• Title/Summary/Keyword: Conservative Treatments

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A Prospective Study Comparing Steroid Injection and Needle Fenestration for the Treatment of Chronic Plantar Fasciitis (만성 족저 근막염 환자에게 전향적으로 시행한 스테로이드 주사와 주사침 천공술)

  • Lee, Jiwon;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.4
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    • pp.171-176
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    • 2021
  • Purpose: This study sought to compare needle fenestration with a corticosteroid injection for the treatment of chronic plantar fasciitis. We hypothesized that needle fenestration would be as effective as a corticosteroid injection while avoiding the potential adverse effects of the corticosteroid. Materials and Methods: Forty female patients with unilateral chronic plantar fasciitis who did not respond to a minimum of 6 months of various conservative treatments were prospectively randomized to receive either a corticosteroid injection or needle fenestration. Visual analogue scale and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were used for all patients before treatment and at 3-, 6-, and 12-month following treatment. Results: The corticosteroid injection group had a before-treatment average AOFAS Ankle-Hindfoot score of 56.4, which increased to 87.3 at 3 months and 78.2 at 6 months after treatment but decreased to 62.4 at 12 months. The needle fenestration group had a before treatment average AOFAS ankle-hindfoot score of 49.5, which increased to 77.8 at 3 months and 92.1 at 6 months after treatment and remained at a high score of 89.4 at 12 months. There were no complications in either group. Conclusion: In the treatment of chronic plantar fasciitis, needle fenestration is as effective at 3- and 6-month post-treatment as a corticosteroid injection. Also, unlike a corticosteroid, its effect remains until 12 months post-treatment.

Effect of cooling water temperature on the temperature changes in pulp chamber and at handpiece head during high-speed tooth preparation

  • Farah, Ra'fat I.
    • Restorative Dentistry and Endodontics
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    • v.44 no.1
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    • pp.3.1-3.10
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    • 2019
  • Objectives: It was the aim of this study to evaluate the effect of cooling water temperature on the temperature changes in the pulp chamber and at the handpiece head during high-speed tooth preparation using an electric handpiece. Materials and Methods: Twenty-eight intact human molars received a standardized occlusal preparation for 60 seconds using a diamond bur in an electric handpiece, and one of four treatments were applied that varied in the temperature of cooling water applied (control, with no cooling water, $10^{\circ}C$, $23^{\circ}C$, and $35^{\circ}C$). The temperature changes in the pulp chamber and at the handpiece head were recorded using K-type thermocouples connected to a digital thermometer. Results: The average temperature changes within the pulp chamber and at the handpiece head during preparation increased substantially when no cooling water was applied ($6.8^{\circ}C$ and $11.0^{\circ}C$, respectively), but decreased significantly when cooling water was added. The most substantial drop in temperature occurred with $10^{\circ}C$ water ($-16.3^{\circ}C$ and $-10.2^{\circ}C$), but reductions were also seen at $23^{\circ}C$ ($-8.6^{\circ}C$ and $-4.9^{\circ}C$). With $35^{\circ}C$ cooling water, temperatures increased slightly, but still remained lower than the no cooling water group ($1.6^{\circ}C$ and $6.7^{\circ}C$). Conclusions: The temperature changes in the pulp chamber and at the handpiece head were above harmful thresholds when tooth preparation was performed without cooling water. However, cooling water of all temperatures prevented harmful critical temperature changes even though water at $35^{\circ}C$ raised temperatures slightly above baseline.

A Case of Frozen Shoulder Treated with Korean Medicine (開結舒經湯(개결서경탕) 투여를 포함한 동결견 환자 한방복합치료 치험례 1례)

  • Choi, Ki-won;Lee, Yu-jin;Kwon, Min-jin;Park, Han-bin;Jang, Won-suk;Kim, Ho;Bae, In-su;Youn, Jun-heum
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.883-892
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    • 2021
  • Background: This case study suggests the potential usefulness of Korean medicine treatment with herbal medicines for shoulder pain and improving the quality of life of patients with frozen shoulder. Case Summary: A patient had shoulder pain and decreased daily living function due to frozen shoulder. Korean medicine treatments, including herbal medicine; acupuncture at points TE14, HT1, BL11, SI10, and LI15; and pharma-acupuncture containing Sinbaro, were applied for 31 days. The Numeric Rating Scale scores for shoulder pain decreased from 7 to 4, and the Shoulder Pain and Disability Index scores decreased from 71.54 to 66.15, with an increase in range of motion from 30° flexion, 60° abduction, and 10° external rotation to around the normal range of motion. Conclusion: Korean medicine treatment can be considered an effective conservative management option for pain and decreased daily living function in patients with frozen shoulder.

