Myoglobin cast nephropathy following multiple bee stings

Bee stings usually result in mild allergic reactions; however, mass envenomation can cause severe complications such as rhabdomyolysis, hemolysis, shock, or multi-organ damage. Rhabdomyolysis can result in acute renal failure either by tubular obstruction by myoglobin casts or by direct cytotoxic injury. We present a case of a 12-year-old female child who presented with sudden onset anuria and hypertension following mass envenomation by bees. A renal biopsy was performed, the microscopic evaluation of which revealed tubular injury, with associated intratubular pigmented casts. The casts stained positive for myoglobin immunohistochemical stain, thus confirming a diagnosis of myoglobin cast nephropathy. The patient was given IV steroids and underwent seven sessions of hemodialysis, following which there was complete recovery of renal function.

The use of serial casting in the treatment of children with cerebral palsy: a study protocol

Introduction: Cerebral Palsy (CP) is characterized by a disorder of posture and movement, commonly leading to disabling orthopedic alterations, including muscle shortening, especially in the lower limbs. Stretching methods, performed gradually, are necessary to delay the impairment in function from muscle shortening. The use of serial casting aims to promote proper alignment, and an ideal and stable support base, in addition to better bone and joint health, leading to better posture, mobility, muscle function, and, subsequently, increased fitness and health.Objective: evaluate range of motion, postural control, and motor performance in children with CP, using serial casting, as well as to measure its effect on fitness through the autonomic nervous system (ANS).Methods: Sixty children and adolescents with CP, of both sexes, 3 to 12 years of age, will be divided into three groups: Groups A, B, and C, with 20 individuals each. Group A will use serial casting, Group B will use the orthosis continuously (with removal only allowed for bathing), and Group C will use the orthosis in their daily routine. Range of motion of the ankle of first and second resistance levels (R1 and R2), gross motor function measure (GMFM), and balance (measured by BERG scale) will be used in the initial and final assessments, and after 6 months and one year of follow-up. Timed-up-and-go (TUG), load distribution (baropodometry), motor performance measured through a real basketball game and the virtual MoveHero game, analysis of body angulation with "mydartfish", and cardiac autonomic modulation through heart rate variability will be assessed in three different situations: barefoot, with orthosis, and with casting.Conclusion: Serial casting demonstrates the potential to produce positive results in the treatment of individuals with CP regarding better alignment, with consequent motor and autonomic improvement.

Comportamiento de fracturas diafisarias del fémur en el niño

Introducción: Las fracturas de la diáfisis del fémur en las edades pediátricas representan un problema de salud que necesita de la intervención del ortopedista, quien aplica una de las distintas modalidades de tratamiento, que van desde la conservadora a la quirúrgica. Objetivo: Describir las características epidemiológicas de un grupo de pacientes pediátricos diagnosticados y tratados con esta enfermedad traumática. Métodos: Se realizó un estudio observacional descriptivo en 54 pacientes atendidos en el Hospital Pediátrico Provincial Dr. Eduardo Agramonte Piña de la provincia Camagüey desde el primero de enero de 2018 al 31 de diciembre del año 2022 con un total de 60 meses. Resultados: La razón sexo masculino-femenino de los 54 pacientes fue de 2,8 a 1, fémur izquierdo-derecho de 1,2 a 1. El promedio de edades en general fue de 8,1 años. La estadía hospitalaria promedio fue de seis días. El tercio medio estuvo afectado en el 57,4 % de los casos. Los meses de julio y diciembre en conjunto con los días del martes y domingo fueron los que presentaron la mayor cantidad de pacientes. El tratamiento más empleado fue la colocación de espica de yeso en 28 pacientes para un 51,8 %, los clavos rígidos fueron utilizados en 16 enfermos y representó el 29,6 %. Por su parte, los clavos flexibles fueron colocados en 10 casos para un 18,5 %. Conclusiones: Las fracturas de la diáfisis femoral en las edades pediátricas son más frecuentes en el sexo masculino, lado izquierdo, en el tercio medio, con patrón transversal. Los meses del año con mayor incidencia fueron julio y diciembre y los días martes y domingo. El tratamiento depende de la edad, peso y configuración de la fractura.

