• Title/Summary/Keyword: Blood sealing

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Evaluation of Microleakage with Retrograde Filling Materials in Blood Contamination (혈액 오염된 역충전 재료의 미세누출 평가)

  • Cho, Hye-Jin;Moon, Jhong-Hyun;Chon, Seong-Min;Yu, Mi-Kyung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.23 no.1
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    • pp.85-93
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    • 2007
  • The purpose of this study was to evaluate the microleakage of root-end filling material filled in blood contaminated root-end cavity and self-etching adhesive placed over blood contaminated resected root apices without root-end preparation. Extracted, human maxillary incisors, canines and mandibular premolar were randomly divided into four groups of 15 teeth each. After canal preparation, resection of the apex and root-end preparation, MTA and IRM were filled in the root-end cavity (A and B group). After canal preparation and resection of the apex, Clearfil SE Bond and Prompt L-Pop were applied over the contaminated root-end surfaces (C and D group). The roots were then subjected to 15cm of water pressure to simulate periapical microleakage stress. Data were analyzed using one-way ANOVA. The results were as follows : 1. All groups showed a tendency of decreasing microleakage in process of time after 2weeks later except IRM group. 2. After 2 weeks and 1 month, MTA group showed less microleakage significantly than other groups(p<0.05). After 2 months, Prompt L-Pop group showed less microleakage significantly than other groups(p<0.05). 3. After 9 months, there were no significant differences among four groups(p>0.05). Thus it is considered that apical sealing using adhesives system without root-end preparation is good method in endodontic surgery.

Comparison of Ligasure Versus Conventional Surgery for Curative Gastric Cancer Resection: a Meta-Analysis

  • Hu, Tian-Peng;He, Xiang-Hui;Meng, Zhao-Wei;Jia, Qiang;Tan, Jian;Li, Xue
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2049-2053
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    • 2016
  • Background: The LigaSure vessel sealing system has been proposed to save operation time and reduce intraoperative blood loss for various surgeries. However, its usage for gastric cancer is still controversial. The aim of the present meta-analysis was to compare the effectiveness of LigaSure with conventional surgery in gastrectomy. Materials and Methods: Sources were retrieved from the Cochrane Library, MEDLINE, EMBASE, SCOPUS and Google Scholar until February, 2015. All randomized controlled trials comparing LigaSure with conventional surgery in curative gastric cancer resection were selected. After data extraction, statistics were performed by Review Manager 5.1 software. Results: Three eligible randomized controlled trials were evaluated, with a total of 335 patients. The quality of the included trials was good, yet some methodological and clinical heterogeneity existed. There were no significant differences between the LigaSure and conventional groups in operative time (weighted mean difference [WMD], -22.95 minutes; 95% confidence interval [CI], [-59.75, 13.85]; P = 0.22), blood loss (WMD, -45.8 ml; 95% CI, [-134.5, 42.90]; P = 0.31), nor the incidence of surgical complications (odds ratio, 1.18; 95% CI, [0.68, 2.05]; P = 0.54). But there was a longer duration of hospital stay in LigaSure group (WMD, 1.41 days; 95% CI, [0.14, 2.68]; P = 0.03). Conclusions: All available randomized evidence has been summarized. LigaSure does not confer significant advantage over conventional surgery for curative gastric cancer resection. The usefulness of the device may be limited in gastrectomy. But, more trials are needed for further assessment of the LigaSure system for gastric cancer.

Klebsiella pneumoniae necrotizing fasciitis on the upper lip in a patient with uncontrolled diabetes

  • Kim, Hyeong Seop;Chang, Yong Joon;Chung, Chul Hoon
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.127-131
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    • 2020
  • A 60-year-old woman with a history of diabetes mellitus and chronic renal failure was admitted to the hospital with severe pain in the upper lip, which began 4 days prior to admission, accompanied by a bullous lesion and suspected cellulitis in the upper lip. Immediately after admission, as the patient's general condition worsened, tests revealed a non-ST elevated myocardial infarction, septic embolism of the lung, as well as septic shock. Her upper lip suddenly presented a gangrenous and necrotic change, which the tissue and blood culture confirmed to be a Klebsiella pneumoniae infection. After a quick response, the patient's general condition improved. Subsequently, serial debridement was performed to effectively clear away the purulent discharge. While under general anesthesia, the process confirmed full-layer necrosis of the upper lip including the orbicularis oris muscle. Almost half of the entire upper lip sustained a full-layer skin and soft tissue defect, with scar contracture. Six months later, to correct the drooling and lip sealing following the defects, a scar release and an Abbe flap coverage were performed considering both functional and aesthetic aspects. The follow-up revealed a favorable corrective result of the upper lip drooling, and the patient was satisfied from a functional perspective.

