ABSTRACT
RESUMO - RACIONAL: Três técnicas cirúrgicas para correção de hérnia inguinal estão atualmente validadas. Poucos estudos compararam os resultados entre Lichtenstein e a abordagem laparoscópica transabdominal pré-peritoneal obtidos em uma etapa inicial da curva de aprendizado. OBJETIVO: Comparar os resultados iniciais do tratamento entre a técnica de Liechtenstein e a abordagem pré-peritoneal transabdominal laparoscópica para fornecer uma base para a tomada de decisão do cirurgião. MÉTODO: Os pacientes foram divididos em grupo 1: aborgadem laparoscópica transabdominal pré-peritoneal (114 pacientes), e grupo 2: reparo aberto de Lichtenstein (35 pacientes). Os dados foram coletados em prontuários médicos durante a evolução do pós-operatório imediato e por contato telefônico após a alta hospitalar. Para a análise das variáveis, foi implementado o teste de independência Qui-Quadrado, com nível de significância estabelecido em p-valor = 0,05. RESULTADOS: Houve forte associação entre laparoscopia, menos dor pós-operatória e maior tempo operatório. Além disso, notou-se preferência pela técnica nos casos de recorrência, bilateralidade, hérnia umbilical associada ou obesidade. Neste estudo, a técnica de Lichtenstein foi associada a um menor tempo de retorno ao trabalho e foi o tratamento de escolha para pacientes idosos. CONCLUSÃO: A herniorrafia laparoscópica transabdominal pré-peritoneal deve ser a primeira escolha em casos de bilateralidade, hérnia umbilical associada, obesidade e recorrência para reparo anterior. O risco cirúrgico é adequado para o procedimento, mesmo nos estágios iniciais da curva de aprendizado.
ABSTRACT - BACKGROUND: Three surgical techniques for inguinal hernia repair are currently validated. Few studies have compared results among Lichtenstein and transabdominal preperitoneal (TAPP) laparoscopic approach obtained at an early step of the learning curve. AIM: This study aims to compare the early treatment results between the Liechtenstein technique and the laparoscopic TAPP approach to provide a basis for the surgeon's decision-making. METHODS: Patients were divided into two groups: those who underwent laparoscopic TAPP approach (114 patients), and those who underwent open Lichtenstein repair (35 patients). Data were collected from the medical records during the evolution of the immediate postoperative period and by telephone contact after hospital discharge. For the analysis of the variables, the chi-square test of independence was implemented, with a level of significance set at a p-value of 0.05. RESULTS: There was a strong association between laparoscopy, less postoperative pain, and longer operative time. In addition, a preference for the technique in cases of recurrence, bilaterality, associated umbilical hernia, or obesity was noticed. In this study, the Lichtenstein technique was associated with a shorter time to return to work and was the treatment of choice for elderly patients. CONCLUSION: TAPP laparoscopic herniorrhaphy should be the first choice in cases of bilaterality, associated umbilical hernia, obesity, and recurrence to a previous anterior repair. The surgical risk is adequate for the procedure, even at early stages of the learning curve.
Subject(s)
Humans , Aged , Laparoscopy , Herniorrhaphy , Postoperative Period , Surgical Mesh , Prospective Studies , LiechtensteinABSTRACT
OBJECTIVES: This study aims to compare the fluoride-release between different fluorine varnish under in vitro experimental conditions.METHODS: In this study, 5 fluoride varnish products distributed in Korea were selected. V-varnish™ (Vericom, Korea: VV), CavityShield™ (3M ESPE, USA: CS), Clinpro™ White varnish™ (3M ESPE, USA: CP), MI Varnish™ (GC, Japan: MI), and Fluor Protector (Ivoclar Vivadent, Liechtenstein: FP). For the in vitro study, 10 mg of each fluoride varnish was thinly applied to the same area of the specimen. The specimen was then immersed in 3 ml of distilled water at consistent intervals to confirm fluoride release. Nine specimens per group were used. Fluoride ion electrodes were used to measure the fluoride concentration of the solution. The Kruskal-Wallis nonparametric test was performed to compare between each experimental group, and the Wilcoxon signed-rank nonparametric test was performed to compare experimental groups over time. The significance level for a Type I error was set at 0.05. All statistical analyses were performed using SPSS 25.0 (IBM Co., Armonk, NY, USA).RESULTS: In vitro experiments showed that the amount of fluoride released from MI was higher than the other groups during the first 12 hours after application. However, the amount of fluoride released from CP and CS was higher than MI as the immersion time increased over 12 and 20 hours, respectively. The fluoride release from FP was the lowest at all measurement points.CONCLUSIONS: The results of this study showed that the remaining fluoride effect from rosin type fluoride varnishes was higher than liquid type fluoride varnishes. There were differences in the residual fluoride concentrations despite each fluoride varnish having the same fluoride content.