Introduction: Fractures of the diaphysis of the femur in children, represent a health problem that requires the intervention of an orthopedist who applies various treatment modalities ranging from conservative to surgical. Objective: To describe the epidemiological characteristics of a group of pediatric patients with this traumatic entity. Methods: A descriptive observational study was carried out in 54 patients treated at the Dr. Eduardo Agramonte Piña Provincial Pediatric Hospital in the city of Camagüey from January 1st, 2018 to December 31st, 2022 with a total of 60 months. Results: The male-female sex ratio of the 54 patients was 2.8 to 1, left-right femur 1.2 to 1. The average age in general was 8.1 years. The average hospital stay was 6 days. The middle third was affected in 57.4 % of the cases. The months of July and December together with the days of Tuesday and Sunday were the ones that presented the largest number of patients. The most used treatment was the placement of a plaster spike in 28 patients for 51.8%, rigid intramedullary nails were used in 16 patients and represented 29.6 %. On the other hand, flexible intramedullary nails were placed in 10 cases for 18.5%. Conclusions: Femoral diaphysis fractures in children are more frequent in males, left side, in the middle third, with a transversal pattern. The months of the year with the highest incidence were July and December and on Tuesdays and Sundays. Treatment depends on age, weight, and configuration of the fracture.

Evaluation of an open access generic 3D software for Orthodontic diagnosis and treatment planning

Aim: To evaluate the accuracy and the validity of orthodontic diagnostic measurements, as well as virtual tooth transformations using a generic open access 3D software compared to OrthoAnalyzer (3Shape) software; which was previously tested and proven for accuracy. Methods: 40 maxillary and mandibular single arch study models were duplicated and scanned using 3Shape laser scanner. The files were imported into the generic and OrthoAnalyzer software programs; where linear measurements were taken twice to investigate the accuracy of the program. To test the accuracy of the program format, they were printed, rescanned and imported into OrthAnalyzer. Finally, to investigate the accuracy of editing capabilities, linear and angular transformation procedures were performed, superimposed and printed to be rescanned and imported to OrthoAnalyzer for comparison. Results: There was no statistically significant difference between the two groups using the two software programs regarding the accuracy of the linear measurements (p>0.05). There was no statistically significant difference between the different formats among all the measurements, (p>0.05). The editing capabilities also showed no statistically significant difference (p>0.05). Conclusion: The generic 3D software (Meshmixer) was valid and accurate in cast measurements and linear and angular editing procedures. It can be used for orthodontic diagnosis and treatment planning without added costs

Three-dimensional analysis of the gap space under forearm casts / 中华创伤杂志(英文版)

PURPOSE@#Secondary displacement represents a frequent complication of conservative treatment of fractures, particularly of the distal radius. The gap space between skin and cast may lead to a certain degree movements and this increased mobility might favor redisplacement. The aim of this study was to develop a new 3D method, to measure the gap space in all 3 geometrical planes, and to validate this new technique in a clinical setting of distal radius fractures.@*METHODS@#This study applies 3D imaging to measure the space between plaster and skin as a potential factor of secondary displacement and therefore the failure of conservative treatment. We developed and validated a new methodology to analyze and compare different forearm casts made of plaster of Paris and fiberglass. An unpaired t-test was performed to document differences between the investigated parameters between plaster of Paris and fiberglass casts. The significance level was set at p < 0.05.@*RESULTS@#In a series of 15 cases, we found the width of the gap space to average 4 mm, being slightly inferior on the radial side. Comparing the two different casting materials, plaster of Paris and fiberglass, we found a significantly larger variance of space under casts made of the first material (p=0.39). A roughness analysis showed also a markedly significantly higher irregularity of the undersurface of plaster of Paris as compared with fiberglass.@*CONCLUSION@#This study allows for a better understanding of the nature of the "gap space" between cast and skin and will contribute to develop and improve new immobilization techniques and materials.

