Amniotic Allograft, A Possible Alternative to Free Gingival Graft in Improving Attached Gingiva Width: A Randomized Controlled Clinical Trial.

Background: Years of research have well demonstrated the pivotal role the attached gingiva plays in maintaining of periodontal health. Objective: This study aimed to compare the efficacy of two technics, amniotic allograft and free gingival graft (FGG), in improving the attached gingiva width (AGW) around the teeth. Methods: In this randomized controlled clinical trial study, 28 patients all in need of increased AGW were randomly halved and assigned to a test group receiving the amniotic allograft and a control group treated by a palatal FGG. Following the operation, the mean AGW, graft shrinkage, and color match were assessed and photographed at various intervals (1, 2, 6, and 12 weeks). The level of pain was also evaluated based on the visual analog scale (VAS). Results: The AGW was not significantly different between the two groups in 2, 6 and, 12 weeks postoperatively (P=0.17, 0.73, 0.76 respectively). The same applied to the amount of shrinkage between the two groups at the intervals (p=0.38, p=0.57 and p=0.52 respectively). The amniotic allograft group was superior (not significantly) in terms of the color match (p=0.59, p=0.31 and p=0.18 respectively). However, it was found to have significantly lower VAS pain scores than did the control group (p <0.05). Conclusion: Application of the amniotic allograft could decrease the postoperative pain as well as discomfort and effectively increase the AGW. Therefore, given the drawbacks of FGG, the amniotic allograft can be considered as a viable alternative.

Brain-dead Donation Rate in Month of Ramadan and the other Months: 2005-2014.

Regardless of the level of development, religion and beliefs have crucial impact on people's attitude towards organ donation. Although organ donation in Islam is obviously appraised, mainly due to lack of an appropriate infrastructure, post-mortem donation rate in Islamic countries is not comparable to successful settings. We conducted this study to assess the extent of contribution of factors that reduce the level of effectiveness, and also to determine the impact of altruistic feelings in the month of Ramadan on family refusal as the leading modifiable contributor to organ donation rate. All records of potential and actual brain-dead donors, referred to Organ Procurement Unit of the Iranian Tissue Bank, from January 1, 2005 to December 31, 2014, were analyzed. In each year, the number of potential and actual donors in the month of Ramadan was compared to the mean value in the remaining 11 months. Of 1758 total potential donors in 10 years, 464 cases became actual donors (26.4% as overall level of effectiveness). The reasons for non-effectiveness were medical contraindications (25.4%), cardiac arrest before referral or during maintenance (7.4%), family refusal (30.8%), judicial refusal (8.7%), etc (1.3%). Analysis showed no significant differences between donation rates (both potential and actual) in Ramadan and non-Ramadan months for potential (Δ=3.55, 95% CI: -6.7 to 13.8) and actual donors (Δ=1.35, 95% CI: -2.3 to 5). Despite the undeniable role of religion and beliefs in the establishment of organ procurement program from brain-dead donors, there was no monthly variability in post-mortem organ donation rate.

Human Split-Thickness Skin Allograft from Brain-Dead Donors.

BACKGROUND: Looking for an appropriate skin substitute for temporary and permanent coverage of wounds remains one of the main obstacles of medical researchers. OBJECTIVE: To investigate the rate of inflammation, symbiosis, and survival of grafted allograft skin from brain-dead donors (BDDs) in rabbits. METHODS: After receiving negative serologic tests of BDDs, we prepared partial thickness skin grafts. They were then used in treating wounds of 5 rabbits in comparison with split-thickness skins taken from cardiac dead donors. RESULTS: On histopathological examinations, we found no difference between the skins. All samples were separated from the baseline in 15-20 days. CONCLUSION: Gamma-irradiated freeze-dried human split-thickness skin taken from BDDs is safe and can be used for the treatment of deep skin burns.

Do spinal cord-injured individuals with stronger sense of coherence use different psychological defense styles?

OBJECTIVES: Although the importance of sense of coherence (SOC) and psychological defense mechanisms (PDMs) in the process of coping has been demonstrated, it has not yet been clarified whether individuals with stronger SOC use specific PDMs. STUDY DESIGN: Cross-sectional. SETTING: Iran. METHODS: Demographic and injury-related variables including injury level, time since injury, American Spinal Cord Association (ASIA) Scale and Spinal cord independence measure-III were collected among individuals with spinal cord injury (SCI). SOC was assessed by the Short-form Sense of Coherence Scale. PDMs were identified using 40-version of the Defense Style Questionnaire. RESULTS: Neurotic defense style was the most commonly used style especially. The overall most commonly used PDM was 'rationalization', which was used by 95%. Individuals with stronger SOC used more mature style (P=0.001, r=0.52), particularly 'humor' and 'suppression' mechanisms (P<0.0001 and 0.024, respectively). There was a negative correlation between stronger SOC and the use of immature defenses including passive aggression (P=0.001, r=-0.51), acting out (P=0.001, r=-0.48), isolation (P=0.009, r=-0.50), autistic fantasy (P=0.010, r=-0.30) and somatization (P<0.0001, r=-0.62). Married individuals had significantly stronger SOC (P=0.01). Age, gender, age at the time of injury incidence, time since injury, ASIA score and cause of injury were not determinants of SOC. CONCLUSION: In this study, PDMs, which are more probable to be used by individuals with stronger SOC, have been identified. Mature defenses including 'humor' and 'suppression' are used by stronger SOC more often, whereas immature mechanisms are less likely to be used.

