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Plastic and Reconstructive Surgery.... Jun 2024The maxilla comprises horizontal and vertical buttresses, each with specific functions, supporting various organs, such as the eyes, nose, and oral cavity. Notably, they...
BACKGROUND
The maxilla comprises horizontal and vertical buttresses, each with specific functions, supporting various organs, such as the eyes, nose, and oral cavity. Notably, they combine to form a three-dimensional structure, which enables the buttresses to provide their inherent support strength. However, reconstructing the maxilla after maxillectomy by assembling new buttresses is challenging. We successfully reconstructed all the buttresses crucial for facial appearance and dental rehabilitation using a vascularized fibular flap.
METHODS
Four patients underwent maxillary buttress reconstruction with a fibular flap after total or subtotal maxillectomy. We used computer-aided design/computer-aided manufacturing digital technology to osteotomize the fibula into multiple segments and assemble them to reconstruct the maxillary buttresses. Each buttress was assembled based on a preoperative simulation.
RESULTS
All patients underwent immediate one-stage maxillary reconstruction. They had good maxillary buttress alignment and acquired good facial appearance, eye position, nasal airway, and prosthetically suitable maxillary alveolus ridge.
CONCLUSIONS
The combination of computer-aided design/computer-aided manufacturing digital technology and surgical techniques has enabled novel maxillary reconstruction, providing great hope to patients experiencing facial disfigurement and loss of function after maxillectomy.
PubMed: 38911572
DOI: 10.1097/GOX.0000000000005914 -
Journal of Maxillofacial and Oral... Jun 2024Blum defined dry socket as the presence of postoperative pain in and around the extraction site that worsens 1-3 days after the extraction.
The Effect of Intra-socket Vitamin E Application on the Reduction in Postoperative Pain and Reduction in Incidence of Dry Socket in Female Patients: A Randomized Controlled Trial.
INTRODUCTION
Blum defined dry socket as the presence of postoperative pain in and around the extraction site that worsens 1-3 days after the extraction.
METHODS
90 female patients seeking extraction of a single tooth in the lower posterior region were divided randomly into 45 patients who received vitamin E inside the socket after extraction (study group) and 45 patients who did not receive vitamin E after extraction (control group).
RESULTS
After 3 days, there was a decrease in pain levels in the study group compared to the control group. Only 7 patients out of 45 (16%) suffered from pain compared to 17 patients out of 45 (38%) in the control group. So, the improvement in pain was statistically significant = 0.02. After 7 days, there was a decrease in wound healing levels in the study group compared to the control group. Only 8 patients out of 45 (17%) had poor wound healing compared to 7 patients out of 45 (16%) in the control group. However, the improvement in wound healing was not statistically significant = 0.8.
CONCLUSION
Based on the current results, we recommend the use of vitamin E as topical intra-socket medication in reducing the early postoperative pain.
PubMed: 38911421
DOI: 10.1007/s12663-023-02076-2 -
Journal of Maxillofacial and Oral... Jun 2024To evaluate the variation in the position of the mandibular foramen and mandibular canal in patients with and without temporomandibular joint ankylosis.
AIM
To evaluate the variation in the position of the mandibular foramen and mandibular canal in patients with and without temporomandibular joint ankylosis.
MATERIALS AND METHODS
100 temporomandibular joints were evaluated of which 50 joints were ankylosed joints (Group A) and the rest 50 were normal joints (Group B) without ankylosis. These groups were further divided into those with growing potential (less than 18 years) and those without growing potential (above 18 years). The position of the mandibular foramen was measured from its center to the glenoid fossa, sigmoid notch, coronoid notch, gonion and posterior border on CBCT scans. The position of the mandibular canal was measured from the outer aspect of the canal to the lower border of the mandible, buccal and lingual cortical plates and the alveolus in the region of the 1st, 2nd and 3rd molars.
RESULTS
The mean distance of the foramen from the base of the skull in Group A was 19.01 mm while the same for Group B was 31.26 mm. The mandibular foramen was found to be closer to the occlusal plane (5.43 mm) in Group A as compared to the mean distance of 6.21 mm reported in Group B. There was no significant difference in the position of the foramen from the posterior border, gonion and sigmoid notch between the groups. The mental foramen was seen more commonly posterior to the 2nd premolar and closer to the first molar region in Group A while in Group B it was seen anterior or near the 2nd premolar. In Group A, the mean distance of the canal to the buccal cortical plate in the 1st and 2nd molar regions was 3.65 mm and 5.76 mm, respectively, while in Group B it was 6.09 mm and 6.59 mm. The canal was further away from the lower border in ankylosis cases (8.79 mm) than the control group (7.41 mm). On comparing the unaffected side in unilateral cases with the normal mandible, the canal and the foramen location were similar to that of a normal mandible with the values in the lower range that is usually seen in normal mandibles.