Trido Mitral Valve Replacement with Dacron Collar Prosthetic Valve due to Paravalvular Leak (판막주위 누출에 대한 다크론 확장 인공판막을 이용한 판막치환술 치험)

  • 배윤숙;정성철;김우식;정승혁;이정호;김병열
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.822-825
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    • 2002
  • The paravalvular leak after redo mitral prosthetic valve replacement is rare but serious complication when it does happen. This condition should be corrected surgically to increase life span and improve symptoms. But simple closure or patch closure of paravalvular leak are not effective in cases of weak annulus or broad defect. We report 3 cases of trido mitral valve replacement using mechanical valve with its sewing ring expanded by a collar of Dacron sheet. The prosthetic sewing ring is anchored on the weak mitral annulus with multiple interrupted sutures, while the Dacron collar is contineuously sutured to the left atrial wall for blood tight sealing. All of the three cases showed event free postoperative course.

Regenerative Endodontic Treatment Without Discoloration of Infected Immature Permanent Teeth Using Retro MTA : Two Case Reports (치수 괴사된 미성숙 영구치에서 Retro MTA를 이용한 변색 없는 재생적 근관치료 : 증례 보고)

  • Kim, Yujeong;Kim, Seonmi;Choi, Namki
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.4
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    • pp.335-343
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    • 2014
  • Regenerative endodontic treatment has the potential to heal a necrotic pulp, which can affect root development in immature teeth. However, several drawbacks and unfavorable outcomes are associated with regenerative endodontic treatment, of which the most significant is coronal discoloration due to the presence of minocycline in triple antibiotic paste and mineral trioxide aggregate (MTA). To prevent tooth discoloration following pulp treatment, the modified triple antibiotics (ciprofloxacin, metronidazole, clindamycin) were used as canal disinfectants and Retro MTA, a $ZrO_2$-containing calcium aluminate cement, was used to seal the canal. Following access cavity acquisition, the canal was copiously irrigated with 2.5% sodium hypochlorite. A modified triple antibiotic paste was then applied to the canal. Once the tooth was asymptomatic (after between 3 and 8 weeks), Retro MTA was carefully placed over the blood clot or a collagen plug. Follow-up radiographs revealed normal periodontal ligament space and root development. In two cases, successful regenerative endodontic treatment of the infected immature tooth, without discoloration, was achieved with disinfection using modified triple antibiotics and Retro MTA sealing.

Pulp Revascularization of Infected Immature Permanent Teeth Using Platelet-Rich Fibrin and Double Antibiotic Paste : Case Report (감염된 미성숙 영구치에서 platelet-rich fibrin과 double antibiotic paste를 이용한 치수 재혈관화 : 증례 보고)

  • Jeon, Sang-Yun;Lee, Nan-Young;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.3
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    • pp.216-222
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    • 2013
  • Paradigm shift in management of infected immature permanent teeth has occurred. The new concept of the treatment includes minimal or no intracanal instrumentation, disinfection with triple antibiotic paste and sealing with mineral trioxide aggregate. This regenerative endodontic treatment promotes differentiation of periradicular stem cells that induce regeneration of vital tissue and continuation of root formation. Thorough disinfection and three-dimensional scaffold are important in this new concept of the treatment. Platelet-rich fibrin has been reported as 'new scaffold' instead of blood clot, which had been used in the past. Triple antibiotics can be used to disinfect the tooth but may lead to complications including discoloration. Three cases of infected immature permanent tooth caused by dens evaginatus fracture are presented. After removal of necrotic pulp and thorough intracanal irrigation, only platelet-rich fibrin was applied to the root canal in the first case. In the other cases, topical antibiotics was used for disinfection and platelet-rich fibrin for scaffold. In all the cases, the opening was sealed with mineral trioxide aggregate. All the cases showed proper healing of inrabony lesion and some lengthening of root. According to these cases, regenerating vital tissue of the infected immature permanent tooth can be achieved with disinfection and application of platelet-rich fibrin.