Seguimiento por cuatro años de pacientes con pie equinovaro aducto congénito manejados con método Ponseti / Four years follow up in congenital talipes equino varus patients managed with Ponseti method

Resumen: Introducción: El pie equinovaro aducto congénito (PEVAC) es una deformidad congénita frecuente del pie. El método Ponseti es el estándar de oro para el tratamiento. Consiste en la manipulación del pie con yesos seriados semanales, una cirugía mínimamente invasiva y barra Dennis-Brown hasta los cinco años. Objetivo: Describir el seguimiento de los pacientes con PEVAC tratados mediante método Ponseti. Material y métodos: Estudio descriptivo, longitudinal, durante 2013-2019, en pacientes con PEVAC manejados con método Ponseti. Se incluyeron pacientes con PEVAC uni- o bilateral, menores de dos años, sin cirugía previa, cuyos padres firmaron consentimiento informado. Se excluyeron pacientes con otras malformaciones. Se colocó yeso semanal seriado por cuatro a ocho semanas, se realizó tenotomía del tendón de Aquiles y yeso por tres semanas más; luego calzado de horma inversa con barra Dennis-Brown. Se registraron las revisiones al día cero, a las ocho semanas y cada tres meses hasta los cinco años de edad. Se valoró la corrección de la deformidad y el dolor a la marcha. Resultados: Fueron 22 pacientes; 17 (77.3%) corrigieron más de 90% de la deformidad, con adecuada funcionalidad y 86.3% sin dolor a la marcha, seguimiento medio de 3.9 años (uno a siete años); seis pacientes tuvieron recidiva (27.27%) por mal apego, uno retratado con yesos y cinco con transferencia de tibial anterior, todos con éxito. Conclusiones: El PEVAC manejado con método Ponseti corrige más de 90% de la deformidad y sin o mínimo dolor con buen apego al tratamiento. Tuvimos una recidiva de 27.27% en nuestra serie.

Abstract: Introduction: Congenital talipes equino varus (club foot) is a frequent congenital deformity of the foot. The Ponseti method is the gold standard for treatment. It consists of foot manipulation with weekly serial cast, minimally invasive surgery and Dennis-Brown bar up to five years. Objective: To describe the follow-up of patients with PEVAC treated using the Ponseti method. Material and methods: Descriptive, longitudinal study, during 2013-2019, in patients with PEVAC managed with Ponseti method. We included patients with uni- or bilateral club foot, under two years of age, without prior surgery, whose parents signed informed consent. Patients with other malformations were excluded. Serial weekly cast was placed for 4-8 weeks, a tenotomy of the Achilles tendon was performed, and cast for three more weeks; then reverse footwear with Dennis-Brown bar. The revisions were recorded at day zero, at eight weeks and every three months up to five years of age. Correction of deformity and pain on walking was assessed. Results: There were 22 patients; 17 (77.3%) corrected more than 90% of the deformity, with adequate functionality and 86.3% without pain on gait, mean follow-up 3.9 years (1-7 years); six patients relapsed (27.27%) due to poor attachment, one re-treated with cast, and five with anterior tibial transfer, all successfully. Conclusions: The club foot managed with Ponseti method corrects more than 90% of the deformity and without or minimal pain with good adherence to treatment. We had a 27.27% recurrence in our series.

Risk factors for avascular necorosis after closed reduction of developmental dysplasia of the hips / 中华骨科杂志

