Efficacy of scleral buckling for retinal detachment secondary to familial exudative vitreoretinopathy / 中华实验眼科杂志

Objective:To evaluate the efficacy of scleral buckling in the treatment of retinal detachment (RD) secondary to familial exudative vitreoretinopathy (FEVR).Methods:An observational case series study was conducted.A total of 37 patients (42 eyes) of RD secondary to FEVR who were treated with scleral buckling in Beijing Tongren Hospital from July 2010 to March 2021 were enrolled.There were 30 males (35 eyes) and 7 females (7 eyes), with an average age of (15.21±5.42) years old.Scleral buckling under general anesthesia was performed in all patients.There were 22 eyes with rhegmatogenous RD (RRD), of which 21 eyes were treated with local external compression combined with cerclage, and 1 eye was treated with radial spinal compression.There were 13 eyes with tractive RD (TRD), of which 12 eyes were treated with local external compression combined with cerclage and subretinal fluid drainage, and 1 eye was treated with scleral buckling combined with vitrectomy.There were 7 eyes with RRD combined with TRD, of which 4 eyes were treated with local external compression combined with cerclage and subretinal fluid drainage, and 3 eyes were treated with scleral buckling combined with vitrectomy.The average follow-up time was (30.61±10.50) months.The main outcomes were best corrected visual acuity (BCVA) of the operated eye converted to the logarithm of the minimum angle of resolution, retinal reattachment rate, and incidence of complications.The study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2018-056-GZ[2022]-07). Written informed consent was obtained from each subject or their guardians before entering the cohort.Results:The average BCVA was 0.83±0.50 at last follow-up after surgery which was better than 1.10±0.39 before surgery, and the difference was statistically significant ( t=6.639, P<0.001). There were 39 eyes with retinal reattachment and 3 eyes without retinal reattachment.The reattachment rate was 95.45%(21/22) in RRD, 84.62%(11/13) in TRD, and 100%(7/7) in RRD combined with TRD.No serious complication occurred in any patients during postoperative follow-up. Conclusions:On the premise of optimized surgical strategy based on the indications of RD secondary to FEVR, scleral buckling has a high retinal reattachment rate in the treatment of RD secondary to FEVR.

Effect of preconditioning the fractured coronal fragments with remineralizing agents on fracture resistance of re-attached teeth

Background: Fragment re-attachment has been considered as one of the treatment modalities for the management of fractured anterior teeth. Hydration of fractured fragments aids in inhibiting the loss of ions and maintains vitality and esthetics. Aim: The study aimed to evaluate the effect of preconditioning the fractured fragments with remineralizing agents on fracture resistance of re-attached teeth. Settings and Design: This was an in vitro study. Materials and Methods: Sixty freshly extracted noncarious human permanent maxillary central and lateral incisors were randomly allocated into three Groups of 20 each: Group 1: 2% sodium fluoride (2%NaF), Group 2: casein phosphopeptide–amorphous calcium phosphate (CPP-ACP), and Group 3: self-assembling peptide P11-4 (SAP). These were further divided into two subgroups of 10 teeth each, based on contact time with remineralizing agents, i.e., 30 min and 2 h. Fractured fragments were treated with remineralizing agents for a specified contact time and then re-attached with flowable composite resin. Force required to fracture the re-attached tooth was recorded in Newtons using universal testing machine. Statistical Analysis: Unpaired t-test, one-way analysis of variance test, and post hoc Tukey test were used for the statistical analysis. Results: A higher fracture resistance was noticed in fragments treated with 2% NaF (30 min- 215.6 N, 2 h- 188.5 N) compared to CPP-ACP (30 min- 141.3 N, 2 h- 111.1 N) and SAP (30 min- 134.8 N, 2 h- 149.5 N). At 30 min interval, it was found to be more in 2% NaF and CPP-ACP groups compared to 2 h. However, it increased with time in the SAP group. A statistically significant difference was found between the groups at both time intervals (P = 0.007 and 0.017). Conclusion: Preconditioning of fractured coronal fragments with 2% NaF showed higher fracture resistance compared to CPP-ACP and self-assembling peptide P11-4. Samples treated with SAP P11-4 exhibited good fracture resistance at 2 h contact time.

