materials
PubMed: 38902666
DOI: 10.1186/s12903-024-04468-3 -
The Pan African Medical Journal 2024anorectal malformations (ARM) are among the most common congenital anomalies in pediatric surgery. Early detection and management of vestibular fistulas are crucial for...
INTRODUCTION
anorectal malformations (ARM) are among the most common congenital anomalies in pediatric surgery. Early detection and management of vestibular fistulas are crucial for optimal outcomes, capitalizing on the pliability of sphincter muscles and the preservation of somatosensory integration. This study aimed to assess the incidence, clinical presentation, and management outcomes of vestibular fistula ARM in a low-income hospital setting.
METHODS
a retrospective audit was conducted on female pediatric patients aged up to 12 years treated for vestibular fistula ARM from January 1, 2011, to June 30, 2016. Data were collected from medical records, and patients were categorized into one of three surgical management groups. Clinical assessments, preoperative procedures, and surgical interventions were meticulously documented.
RESULTS
among 656 neonates, the incidence of vestibular fistula ARM was 8.2%. Patients presented at various ages, with 69.4% being early presenters. Notably, 11.1% of cases presented after 30 weeks of age. Functional fistula, constipation, and bowel obstruction were common presenting symptoms. Associated anomalies were relatively low. The choice of surgical approach varied, with a predominant 3-stage at 68%. Complication development did not significantly differ between surgical groups (p-value 0.083). Immediate postoperative complications were minimal, but complications at definitive anoplasty varied among the surgical groups. Anal strictures and fistula recurrence were noted. At 12 months post-surgery, anal strictures persisted in 9 participants.
CONCLUSION
this study highlights the challenges and outcomes associated with vestibular fistula ARM in a resource-constrained setting. The 3-stage approach, despite its historical preference, demonstrated suboptimal outcomes. A 2-stage procedure appears to offer a balanced alternative, particularly suitable for low-income healthcare systems. Further research and collaborative efforts are essential to refine the management of vestibular fistula ARM and improve patient outcomes.
Topics: Humans; Female; Retrospective Studies; Anorectal Malformations; Child; Infant; Child, Preschool; Infant, Newborn; Postoperative Complications; Incidence; Treatment Outcome; Poverty; Developing Countries; Recurrence; Rectal Fistula
PubMed: 38854868
DOI: 10.11604/pamj.2024.47.121.42919 -
Plastic and Reconstructive Surgery.... May 2024This study aimed to demonstrate the clinical application of the dorsoproximal interphalangeal island flap as an alternative approach to skin graft or cross-finger flap...
BACKGROUND
This study aimed to demonstrate the clinical application of the dorsoproximal interphalangeal island flap as an alternative approach to skin graft or cross-finger flap to repair lesions at the ventral site at the proximal interphalangeal (PIP) finger joint.
METHODS
Fifteen patients received flaps (11 men and four women, n = 25 flaps). The repair of volar contracture in finger sequelae after burn injuries was the main indication. Five patients underwent two or more flaps during the same surgical session. The mean patient age was 18 years (range, 7-56 years). Most patients presented with palmar finger contractures of the PIP joint. In three patients, six flaps were rotated to the lateral radial and ulnar proximal surfaces of the finger to treat syndactyly.
RESULTS
Most flaps survived and provided satisfactory functional and aesthetic improvement of palmar scar contracture in the PIP region. Postoperative donor site follow-up was normal. The color and pliability of the skin are similar to those of the surrounding area. The follow-up period ranged from 6 months to 12 years.
CONCLUSIONS
Dorsoproximal interphalangeal island flaps are an option for repairing lesions that lack soft tissue and range in size from 10 × 15 to 12 × 18 mm at the volar site and around the PIP joint. The arch of rotation of this flap allows for lateral, ulnar, and radial rotations around the joint. The indication of six flaps in three patients to repair a proximal lack of tissue caused by syndactyly demonstrated its potential use in this anomaly.
PubMed: 38798926
DOI: 10.1097/GOX.0000000000005805 -
Microsurgery Jul 2024The pure skin perforator (PSP) flap is gaining popularity for its remarkable thinness. The subdermal dissection technique was recently introduced, allowing for a quicker...
BACKGROUND
The pure skin perforator (PSP) flap is gaining popularity for its remarkable thinness. The subdermal dissection technique was recently introduced, allowing for a quicker elevation of a PSP flap. In this report, we present our two-year experience utilizing subdermal dissection for harvesting PSP flaps.
METHODS
All patients who had undergone PSP flap reconstruction at our hospital from February 2021 to February 2023 were included. Demographic data, intraoperative variables, flap characteristics, and postoperative outcomes were collected. Surgical planning involved locating the perforator using ultrasound and harvesting the flap using the subdermal dissection technique.
RESULTS
A total of 26 PSP flap reconstructions were conducted on 24 patients aged between 15 and 86 years. The flaps were based on perforators issuing from the superficial circumflex iliac artery in 24 cases, and from the descending branch of the lateral circumflex femoral artery in 2 cases. Flap sizes ranged from 3 × 1.5 cm to 19 × 6 cm, with a mean thickness of 3.48 mm. The average time for flap harvest was 131.92 min. Postoperatively, we observed four cases of partial necrosis, 1 total flap loss, and 2 instances of vascular thrombosis at the anastomosis site. The flaps exhibited good pliability without contracture, and no debulking procedures were required during the follow-up period (minimum 6 months, range 6-24; mean 9.4615).
