• Title/Summary/Keyword: Conservative Surgery

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Comparison of the sealing ability of various bioceramic materials for endodontic surgery

  • Benjamin Rencher ;Ana M. Chang ;Hanson Fong;James D. Johnson;Avina Paranjpe
    • Restorative Dentistry and Endodontics
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    • v.46 no.3
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    • pp.35.1-35.11
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    • 2021
  • Objectives: Endosequence Bioceramic Root Repair Material (BC-RRM) is used in endodontic microsurgery. It is available as a paste and a putty. However, no studies to date have examined the sealing ability of these forms alone or in combination as root-end filling materials. Hence, this study aimed to compare the sealing properties of these 2 forms of BC-RRM. Materials and Methods: Forty-two extracted upper anterior teeth were divided into 3 experimental groups, a positive and negative control. After the root canal treatment, the root ends were resected, retroprepared and retrofilled with either putty, paste + putty or mineral trioxide aggregate (MTA). The teeth were mounted in tubes so the apical 3 mm was submerged in Brain Heart Infusion (BHI) broth. The coronal portions of the canals were inoculated with Enterococcus faecalis and BHI broth and incubated for 30 days. The broth in the tubes was analyzed for colony forming units to check for leakage of bacteria from the canal. The teeth from the groups were sectioned and analyzed using scanning electron microscopy (SEM). The Kruskal-Wallis test and analysis of variance were used to analyze the data with a significance level p < 0.05. Results: The BC-RRM and MTA groups showed similar sealing ability. The positive control showed leakage in all samples. The SEM imaging showed the presence of bacteria in all experimental groups at the material-tooth interface. Conclusions: No significant differences were noted in the experimental groups, providing sufficient evidence that any combination could be effectively used during endodontic microsurgery.

Comparison of instrumental methods for color change assessment of Giomer resins

  • Luiza de Almeida Queiroz Ferreira;Rogeli Tiburcio Ribeiro da Cunha Peixoto ;Claudia Silami de Magalhaes;Tassiana Melo Sa;Monica Yamauti ;Francisca Daniele Moreira Jardilino
    • Restorative Dentistry and Endodontics
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    • v.47 no.1
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    • pp.8.1-8.9
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    • 2022
  • Objectives: The aim of this study was to compare the color change of the Giomer resin composite (Beautifil-Bulk) by using photographs obtained with a smartphone (iPhone 6S) associated with Adobe Photoshop software (digital method), with the spectrophotometric method (Vita Easyshade) after immersion in different pigment solutions. Materials and Methods: Twenty resin composite samples with a diameter of 15.0 mm and thickness of 1.0 mm were confectioned in A2 color (n = 5). Photographs and initial color readings were performed with a smartphone and spectrophotometer, respectively. Then, samples were randomly divided and subjected to cycles of immersion in distilled water (control), açai, Coke, and tomato sauce, 3 times a day, 20 minutes for 7 days. Later, new photographs and color readings were taken. Results: The analysis (2-way analysis of variance, Holm-Sidak, p < 0.05) demonstrated no statistical difference (p < 0.005) between the methods in all groups. Similar color changes were observed for all pigment solutions when using the spectrophotometric method. For the digital method, all color changes were clinically unacceptable, with distilled water and tomato sauce similar to each other and with statistical differences (p < 0.005) for Coke and açai. Conclusions: Only the tomato sauce produced a color change above the acceptability threshold using both methods of color assessment. The spectrophotometric and digital methods produce different patterns of color change. According to our results, the spectrophotometric method is more recommended in color change assessment.