Fabrication of a hard tissue replacement using natural hydroxyapatite derived from bovine bones by thermal decomposition method.

BACKGROUND: For the treatment of bone defects that exceed the critical size of the injury, several therapies have been investigated. Thermal decomposition method is suggested for extraction of natural hydroxyapatite bioceramic (HA). This technique in comparison with other methods of producing HA, has less complexity and greater economic efficiency. OBJECTIVE: In the present study, a thermal decomposition method is suggested for extraction of natural HA from bovine femur bones. METHODS: In this experiment, to extract the ceramic material, the bone samples were first de-fatted and ground to particles less than 420 µm, and also 420-500 µm, respectively. Prepared powders were heated at 170 °C for 24 h, and then divided into two groups for 6 h. The first group was heated at 750 °C; the second group was heated at 850 °C. The calcium phosphate compounds were obtained with complete elimination of the organic phase of the bone. These bioceramic compounds were characterized physiochemically by X-ray diffraction (XRD), fourier transform infrared spectroscopy (FTIR), energy dispersive X-ray (EDX), and scanning electron microscopy (SEM). RESULTS: We found that the powder heated at 750 °C in two dimensional scales was rich in carbonated hydroxyapatite, and therefore, eminently suitable for using in hard tissue replacements. However, increasing the temperature up to 850 °C reduced the Ca/P ratio to 1.5 in the powder sample sizes less than 420 µm. Consequently, the obtained composition became rather similar to the chemical formula of tricalcium phosphate (TCP) that is appropriate in tissue engineering and drug delivery applications. CONCLUSION: The observations affirmed that by eliminating the collagen and other organic materials existing in the bovine bones, the mineral phase of the bone had the potential of transformation to nano-particles. To investigate the repair of critical-size bone defects and bone augmentation, cylindrical blocks were fabricated by applying different pressures of 150, 160 and 170 MPa. The structure and compressive strength of the pressed samples after sintering at 1200 °C were characterized by SEM and compressive strength test.

Human split-thickness skin allograft: skin substitute in the treatment of burn.

BACKGROUND: Human skin allograft has been used as wound coverage for a long time; it is one of the most successful and widely used dressings for burn wounds in the world. OBJECTIVE: To prepare a freeze-dried human split-thickness skin allograft and evaluate its cytotoxicity, the structure and physical properties after processing methods and clinical efficacy in burn patients. METHODS: After ensuring tissue safety, we lyophilized human cadaveric partial thickness skin and exposed it to gamma radiation. Histopathological and immunohistochemical properties, tensile strength and in vitro cytotoxicity were assayed for the skin samples. Then, we tested the samples in 11 patients with deep skin burn. RESULTS: On histological and histopathological examinations, we found a normal skin structure. The tensile strength of the rehydrated freeze-dried human skin allograft was not lesser than the fresh human skin. Cell viability in MTT testing was more than 95%. None of our patients showed any signs of immunological reactions or complications. CONCLUSION: Gamma-irradiated freeze-dried human split-thickness skin is safe and non-toxic and can be used for the treatment of patients with deep skin burn.

Comparative study of depression and consent among brain death families in donor and nondonor groups from March 2001 to December 2002 in Tehran.

OBJECTIVE: The aim of this research was to study the relationship between depression and organ donation among families of brain death cases. MATERIALS AND METHODS: This descriptive, cross-sectional study included a sample of first-degree relatives of brain death cases: 54 relatives among 27 organ donor families and 104 relatives among 58 nonorgan donor families participated in the research by the counting method. All families were questioned about their willingness for organ donation and at least 3 months had passed from their relative's death to the time we performed the research. Data were collected via a demographic questionnaire and Beck depression inventory (BDI) with a cutoff point of 16; persons with scores over 16 were considered depressed. Data were analyzed using descriptive statistics, Student t test, and chi-square test. RESULTS: Depression was observed in 20.4% of donor families and 17.3% of nondonor families; there was no significant difference between them. There were no significant differences in the frequency of depression between parents, spouses, and children of the 2 groups. The organ donors' relatives reported the effectiveness of organ donation to alleviate their grief: 66% completely and 32% partially. CONCLUSION: Organ donation does not have a significant effect on the course of grief and later depression among relatives of brain death cases.