Objective:To analyze the risk factors of avascular necrosis (AVN) after closed reduction and spcia casting in treating developmental dysplaisa of the hip (DDH).Methods:The patients with DDH who received closed reduction in our department from January 2016 to December 2017 were retrospectively reviewed. The inclusion criteria included aged at reduction ≥6 months, achieving successful reduction, having complete data with more than 2 years follow-up. A total of 48 cases with 54 hips were included in the present study. Among them, there were 2 males and 46 females, 41 unilateral hips and 13 bilateral hips. The mean age at closed reduction was 16.4±3.8 months (range 6-24 months). The mean follow-up duration was 2.9±1.8 years (range 2.3-4.1 years). Closed reduction was conducted under general anesthesia followed with a spcia cast immobilization. The abduction angle of the cast was recorded. The stability of reduction was evaluated by Ramsey safety zone. The maximum abduction and re-dislocation abduction were recorded. The quality of reduction was evaluated by the medial gap and femoral head coverage on intraoperative arthrography and post-reduction MRI. AVN was diagnosed according to Salter criteria. The risk factors of AVN were analyzed by univariate and binary logistic regression analysis.Results:AVN occurred in 12 hips (22.2%) of 54 hips. International Hip Dysplasia Institute (IHDI) grade and the difference between maximum abduction and cast abduction (Max-Cast abduction) were related to the occurrence of AVN in univariate analysis. The incidence of AVN in hips of IHDI grade 4 (42.9%, 9/21) was significantly higher than that in hips of IHDI grade 3 (9.7%, 3/31) (χ 2=6.007, P=0.018). However, the hips of IHDI grade 3 and 2 (0%, 0/2) presented a similar incidence of AVN (χ 2=0.000, P=1.000). The Max-Cast abduction was -0.7°±5.9° in the AVN group and 6.1°±7.6° in the AVN group ( t=2.125, P=0.038). Finally, IHDI grade ( OR=8.256, P=0.015) and Max-Cast abduction ( OR=0.832, P=0.047) were both independent factors of AVN in multivariate analysis. Conclusion:Most of the hips with AVN are IHDI grade 4 after closed reduction for DDH. The abduction angle in a spica cast could not be significantly related to the occurrence of AVN. However, the risk of AVN might be increased when the cast abduction is close to or beyond the maximum abduction. Safe abduction in the cast should be 5 to 10 degrees less than maximum abduction at least.

Results of a Standard versus an Accelerated Ponseti Protocol for Clubfoot: A Prospective Randomized Study

BACKGROUND: The aim of this study was to compare the results of the standard once-weekly Ponseti casting technique to an accelerated twice-weekly regimen in our population cohort.METHODS: A prospective randomized controlled study was conducted with a total of 100 consecutive patients (158 feet) being enrolled for the study. Fifty patients were randomized to each group and followed up for at least one year.RESULTS: Initial mean Pirani score was 4.67 ± 0.73 in the standard group and 4.35 ± 0.76 in the accelerated group, and the score decreased to 0.34 ± 0.38 and 0.35 ± 0.31, respectively. Initial mean Dimeglio score was 11.75 ± 2.75 in the standard group and 10.51 ± 2.57 in the accelerated group, and the score decreased to 0.79 ± 0.77 and 0.79 ± 0.71, respectively, immediately after casting. The average number of casts required to correct all the deformities was 6.3 ± 1.2 in the standard group and 6.1 ± 1.4 in the accelerated group (p = 0.45). Average time spent in cast was 58.2 ± 8.3 days in the standard group and 39.5 ± 5.2 days in the accelerated group (p < 0.001). Percutaneous Achilles tendon tenotomy was done in 86.42% in the standard group and in 84.41% in the accelerated group (p = 0.72). Final results were assessed by using a modified functional rating scoring system: 55.55% clubfeet had excellent results and 44.45% had good results in the standard group, whereas 66.23% clubfeet had excellent results and 33.77% had good results in the accelerated group. None amongst the two groups had fair or poor results.CONCLUSIONS: These results suggest that the accelerated Ponseti technique significantly reduces the correction time without affecting the final results and that it is as safe and effective as the traditional Ponseti technique.

Corrosion Cast- Comparison of Different Techniques and Materials Used in Corrosion Casting

In medical terms, cast refers to the replica obtained after filling a luminal structure with resin to reproduce its morphology. It can be accomplished by removing the soft tissue around it, termed corrosion or maceration. Corrosion casts form very important material in learning morphology of various structures like- vascular tree, tracheobronchial tree, luminal casts of various organs. Vascular casts have been studied using scanning electron microscopy, which has contributed to understanding the biological processes. If the specimen is fixed after resin injection, it can be used for surgical training, medical teaching etc. In the present review, the authors have tried to analyse the technical aspects of corrosion casting. We have also added note on polyurethane foam cast of coronary vessels, which was carried out in our laboratory.

