RESUMO
Objective: To compare the efficacy and safety of thulium fiber laser (TFL) and holmium:yttrium-aluminum-garnet (Ho:YAG) laser for ureteric stone management with semi-rigid ureteroscopy. Methods: In a prospective study from January 2020 to December 2021, we compared 40 patients in each group who underwent semi-rigid ureteroscopic lithotripsy with TFL and that with Ho:YAG laser. Stone volume, stone density, stone fragmentation rates, total lasing time, total operative time, endoscopic vision, retropulsion and stone free rates were analyzed in both groups and compared. Results: Mean stone volume was comparable in the TFL group and the Ho:YAG laser group (282.45 [standard deviation, SD 139.79] mm3 vs. 279.49 [SD 312.52] mm3; p=0.964). Mean stone density was also comparable in the TFL group and the Ho:YAG laser group (1135.30 [SD 317.04] Hounsfield unit vs. 1131.75 [SD 283.03] Hounsfield unit; p=0.959). The mean stone fragmentation rates calculated as stone volume divided by lasing time were 25.85 (SD 10.61) mm3/min and 21.37 (SD 14.13) mm3/min in the TFL group and the Ho:YAG laser group, respectively (p=0.113). The mean total lasing time (10.15 [SD] 4.69 min vs. 11.43 [SD 4.56] min; p=0.222), mean operative time (25.13 [SD 9.51] min vs. 25.54 [SD 10.32] min; p=0.866), and mean total hospital stay (2.62 [SD 0.77] days vs. 2.61 [SD 0.84] days; p=0.893) were comparable in the TFL group and in the Ho:YAG group. The vision was better and retropulsion was less in the TFL group. The stone-free rate at 1 month postoperatively was slightly better in the TFL group (100% vs. 90%; p=0.095). Conclusion: TFL technology was associated with the comparable total surgical time, total lasing time, and stone fragmentation rate with Ho:YAG laser. However, TFL had better endoscopic vision, lesser stone retropulsion, and slightly better stone-free rates.
RESUMO
BACKGROUND: Oral implants are considered safe in the mandibular anterior region, but complications often occur if vital structures such as inferior alveolar nerve, mandibular incisive canal (MIC), anterior mental loop (AL), or mental foramen (MF) are not properly identified. AIM: The aim was to evaluate vital anatomical structures in the mandibular interforaminal region and to investigate sexual dimorphism and differences with respect to left and right side regions using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Eighty CBCT scans (forty male and forty female) were analyzed for MF position and shape, presence and measurement of AL and MIC (both in mm), emergence patterns of mandibular canal, and symmetry of MF and AL. A pilot study was conducted on five patients to determine interobserver reliability among two oral and maxillofacial radiologists, considered for interpretation of CBCT images. All the scans were taken by CS 9300, CBCT machine adjusted at 80 kVp, 15 mA, voxel size 0.3 × 0.3 × 0.3, and field of view of 10 × 5 (mandible only). The acquired images were reconstructed into multiplanar views (axial, panoramic, and cross-sectional) for evaluation. RESULTS: The mean age of the study population was 42.64 ± 16.22 years, with males noted with slightly higher age. Position 4 of MF (below the apex of the second premolar) was noted the most on the right side, whereas position 3 (between the first and second premolars) was noted on the left side, with 75% of symmetrical MF position. The oval-shaped MF was most common among both genders and sides. The prevalence of MIC was noted in 93.75% of patients with a mean length of 12.09 ± 5.95 mm. The prevalence of AL was 53.13%, with a mean length of 1.07 ± 1.42 mm. No statistically significant sexual dimorphism (P > 0.05) was found between genders or sides for all the evaluated interforaminal parameters. CONCLUSION: CBCT evaluation of vital anatomical structures needs to be elicited before planning an interforaminal placement of implants, and no sexual dimorphism was found regarding them.
RESUMO
BACKGROUND: Mandible is a dimorphic, dense compact bone that makes it very durable and well preserved in mass disasters for personnel identification. Mandibular ramus morphometric measurements can be used for gender determination using orthopantomogram (OPG) or on dry mandibles. AIM: To determine gender from morphometric analysis of mandibular ramus of 200 digital OPG of patients from Sriganganagar population. MATERIALS AND METHODS: The study was conducted on randomly selected digital OPG of 200 patients of both genders between the ages of 21 and 70 years taken using CS8000C machine from daily OPD. Morphometric analysis of mandibular ramus (maximum ramus breadth, minimum ramus breadth, condylar height, projective height of ramus, and coronoid height) was done twice by single maxillofacial radiologist independently at an interval of 1 day and mean of both the values were considered. The collected data was tabulated and analyzed using SPSS Software version 20 using independent t-test and discriminant function analysis. RESULTS: Out of total 200 subjects, 37% were male and 63% were female. Mean of minimum ramus breadth, maximum ramus height, and projected ramus height was noted significantly more among males while maximum ramus breadth was noted slightly higher in females. The overall accuracy for determining sex from mandibular ramus was found to be 77.6%, whereas for determining male and female, the accuracy was 78.4% and 76.8%, respectively. CONCLUSION: Mandibular ramus can be used for sexual dimorphism by morphometric analysis done on OPG among Sriganganagar population.