Bone density and implant stability with advanced platelet-rich fibrin in immediately loaded- implant assisted mandibular overdentures / Densidade óssea e estabilidade dos implantes com fibrina rica em plaquetas avançada em overdentures mandibulares com carga imediata

ABSTRACT Objective: The aim of this study is to determine the effect of Advanced Platelet-Rich Fibrin on bone density and implant stability in immediately loaded- implant-assisted mandibular overdentures (Split-mouth study). Material and Methods: Ten completely edentulous patients received two implants in the mandibular canine region and locator attachments were used to retain immediately loaded- implant mandibular overdentures. Each patient served in two Groups, one Group for each side. One side of the mandible received an implant with topical application of Advanced Platelet-Rich Fibrin in the implant osteotomy site (Group I) and the other site received an implant without application of Advanced platelet-rich fibrin (Group II). Each patient was examined clinically for implant stability using Osstell Mentor device and radiographically by ultra-low dose CT scan to measure bone density around the implant at baseline, three, six months, and one year. Results: There were no statistically significant differences (P>.05) in bone density and implant stability among the studied Groups during one year follow-up period. Conclusion : Advanced Platelet-Rich Fibrin has no effect on bone density and implant stability in immediately loaded implant-assisted mandibular overdenture.(AU)

RESUMO Objetivo: O objetivo deste estudo é determinar o efeito da Fibrina Rica em Plaquetas Avançada na densidade óssea e estabilidade dos implantes em Overdentures mandibulares com carga imediata (estudo de boca dividida). Material e Métodos: Dez pacientes edêntulos foram submetidos à instalação de dois implantes mandibulares na região dos caninos e pilares locator foram utilizados como sistema de retenção para as overdentures mandibulares com carga imediata. Cada paciente participou nos dois grupos, sendo um grupo para cada lado. Um lado da mandíbula recebeu implante com aplicação tópica de Fibrina Rica em Plaquetas Avançada no local do sítio cirúrgico do implante (Grupo I) e o outro local recebeu implante sem aplicação de Fibrina Rica em Plaquetas Avançada (Grupo II). Cada paciente foi examinado clinicamente quanto à estabilidade do implante usando o dispositivo Osstell Mentor e radiograficamente por tomografia computadorizada de ultrabaixa dose para medir a densidade óssea ao redor do implante no início do estudo, três, seis meses e um ano. Resultados: Não houve diferenças estatisticamente significativas (P>0,05) na densidade óssea e na estabilidade do implante entre os grupos estudados durante o período de acompanhamento de um ano. Conclusão: A Fibrina Rica em Plaquetas Avançada não tem efeito na densidade óssea e na estabilidade de implantes em Overdentures mandibulares com carga imediata (AU)

protective effect of magnesium on the neurocognitive function in hypothermic circulatory arrest and retrograde cerebral perfusion for aortic arch surgery

Background: Neuropsychological dysfunction is a major complication of thoracic aortic surgery with hypothermic circulatory arrest [HCA]. Magnesium has been shown to have neuroprotectant effect in acute stroke and in short term neurological dysfunction after cardiopulmonary bypass. We sought to study the effect of magnesium on the neuropsychological function after HCA for aortic arch surgery using retrograde cerebral perfusion [RCP]

Methods: Forty patients scheduled for elective thoracic aortic surgery including the arch using HCA with RCP were randomly assigned to two equal groups. The magnesium group received magnesium sulfate to increase plasma magnesium level between 1.5 to 2 folds throughout the operation and for 24 hours, while the placebo group received normal saline over the same period as a control. The patients' neurocognitive state was assessed by cognitive P300 visual evoked potentials and the revised Wechsler Adult Intelligence Scale done the day before the operation and 2 weeks postoperatively. P300 was assessed as area under the curve [AUC] between 280 and 600 ms and center of this area [Ct [time], Cv [voltage]]. The ratio of these parameters acquired by target [TG] and non-target [NTG] stimulus [TG/NTG], was calculated to assess concentration on TG stimulus and defined as concentration index [CI: CI[AUC], CI[Ct], and CI[Cv]]

