The Orthodontics-Periodontics Challenges in Integrated Treatment: A Comprehensive Review.

Orthodontics and periodontics are intricately linked since adult orthodontics often implicate the periodontium. Periodontal intervention is needed throughout all phases of orthodontic treatment, from orthodontic diagnosis to mid-treatment periodontal assessment and postoperative evaluation. Invariably, periodontal health affects orthodontic success. Conversely, orthodontic tooth movements may serve as adjunctive therapy in patients with periodontal disease. This review aimed to provide a comprehensive understanding of the orthodontic-periodontic relationship for optimizing therapeutic strategies and achieving the best treatment outcomes in patients.

Sub-clinical Cervical Root Resorption: A Case Report.

External cervical resorption (ECR) is a dynamic pathological process characterized by its cervical position on the root and arises below the epithelial attachment and the coronal part of the bone. This report will highlight a case of ECR in an asymptomatic patient. A radiolucent area was noted during a routine dental follow-up examination on the bitewings at the mesial surface of the upper right second premolar. Persistently, the radiolucency had multiple radiographic views indicating a true form of a lesion that could be diagnosed as external cervical resorption. The patient did not report any complaints since dental treatment was completed in 2016. After a series of radiographs and conducting further diagnostic measures, a diagnosis of ECR was confirmed. The best treatment of choice for this case was extraction and restoring the missing tooth with an implant-supported crown. The size and the extent of such a defect could affect the strategy for implant placement. This paper aimed to report that ECR can be asymptomatic for a long time with advanced cervical root resorption in some cases.

Establishing a 130-Bed Field Intensive Care Unit to Prepare for COVID-19 in 7 Days in Bahrain Military Hospital.

This article reports the establishment of an isolated, fully functional field intensive care unit (FICU) unit equipped with all necessary critical care facilities as a part of the national pre-emptive preparedness to treat an unexpected surge outbreak of coronavirus disease 2019 (COVID-19) patients in Bahrain. One floor of an existing car parking structure was converted into a 130-bed FICU set-up by the in-house project implementation team comprised of multidisciplinary departments. The setting was a military hospital in the Kingdom of Bahrain, and the car park was on the hospital premises. The FICU contained a 112-bed fully equipped ICU and an 18-bed step-down ICU, and was built in 7 d to cater to the intensive care of COVID-19 patients in Bahrain.

Angulating-Distraction Ulnar Osteotomy and Interpositional Phosphocalcic Ceramic Wedge Graft for a Chronic Monteggia Lesion.

BACKGROUND: Various types of osteotomies have been used to facilitate reduction of the radial head and to prevent recurrent subluxation. The Bouyala technique - open reduction of radial head associated with open wedge ulnar osteotomy with or without annular ligament reconstruction, is presently the most widely used treatment for long- standing traumatic dislocation of the radial head, independently of age, in the absence of osteoarthritis remodeling, and should preferably be performed within 1 year of trauma. METHOD: In this article, we present a similar case operated by same technique, but we used synthetic phosphocalcic ceramic wedge graft instead of auto bone graft as described in many other studies. We believe that, this will limit the donor site morbidity and also aid in achieving better stability at osteotomy site, which in turn help in proceeding with early active mobilization protocol. RESULT: We achieved union of the osteotomy by three months. Clinically, there was no deformity and she achieved full pain-free range of motion of elbow joint. CONCLUSION: We believe that, use of synthetic phosphocalcic ceramic wedge graft allow rigid fixation of osteotomy, provides additional stability, decrease the risk of secondary displacement and allow early mobilization, which may minimize contracture and we could achieve fairly good clinical outcome.

Modified Tension - Slide Technique for Anatomical Distal Biceps Tenodesis using a Bicortical EndoButton and a Tenodesis Screw.

INTRODUCTION: Many surgical techniques have been described in the literature. In this article, we describe surgical technical details along with tips and tricks of distal biceps tendon tenodesis using the EndoButton and tension - slide technique, a modification of the suspensory cortical button technique, which allows the surgeon to tension and repairs the biceps tendon through the single longitudinal anterior incision. This modification in surgical technique of using dual implants, i.e., EndoButton and interference screw as fixation tools and concept of tendon sliding principle made this procedure unique. In this article, we describe surgical technique along with tips and tricks of distal biceps tendon tenodesis using the EndoButton and tension - slide technique and also discussed about modification of EndoButton technique reported in many other articles to overcome the possible complications. CASE REPORT: We report six consecutive patients, presented with distal biceps tendon rupture (4 acute; 2 chronic cases) between June 2013 and March 2015, who underwent single-incision, anatomical distal biceps tenodesis procedure with bicortical EndoButton and tenodesis screw using tension slide technique. Radiographs were taken immediate post-operative to document for displacement or loosening of EndoButton if any. CONCLUSION: The use of an EndoButton and an interference screw for repairing distal biceps tendons have been previously described. We describe a modification of originally described technique which is worth considering, as it provides two levels of fixation, whilst avoiding possible complications of such procedures. It is ideal for repairing both acute and chronic ruptures, without the need for allograft or autograft augmentation and describes detailed technical steps to avoid possible iatrogenic complications.

Patterns of collapse in thoracolumbar burst fractures.

OBJECTIVE: Functional outcomes of neurologically intact patients with burst fractures may be dependent on final kyphosis at the end of treatment. Conservative treatment is indicated if an acceptable sagittal alignment of the spine can be anticipated. Thoracolumbar burst fractures are often grouped as a single entity where, in fact, anatomically distinct areas of the spine may behave differently owing to different biomechanical factors. The goal of this work was to evaluate differential behavior in terms of final kyphosis in anatomically distinct regions of the spine following stable burst fractures. METHODS: Prospective analysis of kyphosis in 60 patients treated conservatively for traumatic thoracolumbar burst fracture was conducted. Initial trauma supine radiographs were measured for initial kyphosis (Ki). Final kyphosis (Kf) in the upright patient was measured at the end of treatment. The Ki and Kf were plotted on a scatter graph; with use of linear regression analysis, a mathematical model was created to define a relationship between Ki and Kf based on anatomic level of the spine. RESULTS: The thoracolumbar spine behaved in two independent patterns with respect to Kf. Kf at the thoracolumbar junction (T11-L1) had a collapse pattern that could be approximated most accurately with the equation Kf = Ki + 0.5 Ki. At the midlumbar spine, L2-L3 level, a best-fit model for collapse was Kf = Ki + 4 degrees . CONCLUSION: In this cohort of patients, fractures that were categorized as "stable" and not requiring surgery were studied for the purpose of determining differential collapse patterns in anatomically distinct areas of the lumbar spine. We have demonstrated that the thoracolumbar junction and the midlumbar spine behave differently biomechanically and recommend that these two anatomic levels be studied independently for research purposes.