CONCLUSION
Ankylosis of the mandible is a debilitating condition especially when it develops in an individual prior completion of growth as it can affect the mandibular anatomy. Understanding the variations that accompany a deranged mandible can assist the surgeon in planning of surgical procedures in a manner that limits the possible complications resulting from surgery.
PubMed: 38911403
DOI: 10.1007/s12663-023-02072-6 -
Translational Research : the Journal of... Jun 2024Mammalian lung is the important organ for ventilation and exchange of air and blood. Fresh air and venous blood are constantly delivered through the airway and vascular... (Review)
Review
Mammalian lung is the important organ for ventilation and exchange of air and blood. Fresh air and venous blood are constantly delivered through the airway and vascular tree to the alveolus. Based on this, the airways and alveolis are persistently exposed to the external environment and are easily suffered from toxins, irritants and pathogens. For example, acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is a common cause of respiratory failure in critical patients, whose typical pathological characters are diffuse epithelial and endothelial damage resulting in excessive accumulation of inflammatory fluid in the alveolar cavity. The supportive treatment is the main current treatment for ALI/ARDS with the lack of targeted effective treatment strategies. However, ALI/ARDS needs more targeted treatment measures. Therefore, it is extremely urgent to understand the cellular and molecular mechanisms that maintain alveolar epithelial barrier and airway integrity. Previous researches have shown that the lung epithelial cells with tissue stem cell function have the ability to repair and regenerate after injury. Also, it is able to regulate the phenotype and function of innate immune cells involving in regeneration of tissue repair. Meanwhile, we emphasize that interaction between the lung epithelial cells and innate immune cells is more supportive to repair and regenerate in the lung epithelium following acute lung injury. We reviewed the recent advances in injury and repair of lung epithelial stem cells and innate immune cells in ALI/ARDS, concentrating on alveolar type 2 cells and alveolar macrophages and their contribution to post-injury repair behavior of ALI/ARDS through the latest potential molecular communication mechanisms. This will help to develop new research strategies and therapeutic targets for ALI/ARDS.
PubMed: 38897427
DOI: 10.1016/j.trsl.2024.05.012 -
American Journal of Perinatology Jun 2024Extremely preterm infants are at high risk of neonatal mortality and morbidity. Extreme preterm birth may result from spontaneous preterm labor or preterm premature...
BACKGROUND
Extremely preterm infants are at high risk of neonatal mortality and morbidity. Extreme preterm birth may result from spontaneous preterm labor or preterm premature rupture of membranes (PPROM), or may be indicated due to pre-eclampsia, eclampsia, hypertension or other causes.
METHODS
Our objective was to identify single nucleotide polymorphisms (SNPs) and biological pathways associated with spontaneous versus indicated extreme preterm birth using the neonatal genome. We evaluated 523 spontaneous births and 134 indicated births weighing 401-1000 g at birth from the Eunice Kennedy Shriver NICHD Neonatal Research Network (NRN)'s Genomics dataset by GWAS and pathway analysis. The TOLSURF cohort was used to replicate the results.
RESULTS
In the NRN GWAS, no statistically significant results were found, although the Manhattan plot showed one almost significant peak (rs60854043 on chromosome 14 at p=1.03E-07) along with many other modest peaks at p=1-9E-06, for a total of 15 suggestive associations at this locus. In the NRN pathway analysis, multiple pathways were identified, with the most significant being "GO_mf:go_low_density_lipoprotein_particle_receptor_activity" at p=1.14E-06. However, these results could not be replicated in the TOLSURF cohort.
CONCLUSION
Genomic differences are seen between infants born by spontaneous versus indicated extreme preterm birth. Due to the limited sample size, there is a need for larger studies.
PubMed: 38889886
DOI: 10.1055/a-2347-3751 -
BMC Oral Health Jun 2024Post-tooth extraction, dry socket is a frequently encountered complication, causing substantial pain and hindering the healing process. Conventional approaches to manage... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Post-tooth extraction, dry socket is a frequently encountered complication, causing substantial pain and hindering the healing process. Conventional approaches to manage this condition have traditionally involved the use of antiseptic dressings to diminish bacterial presence and facilitate healing. This study aims to assess the efficacy of laser therapy in the symptomatic treatment of alveolitis.