A Fiberglass and Resin Post Technique Combined with Fragment Collage of an Upper Central Incisor: Multidisciplinary Treatment / Unión de fragmento de un incisivo central superior con una técnica combinada: Tratamiento multidisciplinario

ABSTRACT: The clinical treatment of anterior tooth fractures requires specialized knowledge, technical skill, and a degree of artistic sense to ensure successful treatment. Herein, we describe the reattachment of an original tooth fragment with endodontic involvement via the utilization of a micro-hybrid composite resin and an aesthetic fiberglass post.

RESUMEN El tratamiento clínico de las fracturas coronarias en dientes anteriores superiores requiere de conocimientos especializados, habilidades técnicas y un grado de sentido artístico para garantizar un exitoso tratamiento. En este reporte de caso, se describe la unión de un fragmento de un incisivo superior, que requirió previamente un tratamiento endodóntico, mediante la utilización de una resina compuesta micro- híbrida y un poste de fibra de vidrio.

Comparison of surgical outcomes in air versus silicone oil tamponade in rhegmatogenous retinal detachment after 25G pars plana vitrectomy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the efficacy of air versus silicone oil tamponade for management of rhegmatogenous retinal detachment(RRD)following 25G pars plana vitrectomy(PPV).<p>METHODS: A prospective, randomized comparative study. 146 eyes from 146 patients who underwent 25G transconjunctival sutureless vitrectomy to repair rhegmatogenous retinal detachment were performed. Totally 60 eyes used air tamponade but 86 eyes used silicone oil tamponade. The follow-up time ranged from 6-12mo. The best corrected visual acuity(LogMAR), intraocular pressure, retinal reattachment rate, intraoperative and postoperative complications were compared.<p>RESULTS: One month after surgery, the mean BCVA was 0.45±0.5 in the air tamponade group and 0.78±0.65 in the silicone oil tamponade group, it were both evidently improved in comparison with before surgery, what's more, air tamponade had significantly better BCVA than those in the silicone oil tamponade(both <i>P</i><0.05). 3mo after surgery, the reattachment rate of patients in air group was lower than that of silicone oil group(93.3% <i>vs</i> 97.7%), but had no significant differences between the two groups. 6mo after surgery, the anatomical success rate were 100% in both groups. The main intraoperative complication was iatrgenic retinal breaks in 10 eyes(6.8%). The main postoperative complication was high intraocular pressure, the intraocular pressure 1wk after surgery in the silicone oil tamponade group was evidently higher than that air tamponade group(<i>P</i><0.001). No serious complication such as endophthalmitis and choroidal hemorrhage were observed in both groups.<p>CONCLUSION: For the simple early RRD, air tamponade had equivalent reattachment rate to silicone oil tamponade after 25G PPV. In the early postoperative, the visual acuity of air group was better comparing with silicone oil group, and was lower incidence of high intraocular pressure.

Reattachment of complex fractures; a reality by advances in self-etch bonding systems

An 18-year-old female patient reported to the Department of Conservative and Endodontics with the chief complaint of fractured tooth with respect to 21 and increased pain and mobility tooth with respect to 22. Intraoral periapical radiograph of 21 revealed coronal loss of tooth structure involving enamel, dentin, and pulp, suggestive of split tooth with respect to 21. Intraoral examination revealed a fracture of coronal structure of 22 and increased mobility in the coronal aspect, suggestive of horizontal crown–root fracture. For management of 21, after endodontic phase, placement of fiberpost, and coronal buildup, intentional reimplantation was done to expose and reattach the vertically fractured root fragment. For management of 22, after endodontic phase, crown lengthening was done, and the fractured fragment was reattached by making it a Natural Richmond's Crown. Radiographs revealed a complete sealing of the fractured fragment and proper positioning of the tooth.

Conservative and esthetic approach in crown fracture of maxillay anterior tooth: tooth fragment reattachment

Crown fractures are the most frequent traumatic injuries to permanent teeth and mainly involve the maxillary incisors due to their exposed position in the dental arch. One option for managing crown fractures, when the tooth fragment is present and in good condition, is reattachment of the fragment to its original position. This paper reports on three crown fracture cases in which successful esthetic and functional results were achieved by reattachment of the tooth fragment.

