Investigation and comparison of patient experiences with removable functional appliances.

OBJECTIVES: To compare patients' experiences with the Invisalign Teen with Mandibular Advancement® (ITMA) and Twin Block (TB) appliances, both initially and after several months of wear. MATERIALS AND METHODS: Sixty-eight patients completed an anonymous survey after at least 2 months of wearing ITMA or TB. Forty-five patients treated with ITMA (18 boys, 27 girls, mean age 13.6 years, SD ± 1.54) and 23 patients treated with TB (13 boys, 10 girls, mean age 10.60 years, SD ± 1.92) were included. RESULTS: More patients using the TB found their appliance to be visually intimidating as compared with patients using the ITMA (21.7% vs 8.9%). TB was more noticeable than the ITMA (69.6% vs 25%). Appliance insertion was more difficult for TB patients (21.8% vs 4.44% for ITMA). After several months, there were more reports of tooth soreness and lip/cheek soreness in the ITMA group. TB patients were more embarrassed even after several months (14.3% vs 0% for ITMA). More TB patients required extra appointments for breakage (50% vs 22.2% for ITMA). Speech, drooling, and jaw and lip/cheek soreness worsened initially for both groups but improved over time. There were no differences between the groups regarding visible facial changes, satisfaction with treatment experience, or time to acclimatize to the appliance. CONCLUSIONS: TB and ITMA patients shared similar experiences for most of the parameters measured, but there were significant differences between the groups regarding appliance wear and management, discomfort, and function.

A randomized clinical trial of cyanoacrylate tissue adhesives in donor site of connective tissue grafts.

BACKGROUND: The purpose was to compare patient-centered outcomes, early wound healing, and postoperative complications at palatal donor area of subepithelial connective tissue grafts (CTG) between cyanoacrylates tissue adhesives and polytetrafluoroethylene (PTFE) sutures. METHODS: Thirty-six patients who required harvesting of CTG were enrolled in this randomized clinical trial and assigned to one of two groups. In the "suture" group, wound closure was achieved with standardized continuous interlocking 6-0 PTFE sutures, while in the "cyanoacrylate" group, a high viscosity blend of n-butyl and 2-octyl cyanoacrylate was applied until hemostasis was achieved. The primary outcome was the discomfort (eating, speaking, etc.) from the donor site during the first postoperative week; this was self-reported on a visual analog scale questionnaire. Secondary outcomes were the time required for suture placement or cyanoacrylate application, patient self-reported pain on the first day and the first week after surgery, the analgesic intake and the modified early-wound healing index (MEHI). RESULTS: The median value of discomfort was 1.49 in the "suture" group and 1.86 in the "cyanoacrylate" (P = 0.56). The mean time required for suture placement was 7.31 minutes and for cyanoacrylate application 2.16 minutes (P < 0.0001). No statistically significant differences were found between the two methods in reported pain level, analgesic intake, and MEHI. CONCLUSIONS: Cyanoacrylate performs similarly to sutures and can be used for wound closure of the donor site of CTG. The application was about 5 minutes faster than conventional suture placement, reducing the total time of the surgical procedure.

Vacuum-induced Suction Stimulates Increased Numbers of Blood Vessels in Healthy Dog Gingiva.

UNLABELLED:  This study was designed to determine if vacuum-induced suction increased the number of blood vessels in healthy dog gingiva as a prelude to future studies testing vacuum therapy for improving local blood supply and controlling periodontal disease. METHODS: The buccal gingiva of five dogs was treated with subatmospheric pressure for 5 days, with untreated tissues acting as controls. Biopsies were analyzed for vascular endothelial growth factors (VEGF) and blood vessels were counted. RESULTS: VEGF and vessel numbers were elevated in treatment groups compared to controls (P < 0.05). CONCLUSION: A single daily application of subatmospheric pressure might be beneficial for healing damaged or diseased gingival tissues. .