Subject(s)
Dental Caries , Electrodes , Fluorides , Fluorides, Topical , Fluorine , Immersion , In Vitro Techniques , Japan , Korea , Liechtenstein , Paint , WaterABSTRACT
PURPOSE: This in vitro study evaluated shear bond strengths of surface treatment porcelains with four porcelain repair systems simulating intraoral bonding of composite resin to feldspathic porcelain or pressable porcelain. MATERIAL AND METHODS: Eighty Porcelain disks were prepared. Group A: forty disk specimens were fabricated with Feldspathic Porcelain(Omega(R)900, Vident, Menlo Park, CA, USA). Group B: forty disk specimens were fabricated with Pressable Porcelain(IPS Empress 2 ingot, Ivoclar-Vivadent, Schaan, Liechtenstein, Germany). Each groups was divided into 4 subgroups and composite resin cylinders were bonded to specimen with one of the following four systems: Clearfil Porcelain Bond(L. Morita, Tustin, CA, USA), Ulradent Porcelain Etch.(Ultradent, Salt Lake City, UT, USA), Porcelain Liner-M(Sun Medical Co., Kyoto, Japan), Cimara Kit(Voco, Germany). After surface conditioning with one of the four porcelain repair systems, substrate surfaces of the specimen were examined microscopically(SEM). Shear bond strengths of specimens for each subgroup were determined with a universal testing machine (5mm/min crosshead speed) after storing them in distilled water at 37+/-1 degrees C for 24 hours. Stress at failure was measured in MPa, and mode of failure was recorded. Differences among four repair systems were analyzed with two way ANOVA and Duncan test at the 95% significance level. RESULTS: In the scanning electron photomicrograph of the treated porcelain surface, hydrofluoric acid etched group appeared the highest roughness. The shear bond strength of the phosphoric acid etched group was not significantly(p>0.05) different between feldspathic porcelain and pressable porcelain. But in no treatment and roughened with a bur group, the shear bond strength of the feldspathic porcelain was significantly higher than that of the pressable porcelain. In hydrofluoric acid etched group, the shear bond strength of the pressable porcelain was significantly higher(p0.05). However in the other groups, there were significant differences in shear bond strengths between feldspathic porcelain and pressable porcelain(p<0.05).