Comparative study of the clinical efficacy of 25G versus 27G vitrectomy for rhegmatogenous retinal detachment with air tamponade / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the clinical efficacy and safty of 25G and 27G pars planavitrectomy(PPV)in the treatment of rhegmatogenous retinal detachment(RRD)with air tamponade.<p>METHODS: Sixty-three cases(63 eyes)with RRD underwent 27G or 25G PPV from May 2016 to June 2018 were retrospectively reviewed. Thirty-three eyes(33 eyes)for 25G vitrectomy and 30 eyes underwent 27G vitrectomy. The main outcome measurements of the study included the best corrected visual acuity(BCVA, LogMAR), intraocular pressure, surgicaltime, retinal reattachment rate, intraoperative and postoperative complications.<p>RESULTS: There were no significant differences in baseline demographic between the two groups(<i>P</i>>0.05). The BCVA was increased significantly in both groups(all <i>P</i><0.01), but there was no significant difference in terms of visual improvement between the two groups(<i>P</i>>0.05). The mean surgical time in the 25G group was(44.13±5.9)min, which was no significant difference than that of 27G group(46.07±6.1)min(<i>t</i>=0.028, <i>P</i>=0.412). The retinal reattachment rate after a single operation was 91% and 93% for 25G and 27G group respectively(χSymbolr@@=0.015, <i>P</i>=0.902). There was no significant difference about hypotony(<6mmHg, 1mmHg=0.133kPa)between the 25G group(15%)and the 27G group(10%),(χSymbolr@@=0.376, <i>P</i>=0.540). No serious complication such as choroidal detachment and endophthalmitis was observed in both groups.<p>CONCLUSION: This study finds no significant differences in the surgical time, the rate of reattachment of retina, improvement of BCVA and complications between the 25G or 27G vitrectomy for rhegmatogenous retinal detachment with air tamponade. 27G vitrectomy with air tamponade seems to be a safe, economical and effective surgery for RRD.

Minimally invasive vitrectomy for open ocular trauma with retinal detachment at different stages / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To study the clinical efficacy of phase Ⅱ minimally invasive vitreous surgery in different stages in treatment of open ocular trauma with retinal detachment.<p>METHODS: A retrospective analysis was performed on 41 patients(41 eyes)with open eye trauma combined with retinal detachment from December 2013 to June 2018 in the Ophthalmology Department of Xiaolan People's Hospital of Zhongshan. According to the opportunity of phase Ⅱ vitrectomy, 41 eyes were divided into two groups: 24 eyes in the early group(6d after injury)and 17 eyes in the conventional group(7-14d after injury). Postoperative follow-up with 6mo as the time point, the retinal reattachment rate, TPVR incidence, visual acuity and complications were compared between the two groups.<p>RESULTS: The retinal reduction rate was 92% in the early group and 76% in the conventional group, and the difference was not statistically significant, there was no statistical difference(<i>P</i>=0.692)in retinal reduction rate between the two groups. The incidence of TPVR in the early group was lower than that in the conventional group(<i>P</i>=0.014). The improvement of postoperative visual acuity in early group was better than the conventional group(<i>U</i>=119.5,<i> P</i>=0.0018). There was no significant difference in complications between the two groups.<p>CONCLUSION: Open ocular trauma patients with retinal detachment have better prognosis after phase Ⅱ vitrectomy within 6d after injury than 7-14d.

