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BMC Musculoskeletal Disorders Jul 2018Minimally invasive techniques for lumbar discectomy have been recommended as superior to open techniques due to lower blood loss, lower rates of infection and shorter...
BACKGROUND
Minimally invasive techniques for lumbar discectomy have been recommended as superior to open techniques due to lower blood loss, lower rates of infection and shorter recovery. There are, however, concerns that this approach does not sufficiently remove the herniated nuclear material, thus leaving the patient susceptible to reherniation requiring reoperation. The purpose of this study was to examine the safety and viability of an annular closure device in limiting reherniation and reoperation in a cohort of patients undergoing minimally invasive lumbar discectomy with the assistance of an annular closure device.
METHODS
We retrospectively analysed the results from patients treated by a single surgeon between March 2011 and December 2017. All patients had been diagnosed with a large (≥ 5 mm) defect and were treated via minimally invasive surgical techniques. Outcomes included demographic data, the procedural duration and the rates of symptomatic reherniation and reoperation.
RESULTS
60 patients were included in the study. The mean age was 42 years (range: 19-66); mean BMI was 24.1 (range: 16.7-36.3). Mean surgical duration was 29 min (range: 16-50). Reoperation was required in 5% (3/60) of patients, although only 3% (2/60) experienced symptomatic reherniation at the index level. No other complications were reported.
CONCLUSIONS
In our study, the use of an annular closure device during minimally invasive lumbar discectomy in a population of patients with large herniations was associated with low rates of reherniation and reoperation at the index level. While more research is required, the results of this study demonstrate the safety and viability of the annular closure device as an adjunct to minimally invasive discectomy.
Topics: Adult; Aged; Bone-Anchored Prosthesis; Diskectomy, Percutaneous; Female; Humans; Intervertebral Disc; Intervertebral Disc Displacement; Lumbar Vertebrae; Male; Microsurgery; Middle Aged; Minimally Invasive Surgical Procedures; Periodontal Dressings; Prosthesis Design; Recurrence; Reoperation; Resins, Synthetic; Retrospective Studies; Risk Factors; Time Factors; Total Disc Replacement; Treatment Outcome; Young Adult
PubMed: 30053813
DOI: 10.1186/s12891-018-2178-4 -
The Open Dentistry Journal 2018Conventional periodontal treatment, performed quadrant by quadrant in multiple visits, was re-evaluated in the early 1990s when the full-mouth disinfection concept was... (Review)
Review
BACKGROUND
Conventional periodontal treatment, performed quadrant by quadrant in multiple visits, was re-evaluated in the early 1990s when the full-mouth disinfection concept was introduced. Over the years, several modifications to the full-mouth disinfection approach have been suggested.
OBJECTIVE
The purpose of this article is to review the evolution of full-mouth disinfection during the past 20 years, to specify its indications and to consider the prospects for this approach.
MATERIALS AND METHODS
An electronic and manual search of the literature, ending in December 2016, was performed by two independent researchers. Only pivotal studies and randomized controlled clinical trials published in the English language that evaluated a new approach to full-mouth disinfection were selected.
RESULTS
According to the studies included in our analysis (21 articles), several modified full-mouth disinfection protocols have been designed including: full-mouth treatment without chlorhexidine, the extension of hygiene methods and an increase in the duration of post-treatment chlorhexidine use, the replacement of chlorhexidine with other antiseptics, supplementation with antibiotics or probiotics, full-mouth antimicrobial photodynamic therapy and one-stage full-mouth disinfection combined with a periodontal dressing.
CONCLUSION
Since 1995, several modifications have been suggested to improve the effectiveness of full-mouth disinfection. The majority of the studies demonstrate that the results obtained with full-mouth disinfection and its variants are equivalent to each other and to those obtained with the conventional quadrant method. Currently, the selection of this technique remains empirical and depends on the preferences of the practitioner and the patient. In the future, a patient-centered approach should be the best indication for the use of this technique.
PubMed: 29988213
DOI: 10.2174/1874210601812010435 -
Journal of Indian Society of... 2018The platelet concentrate is a windfall in the field of regenerative therapy in periodontology. It accelerates wound healing by excellent neovascularization and promoting...
BACKGROUND
The platelet concentrate is a windfall in the field of regenerative therapy in periodontology. It accelerates wound healing by excellent neovascularization and promoting fast cicatricle tissue remodeling.
AIM
This study aims to evaluate clinically and histologically accelerated effect of platelet-rich fibrin (PRF) membrane and PRF matrix (PRFM) following depigmentation procedure.