Comparison of treatment outcomes in chronic coccygodynia patients treated with ganglion impar blockade versus caudal epidural steroid injection: a prospective randomized comparison study

  • Sencan, Savas;Yolcu, Gunay;Bilim, Serhad;Kenis-Coskun, Ozge;Gunduz, Osman Hakan
    • The Korean Journal of Pain
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    • v.35 no.1
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    • pp.106-113
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    • 2022
  • Background: Coccygodynia is one of the chronic, refractory painful musculoskeletal disorders. Interventional procedures are applied to patients unresponsive to initial treatment in coccygodynia. This study aims to compare the treatment outcomes of ganglion impar block (GIB) and caudal epidural steroid injection (CESI) in patients with chronic coccygodynia. Methods: This study was a prospective randomized comparison study conducted between June 2019 and January 2021. Patients diagnosed with chronic coccygodynia were randomly divided into two groups: the GIB group and the CESI group. The severity of pain, presence of neuropathic pain, and quality of life were evaluated using the Numeric Rating Scale, Leeds Assessment of the Neuropathic Symptoms and Signs Scale, and Short Form-12 Health Survey (SF-12), respectively. Results: A total of 34 patients in each group were included in the final analyses. While there was a significant decrease in pain intensity in both groups in the 3-month follow-up, this decrease was more significant in the GIB group at the 3rd week. There was a significant improvement in the SF-12 physical score and the number of patients with neuropathic pain in both groups in the 3rd week, but this improvement was not observed in the 3rd month. Conclusions: Although GIB may provide more pain relief in short term, both GIB and CESI are useful treatment methods in coccygodynia unresponsive to more conservative treatments.

Effect of Integrative Korean Medicine Treatment for Patient with Acute Pelvic Fracture Caused by Traffic Accident: Case Report (교통사고로 인한 급성 골반 골절 환자에 대한 한의학적 복합치료의 효과: 증례보고)

  • Seunghyeok Ku;Sunghyun Kim;Hyunwoo Moon;Sangjoon An;Hyunjin Choi;Seungyoon Hwangbo;Hyunsuk Park;Jonghyun Lee
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.1
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    • pp.97-108
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    • 2023
  • The purpose of this study is to investigate the effectiveness of integrative Korean medicine treatment for patients who were diagnosed as acute fracture on pelvis. The patients were treated by Korean medicine as conservative management including acupuncture, pharmacopuncture, herbal medication and cupping for hospitalization periods. Numerical rating scale (NRS), EuroQol-5 dimensions (EQ-5D), Oswestry disability index (ODI), patient global impression of change (PGIC), self-walking distance and the changes of symptoms were measured to assess patients' improvement. NRS, ODI scores and EQ-5D definitely improved on 4 patients of 5 cases. NRS decreased from 6~7 to 3~5, ODI scores decreased from 62~75.11 to 40~52 and EQ-5D increased from 0.013~0.331 to 0.47~0.773. PGIC and self-walking distance were also enhanced after treatments. In conclusion, this study suggests that integrative Korean medicine could be effective treatment for acute pelvic fracture.

Effectiveness of Korean Medicine Treatment for Knee Joint Pain with Plica Syndrome after Traffic Accident: Case Report (교통사고로 인한 추벽증후군에 대한 한의학적 치료의 효과: 증례보고)

  • Hyunwoo Moon;Seunghyeok Ku;Sunghyun Kim;Seungyoon Hwangbo;Hyunjin Choi;Sangjoon An;Jonghyun Lee;Hyunsuk Park
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.1
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    • pp.87-96
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    • 2023
  • This study aims to evaluate the effect of various Korean medicine treatment techniques on knee pain with medial plica syndrome. We treated three knee pain patients with medial plica syndrome using acupuncture, herbal medicine, pharmacopuncture and cupping during their hospitalization. EuroQol-five dimensions (EQ-5D), Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC), numerical rating scale (NRS) and the changes of symptoms were used for patient assessment. There were notable decreases in WOMAC and NRS and a notable increase in EQ-5D of case 1 and 3. There was also an improvement in the symptoms experienced by the patients. Our study is the first case report to demonstrate the applicability and effectiveness of Korean medicine treatment compared to those of the pre-existing surgical and conservative treatments for knee pain patients with medial plica syndrome.