Thermoplastic nipple splint: A simple method of maintaining nipple projection

Maintaining projection of the reconstructed nipple is important for achieving natural and aesthetically appealing outcomes in breast reconstruction. Although various methods of avoiding mechanical force on the reconstructed nipple have been developed, the existing methods are inconvenient, crude, non-reusable, and difficult to clean or adjust. In the present study, a simple method of creating a nipple splint using a thermoplastic material is described. This splint can be easily manipulated, washed, and reused, and it is comfortable to wear for long-term use without any complications and convenient for the patient to apply.

Microvascular anatomy of olfactory and accessory olfactory (vomeronasal) organs in adult Xenopus laevis: scanning electron microscopy of vascular corrosion casts / Anatomía microvascular de órganos olfatorios y accesorios (vomeronasal) en adultos Xenopus laevis: microscopía electrónica de barrido de moldes de corrosión vascular

Microvascular anatomy and histomorphology of olfactory and vomeronasal organs in adult Xenopus laevis Daudin were studied by scanning electron microscopy of vascular corrosion casts and paraplast embedded stained serial tissue sections. Results show that the arterial supply is bilaterally by terminal arterioles of the medial branch of the nasal artery and by the palatal artery. Arterioles give rise to a capillary meshwork characteristic for respiratory surfaces in principal chambers and in dorsal and caudal areas of middle chambers. Anterior and inferior areas of the middle chambers own a distinctly different capillary network with conspicuous short capillary loops. Loops have a dilated tip and extend in acute angles towards the chamber lumen. The vomeronasal organ (VNO) locates beneath the olfactory organ. It has a medial to lateral extension and attaches with its caudal circumference to the medial nasal glands. Its capillary bed displays rectangular meshes which preferentially orientate along the long axis of the VNO. Locally, capillaries form short hairpin-like or strongly twisted loops with dilated tips which point towards the lumen of the VNO. These capillaries slow-down blood velocity and may lead to an increased exchange of oxygen, nutrients and water-borne odorants in the middle chambers and of pheromones in the VNO. In the latter vascular structures are present which might serve as a vascular pump.

Se estudiaron la anatomía microvascular e histomorfología de los órganos olfatorios y vomeronasales de Xenopus laevis Daudin adultos, mediante microscopía electrónica de barrido de moldes de corrosión vascular y secciones de tejido seriadas, teñidas e incluídas en paraplast. Los resultados muestran que el suministro arterial es bilateral por arteriolas terminales de la rama medial de la arteria nasal y por la arteria palatina. Las arteriolas dan lugar a un lecho capilar característico de las superficies respiratorias en las cámaras principales y en las áreas dorsal y caudal de las cámaras intermedias. Las áreas anterior e inferior de las cámaras centrales poseen una red capilar significativamente diferente con llamativos bucles capilares cortos. Los bucles tienen una punta dilatada y se extienden en ángulos agudos hacia la luz de la cámara. El órgano vomeronasal (VNO) se ubica debajo del órgano olfatorio. Se extiende de medial a lateral y se une con su circunferencia caudal a las glándulas nasales mediales. El lecho capilar muestra mallas rectangulares que se orientan preferentemente a lo largo del eje longitudinal del VNO. Localmente, los capilares forman bucles cortos en forma de horquilla o fuertemente retorcidos con puntas dilatadas que apuntan hacia la luz del VNO. Estos capilares ralentizan la velocidad de la sangre y pueden conducir a un mayor intercambio de oxígeno, nutrientes y odorizantes, a base de agua en las cámaras intermedias y de feromonas, en el VNO. En este último, están presentes estructuras vasculares que podrían servir como una bomba vascular.