Clinical effects on reattachment and pulpotomy of young crown-fractured and pulp-exposed permanent incisors / 口腔疾病防治

Objective @# The present study observed the clinical effects on reattachment and pulpotomy of young crown-fractured and pulp-exposed permanent incisors. @*Methods @#In a one-year retrospective clinical observation study, 30 traumatic intact segments of permanent incisors with crown fracture and pulpal exposure were treated using a pulpotomy and reattachment technique with an enamel-dentin luting agent and composite resin. @*Results @#The number of subsequent visit teeth was 30, 29, 25 at 1, 3, 6 months follow-up respectively. The pulpotomy success rates were 100% at 1 month, 93.1% at 3 months, 93.1% at 6 months. The retention rates using the reattachment technique were 100% at 1 month, 100% at 3 months, 100% at 6 months.@*Conclusion@#Pulpotomy is the preferred method of preserving live pulp after pulpal exposure of young permanent incisors, and the clinical effect is prominent. The fragment reattachment technique is an effective middle- and short-term method for temporary restoration of young crown-fractured permanent incisors.

One-visit Apexification Using MTA and Reattachment of a Crown-root Fractured Tooth with Severe Coronal Damage: A Case Report / 대한소아치과학회지

In dental trauma, reattachment of the original tooth fragment improves the reproduction of original tooth shape, texture, color, and radiolucency; thus, it provides good aesthetics.A 9-year-old boy was referred due to complicated crown-root fracture of the maxillary right central incisor. Although it had poor prognosis due to severe coronal damage and subcrestal fracture, reattachment of the tooth fragment was chosen due to the patient's age. One-visit apexification with mineral trioxide aggregate (MTA) was performed, followed by osteotomy and reattachment of the tooth fragment with post placement.Regular observation revealed no clinical signs or symptoms and no radiologic complications.

Tooth fragment re-attachment in fracture with biological width violation: case

ABSTRACT: Dento-alveolar traumas are one of the most frequent injuries to teeth, mainly affecting the upper incisors due to their exposed position in the dental arch. In such cases, esthetics, function and phonetics of anterior teeth may be compromised. Furthermore, when there is involvement of the biological width, there is often a poor prognosis. This case report describes the multidisciplinary approach to tooth fragment re-attachment in a fracture with biological width violation. The patient presented with an oblique crown fracture in the maxillary right lateral incisor, extending from the buccal to palatal side, as well as a biological width invasion. The re-establishment of the biological width was obtained by periodontal surgery to achieve clinical-crown lengthening and tooth fragment re-attachment with a glass fiber post to increase retention. After 3 years of follow-up, the rehabilitated lateral incisor remains in good condition, with satisfactory esthetic and periodontal health.

Reattachment of Fracture of Maxillary Anterior Tooth-An Aesthetic Approach

Fracture of anterior teeth is a very common form of dental injuries among children and young adolescents. Aesthetic rehabilitation of crown fractures of the maxillary anterior teeth is one of the greatest challenges to the dentist. Various treatment modalities have been practiced in past but reattachment of fracture is considered to be one of the most conservative, natural, and aesthetic approach. The restoration of natural teeth form, colour, and alignment in these patients create a positive social and emotional response in such patients. This paper discusses a case of 16-year-old male patient with fractured left central incisor (Ellis class 3 fracture). Reattachment of fracture was done along with single sitting endodontic treatment with fibre post using flow able composite resin cement. Evaluation at 6 weeks yields good reattachment, intact post, good aesthetics, and good periodontal health.

Natural Rehabilitation of Fractured Anterior Tooth Using Reattachment, a Single Visit Endo- Esthetic Approach- A Case Report.

Anterior teeth crown fracture of a growing child requires immediate attention, not only because of damage to the dentition but also due to unsightly smile and facial appearance affected by trauma to the child. Thus esthetic management of anterior tooth fracture has been one of the most important aspects of dentistry and when it has to be done using the tooth’s own structure, it sounds psychologically more acceptable. And with the development of resin-based materials that offer high bond strength values, it has made possible to undoubtedly go for reattachment technique with ease. For further simplification, single visit rotary endodontics using ProTaper Universal system is recommended as it is designed to offer better features like flexibility and less chairside time than hand instrumentation. Presented here is one such case in which a combination of single visit rotary endodontics and adhesive reattachment using flowable composites has been carried out to reframe the broken tooth and comply with the patient’s concern. The treatment was found to be successful both functionally and aesthetically at the 18-month follow-up.