Results: There were no stroke, seizure, or hospital mortality in either group. Preoperatively, in the magnesium group, AUC and Cv acquired by TG stimulus in both Cz and Fz leads were significantly altered postoperatively [P value <0.05]. In the placebo group, no significant postoperative change was observed in all leads on TG stimulus. Postoperative CI [Ct] in the placebo group, were significantly impaired in all leads. The revised Wechsler Adult Intelligence Scale shows significant decline between baseline and postoperative scores in three subtests [digit span P value <0.05, arithmetic, and picture completion P value <0.01] for magnesium group and four [digit span, arithmetic, picture completion, and picture arrangement P value <0.01] for placebo group. Statistical difference between groups in test score changes was found in one subtest [picture arrangement P value <0.05]

Conclusion: Magnesium administration in patients undergoing aortic arch surgery with hypothermic circulatory arrest using retrograde cerebral perfusion did not affect the neurocognitive outcome assessed by cognitive P300 visual evoked potentials and the revised Wechsler Adult Intelligence Scale, further work is needed to prove any protective value for magnesium in this context

Angiogenesis in rheumatoid patients: clinical, radiological and histopathological study

To evaluate angiogenesis and cartilage destruction in rheumatoid arthritis [RA] patients. This was performed using power Doppler ultrasonography [PDS] and detection of vascular endothelial growth factor [VEGF] in the serum and immunohistochemically. Eighteen Rheumatoid arthritis patients [group 1] and ten apparently healthy subjects [group 2] participated in this study. Full history taking, thorough clinical examination and routine rheumatological profile investigation were done. Serum VEGF was measured in all patients and controls using ELISA technique. The knee joints were examined with ultrasound and resistance index was measured with spectral ultrasonography. Histological examination for synovial membranes was done with hematoxylin and eosin, factor VIII and VEGF with immunohistochemical staining. There was a highly significant difference between RA patients and controls as regard sVEGF [582.22 +/- 84.89, 176 +/- 20.55 pg/ml], histological score [36.94 +/- 7.83, 2.72 +/- 1.2], factor VIII [3.16 +/- 0.618, 1.2 +/- 0.41], VEGF staining [3.03 +/- 0.89, 0.5 +/- 0.32] and PDS [3.027 +/- 0.58, 0.41 +/- 0.24] [p<0.001 in all parameters]. Also, there was a significant difference between patients and control as regard resistive index [RI] [0.72 +/- 0.19, 1.07 +/- 0.1] and synovial proliferation [3.055 +/- 0.7, 0.25 +/- 0.263] [p<0.05 in both parameters]. RA patients were classified according to VEGF staining into low, moderate and intense staining. There was a highly significant difference between patient subgroups regarding serum VEGF, synovial proliferation, PDS score [p<0.001] and a significant difference regarding histopathological score, factor VIII and RI [p<0.05 in all parameters]. There was a positive correlation between sVEGF and DAS score, synovial proliferation, ESR, PDS, VEGF staining and histological score, and negative correlation with RI. Also, there was a positive correlation between VEGF staining and histological score, sVEGF, PDS, synovial proliferation and negative correlation with RI. VEGF is a potent mediator of endothelial proliferation of angiogenesis, the expression of VEGF depending on the activity and plays a part of pathogenesis of RA and synovitis. PDS is a useful method demonstrating synovial vascularization and monitoring disease activity. RI is an objective tool to estimate the degree of inflammation in RA

Study of psychological aspects and EEG changes in attention deficit disorder with hyperactivity

This work was carried out on 32 children suffering from attention deficit disorder with hyperactivity and 30 children as nomal control. The results showed E.E.G. changes in [40%] of patients especially on the temporal region than the control group. The results showed E.E.G. changes in [40%] of patients especially on the temporal region than the controls. However, there was no difference in level of inteligence between patients and the controls