CONCLUSION
The subdermal dissection technique is a safe and efficient approach for elevating PSP flaps. Our initial experience with this technique has been encouraging, and it currently serves as our preferred reconstructive option for defects requiring thin reconstruction.
Topics: Humans; Perforator Flap; Adult; Middle Aged; Male; Female; Aged; Adolescent; Plastic Surgery Procedures; Aged, 80 and over; Young Adult; Burns; Retrospective Studies; Dissection; Treatment Outcome; Skin Transplantation
PubMed: 38798132
DOI: 10.1002/micr.31189 -
International Wound Journal May 2024Preservation and restoration of hand function after burn injuries are challenging yet imperative. This study aimed to assess the curative effect of a composite skin... (Comparative Study)
Comparative Study
Preservation and restoration of hand function after burn injuries are challenging yet imperative. This study aimed to assess the curative effect of a composite skin graft over an acellular dermal matrix (ADM) and a thick split-thickness skin graft (STSG) for treating deep burns on the hand. Patients who met the inclusion criteria at the First Affiliated Hospital of Wenzhou Medical University between September 2011 and January 2020 were retrospectively identified from the operative register. We investigated patient characteristics, time from operation to the start of active motion exercise, take rates of skin graft 7 days post-surgery, donor site recovery, complications and days to complete healing. Patients were followed up for 12 months to evaluate scar quality using the Vancouver Scar Scale (VSS) and hand function through total active motion (TAM) and the Jebsen-Taylor Hand Function Test (JTHFT). A total of 38 patients (52 hands) who received thin STSG on top of the ADM or thick STSG were included. The location of the donor sites was significantly different between Group A (thick STSG) and Group B (thin STSG + ADM) (p = 0.03). There were no statistical differences in age, gender, underlying disease, cause of burn, burn area, dominant hand, patients with two hands operated on and time from burn to surgery between the two groups (p > 0.05). The time from operation to the start of active motion exercise, take rates of skin graft 7 days post-surgery and days to complete healing were not significantly different between Group A and Group B (p > 0.05). The rate of donor sites requiring skin grafting was lower in Group B than in Group A (22.2% vs. 100%, p < 0.001). There were no statistically significant differences in complications between the groups (p = 0.12). Moreover, 12 months postoperatively, the pliability subscore in the VSS was significantly lower in Group A than in Group B (p = 0.01). However, there were no statistically significant differences in vascularity (p = 0.42), pigmentation (p = 0.31) and height subscores (p = 0.13). The TAM and JTHFT results revealed no statistically significant differences between the two groups (p = 0.22 and 0.06, respectively). The ADM combined with thin STSG is a valuable approach for treating deep and extensive hand burns with low donor site morbidity. It has a good appearance and function in patients with hand burns, especially in patients with limited donor sites.
Topics: Humans; Burns; Male; Female; Skin Transplantation; Adult; Retrospective Studies; Middle Aged; Acellular Dermis; Hand Injuries; Young Adult; Wound Healing; Cicatrix; Treatment Outcome
PubMed: 38783559
DOI: 10.1111/iwj.14934 -
Aesthetic Plastic Surgery May 2024Laser therapy has emerged as a promising treatment modality for improving the appearance and symptoms associated with hypertrophic and keloid scars. In this network... (Review)
Review
BACKGROUND
Laser therapy has emerged as a promising treatment modality for improving the appearance and symptoms associated with hypertrophic and keloid scars. In this network meta-analysis, we aimed to evaluate the efficacy of different laser types in treating hypertrophic and keloid scars.
METHODS
A comprehensive search of four databases was conducted to identify relevant studies published up until July 2023. Data were extracted from eligible studies and pooled as mean difference (MD) for continuous outcomes and risk ratio (RR) for dichotomous data in a network meta-analysis (NMA) model, using R software.
RESULTS
A total of 18 studies, comprising 550 patients, were included in the analysis. Pooling our data showed that fractional carbon dioxide (FCO2) plus 5-fluorouracil (5-FU) was superior to control in terms of Vancouver Scar Scale (VSS), pliability score, and thickness; [MD = - 5.97; 95% CI (- 7.30; - 4.65)], [MD = - 2.68; 95% CI (- 4.03; - 1.33)], [MD = - 2.22; 95% CI (- 3.13; - 1.31)], respectively. However, insignificant difference was observed among FCO2 plus 5-FU compared to control group in terms of erythema, vascularity, redness and perfusion, and pigmentation [MD = - 0.71; 95% CI (- 2.72; 1.30)], [MD = - 0.44; 95% CI (- 1.26; 0.38)], respectively.
CONCLUSION
Our NMA found that the FCO2 plus 5-FU was the most effective intervention in decreasing the VSS and thickness, while FCO2 plus CO2 was the most effective intervention in decreasing the pliability score. Further research is needed to determine the optimal laser parameters and long-term efficacy of laser therapy in hypertrophic and keloid scars.
LEVEL OF EVIDENCE IV
This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
PubMed: 38760539
DOI: 10.1007/s00266-024-04027-9