Nebulized N-Acetylcysteine for Management of Plastic Bronchitis

Background: Plastic bronchitis is characterized by formation of extensive obstructiveendobronchial casts and high recurrence rates. Case characteristics: Two children (1-year-old girl, 7-year-old boy) who had recurrent episodes of respiratory distress with acuteworsening. Bronchoscopy revealed membrane-like casts. Both children were managed withnebulized N-acetylcysteine in addition to management for asthma. Outcome: Symptom-free without recurrence for more than 9 months of follow-up. Message: Nebulized N-acetylcysteine may be helpful in prevention of recurrence of plastic bronchitis due to asthma.

Influence of preheating and post-curing on a novel fiber-reinforced composite post material

Abstract The aim of this study was to investigate the influence of preheating and post-curing methods on diametral tensile strength (DTS), flexural strength (FS), knoop microhardness (KHN), and degree of conversion (DC) of an experimental fiber-reinforced composite (FRC). Specimens (30 wt% of 3-mm-short E-glass fiber, 22.5 wt% of methacrylated-based resin and 47.5 wt% of filler particles) were subjected to: P - photocuring at 1500 mW/cm2 for 40 s (control); P/M - photocuring and microwave post-curing (540W/5 minutes); P/A - photocuring and autoclave post-curing (120°C/15 minutes); PH-P - preheating (60°C) and photocuring; PH-P/M - preheating, photocuring and microwave post-curing; and PH-P/A - preheating, photocuring and autoclave post-curing. Specimens for DTS (Ø 3 x 6 mm) and FS (25 x 2 x 2 mm) were tested at Instron 5965. KHN employed a 50g load for 30s. DC was measured using FTIR spectroscopy. Statistical analysis employed: factorial analysis, normality test, one-way ANOVA and Tukey's HSD test, independent T-test and the Dunnett test. Interaction between factors was not significant (P>0.05). Preheating promoted significantly higher values of FS and KHN (p = 0.0001). Post-curing promoted significantly higher values for KHN (p = 0.0001). For DTS (p = 0.066) and DC (p= 0.724) no statistical difference was found between groups. SEM images showed that preheating promoted better interaction between glass fibers and resin matrix. Preheating increased FS, KHN and DTS, and post-curing increased KHN. DC was not affected by both methods. Preheating and post-curing methods can be used to improve some mechanical properties of FRCs' but degree of conversion remains unaffected.

Anterior esthetic restoration accompanied by gingivectomy of patient with unesthetic tooth proportion of maxillary anterior teeth: a case report

The maxillary anterior teeth play an important role in esthetics. The esthetic of maxillary anterior teeth is closely related to tooth morphology and also harmony with gingiva. Precise diagnosis and treatment plan are essential to satisfy patient's demand, and sometimes surrounding soft tissue management is involved to achieve the goal. Gingivectomy can be considered as one method to make esthetic restoration possible. As well as esthetics, function has to be considered in maxillary anterior teeth restoration. Definitive cast of abutment and diagnostic cast waxed up labially were superimposed with model scanner, so can provide former comfortable occlusion. This case report demonstrates functional and esthetic improvements of two patients through gingivectomy and the data of superimposed image of casts.

Treatment of children with femoral subtrochanteric fractures by the external fixation combined with single hip plaster / 中国骨伤

<p><b>OBJECTIVE</b>To explore curative effects of external fixation combined with single hip plaster in treating children with femoral subtrochanteric fracture.</p><p><b>METHODS</b>Form March 2009 to July 2016, 15 children with femoral subtrochanteric fracture were treated with external fixation combined with single hip plaster, including 9 males and 6 females with a mean age of 8.5 years old ranging from 5 to 14 years old. According to fracture classification of Seinsheimer, 3 cases were type IIA, 4 cases were type IIB, 3 cases were type IIC, 2 cases were type IIIA, 1 case was type IIIB, 1 case was type IV, 1 case was type V. Complications and radiographs were retrospectively reviewed. Postoperative function of hips were evaluated according to Sanders criteria.</p><p><b>RESULTS</b>All children were followed up from 16 to 48 months with an average of 32 months. No early closure of epiphysis, bone nonunion and breakage of screw occurred. According to the Sanders score standard of hip function, the result was excellent in 14 cases, good in 1 case. There were no hip inversion, limb shortening, excessive growth and other malformations.</p><p><b>CONCLUSIONS</b>External fixation combined with single hip plaster for the treatment of children is a safe and effective fixation, which provide a new choice of femoral subtrochanteric fracture.</p>