METHODS
A literature search was conducted on PubMed, Embase, Scopus, Google Scholar, Web of Science, focusing on publications from 1998 to 31/01/2024 using relevant keywords. The combination of "laser" and "dry socket" was executed through the boolean connection AND.
RESULTS
At the conclusion of the study, a total of 50 studies were identified across the three search engines, with only three selected for the current systematic study and meta-analysis. The meta-analysis indicated that laser treatment proves effective in addressing alveolitis compared to Alvogyl. However, the correlation between the two was not highly significant.
CONCLUSION
These findings suggest that laser therapy may serve as a viable alternative to traditional treatments for dry socket. This minimally invasive procedure has the potential to alleviate pain and promote healing with fewer associated side effects."
Topics: Humans; Dry Socket; Laser Therapy; Treatment Outcome; Tooth Extraction; Low-Level Light Therapy; Wound Healing
PubMed: 38886713
DOI: 10.1186/s12903-024-04461-w -
Clinical Oral Investigations Jun 2024To describe the clinical and radiographic performance and survival rate of a new two-piece ceramic implant system after at least 12 months of follow-up. (Clinical Trial)
Clinical Trial
OBJECTIVE
To describe the clinical and radiographic performance and survival rate of a new two-piece ceramic implant system after at least 12 months of follow-up.
MATERIALS AND METHODS
Sixty-five implants were placed and followed up for at least 12 months (12.3 ± 1.5), in 50 patients. The implants were installed both in fresh extraction sockets and in healed sites and received provisional restoration when the clinical insertion torque was greater than 35Ncm. The primary results describe the survival rate of these implants. Clinical performance was evaluated through the evaluation of the Pink Esthetic Score (PES) and the degree of satisfaction of the patients. Bone loss was measured through radiographic measurements of the marginal bone loss in the mesial (MBLM) and distal (MBLD) sites.
RESULTS
The survival rate was 98.5%. The average MBLM was 0.24 mm (± 0.53) and the MBLD was 0.27 mm (± 0.57). A statistical difference was observed only when comparing immediate implants with delayed ones (MBLM - p = 0.046 and MBLD - p = 0.028) and when they received immediate provisionalization or not (MBLM - p = 0.009 and MBLD - p = 0.040). The PES before the intervention (T0) was 13.4 (± 0.8) and the PES at T2 (12-month follow-up) was 12.9 (± 1.5) (p = 1.14).
CONCLUSION
The new two-piece ceramic implant used in the present study showed predictable and reliable results, similar to those found with titanium implants after one year of follow-up.
CLINICAL RELEVANCE
These implants can be used as an alternative to titanium implants in terms of the marginal bone loss and the degree of patient satisfaction.
Topics: Humans; Prospective Studies; Male; Female; Middle Aged; Dental Prosthesis Design; Ceramics; Treatment Outcome; Adult; Patient Satisfaction; Aged; Esthetics, Dental; Alveolar Bone Loss; Tooth Socket; Dental Restoration Failure; Dental Implants
PubMed: 38886209
DOI: 10.1007/s00784-024-05783-3 -
Journal of Visualized Experiments : JoVE May 2024We introduce an advanced immunocompetent lung-on-chip model designed to replicate the human alveolar structure and function. This innovative model employs a...
We introduce an advanced immunocompetent lung-on-chip model designed to replicate the human alveolar structure and function. This innovative model employs a microfluidic-perfused biochip that supports an air-liquid interface mimicking the environment in the human alveoli. Tissue engineering is used to integrate key cellular components, including endothelial cells, macrophages, and epithelial cells, to create a representative tissue model of the alveolus. The model facilitates in-depth examinations of the mucosal immune responses to various pathogens, including viruses, bacteria, and fungi, thereby advancing our understanding of lung immunity. The primary goal of this protocol is to provide details for establishing this alveolus-on-chip model as a robust in vitro platform for infection studies, enabling researchers to closely observe and analyze the complex interactions between pathogens and the host's immune system within the pulmonary environment. This is achieved through the application of microfluidic-based techniques to simulate key physiological conditions of the human alveoli, including blood flow and biomechanical stimulation of endothelial cells, alongside maintaining an air-liquid interface crucial for the realistic exposure of epithelial cells to air. The model system is compatible with a range of standardized assays, such as immunofluorescence staining, cytokine profiling, and colony-forming unit (CFU)/plaque analysis, allowing for comprehensive insights into immune dynamics during infection. The Alveolus-on-chip is composed of essential cell types, including human distal lung epithelial cells (H441) and human umbilical vein endothelial cells (HUVECs) separated by porous polyethylene terephthalate (PET) membranes, with primary monocyte-derived macrophages strategically positioned between the epithelial and endothelial layers. The tissue model enhances the ability to dissect and analyze the nuanced factors involved in pulmonary immune responses in vitro. As a valuable tool, it should contribute to the advancement of lung research, providing a more accurate and dynamic in vitro model for studying the pathogenesis of respiratory infections and testing potential therapeutic interventions.
