• Archives of Reconstructive Microsurgery
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• v.24 no.1
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• pp.24-27
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• 2015

During flap elevation, most perforators are cut except one or more perforators that are essential to flap survival. However these cutout perforators can cause deterioration of the blood circulation of the flap. To salvage the jeopardized flaps, rebuilding the perforator system is essential for flap survival. In the first case, after flap elevation, the upper abdominal flap margin was severely ischemic. To supply blood to the upper abdominal flaps, we found and used a major perforator underneath the upper abdominal flap which was cut earlier during the elevation, and we performed reanastomosis with ipsilateral deep inferior epigastric artery. Upper abdominal flap ischemic area was limited to a narrow suture area. In the second case, we performed free superficial inferior epigastric artery (SIEA) flap reconstruction. After successful anastomosis of the SIEA and superficial inferior epigastric vein (SIEV) with internal mammary artery and vein, serious venous congestion occurred immediately because of SIEV malfunction. We found the largest perforator vein under the flap, as an alternate way to drain, then connected it with the thoracoacromial vein with a vein graft harvested in the contralateral SIEV. Circulation has improved. In conclusion, perforator system reconstruction is essential in a jeopardized flap salvage.

• Restorative Dentistry and Endodontics
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• v.42 no.3
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• pp.240-252
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• 2017

The restoration of endodontic tooth is always a challenge for the clinician, not only due to excessive loss of tooth structure but also invasion of the biological width due to large decayed lesions. In this paper, the 7 most common clinical scenarios in molars with class II lesions ever deeper were examined. This includes both the type of restoration (direct or indirect) and the management of the cavity margin, such as the need for deep margin elevation (DME) or crown lengthening. It is necessary to have the DME when the healthy tooth remnant is in the sulcus or at the epithelium level. For caries that reaches the connective tissue or the bone crest, crown lengthening is required. Endocrowns are a good treatment option in the endodontically treated tooth when the loss of structure is advanced.

• Restorative Dentistry and Endodontics
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• v.47 no.4
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• pp.36.1-36.17
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• 2022

Objectives: This study aimed to evaluate the effect of aging on the marginal quality of glass hybrid (GH) material used to elevate dentin gingival margins, and to analyze the consistency of the results obtained by 3 in vitro methods. Materials and Methods: Ten teeth received compound class II cavities with subgingival margins. The dentin gingival margins were elevated with GH, followed by resin composite. The GH/gingival dentin interfaces were examined through digital microscopy, scanning electron microscopy (SEM) using resin replicas, and according to the World Dental Federation (FDI) criteria. After initial evaluations, all teeth were subjected to 10,000 thermal cycles, followed by repeating the same marginal evaluations and energy dispersive spectroscopy (EDS) analysis for the interfacial zone of 2 specimens. Marginal quality was expressed as the percentage of continuous margin at ×200 for microscopic techniques and as the frequency of each score for FDI ranking. Data were analyzed using the paired sample t-test, Wilcoxon signed-rank test, and Pearson and Spearmen correlation coefficients. Results: None of the testing techniques proved the significance of the aging factor. Moderate and strong significant correlations were found between the testing techniques. The EDS results suggested the presence of an ion-exchange layer along the GH/gingival dentin interface of aged specimens. Conclusions: The marginal quality of the GH/dentin gingival interface defied aging by thermocycling. The replica SEM and FDI ranking results had stronger correlations with each other than either showed with the digital microscopy results.