Red blood cell casts induced acute renal failure in IgA nephropathy: a childhood case report with literature review / 临床儿科杂志

Objective To explore the rare cause of renal failure in childhood IgA nephropathy.MethodsA six year-old boy presented with recurrent gross hematuria for 3 months and increased serum creatinine for 5 days, blood and urine routine test, renal function, urinary protein concentration and renal biopsy were performed for diagnosis.Results The boy had three episodes of recurrent gross hematuria with a predisposed respiratory tract infection, he recovered within a week after antibiotic therapy from previous two episodes, but oliguria and renal failure were occurred in the third episode. Renal biopsy showed IgA nephropathy with presence of red blood cell casts in as much as 50% of the tubular lumen and acute tubular lesion. His renal function recovered gradually to normal within 4 weeks after treatment with anti-infection, diuresis and alkalization of urine. Conclusions This article reported the renal failure case induced by tubular damage and obstruction by red blood cell casts in childhood IgA nephropathy.

A Nipple Splint Using a Textile-Like Thermoplastic Cast

Nipples are protected by nipple splints after reconstructing or reshaping them using various materials. We have devised a nipple splint using textile-like thermoplastic tape, which is made out of knitted hybrid fabric, is latex-free, and keeps its position well beneath a brassiere with simple taping. Its conformation is readily modifiable according to each patient's breast shape, if it is soaked into hot water. A patient who underwent nipple reconstructive surgery had this thermoplastic cast applied for a month, and the contour of the nipple was well preserved without reports of skin irritation or pressure sores developing on the areola.

Reliability of Bolton analysis evaluation in tridimensional virtual models

Objective: The present study aimed at evaluating the reliability of Bolton analysis in tridimensional virtual models, comparing it with the manual method carried out with dental casts.Methods:The present investigation was performed using 56 pairs of dental casts produced from the dental arches of patients in perfect conditions and randomly selected from Universidade Federal da Bahia, School of Dentistry, Orthodontics Postgraduate Program. Manual measurements were obtained with the aid of a digital Cen-Tech 4"(r) caliper (Harpor Freight Tools, Calabasas, CA, USA). Subsequently, samples were digitized on 3Shape(r)R-700T scanner (Copenhagen, Denmark) and digital measures were obtained by Ortho Analyzer software.Results:Data were subject to statistical analysis and results revealed that there were no statistically significant differences between measurements with p-values equal to p = 0.173 and p= 0.239 for total and anterior proportions, respectively.Conclusion:Based on these findings, it is possible to deduce that Bolton analysis performed on tridimensional virtual models is as reliable as measurements obtained from dental casts with satisfactory agreement.

Objetivo: o presente estudo teve como objetivo avaliar a confiabilidade da análise de Bolton em modelos virtuais tridimensionais, comparando-a com a realizada em modelos de gesso.Métodos:foram utilizados 56 pares de modelos de gesso das arcadas dentárias de pacientes oriundos do Curso de Especialização em Ortodontia da Faculdade de Odontologia da Universidade Federal da Bahia, escolhidos aleatoriamente e em perfeito estado. Medidas manuais foram obtidas utilizando-se o paquímetro digital Cen-Tech(r) 4" (Harpor Freight Tools, Calabasas, CA, EUA). Em seguida, os mesmos foram digitalizados pelo scanner R-700TM(3Shape(r), Copenhagen, Dinamarca) e, por meio do programa Ortho AnalyzerTM, da mesma marca, foram obtidas as medidas digitais.Resultados:os dados foram submetidos a testes estatísticos e os resultados demonstraram que não houve diferença estatisticamente significativa nos dois tipos de medições com valores de p = 0,173 e p = 0,239, respectivamente, para as proporções total e anterior.Conclusão:com base nesses achados, pode-se inferir que a análise de Bolton realizada em modelos virtuais tridimensionais é tão confiável quanto a obtida em modelos de gesso, apresentando uma concordância satisfatória.

