Efficacy of bioresorbable plating system in the treatment of pediatric maxillary fractures: A short clinical study.

Aim: The aim of this study was to evaluate the efficacy, stability, and clinical outcomes of a bioresorbable plating system in the treatment of pediatric maxillary fractures. Materials and Methods: Twenty pediatric patients with maxillary fractures (13 males and 7 females) were included in this study. The 1.5- and 2.0-mm resorbable plates were used and secured with monocortical resorbable screws 6 mm and 7 mm in length. All patients were followed up for 6 months. Clinical parameters, such as pain, swelling, soft-tissue infection, malocclusion, nerve injury, and bite force for stability, were prospectively assessed. Results: Fall from height (50%) was the most common cause of etiology, followed by road traffic accidents (35%). Maxillary alveolar # (40) was the most common fracture site, followed by nasal complex # (25%) and zygomatic complex # (25%). Appropriate fixation and adequate primary bone healing was achieved in 100% of the cases. Few minor complications were observed: (1) soft-tissue infection (5%) and (2) paresthesia (10%). There was a significant increase in bite force in the incisor and molar regions. Observation in clinical parameters shows that there was a significant reduction in postoperative pain and swelling at different follow-up periods. Conclusion: Bioresorbable plating system is used as a load-sharing plate in a semirigid fixation technique after anatomic fracture reduction. Although its high costs limit its feasibility for use low infection rates, minimized second surgery for implant removal attracts its use. 1.5- and 2-mm resorbable plating system along is a good treatment modality for moderately displaced maxillary fractures in pediatric patients. Larger sample size and longer follow-up studies are required for conclusive results.

Condensate loss estimation and transient solar-to-vapor conversion efficiency for effective performance evaluation of the inclined solar still.

Previously, freshwater yields of the solar still were quantified only based on the actual distillate recovery, not considering condensate losses by any means. Likewise, solar-to-vapor conversion efficiencies of the solar still were conventionally considered and evaluated as one-off -rigid values- based on the latent heat of the average water temperature. In most cases, these approaches do not give a comprehensive performance details of the solar still. Thus, we suggest two considerations for effective performance evaluation of the inclined solar still. The first consideration is theoretical estimation of the condensate loss due to the condensate collection channel slope, while the other is the use of a transient method to evaluate the solar-to-vapor conversion efficiency. We demonstrated, geometrically, that the condensate loss on the inclined solar still can be significant-hence the need to consider it alongside the overall yield. We formulated a model to estimate the condensate loss and validated the model by comparing an estimated condensate loss with experimental loss. Similarly, we demonstrated a transient approach to evaluate the solar-to-vapor conversion efficiency by using the latent heat of the hourly water temperature. Accordingly, the optimum hourly efficiency of the investigated solar still prototype was 161.4%, with a daily average of 113.4% versus 108.4% from the conventional method. Overall, no study on the solar still had previously accounted for condensate losses by any means whatsoever, making our current study a reference and a pioneer in this concept and suggesting an advancement in the approach to report the performance productivity of the solar still.•Condensate loss on the inclined solar still due condensate collection channel slope was estimated geometrically and demonstrated to be significant.•Solar-to-vapor conversion efficiency was evaluated using an hourly transient approach.

Optoelectronic Enhancement of Perovskite Solar Cells through the Incorporation of Plasmonic Particles.