Curative effect analysis of 25G+ minimally invasive vitrectomy in the treatment of rhegmatogenous retinal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To investigate the efficacy and safety of minimally invasive vitrectomy with 23G and 25G+ in the treatment of rhegmatogenous retinal detachment.·METHODS:From August 2015 to August 2016, 130 cases of rhegmatogenous retinal detachment patients were chosen as the research object. According to the random number table method, 130 patients were divided into experimental group and control group, 65 cases in each group. The experimental group received 25G+ minimally invasive vitrectomy, the control group was given 23G minimally invasive vitrectomy. The operation time, complication rate, retinal reattachment, visual acuity, intraocular pressure and postoperative complications were compared between the two groups.·RESULTS:The operative time was 69 ± 11min in control group and 66±12min in the experimental group (P>0. 05). The experimental group had 3 cases of iatrogenic retinal breaks, intraoperative complication rate was 4. 6%, the control group of 5 cases of iatrogenic retinal breaks during the operation, the complication rate was 7. 7% (P>0. 05). The experimental group disposable retinal reattachment rate was 96. 9%, the final reduction rate was 90. 8%; the control group disposable retinal reattachment rate was 93. 9%, the final reduction rate was 87. 7%, those differences between the experimental group and the control group were no significant (P>0. 05). At the end of the follow-up visual acuity of experimental group was logMAR 0. 241 ± 0. 062, control group 0. 253 ± 0. 057,significantly different compared with before treatment ( P<0. 05), while not different between the two groups (P>0. 05). intraocular pressure of the two groups were not significantly different before and after surgery (P>0. 05). The complication rate was 44. 6% after operation in the experimental group, the complication rate was 63. 1% in control group (P<0. 05).·CONCLUSION:The 25G+ minimally invasive vitrectomy in the treatment of rhegmatogenous retinal detachment is safe and effective, less operative trauma, rapid postoperative recovery, less postoperative complications compared with 23G vitrectomy.

Pars plana vitrectomy combined with internal limiting membrane peeling for macular hole retinal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the effect of pars plana vitrectomy(PPV)combined with internal limiting membrane peeling(ILMP)for macular hole retinal detachment(MHRD).<p>METHODS: Totally 78 patients with MHRD from December 2013 to December 2015 in our hospital were randomly divided into control group(39 patients 43 eyes)and experimental group(39 patients 40 eyes). The control group was treated with PPV, experimental group with PPV combined with ILMP. We observed the therapeutic effect and recorded the occurrence of postoperative complications. After 6mo follow-up, the vision improvement of the two groups were compared as the average of the best corrected visual acuity(BCVA)before and at 3, 6mo after surgery. <p>RESULTS: The reattachment rate of experimental group was 92%(37/40)with significant difference compared with control group(<i>χ</i>²=6.882, <i>P</i>=0.009). The improvement of visual acuity in the experimental group was better than that in the control group(<i>χ</i>²=14.216, <i>P</i><0.001). The postoperative BCVA of the experimental group at 3 and 6mo was significantly higher than that of the control group(<i>t</i>=7.119, <i>P</i><0.001; <i>t</i>=10.573, <i>P</i><0.001). There were less patients with the situation of increased intraocular pressure and visual field defect(<i>χ</i>²=11.323, <i>P</i>=0.001; <i>χ</i>²=8.573, <i>P</i>=0.003). The lens opacity occurrence rate had not significantly changed(<i>χ</i>²=1.835, <i>P</i>=0.176).<p>CONCLUSION: MHRD patients treated with PPV combined with ILMP recovered better and the incidence of complications was lower. It can improve the patient's retinal restoration effect more.

A Case of Surgical Treatment of Large-angle Esotropia after Scleral Buckling without Buckle Removal