Epigallocatechin-3-gallate prior to composite resin in abfraction lesions: a split-mouth randomized clinical trial

  • Luisa Valente Gotardo Lara Alves;Lisiane Martins Fracasso;Thiago Vinicius Cortez;Aline Evangelista Souza-Gabriel;Silmara Aparecida Milori Corona
    • Restorative Dentistry and Endodontics
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    • v.48 no.2
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    • pp.13.1-13.11
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    • 2023
  • Objectives: Natural extracts have been investigated as a biomimetic strategy to mechanically strengthen the collagen network and control the biodegradation of extracellular matrix. This study evaluated the effect of epigallocatechin-3-gallate (EGCG) on abfraction lesions prior to the composite resin. Materials and Methods: The sample consisted of 30 patients (aged between 28 and 60 years) with abfraction lesions located in 2 homologous premolars. The teeth were randomly assigned according to dentin treatment: 0.02% EGCG solution or distilled water (control). After enamel acid etching, the solutions were applied immediately for 1 minute. The teeth were restored with Universal Adhesive (3M) and Filtek Z350 XT (3M). Analyzes were done by 2 independent examiners using modified USPHS (retention, secondary caries, marginal adaptation, and postoperative sensitivity) and photographic (color, marginal pigmentation, and anatomical form) criteria at baseline (7 days) and final (18 months). The data analysis used Friedman and Wilcoxon signed-rank tests (α = 0.05). Results: At baseline, all restorations were evaluated as alpha for all criteria. After 18 months, restorations were evaluated as alpha for secondary caries, color, and marginal pigmentation. There was significant difference between baseline and 18 months (p = 0.009) for marginal adaptation and postoperative sensitivity (p = 0.029), but no significant difference were verified between treatments (p = 0.433). The EGCG group had a restoration retention rate of 93.3%, while the control group had 96.7%. Conclusions: The application of EGCG solution on abfraction lesions did not significantly influence the survival of the restorations based on clinical and photographic criteria.

Incorporation of amoxicillin-loaded microspheres in mineral trioxide aggregate cement: an in vitro study

  • Fabio Rocha Bohns;Vicente Castelo Branco Leitune;Isadora Martini Garcia;Bruna Genari;Nelio Bairros Dornelles Junior;Silvia Staniscuaski Guterres;Fabricio Aulo Ogliari;Mary Anne Sampaio de Melo;Fabricio Mezzomo Collares
    • Restorative Dentistry and Endodontics
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    • v.45 no.4
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    • pp.50.1-50.11
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    • 2020
  • Objectives: In this study, we investigated the potential of amoxicillin-loaded polymeric microspheres to be delivered to tooth root infection sites via a bioactive reparative cement. Materials and Methods: Amoxicillin-loaded microspheres were synthesized by a spray-dray method and incorporated at 2.5% and 5% into a mineral trioxide aggregate cement clinically used to induce a mineralized barrier at the root tip of young permanent teeth with incomplete root development and necrotic pulp. The formulations were modified in liquid:powder ratios and in composition by the microspheres. The optimized formulations were evaluated in vitro for physical and mechanical eligibility. The morphology of microspheres was observed under scanning electron microscopy. Results: The optimized cement formulation containing microspheres at 5% exhibited a delayed-release response and maintained its fundamental functional properties. When mixed with amoxicillin-loaded microspheres, the setting times of both test materials significantly increased. The diametral tensile strength of cement containing microspheres at 5% was similar to control. However, phytic acid had no effect on this outcome (p > 0.05). When mixed with modified liquid:powder ratio, the setting time was significantly longer than that original liquid:powder ratio (p < 0.05). Conclusions: Lack of optimal concentrations of antibiotics at anatomical sites of the dental tissues is a hallmark of recurrent endodontic infections. Therefore, targeting the controlled release of broad-spectrum antibiotics may improve the therapeutic outcomes of current treatments. Overall, these results indicate that the carry of amoxicillin by microspheres could provide an alternative strategy for the local delivery of antibiotics for the management of tooth infections.