The optoelectronic advantages of anchoring plasmonic silver and copper particles and non-plasmonic titanium particles onto zinc oxide (ZnO) nanoflower (NF) scaffolds for the fabrication of perovskite solar cells (PSCs) are addressed in this article. The metallic particles were sputter-deposited as a function of sputtering time to vary their size on solution-grown ZnO NFs on which methylammonium lead iodide perovskite was crystallized in a controlled environment. Optical absorption measurements showed impressive improvements in the light-harvesting efficiency (LHE) of the devices using silver nanoparticles and some concentrations of copper, whereas the LHE was relatively lower in devices used titanium than in a control device without any metallic particles. Fully functional PSCs were fabricated using the plasmonic and non-plasmonic metallic film-decorated ZnO NFs. Several fold enhancements in photoconversion efficiency were achieved in the silver-containing devices compared with the control device, which was accompanied by an increase in the photocurrent density, photovoltage, and fill factor. To understand the plasmonic effects in the photoanode, the LHE, photo-current density, photovoltage, photoluminescence, incident photon-to-current conversion efficiency, and electrochemical impedance properties were thoroughly investigated. This research showcases the efficacy of the addition of plasmonic particles onto photo anodes, which leads to improved light scattering, better charge separation, and reduced electron-hole recombination rate.

Effect of Short-Term Yoga-Based-Breathing on Peri-Operative Anxiety in Patients Undergoing Cardiac Surgery.

BACKGROUND: Peri-operative anxiety in patients scheduled for cardiac surgery is detrimental. This study evaluated the effect of short-term yoga based-breathing with different variations on peri-operative anxiety. MATERIALS AND METHODS: A prospective randomized controlled study was conducted in patients aged 20-60 years scheduled for major cardiac surgery. Patients in Yoga group were trained for yoga based-breathing with different variations for 5 days; no intervention was done in controls. RESULTS: We analyzed twenty patients in each group. Anxiety scores measured at baseline, presurgery, and postsurgery were entered as the within-subjects factor; group status was entered as the between-subjects factor in the RMANOVA. Baseline demographics and anxiety scores were comparable. The short-term yoga-based breathing exercise-training program had a statistically significant effect on state (F = 13.45, P < 0.0001), Trait (F = 13.29, P < 0.0001) and total anxiety scores (F = 29.44, P < 0.0001) at different time points for yoga over control group. CONCLUSION: Short-term yoga-based breathing for 5 days lowers presurgery and postsurgery anxiety in patients undergoing cardiac surgery.

Comparative evaluation of bite force analytical study following mandibular osteosysthesis using three-dimensional and conventional locking miniplates.

AIMS AND OBJECTIVES: The aim is to study the effectiveness of 2 mm three-dimensional (3D) titanium miniplates and 2 mm conventional titanium miniplates in osteosynthesis of mandibular fractures by comparing the change in bite force. METHODOLOGY: The study comprised forty patients of age group 20-40 years, weighing 55-75 kg having mandibular fractures. Patients were randomly divided into two equal groups In Group A, twenty patients underwent osteosynthesis using 3D titanium miniplates (2.0 mm system), whereas in Group B, twenty patients underwent osteosynthesis using conventional titanium miniplates (2.0 mm system). After fixation of fracture segments with miniplates, the patients were assessed on the basis of evaluation of bite force at incisor, right molar and left molar region after 1, 3, 6 , and 8 weeks. Comparison of change in bite force was done between Group A and Group B at different follow-ups at incisor, right molar, and left molar. RESULTS: Bite force recordings showed increasing values at subsequent follow-ups, corresponding to the healing of the fracture in both groups. At follow-up III (6 weeks) and IV (8 weeks), bite force values reached near to those in healthy individuals. A significant difference was observed in change in bite force of Group A and Group B at incisor left molar and right molar on subsequent followups. 3D titanium miniplate requires less surgical exposure of the underlying fracture site, with a minimal traction of the surrounding soft tissue. INTERPRETATION AND CONCLUSION: 3D miniplates in mandibular fractures are efficacious enough to bear masticatory loads during the osteosynthesis of fractures. It gives the advantage of greater stability, increased bite force, reduced implant material, and 3D stability.

Newer proposed classification of periimplant defects: A critical update.