MATERIALS AND METHODS
Eleven individuals were divided into three groups after depigmentation procedure. PRF membrane and PRFM gel were prepared as per standard protocol. Group A and B received PRF membrane and PRFM gel followed by periodontal dressing, respectively, and the only periodontal dressing was placed in Group C. The individuals were evaluated for visual analog scale (VAS) and healing index (HI) on 3 and 5 day. Epithelization test and histologic analysis from punch biopsy were done on the 5 day. At 3 month, reevaluation was performed.
RESULTS
The intergroup statistical analysis in respect to VAS, HI, epithelization test, and histologic analysis showed a statistically significant results with < 0.001 in Groups A and B compared to Group C. Clinical evaluation of epithelization test and histologic analysis revealed better-wound healing and moderate to no inflammatory cell infiltrate in Groups A and B, respectively, as compared to Group C, which appeared more erythematous with dense inflammatory cells.
CONCLUSION
Thus, the application of PRF membrane and PRFM gel has shown a successful approach to protect the raw wound area of depigmented sites with better patient comfort and faster healing.
PubMed: 29769770
DOI: 10.4103/jisp.jisp_342_17 -
Brazilian Oral Research Mar 2018The aim of this study is to evaluate the action of paramonochlorophenol associated with Furacin followed by calcium hydroxide (CH) dressing in the control of...
The aim of this study is to evaluate the action of paramonochlorophenol associated with Furacin followed by calcium hydroxide (CH) dressing in the control of inflammatory root resorption in cases of immediate tooth replantation with delayed endodontic treatment. A total of 28 incisors of 3 male dogs were extracted and replanted after 15 minutes, and randomly divided into 3 groups: Group I (n = 8) - endodontic treatment was performed before the extraction and replantation; Group II (n = 10) - endodontic treatment was performed 30 days after replantation and the root canal was filled with CH dressing; Group III (n = 10) - endodontic treatment was performed 30 days after replantation and root canals received temporary medication of paramonochlorophenol-Furacin followed by CH dressing. The animals were euthanized 90 days after replantation. The histomorphological events analyzed at the epithelial reattachment site were the intensity and extent of acute and chronic inflammatory processes, periodontal ligament (PDL) organization, the intensity and extent of acute and chronic inflammatory processes in the PDL space, root resorption, bone tissue, and ankylosis. Data were submitted to the Wilcoxon Signed Ranks Test for group comparison (α = 5%). In Groups I, II and III the periodontal ligament was regenerated and most of the resorption areas were repaired by newly formed cementum. The depth and extent of root resorption were significantly higher in Group II than in Group III. The use of paramonochlorophenol-furacin followed by CH dressing was more effective in controlling inflammatory root resorption after immediate tooth replantation.
Topics: Animals; Anti-Infective Agents, Local; Calcium Hydroxide; Chlorophenols; Dogs; Male; Medical Illustration; Nitrofurazone; Periodontal Ligament; Random Allocation; Reproducibility of Results; Root Canal Filling Materials; Root Canal Therapy; Root Resorption; Time Factors; Tooth Replantation; Tooth Root; Tooth, Nonvital; Treatment Outcome
PubMed: 29513885
DOI: 10.1590/1807-3107/2018.vol32.0007 -
Journal of Natural Science, Biology,... 2018The aim was to compare the gingival tissue response following placement of a light cure dressing (Barricaid) and a non-eugenol periodontal dressing (Coe-Pak) after...
AIM
The aim was to compare the gingival tissue response following placement of a light cure dressing (Barricaid) and a non-eugenol periodontal dressing (Coe-Pak) after periodontal flap procedure. This was carried out by evaluating plaque deposition underneath both the dressings, healing response and the patient preference for each.
MATERIALS AND METHODS
A total of 12 patients with chronic generalized periodontitis requiring surgery in at least two different quadrants were enrolled for this split-mouth study. After periodontal flap surgery, Coe-Pak was placed in the quadrant assigned to Group I and Barricaid was placed in the other quadrant assigned to Group II. Clinical parameters were recorded on day 7 and day 14. Patient comfort and pain levels were also evaluated by a questionnaire.
RESULTS
There were no statistically significant differences in wound healing and the clinical gingival parameters between two groups. The only significant difference was found in the plaque attached underneath the dressing, with Coe-Pak showing greater plaque accumulation than Barricaid. Seventy five (75) % of the patients preferred Barricaid over Coe-Pak, based on its appearance and taste.