Periodontal and dental effects of surgically assisted rapid maxillary expansion, assessed by using digital study models

OBJECTIVE: The present study assessed the maxillary dental arch changes produced by surgically assisted rapid maxillary expansion (SARME). METHODS: Dental casts from 18 patients (mean age of 23.3 years) were obtained at treatment onset (T1), three months after SARME (T2) and 6 months after expansion (T3). The casts were scanned in a 3D scanner (D-250, 3Shape, Copenhagen, Denmark). Maxillary dental arch width, dental crown tipping and height were measured and assessed by ANOVA and Tukey's test. RESULTS: Increased transversal widths from T1 and T2 and the maintenance of these values from T2 and T3 were observed. Buccal teeth tipping also showed statistically significant differences, with an increase in all teeth from T1 to T2 and a decrease from T2 to T3. No statistically significant difference was found for dental crown height, except for left first and second molars, although clinically irrelevant. CONCLUSION: SARME proved to be an effective and stable procedure, with minimum periodontal hazards. .

OBJETIVOS: o presente estudo teve o objetivo de avaliar as alterações dentárias e periodontais decorrentes da Expansão Rápida da Maxila Assistida Cirurgicamente (ERMAC). MÉTODOS: foram obtidos os modelos de gesso de 18 pacientes (média de idade de 23,3 anos), ao início (T1), 3 meses após a ERMAC (T2) e 6 meses após a expansão (T3). Os modelos foram digitalizados (Scanner 3D 3Shape D-250) e mensuraram-se as distâncias transversais, bem como a inclinação e a altura da coroa clínica dos dentes posteriores. Para análise dos resultados, aplicou-se a análise de Variância e o teste de Tukey. RESULTADOS: nas distâncias transversais, observou-se um aumento de T1 para T2 e uma manutenção de T2 para T3. As inclinações dentárias demonstraram diferenças estatisticamente significativas em alguns dentes; porém, numericamente tenderam a um aumento de T1 para T2 e a uma diminuição de T2 para T3. Não se observou diferença estatisticamente significativa na altura da coroa clínica, exceto nos primeiros e segundos molares do lado esquerdo, porém, clinicamente irrelevante. CONCLUSÕES: a ERMAC demonstrou ser um procedimento efetivo e estável, com mínima repercussão periodontal. .

Protótipo para realização de cranioplastia de baixo custo / Prototype for cranioplasty low cost in postoperative decompressive craniotomy

Objetivo: O presente trabalho propõe uma técnica para realização de cranioplastia com metilmetacrilato em formas pré-moldadas e esterilizadas visando evitar cranioplastia com prototipagem pré-moldada.Método: Conforme rotina apresentada, o flap ósseo realizado para craniotomia descompressiva é armazenado em recipientes com formol e enviado para o serviço de patologia do hospital. Quando realizamos a cranioplastia, utilizamos o flap ósseo armazenado para realização dos moldes que serão utilizados na cranioplastia. Resultado: O resultado estético é muito bom e os índices de complicação e infecção são baixos. Conclusão: Apresenta resultados estéticos semelhantes aos casos de prototipagemcom baixo custo na confecção.

Objective: This paper proposes a technique for cranioplasty with methyl methacrylate and molded into shapes pre-sterilized to avoid aiming cranioplasty with pre molded prototyping. Method: As presented routine bone flap performed to decompressive craniectomy is stored in containers with formalin and sent to the pathology service of the hospital. When we performed the cranioplasty, we used the bone flap stored for realization of molds that will be used in cranioplasty. Result: The aesthetic result is very good and the rates of complication and infection are lo