The term peri-implantitis is used to describe a destructive inflammatory process affecting the soft and hard tissues around osseo integrated implants, leads to the formation of a peri-implant pocket and loss of supporting bone. Predisposing factors are Poor Plaque Control, inflammation, infection, Smoking, Diabetes and Occlusal Overload. It is diagnosed on the basis of clinical and radiographic interpretation and still no definite criteria have been proposed for the diagnosis and treatment of peri-implantitis. However treatment can be both conservative and surgical. The cumulative interceptive supportive therapy protocol serves as good guide for the treatment of the peri-implantitis. There is lack of a standard classification system to differentiate the various degrees of peri-implantitis, which produces dilemma in evaluating the stages clinical and radiological status, treatment and its outcome. Many classification has been proposed in medical literature with their pros and cons but still there is lack of standard classification system of implant defects and definite treatment protocol according to the same. The classification should be easy to use, clearly understandable and help in communication by clinicians of different speciality. This review aimed to introduce a classification system based on added clinical, and detailed radiological parameters with prognosis and staged treatment algorithms.

Management of pediatric mandibular fractures using bioresorbable plating system - Efficacy, stability, and clinical outcomes: Our experiences and literature review.

AIMS: The purpose of this study was to determine the efficacy and stability of the biodegradable fixation system for treatment of mandible fractures in pediatric patients by measuring the bite force. METHODS: Sixty pediatric patients with mandibular fractures (36 males, 24 females) were included in this study. The 2.5-mm resorbable plates were adapted along Champy's line of ideal osteosynthesis and secured with four 2.5 mm diameter monocortical resorbable screws, 8 mm in length. All patients were followed for 10 months. Clinical parameters, such as soft tissue infection, nonunion, malunion, implant exposure, malocclusion, nerve injury, and bite force for stability, were prospectively assessed. RESULTS: Adequate fixation and primary bone healing was achieved in 100% of the cases. Six minor complications (10%) were observed: 2 soft tissue infections (3%), 1 plate dehiscence (2%), 1 malocclusion (2%), and 2 paresthesia (3%). CONCLUSION: 2.5-mm resorbable plating system along Champy's line of ideal osteosynthesis is a good treatment modality for mandible fractures in pediatric patients.

Botulinum toxin the poison that heals: A brief review.

Botulinum neurotoxins, causative agents of botulism in humans, are produced by Clostridium botulinum, an anaerobic spore-former Gram-positive bacillus. Botulinum neurotoxin poses a major bioweapon threat because of its extreme potency and lethality; its ease of production, transport, and misuse; and the need for prolonged intensive care among affected persons. This paper aims at discussing botulinum neurotoxin, its structure, mechanism of action, pharmacology, its serotypes and the reasons for wide use of type A, the various indications and contraindications of the use of botulinum neurotoxin and finally the precautions taken when botulinum neurotoxin is used as a treatment approach. We have searched relevant articles on this subject in various medical databases including Google Scholar, PubMed Central, ScienceDirect, Wiley Online Library, Scopus, and Copernicus. The search resulted in more than 2669 articles, out of which a total of 187 were reviewed. However, the review has been further constricted into only 54 articles as has been presented in this manuscript keeping in mind the page limitation and the limitation to the number of references. A single gram of crystalline toxin, evenly dispersed and inhaled, can kill more than one million people. The basis of the phenomenal potency of botulinum toxin (BT) is enzymatic; the toxin is a zinc proteinase that cleaves neuronal vesicle-associated proteins responsible for acetylcholine release into the neuromuscular junction. A fascinating aspect of BT research in recent years has been the development of the most potent toxin into a molecule of significant therapeutic utility. It is the first biological toxin which is licensed for the treatment of human diseases. The present review focuses on both warfare potential as well as medical uses of botulinum neurotoxin.

A randomized comparative prospective study of platelet-rich plasma, platelet-rich fibrin, and hydroxyapatite as a graft material for mandibular third molar extraction socket healing.