INFLUENCES OF DRY METHODS OF RETROCAVITY ON THE APICAL SEAL (치근단 역충전와동의 건조방법이 폐쇄성에 미치는 영향)

  • Lee, Jung-Tae;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.24 no.1
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    • pp.166-179
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    • 1999
  • Apical sealing is essential for the success of surgical endodontic treatment. Root-end cavity is apt to be contaminated with moisture or blood, and is not always easy to be dried completely. The purpose of this study was to evaluate the influence of dry methods of retrocavity on the apical seal in endodontic surgery. Apical seal was investigated through the evaluation of apical leakage and adaptation of filling material over the cavity wall. To investigate the influence of various dry methods on the apical leakage, 125 palatal roots of extracted human maxillary molar teeth were used. The clinical crown of each tooth was removed at 10 mm from the root apex using a slow-speed diamond saw and water spray. Root canals of the all the specimens were prepared with step-back technique and filled with gutta-percha by lateral condensation method. After removing of the coronal 2 mm of filling material, the access cavities were closed with Cavit$^{(R)}$. Two coats of nail polish were applied to the external surface of each root. Apical three millimeters of each root was resected perpendicular to the long axis of the root with a diamond saw. Class I retrograde cavities were prepared with ultrasonic instruments. Retrocavities were washed with physiologic saline solution and dried with various methods or contaminated with human blood. Retrocavities were filled either with IRM, Super EBA or composite resin. All the specimens were immersed in 2% methylene blue solution for 7 days in an incubator at $37^{\circ}C$. The teeth were dissolved in 14 ml of 35% nitric acid solution and the dye present within the root canal system was returned to solution. The leakage of dye was quantitatively measured via spectrophotometric method. The obtained data were analysed statistically using one-way ANOVA and Duncan's Multiple Range Test. To evaluate the influence of various dry methods on the adaptation of filling material over the cavity wall, 12 palatal roots of extracted human maxillary molar teeth were used. After all the roots were prepared and filled, and retrograde cavities were made and filled as above, roots were sectioned longitudinally. Filling-dentin interface of cut surfaces were examined by scanning electron microscope. The results were as follows: 1. Cavities dried with paper point or compressed air showed less leakage than those dried with cotton pellet in Super EBA filled cavity (p<0.05). However, there was no difference between paper point- and compressed air-dried cavities. 2. When cavities were dried with compressed air, dentin-bonded composite resin-filled cavities showed less apical leakage than IRM- or Super EBA-filled ones (p<0.05). 3. Regardless of the filling material, cavities contaminated with human blood showed significantly more apical leakage than those dried with compressed air after saline irrigation (p<0.05). 4. Outer half of the cavity showed larger dentin-filling interface gap than inner half did when cavities were filled with IRM or Super EBA. 5. In all the filling material groups, cavities contaminated with blood or dried with cotton pellets only showed larger defects at the base of the cavity than ones dried with paper points or compressed air.

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Exophytic bone formation using porous titanium membrane combined with pins in rabbit calvarium. (핀 고정 천공형 티타늄막을 이용한 수직적 체조제증대술에 관한 연구)

  • Kim, Young;Kwon, Young-Hyuk;Park, Joon-Bong;Herr, Yeek;Chung, Jong-Hyuk
    • Journal of Periodontal and Implant Science
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    • v.36 no.2
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    • pp.273-288
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    • 2006
  • The purpose of this study was to evaluate exophytically vertical bone formation in rabbit calvaria by the concept of guided bone regeneration with a custom-made porous titanium membrane combined with bone graft materials. For this purpose, a total of 12 rabbits were used, and decorticated calvaria were created with round carbide bur to promote bleeding and blood clot formation in the wound area. Porous titanium membranes (0.5 mm in pore diameter, 10 mm in one side, 2 mm in inner height) were placed on the decorticated calvaria, fixed with metal pins and covered with full-thickness flap. Experimental group I was treated as titanium membrane only. Experimental group II, III, IV was treated as titanium membrane with BBM, titanium membrane with DFDB and titanium membrane with FDB. The animals were sacrificed at 8 and 12 weeks after surgery, and new bone formation was assessed by histomorphometric as well as statistical analysis. 1. Porous titanium membrane was biocompatable and capable of maintaining the regeneration space. 2. At 8 and 12 weeks, all groups demonstrated exophytic bone formation and there was a statistical significant difference among different groups only at 12 weeks. 3. The DFDB group revealed the most new bone formation compared to other groups (p<0.05). 4. At 12 weeks, DFDB and FDB groups showed the most significant resorption of graft materials (p<0.05). 5. The BBM was not resorbed at all until 12 weeks. 6. The fixation metal pin revealed excellent effect in peripheral sealing. On the basis of these findings, we conclude that a porous titanium membrane may be used as an augmentation membrane for guided bone regeneration, and DFDB as an effective bone forming graft material. The fixation of the membrane with pin will be helpful in GBR technique. However, further study is required to examine their efficacy in the intraoral experiments.