Bone repair in defects filled with AH Plus sealer and different concentrations of MTA: a study in rat tibiae

  • Jessica Emanuella Rocha Paz;Priscila Oliveira Costa;Albert Alexandre Costa Souza;Ingrid Macedo de Oliveira;Lucas Fernandes Falcao;Carlos Alberto Monteiro Falcao;Maria Angela Area Leao Ferraz;Lucielma Salmito Soares Pinto
    • Restorative Dentistry and Endodontics
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    • v.46 no.4
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    • pp.48.1-48.10
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    • 2021
  • Objectives: This study aimed to evaluate the effects on bone repair of different concentrations of mineral trioxide aggregate (MTA) added to AH Plus. Materials and Methods: Bone tissue reactions were evaluated in 30 rats (Rattus norvegicus) after 7 and 30 days. In the AH + MTA10, AH + MTA20, and AH + MTA30 groups, defects in the tibiae were filled with AH Plus with MTA in proportions of 10%, 20% and 30%, respectively; in the MTA-FILL group, MTA Fillapex was used; and in the control group, no sealer was used. The samples were histologically analyzed to assess bone union and maturation. The Kruskal-Wallis and Mann-Whitney tests were performed for multiple pairwise comparisons (p ≤ 0.05). Results: At the 7-day time point, AH + MTA10 was superior to MTA-FILL with respect to bone union, and AH + MTA20 was superior to MTA-FILL with respect to bone maturity (p < 0.05). At the 30-day time point, both the AH + MTA10 and AH + MTA20 experimental sealers were superior not only to MTA-FILL, but also to AH + MTA30 with respect to both parameters (p < 0.05). The results of the AH + MTA10 and AH + MTA20 groups were superior to those of the control group for both parameters and experimental time points (p < 0.05). Conclusions: The results suggest the potential benefit of using a combination of these materials in situations requiring bone repair.

Association between cigarette smoking and the prevalence of post-endodontic periapical pathology: a systematic review and meta-analysis

  • Nestor Rios-Osorio ;Hernan Dario Munoz-Alvear ;Fabio Andres Jimenez-Castellanos;Sara Quijano-Guauque ;Oscar Jimenez-Pena ;Herney Andres Garcia-Perdomo ;Javier Caviedes-Bucheli
    • Restorative Dentistry and Endodontics
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    • v.47 no.3
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    • pp.27.1-27.14
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    • 2022
  • Objectives: This systematic review and meta-analysis aimed to assess the association of cigarette smoking with the prevalence of post-endodontic apical periodontitis in humans. Materials and Methods: We searched through PubMed/Medline, Web of Science, and Scopus from inception to December 2020. Risk of bias was performed by using the Newcastle-Ottawa Scale for cross-sectional, cohort, and case-control studies. We performed the statistical analysis in Review Manager 5.3 (RevMan 5.3). Results: 6 studies met the inclusion criteria for qualitative and quantitative synthesis. Statistical analysis of these studies suggests that there were no differences in the prevalence of post endodontic apical periodontitis (AP) when comparing non-smokers vs smoker subjects regarding patients (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.31-1.49; I2 = 58%) and teeth (OR, 1.71; 95% CI, 0.99-2.93; I2 = 72%). Conclusions: Our findings suggest that there was no association between cigarette smoking and post-endodontic apical periodontitis, as we did not find statistical differences in the prevalence of post-endodontic AP when comparing non-smokers vs smoker subjects. Therefore, smoking should not be considered a risk factor associated with endodontic failure.

A scientometric, bibliometric, and thematic map analysis of hydraulic calcium silicate root canal sealers