Topics: Humans; Pulmonary Alveoli; Lab-On-A-Chip Devices; Immunity, Mucosal; Microfluidic Analytical Techniques
PubMed: 38884475
DOI: 10.3791/66602 -
Cureus May 2024Following the loss of a tooth, the new edentulous area of the ridge will undergo several adaptive modifications due to changes in function within and surrounding the...
BACKGROUND
Following the loss of a tooth, the new edentulous area of the ridge will undergo several adaptive modifications due to changes in function within and surrounding the socket. This bone resorption explains the need for socket preservation techniques in areas of esthetic concerns and functional demands. Demineralized freeze-dried bone allograft (DFDBA) possesses greater osteoinductive potential due to the exposure of bone morphogenetic protein (BMP-3)and collagen fibrils and can be used efficiently in socket preservation techniques. DFDBA yields better results when combined with an autologous platelet concentrate, such as platelet-rich fibrin. Therefore, we formulated this randomized controlled clinical trial to assess the clinical and radiovisiographical outcomes of platelet-rich fibrin (PRF) and DFDBAs for extraction socket preservation in humans at different time intervals.
MATERIALS AND METHODS
This was a randomized controlled trial with 100 people as study subjects, and they were randomly divided into two groups: the test group (DFDBA and PRF placed in the extraction socket) and the control group (natural healing of the extraction socket). Clinical and radiographic evaluation using radiovisiography (RVG) was done at baseline, three-month, and six-month intervals. Cone-beam computed tomography (CBCT) was used at six months to determine the bone density in the test and control groups.
RESULTS
When compared from baseline to six months, the percentage change in clinical and RVG measurements for the test group was 15.96% (11.9064 mm) and 16.77% (12.1840 mm), respectively, whereas for the control group, it was 46.09% (14.0396 mm) and 47.61% (14.5716 mm), thus indicating lesser bone resorption in the test group as opposed to the control group. CBCT values also showed greater bone density for the test group (682.3120 HU) than the control group (503.8336 HU).
CONCLUSION
This study demonstrates the advantages of DFDBA bone graft with PRF compared to natural healing in achieving socket preservation by maintaining the marginal and buccolingual bone levels.
PubMed: 38883015
DOI: 10.7759/cureus.60388 -
RSC Advances Jun 2024Post-extraction wound infections are a common complication of dental extractions. More specifically, infection in the alveolar socket after tooth extraction accelerates...
Post-extraction wound infections are a common complication of dental extractions. More specifically, infection in the alveolar socket after tooth extraction accelerates the resorption and destruction of the alveolar bone, and ultimately affects the final restoration results. Currently, the main clinical treatment approaches applied to the socket after tooth extraction include mechanical wound debridement, chemical rinses (, chlorhexidine), filling of the extraction socket with absorbent gelatin sponges, and the systemic application of antibiotics. However, these traditional treatment modalities have some limitations and their therapeutic effects are unsatisfactory. In this study, a phototherapeutic temperature-sensitive hydrogel material was constructed for injection using a tea polyphenol (TP)-modified poly--isopropylacrylamide (PNIPAM) hydrogel skeleton loaded with the photosensitiser indocyanine green (ICG). The resulting PNIPAM-TP/ICG system exhibited an excellent injectability and temperature-sensitive properties. In addition, it stopped haemorrhaging and acted as a wound astringent. The hydrogel steadily released ICG into the oral environment to exert photothermal/photodynamic effects along with synergistic antibacterial and anti-inflammatory properties when combined with tea polyphenols. experiments demonstrated that the application of PNIPAM-TP/ICG to infected dental extraction wounds in rats rapidly stopped the bleeding and accelerated wound healing. Overall, this study describes a drug-loaded, temperature-sensitive hydrogel for the treatment of open wound infections, and shows promise as a reference for the treatment of tooth extraction wounds.
PubMed: 38882475
DOI: 10.1039/d4ra03211j