Subject(s)
Dental Porcelain , Hydrofluoric Acid , Lakes , Liechtenstein , WaterABSTRACT
STATEMENT OF PROBLEM: Unreasonable distal cantilevered implant-supported prosthesis can mask functional problems of reconstruction temporarily, but it can cause serious strain and stress around its supported implant and surrounding alveolar bone. PURPOSE: The purpose of this study was to evaluate strain of implants supporting distal cantilevered fixed prosthesis with two different cantilevered length under distal cantilevered static load. MATERIAL AND METHODS: A partially edentulous mandibular test model was fabricated with auto-polymerizing resin (POLYUROCK; Metalor technologies, Stuttgart, Swiss) and artificial denture teeth (Endura; Shofu inc., Kyoto, Japan). Two implants-supported 5-unit screwretained cantilevered fixed prosthesis was made using standard methods with Type III gold alloy (Harmony C & B55; Ivoclar-vivadent, Liechtenstein, Germany) for superstructure and reinforced hard resin (Tescera; Ivoclar-vivadent, Liechtenstein, Germany) for occlusal material. Two strain gauges (KFG-1-120-C1-11L1M2R; KYOWA electronic instruments, Tokyo, Japan) were then attached to the mesial and the distal surface of each standard abutment with adhesive (M-bond 200; Tokuyama, Tokyo, Japan). Total four strain gauges were attached to test model and connected to dynamic signal conditioning strain amplifier (CTA1000; Curiotech inc., Paju, Korea). The stepped 20-100 N in 25 N increments, cantilevered static load 8mm apart (Group I) or 16mm apart (Group II), were applied using digital push-pull gauge (Push-Pull Scale & Digital Force Gauge, Axis inc., Seoul, Korea). Each step was performed ten times and every strain signal was monitored and recorded. RESULTS: In case of Group I, the strain values were surveyed by 80.7 ~ 353.8 micrometer/m in Ch1, 7.5 ~ 47.9 micrometer/m in Ch2, 45.7 ~ 278.6 micrometer/m in Ch3 and -212.2 ~ -718.7 micrometer/m in Ch4 depending on increasing cantilevered static load. On the other hand, the strain values of Group II were surveyed by 149.9 ~ 612.8 micrometer/m in Ch1, 26.0 ~ 168.5 micrometer/m in Ch2, 114.3 ~ 632.3 micrometer/m in Ch3, and -323.2 ~ -894.7 micrometer/m in Ch4. CONCLUSION: A comparative statistical analysis using paired sample t-test about Group I Vs Group II under distal cantilevered load shows that there are statistical significant differences for all 4 channels (P<0.05).
Subject(s)
Adhesives , Alloys , Axis, Cervical Vertebra , Dentures , Hand , Liechtenstein , Masks , Prostheses and Implants , Seoul , ToothABSTRACT
Hernia repair is one of the most commonly performed general surgical procedures. Several methods have been developed over years to improve the traditional methods of hernia repair. The most important recent innovations being the Lichtenstein mesh repair and the laparoscopic mesh repair. To compare Lichtenstein hernia repair with Laparoscopic totally extra-peritoneal hernia repair [TEP]. A prospective randomized controlled study including a total of 96 male patients with 110 inguinal hernias. They were randomized into 2 groups, group I underwent laparoscopic [TEP repair [n = 56] 50.9% and group 2 underwent Lichtenstein repair [n = 54] 49.1% for inguinal hernia. Statistical analysis was performed using SPSS 10.0 where student 1-tests and chi-square tests, were applied. The two groups of patients were comparable in age and type of hernia. The mean age in the first group was 44.4 +/- 14.6 years [range from 19-65 years], in the second group was 46.8 +/- 14.7 years [range from 20-70 years] and P value was > 0.05. In unilateral hernias the operative time was comparable in both groups. [49 +/- 5.5 min. in group 1 and 50.2 +/- 9.3 min. in group 2] and P > 0.05. On the other hand, in bilateral and recurrent cases the operative lime was 65 +/- 9.1 min. and 48.3 +/- 2.9 min in-group 1 [TEP], while in-group 2 [open], it was 81.7 +/- 7.6 min. and 66.3 +/- 7.5 min. respectively. This was significantly positive [P < 0.05]. Hospital stay was shorter in laparoscopic group [1.6 +/- 0.6 nights] than in open group [2.1 +/- 0.8 nights], but this was not statistically significant [P > 0.05]. On average, analgesia was taken for 5 +/- 1.1 days after Lichtenstein repair compared with 3.1 +/- 1 days after laparoscopic repair [p < 0.05]. Post-operatively, a seroma or a wound haemnatomna developed in five [9.3%] patients after Lichtenstein repair and in one [1.8%] patient after laparoscopic repair [p < 0.05]. Other complications like urinary retention and surgical emphysema were minimal and comparable in both groups. There was no recurrence in either group of patients all over the period of follow up ranged from 3-24 months [mean 15 +/- 7.3 months]. This study confirms that, in short term evaluation, laparoscopic total extraperitoneal hernia repair is superior to Lichtenstein repair in term of hospital stay, post operative pain, complications and operative time particularly in bilateral and recurrent cases