PURPOSE: Strabismus can occur after retinal reattachment surgery with scleral buckling (SB). We performed surgical treatment of a large-angle esotropia after SB without buckle removal and achieved good surgical outcome. CASE SUMMARY: A 21-year-male revisited our clinic for surgical treatment of esotropia. He had cicatricial retinopathy of prematurity in the right eye, and retinal detachment developed when he was 4 years old. Retinal reattachment surgery was performed with a 360-degree encircling band, a radial buckle at the 8 o'clock position, and a circumferential buckle ranging from the 7 to 11 o'clock position. He was not available for follow-up 2 years after surgery due to a change of residence, but exhibited a 5 prism diopters (PD) esotropia at the last visit. He demonstrated 55 PD esotropia of the right eye in the primary position with limited abduction. Surgery was performed without buckle removal, as recommended by a retinal specialist. Under general anesthesia, a forced duction test revealed a restriction of the medial rectus of the right eye. Exploration showed extensive adhesions around both the medial and lateral rectus with the buckle. Careful adhesiolysis and dissection were performed. A 8-mm resection of the lateral rectus and a 6-mm recession of the medial rectus were performed. The patient demonstrated favorable ocular alignment, and the limited abduction of the right eye improved after surgery. CONCLUSIONS: We report a case of surgical treatment of a large-angle esotropia after SB without buckle removal. This case can be helpful for surgeons planning the treatment of strabismus in patients who had undergone SB.

Immediate Esthetics: Reattachment and Reestablishing the Natural Contact.

Tooth fragment reattachment procedure offers an ultra-conservative, safe, and esthetically pleasing result. This procedure is an apt procedure to minimize emotional trauma to the patient and for quick and incredible esthetic results. A trauma resulting in fracture of anterior teeth is a tragic experience for the patient and requires immediate attention not only because of damage to the dentition but also because of the psychological effect of the trauma to the patient. This article deals with the immediate rehabilitation of the fractured fragment and providing the best of the margin than any prosthesis. This article also portrays the cleansing of the crown fragment of discoloration and providing esthetics.

Management of Crown Root Fracture by Multi-disciplinary Approach-A Case Report

Trauma to anterior tooth is a relatively common event. Crown-root fractures are often difficult to treat and are time consuming, which causes psychological trauma to the patient during that period. Fracture of tooth after trauma is distressing to a person because of the discomfort and pain due to pulpal injury. Crown root fractures of anterior teeth cause concomitant periodontal injury and there will be concern about appearance and aesthetics. Management of pulpal and periodontal tissue relieves pain and restoration of tooth form regains patient's confidence. Restoration of fractured tooth will be accepted readily if it is minimally invasive, less expensive, and aesthetically acceptable. Reattachment is an option for restoration of anterior teeth compared to other artificial replacements because of its appearance as natural. This method is favourable when the fractured fragment is intact and available. Utilization of pulp space for retention of fragment is achieved by the insertion of a dentine bonding post. This case report describes a case of tooth reattachment after trauma in which the pulp space is utilized to bond a fibre-reinforced post for retention after periodontal tissue management.

Reattachment of coronal fragment using fiber reinforced post.

Anterior crown fractures are a common form of injury that mainly affects children and adolescents due to their position in the oral cavity especially in the maxillary arch. Reattachment of original tooth fragment to the fractured tooth forms a relatively quick, biologic and esthetic restoration. A 28 years old male reported to the Department of conservative dentistry & endodontics with a complex crown fracture of 21 and 22 one day after the trauma had occurred. Following endodontic treatment, a glass fibre post was used to increase retention and distribute stresses along the tooth. The dental restoration was completed using the original fragment and a dual cure resin composite. Clinical and radiographic examination at 3, 6 & 11 months recall showed the glass fiber post and restoration was in place, indicating the success of the treatment in maintaining the fractured tooth.

Design and application of multifunction treatment beds in patients after intraocular retinal reattachment surgery / 现代临床护理

Objective To explore the design and application of the multifunctional treatment beds on patients′ position compliance and comfort after intraocular retinal reattachment surgery. Methods Eighty-six patients needing special position nursing after intraocular retinal reattachment surgery were randomly divided into experiment and control groups. The former received the special multifunction treatment beds while normal ward beds were used for the control patients . The position compliance , comfort and the complications were observed one month after surgery. Result The position compliance and the degree of comfort in the experiment group were significantly better than those in the control group and the complication rate was significantly lower than that of the control group (all P<0.05). Conclusion The special multifunction treatment beds can be effective in increasing the patients compliance in positions and compliance as well as reducing postoperative complications and increasing the operation success rate.