CONCLUSION
The non-eugenol dressing seemed to retain more plaque on its undersurface than light-cure dressing. However, this did not have much influence on the healing outcome and clinical gingival parameters, which were optimal and comparable in both groups. The greater number of patients showed a preference for light cure dressing, based on its superior esthetics and taste.
PubMed: 29456396
DOI: 10.4103/jnsbm.JNSBM_75_17 -
Journal of Pharmacy & Bioallied Sciences Nov 2017Alveolar bone resorption is a significant clinical problem. Bone loss in third molar region following extraction or surgical removal not only leads to periodontal...
Assessment of Regeneration of Bone in the Extracted Third Molar Sockets Augmented Using Xenograft (CollaPlug Zimmer) in Comparison with the Normal Healing on the Contralateral Side.
INTRODUCTION
Alveolar bone resorption is a significant clinical problem. Bone loss in third molar region following extraction or surgical removal not only leads to periodontal problems in second molar region but also it may lead to some serious problems like increased incidence of angle fractures. In order to reduce the risks following third molar surgery, the socket should be augmented with bone grafts. In recent days guided tissue regeneration is the most accepted and successful technique followed many authors and its efficacy has been proved.
MATERIALS AND METHODS
Based upon our clinical experience, the use of bio absorbable collagen wound dressing such as CollaPlug has achieved quick healing and more primary wound coverage. Amongst the graft materials collagen is preferable due to its high biocompatibility and hemostatic ability. This study was done to assess the regeneration of bone in the extracted third molar sockets using xenograft (CollaPlug-Zimmer) which was compared with the normal healing on the contra lateral side. The assessment was done to analyze post-operative healing complications and to compare the bone density formed between control site and implant site radiologically.
CONCLUSION
On this basis of this study, the use of collaplugTN appears to be beneficial to the patient in postoperative wound healing and also for better bone formation. The use of this material was advantageous because of its simplicity of application cost effectiveness and availability. There is enhanced wound healing and early bone formation.
PubMed: 29284960
DOI: 10.4103/jpbs.JPBS_176_17 -
Journal of Clinical and Experimental... Oct 2017Presence of voids at root canal wall‒apical seal material interface gives rise to the entrapment of toxins and microorganisms, which might have a relationship with...
BACKGROUND
Presence of voids at root canal wall‒apical seal material interface gives rise to the entrapment of toxins and microorganisms, which might have a relationship with post treatment disease. The present study was carried out to evaluate the effect of different mixing (manual and ultrasonic) and placement (manual and manual in association with indirect ultrasonic) methods of Calcium-enriched Mixture (CEM) cement on the number and dimensions of voids in the apical plug in simulated apexification models.
MATERIAL AND METHODS
A total of 80 human maxillary central incisors with mature apices were selected. After simulation of the open apices, the teeth were divided into 4 groups (n=20) based on the mixing and placement techniques of CEM cement: group 1, manual mixing‒manual placement; group 2, manual mixing‒manual placement in association with indirect ultrasonic technique; group 3, ultrasonic mixing‒manual placement; and group 4, ultrasonic mixing‒manual placement in association with indirect ultrasonic technique. The samples were placed within gypsum sockets in which the periodontal ligament was reconstructed with polyether impression material. After placement the apical plugs, a wet piece of cotton was placed on canal orifices, followed by dressing with Cavit. The samples were incubated at 37°C and 100% relative humidity for 7 days. Then the voids between the material and root canal walls were counted with the CBCT technique. The void dimensions were scored with the following scoring system: score 1, no voids; score 2, the void size less than half of the size of the evaluated cross-section; score 3, the void size larger than half of the size of the evaluated cross-section. Statistical analyses were carried out with chi-squared and Fisher's exact tests. Statistical significance was defined at <0.05.
RESULTS
The maximum (7) and minimum (2) number of voids were detected in groups 1 and 2, respectively. The difference between these two groups was statistically significant (<0.05). The differences in the number of voids between groups with similar mixing technique and different mixing techniques (i.e. groups 1 and 3 and groups 2 and 4) were not significant (>0.05). Void dimensions in all the study groups were in score 2 category and no score 3 was recorded in the study groups.
CONCLUSIONS
Under the limitations of the present study, manual placement in association with indirect ultrasonic technique was a proper technique to improve the quality of apical plug, considering the decrease in the number of voids. Apical plug, CEM cement, void.
PubMed: 29167715
DOI: 10.4317/jced.53236 -
Iranian Endodontic Journal 2017The aim of this study was to evaluate and compare the penetration depth of conventional (CH) and nano-particle calcium hydroxide (NCH) into dentinal tubules.