  • Anastasios Katakidis;Konstantinos Kodonas;Anastasia Fardi;Christos Gogos
    • Restorative Dentistry and Endodontics
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    • v.48 no.4
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    • pp.41.1-41.17
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    • 2023
  • Objectives: This scientometric and bibliometric analysis explored scientific publications related to hydraulic calcium silicate-based (HCSB) sealers used in endodontology, aiming to describe basic bibliometric indicators and analyze current research trends. Materials and Methods: A comprehensive search was conducted in Web of Science and Scopus using specific HCSB sealer and general endodontic-related terms. Basic research parameters were collected, including publication year, authorship, countries, institutions, journals, level of evidence, study design and topic of interest, title terms, author keywords, citation counts, and density. Results: In total, 498 articles published in 136 journals were retrieved for the period 2008-2023. Brazil was the leading country, and the universities of Bologna in Italy and Sao Paolo in Brazil were represented equally as leading institutions. The most frequently occurring keywords were "calcium silicate," "root canal sealer MTA-Fillapex," and "biocompatibility," while title terms such as "calcium," "sealers," "root," "canal," "silicate based," and "endodontic" occurred most often. According to the thematic map analysis, "solubility" appeared as a basic theme of concentrated research interest, and "single-cone technique" was identified as an emerging, inadequately developed theme. The co-occurrence analysis revealed 4 major clusters centered on sealers' biological and physicochemical properties, obturation techniques, retreatability, and adhesion. Conclusions: This analysis presents bibliographic features and outlines changing trends in HCSB sealer research. The research output is dominated by basic science articles scrutinizing the biological and specific physicochemical properties of commonly used HCSB sealers. Future research needs to be guided by studies with a high level of evidence that utilize innovative, sophisticated technologies.

Current Concepts in the Treatment of Traumatic C2 Vertebral Fracture : A Literature Review

  • Subum Lee;Junseok W Hur;Younggyu Oh;Sungjae An;Gi-Yong Yun;Jae-Min Ahn
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.6-13
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    • 2024
  • The integrity of the high cervical spine, the transition zone from the brainstem to the spinal cord, is crucial for survival and daily life. The region protects the enclosed neurovascular structure and allows a substantial portion of the head motion. Injuries of the high cervical spine are frequent, and the fractures of the C2 vertebra account for approximately 17-25% of acute cervical fractures. We review the two major types of C2 vertebral fractures, odontoid fracture and Hangman's fracture. For both types of fractures, favorable outcomes could be obtained if the delicately selected conservative treatment is performed. In odontoid fractures, as the most common fracture on the C2 vertebrae, anterior screw fixation is considered first for type II fractures, and C1-2 fusion is suggested when nonunion is a concern or occurs. Hangman's fractures are the second most common fracture. Many stable extension type I and II fractures can be treated with external immobilization, whereas the predominant flexion type IIA and III fractures require surgical stabilization. No result proves that either anterior or posterior surgery is superior, and the surgeon should decide on the surgical method after careful consideration according to each clinical situation. This review will briefly describe the basic principles and current treatment concepts of C2 fractures.

Interventional Management for Pelvic Trauma (골반 외상 인터벤션)

  • Jung Han Hwang;Jeong Ho Kim;Suyoung Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.835-845
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    • 2023
  • Traumatic pelvic injuries usually include high-energy crush injuries and are associated with significant morbidity and mortality. Mortality rates range from 6% to 15% and increase to 36%-54% in cases of fractures that result in increased pelvic volume. Therefore, retroperitoneal hemorrhage can spiral and progress to hemorrhagic shock. Pelvic hemorrhage most commonly occurs secondary to disrupted pelvic veins or fractured bones, and 10%-20% of cases involve arterial injuries. Owing to extensive bleeding and limitations of surgery for pelvic hemorrhage, interventional treatment is at the forefront of pelvic hemorrhage management. CT is an accurate indicator of active hemorrhage in patients with pelvic trauma that affects the diagnosis and management, including interventions. Identification of the site of hemorrhage is necessary for focused interventional treatment. The current trend toward a more conservative approach for treatment of pelvic trauma and advances in interventional radiology in the field of pelvic trauma may favor widespread use of interventional treatment for patients with pelvic injuries. In this review, we discuss therapeutic modalities available to the interventional radiologist and common angiographic treatment strategies and techniques.