AIM: The purpose of this study was to compare the efficacy of platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and hydroxyapatite (HA) for reduction of pain and swelling, absence of dry socket, soft tissue healing, and bone regeneration after mandibular third molar extraction in human patients. MATERIALS AND METHODS: Forty patients requiring extraction of mandibular third molars were randomly grouped as control, PRP, PRF, and HA-treated. The patients were assessed for postoperative pain, swelling, dry socket, and soft tissue healing on the 3rd, 7th, and 14th day of postoperative periods depending on the standard methods. Radiological assessment of the extraction site was done at 1, 2, and 6 months interval to compare the change in bone density in the sockets in control and treated patients. RESULTS: Pain and swelling were less on PRP and PRF site when compared to HA and control site. PRP and PRF site showed better soft tissue healing when compared to HA and control site. Radiographic assessment showed comparatively lesser bone density values in PRP, PRF, and control site at 1, 2, and 6 months than HA site. CONCLUSION: Our study showed that PRP and PRF are better graft materials than HA regarding pain, swelling, dry socket, and soft tissue healing. Bone regeneration is induced promptly by HA as compared to other graft materials. However, a more elaborate study with a larger number of clinical cases is very much essential to be more conclusive regarding the efficacy of the graft materials.

Treatment modalities for surgical management of anterior palatal fistula: Comparison of various techniques, their outcomes, and the factors governing treatment plan: A retrospective study.

AIM: Aim of this retrospective study was to access the various surgical treatment options available for repair of Anterior palatal fistula depending upon their size and presenting age, and also to anticipate the treatment outcome. MATERIALS AND METHODS: The series include study report of forty patients with secondary anterior palatal fistula post cleft palate repair, reported in a single unit during a duration of 3 years. All the cases were managed surgically under general anesthesia. The patients were classified depending upon the location of anterior palatal fistula (APF), the quality of tissue and age of patients to chalk out a justified treatment option outlay. RESULTS: Forty cases were split for surgical correction into various options depending on their size, site, and quality of the tissue. Most of the cases were operated with a Bardach's Redo for fistula closure (n = 16) (40%) and crevicular flap technique (n = 13) (32.5%). Our overall success (satisfactory results) was 77.5% as observed in 31 out of 40 cases with individual success rates for Bardach's and crevicular being 75% and 77%, respectively. There was reduction in size of fistula in three cases (7.5%) and a remnant pinpoint hole in four cases (10%) among all the operated cases. CONCLUSION: Management of post palatoplasty fistulas of the hard palate presents a challenging situation for a clinician following the surgical correction of cleft palate. Current paper describes the diagnosis and clinical management of forty cases reporting with unilateral APF following cleft palate surgery, over 3 years. Authors have attempted to propose different treatment modalities for surgical management of unilateral APF. It was concluded in the primary review that the size of fistula was irrelevant in determining the clinical outcome. Instead, the quality and condition of the adjacent tissue appear to be the major governing factors for selecting treatment modality as well as the surgical consequences.

Evaluation of two socket healing procedures with and without mesenchymal stem cells: A comparative study.

AIMS AND OBJECTIVES: Successful preservation of the edentulous ridge after extraction may eliminate or reduce the need for ridge augmentation procedures. It is proved that grafting of fresh extraction sockets with bone grafts promotes ridge preservation. An objective method of maintaining height and width of alveolar ridge using mesenchymal stem cells (MSCs) seeded on collagen membrane was implemented in this study. METHODOLOGY: Ten bilaterally symmetrical extraction sockets scheduled for extraction were selected for this study. Involved teeth were extracted atraumatically and the sockets were curetted. MSCs seeded on collagen membrane were placed in the extracted socket on one side. On the other side, only collagen membrane was placed inside the socket. Both the sockets were closed primarily with nonresorbable sutures. Buccolingual and mesiodistal widths of the ridges at three different levels (2 mm below cementoenamel junction [CEJ], 5 mm below CEJ, and 8 mm below CEJ) were assessed immediately after extraction and postoperatively at 3 and 6 months. RESULTS: There was statistically significant observation in maintaining the alveolar ridge width in the grafted site when compared to the nongrafted site. CONCLUSION: Socket healing procedure using MSCs and collagen membrane was successful in maintaining width of alveolar socket.