INTRODUCTION
The aim of this study was to evaluate and compare the penetration depth of conventional (CH) and nano-particle calcium hydroxide (NCH) into dentinal tubules.
METHODS AND MATERIALS
Ninety human single-rooted teeth were instrumented by RaCe rotary system and after chemomechanical preparation were randomly divided in two equal groups (=45). In the first group conventional CH and in the other NCH was used as intracanal medicament. After 2 weeks of incubation all roots were intentionally split at longitudinal axis and prepared for scanning electron microscope (SEM) observation. Three zones of each root, coronal, middle and apical were examined under SEM and the maximum penetration depth of the dressing material into dentinal tubules was recorded for each zone. Data were analyzed using the independent sample test and the level of significance was set at 0.05.
RESULTS
In all of the three zones, NCH group had greater penetration depth than CH (<0.001). In both groups the penetration depth increased from the apical section to the coronal.
CONCLUSION
The depth of penetration of nano-particle calcium hydroxide into the dentinal tubules was significantly higher than that of conventional calcium hydroxide. The lowest penetration depth was observed in apical zone in both groups.
PubMed: 28808467
DOI: 10.22037/iej.v12i3.16421 -
Acta Stomatologica Croatica Mar 2017Ishemic bone disease has multifactorial etiologies. Cronic dental infections should be eliminated to prevent osteonecrosis of the jaw.
OBJECTIVE
Ishemic bone disease has multifactorial etiologies. Cronic dental infections should be eliminated to prevent osteonecrosis of the jaw.
CASE REPORT
We report an unusual case of osteonecrosis due to the pulpal-peridontal syndrome and subsequent pulp necrosis. A case of 38 year old woman who presented with exposed bone, 8 mm in diameter, in the lingual area of the right lower third molar. The patient was otherwise healthy and was not taking any medications. A detailed medical history showed no previous diseases. Patient denied any type of local trauma. A complete blood count showed no abnormalities. The panoramic radiograph revealed a deep periodontal pocket between teeth 47 and 48. The CBCT revealed a deep periodontal pocket between molars and bone sequestrum of the lingual plate. Topical treatment consisted of adhesive periodontal dressing based on the cellulose and bethamethasone oitnment together with orabase, without improvement. Therefore, peroral amoxycillin was prescribed for a week. Since there was no improvement, the third molar was removed as well as necrotic bone; the alveolar bone was remodelled and sutures were placed. After suturing, the whole area was covered using intraoral resorbable bandage. Microbial swab of the wound aspirate did not reveal polymorphonuclears or the presence of microorganisms. Microbial swab of the biopsy specimen of the necrotic bone particle and sequestrum showed a large amount of gram-positive coccae, however, polymorphonuclears were not found. Histopathological analysis revealed acute chronic inflammation. One week after the surgery, the area healed completely.
CONCLUSION
This case highlights the fact that in some patients bone exposure might develop due to the pulpal-periodontal syndrome i.e. pulp necrosis.
PubMed: 28740273
DOI: 10.15644/asc51/1/9 -
Journal of Oral & Maxillofacial Research 2017The purpose of the present study was to compare the cytotoxicity of Reso-Pac and Coe-Pak periodontal dressing.
OBJECTIVES
The purpose of the present study was to compare the cytotoxicity of Reso-Pac and Coe-Pak periodontal dressing.
MATERIAL AND METHODS
According to ISO-10993-12:2012, 1-, 3- and 7-day extracts of the two periodontal dressings were prepared in cell culture medium and exposed to the two cultured cell lines. Cell viability and proliferation at 24 h and 72 h following exposure were evaluated using quantitative MTT assay.
RESULTS
The results showed a significant (P < 0.05) reduction in the viability of cells exposed to the 3- and 7-day Coe-Pak extracts at 24 h and 72 h compared to the control group (no exposure to the extract). Reso-Pac extracts slightly decreased cell viability compared to the control group. Understudy materials showed greater cytotoxicity against human osteoblast-like compared to the human gingival fibroblast cells. No significant (P > 0.05) difference was found in the viability of cells exposed to undiluted (100%) one-day extract and diluted (50%) extract of both understudy materials at 24 h and 72 h after exposure.
CONCLUSIONS
Based on the results, Reso-Pac periodontal dressing has less cytotoxicity than Coe-Pak.
PubMed: 28496963
DOI: 10.5037/jomr.2017.8103