Complete Rupture of the Extensor Hallucis Longus Tendon with Accessory Slip Mimicking a Partial Rupture: A Case Report (부분파열로 오인된 긴엄지발가락폄근의 주힘줄의 완전파열과 동반된 보조힘줄: 증례 보고)

  • Dong Hyeon Kim;Ji Hae Lee;Myeong Ja Jeong;Soung Hee Kim;Ji-Young Kim;Soo Hyun Kim;Mi-Jin Kang
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.726-730
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    • 2023
  • The accessory tendon of the extensor hallucis longus is a common type of extensor hallucis longus variation. This is a case of a 38-year-old female patient who initially considered conservative treatment for a suspected partial rupture, but finally underwent surgery after being diagnosed with a complete rupture of the main tendon and accessory tendon medial to the main tendon on MRI scan.

Total Hip Arthroplasty in Protrusio Acetabuli: A Systematic Review

  • Sajid Ansari;Kshitij Gupta;Tushar Gupta;Balgovind S. Raja;Pranav J.;Roop Bhushan Kalia
    • Hip & pelvis
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    • v.36 no.1
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    • pp.12-25
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    • 2024
  • Protrusio acetabuli, or abnormal protrusion of the femoral head into the acetabulum, requires performance of a total hip arthroplasty (THA) for which various reconstruction techniques and outcomes have been described. The aim of this systematic review is to provide a comprehensive analysis of the current evidence, evaluate treatment efficacy, compare surgical techniques, and identify topics for future research along with improving evidence-based decision-making, improving patient outcomes in the management of this condition. A thorough systematic review of the PubMed, Embase, Cochrane Library databases, and Scopus library was conducted, and articles describing techniques of THA for treatment of protrusion acetabuli were extracted. The initial search generated 751 results. After exclusion, 18 articles were included. Of these, eight were prospective studies and 10 were retrospective. Surgery was performed on 783 hips with a mean age of 60 years; 80% of females who mostly had inflammatory arthritis were followed up for 8.86 years (range, 2-15.4 years). Good outcomes have been achieved with THA using uncemented cups with bone graft; however, no conclusion could be drawn with regard to the femoral side. It can be concluded that the concept of restoration of the anatomical hip center of rotation is paramount for good outcome and better survival of the implant is important when using uncemented cups with a bone graft. In addition, screw augmentation for fixation is not recommended unless absolutely necessary. The most common complications were aseptic loosening and heterotopic ossification. While the former required revision, conservative management was administered for the latter.

Cranial Tibial Wedge Osteotomy for Treatment of Concomitant Cranial Cruciate Ligament Rupture and Medial Patellar Luxation Using Patient-Specific Surgical Guide in an Immature Cat

  • Ho-Hyun Kwak;Su-Hwan Koh;Jun-Hyung Kim;Heung-Myong Woo
    • Journal of Veterinary Clinics
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    • v.41 no.4
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    • pp.228-233
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    • 2024
  • A 7-month-old, 5.2 kg spayed female Norwegian Forest cat was referred for chronic, non-weight-bearing lameness in the left pelvic limb that has been present since 3 months old and has not responded to medical conservative therapy. Based on orthopedic and radiographic examination, concomitant cranial cruciate ligament rupture (CCLR) and medial patellar luxation (MPL) of the left hind limb were diagnosed. In this case, cranial tibial wedge osteotomy (CTWO) was adopted to overcome side effect of performing other osteotomy techniques such as impairing the growth plates in the proximal tibia. Additionally, patient-specific surgical guides were applied to improve surgical accuracy. The patient showed an improvement in weight-bearing scores and gait condition during follow-up periods without complications. In our case, CTWO combined with corrective surgery for MPL can be used to treat concomitant CCLR and MPL without damaged on the growth plates and shows good clinical outcomes in an immature cat. Furthermore, the use of a surgical guide facilitates surgical procedures that minimize surgical error and increase surgical precision. This case study suggests that CTWO assisted by patient-specific surgical guides may be a viable surgical option for treating an immature cat with concomitant CCLR and MPL.