Pomegranate extract on eroded dentin: antioxidant action, bond strength and morphology of the adhesive interface after aging

  • Thiago Vinicius Cortez;Nathalia Mancioppi Cerqueira;Julia Adornes Gallas;Wanderley Pereira Oliveira;Silmara Aparecida Milori Corona;Aline Evangelista Souza-Gabriel
    • Restorative Dentistry and Endodontics
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    • v.49 no.1
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    • pp.9.1-9.14
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    • 2024
  • Objectives: This study aimed to evaluate the effect of pomegranate solution (Punica granatum) on eroded dentin through antioxidant action, shear bond strength (SBS) and interface morphology. Materials and Methods: The 10% pomegranate peel extract was prepared by the lyophilization method. Punicalagin polyphenol was confirmed by high-performance liquid chromatography. Antioxidant activity was evaluated by capturing the 2,2-diphenyl1-picrylhydrazyl (DPPH) radical. For the SBS, 48 dentin fragments were divided into sound or eroded, and subdivided according to the pretreatment (n = 12): water or P. granatum. The surfaces were restored with self-etch adhesive and a bulk-fill resin (Ecosite; DMG). The SBS was done immediately (24 hours) and after thermal cycling + water storage (12 months). For scanning electron microscopy, 48 dentin fragments (24 sound and 24 eroded) received the same treatments as for SBS (n = 6), and they were analyzed after 24 hours and 12 months. Results: The P. granatum had antioxidant action similar (p = 0.246) to the phenolic standard antioxidants. After 24 hours, eroded dentin had lower SBS than sound dentin (p < 0.001), regardless of the pretreatment. After 12 months, P. granatum maintained the SBS of sound dentin (13.46 ± 3.42 MPa) and eroded dentin (10.96 ± 1.90 MPa) statistically similar. The lowest values were found on eroded dentin treated with water (5.75 ± 1.65 MPa) (p < 0.001). P. granatum on eroded dentin caused peritubular demineralization and hybrid layer with resin tags. Conclusions: The pomegranate extract had antioxidant action and preserved the adhesive interface of the eroded dentin.

Nonvital Pulp Therapy of Elongation of Roots of Mandibular Cheek Teeth in Pet Rabbits (애완토끼에서 과잉성장된 하악치아의치신경치료 연구)

  • Park, Cheon-Sik;Cha, Se-Yeoun;Kang, Min;Kim, Jury;Jeong, Soon-Wuk;Jang, Hyung-Kwan
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.474-482
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    • 2012
  • Elongation of cheek teeth roots in pet rabbits is very common, and is associated with malocclusion followed by reduced appetite, salivation, periapical abscess, and epiphora. Conservative methods including medication, drainage, irrigation, tooth trimming, intraoral and extraoral extraction, surgical treatment of periapical abscessation, and diet control have been adapted as the only treatments to resolve elongation of teeth roots. However, remaining challenges include the long-term period of cure and recurrence. This study was performed to investigate the possibility of nonvital pulp therapy on elongation of the mandibular cheek teeth roots in pet rabbits. Thirty-one pet rabbits with dental problems due to root elongation were submitted. Ten pet rabbits among them were treated by nonvital pulp therapy procedures (group A), while the others were treated by conservative methods (group B). Appetite improved within 1-5 days after nonvital pulp therapy and the treatment was discontinued 1 month postoperatively in group A. Abscess occurred in another site not treated with nonvital pulp therapy in only two rabbits. Growth of the mandibular cheek teeth treated with nonvital pulp therapy stopped, resulting in malocclusion, intraoral inflammation from the enamel spur, and abscess of the teeth roots. In the group B rabbits treated with conservative therapy, partial drainage, long term medication, recurrent oral trimming and control of repeated oral inflammation occurred. Consequently, buccotomy or tooth extraction was performed in group B. Owners were satisfied with nonvital pulp therapy preventing dental root abscess and repeated troubles including inflammation and malocclusion and reduction of the treatment period. These results suggest that nonvital pulp therapy can be performed on pet rabbits with elongation of mandibular cheek teeth roots.