Pub Date : 2024-10-16DOI: 10.1186/s13005-024-00461-x
Marco Serafin, Gero Kinzinger, Jan Hourfar, Valentina Mantellini, Rosamaria Fastuca, Alberto Caprioglio
Objectives: The purpose of this multicenter retrospective study was to perform a two-dimensional analysis of upper airway changes in adolescent patients following molar distalization with the Pendulum appliance.
Materials and methods: The study involved the cephalometric analysis of 88 patients, retrospectively categorized into two groups: skeletal Class II with a dental Class II molar relationship (36 patients, mean age 12.6 ± 1.1 years) and skeletal Class I with a dental Class II molar relationship (54 patients, mean age 12.3 ± 1.2 years). Changes were observed using lateral radiographs before (T0) and after Pendulum appliance removal (T1); treatment time averaged 7 months. Upper airways were subsequently analyzed by tracing lateral radiographs. The Shapiro-Wilk test showed a normal distribution of the data, therefore parametric tests were used for statistical analysis. Intragroup changes between T0 and T1 were evaluated using paired t-tests, and intergroup differences were assessed using independent student t-tests; statistical significance was set at 0.05.
Results: Statistically significant differences were observed in the skeletal measurements that characterized both groups, particularly in ANB and Wits appraisal, at T0 (P < 0.001). After molar distalization, Class I and Class II groups reported no statistically significant differences with changes almost equal to zero between timepoints (P > 0.05). Additionally, intergroup comparisons of airway changes at T1 did not show statistically significant differences (P > 0.05).
Conclusions: The Pendulum appliance does not significantly change the upper airway dimensions in Class I and Class II malocclusion patients, thereby minimizing potential respiratory risks.
研究目的这项多中心回顾性研究旨在对青少年患者使用摆锤矫治器进行磨牙远端矫治后的上气道变化进行二维分析:研究对 88 名患者进行了头颅测量分析,并回顾性地将其分为两组:臼齿关系为牙科 II 类的骨骼 II 类患者(36 名,平均年龄为 12.6 ± 1.1 岁)和臼齿关系为牙科 II 类的骨骼 I 类患者(54 名,平均年龄为 12.3 ± 1.2 岁)。使用摆动矫治器拆除前(T0)和拆除后(T1)的侧位X光片观察其变化;治疗时间平均为 7 个月。随后,通过描记侧位片对上呼吸道进行了分析。Shapiro-Wilk 检验显示数据呈正态分布,因此采用参数检验进行统计分析。使用配对 t 检验评估 T0 和 T1 之间的组内变化,使用独立学生 t 检验评估组间差异;统计显著性设定为 0.05:在 T0 阶段,两组的骨骼测量结果,尤其是 ANB 和 Wits 评估结果,存在明显的统计学差异(P 0.05)。此外,对 T1 阶段气道变化的组间比较也未发现有统计学意义的差异(P > 0.05):结论:摆动矫治器不会明显改变 I 类和 II 类错牙合畸形患者的上气道尺寸,从而将潜在的呼吸风险降至最低。
{"title":"Upper airways changes associated with orthodontic molar distalization by Pendulum appliance in adolescent patients: a multicenter retrospective cephalometric study.","authors":"Marco Serafin, Gero Kinzinger, Jan Hourfar, Valentina Mantellini, Rosamaria Fastuca, Alberto Caprioglio","doi":"10.1186/s13005-024-00461-x","DOIUrl":"10.1186/s13005-024-00461-x","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this multicenter retrospective study was to perform a two-dimensional analysis of upper airway changes in adolescent patients following molar distalization with the Pendulum appliance.</p><p><strong>Materials and methods: </strong>The study involved the cephalometric analysis of 88 patients, retrospectively categorized into two groups: skeletal Class II with a dental Class II molar relationship (36 patients, mean age 12.6 ± 1.1 years) and skeletal Class I with a dental Class II molar relationship (54 patients, mean age 12.3 ± 1.2 years). Changes were observed using lateral radiographs before (T0) and after Pendulum appliance removal (T1); treatment time averaged 7 months. Upper airways were subsequently analyzed by tracing lateral radiographs. The Shapiro-Wilk test showed a normal distribution of the data, therefore parametric tests were used for statistical analysis. Intragroup changes between T0 and T1 were evaluated using paired t-tests, and intergroup differences were assessed using independent student t-tests; statistical significance was set at 0.05.</p><p><strong>Results: </strong>Statistically significant differences were observed in the skeletal measurements that characterized both groups, particularly in ANB and Wits appraisal, at T0 (P < 0.001). After molar distalization, Class I and Class II groups reported no statistically significant differences with changes almost equal to zero between timepoints (P > 0.05). Additionally, intergroup comparisons of airway changes at T1 did not show statistically significant differences (P > 0.05).</p><p><strong>Conclusions: </strong>The Pendulum appliance does not significantly change the upper airway dimensions in Class I and Class II malocclusion patients, thereby minimizing potential respiratory risks.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"59"},"PeriodicalIF":2.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.1186/s13005-024-00463-9
Johannes G Schuderer, Florian Hoferer, Jonas Eichberger, Mathias Fiedler, André Gessner, Florian Hitzenbichler, Maximilian Gottsauner, Michael Maurer, Johannes K Meier, Torsten E Reichert, Tobias Ettl
Literature suggests that intravenous prophylaxis exceeding 48 h offers no additional benefit in preventing surgical site infections (SSI) in patients with microvascular head and neck reconstruction. However, protocols for antibiotic therapy duration post-reconstruction are not standardized. This study identifies factors predicting prolonged intravenous antibiotic use and antibiotic escalation in patients receiving free flap head neck reconstruction. A retrospective analysis of 446 patients receiving free flap reconstruction was conducted, examining predictors for antibiotic therapy > 10 days and postoperative escalation. 111 patients (24.8%) experienced escalation, while 159 patients (35.6%) received prolonged therapy. Multivariate regression analysis revealed predictors for escalation: microvascular bone reconstruction (p = 0.008, OR = 2.0), clinically suspected SSI (p < 0.001, OR = 5.4), culture-positive SSI (p = 0.03, OR = 2.9), extended ICU stay (p = 0.01, OR = 1.1) and hospital-acquired pneumonia (p = 0.01, OR = 5.9). Prolonged therapy was associated with bone reconstruction (p = 0.06, OR = 2.0), preoperative irradiation (p = 0.001, OR = 1.9) and culture-positive SSI (p < 0.001, OR = 3.5). The study concludes that SSIs are a primary factor driving the escalation of perioperative antibiotic use. Clinical suspicion of infection often necessitates escalation, even in the absence of confirmed microbiological evidence. Microvascular bone reconstruction was a significant predictor for both the escalation and extension of antibiotic therapy beyond 10 days. Furthermore, preoperative radiation therapy, hospital-acquired pneumonia, and prolonged ICU stay were associated with an increased likelihood of escalation, resulting in significantly extended antibiotic administration during hospitalization. Antibiotic stewardship programmes must be implemented to reduce postoperative antibiotic administration time.Trial registration The study was registered approved by the local Ethics Committee (Nr: 18-1131-104).
{"title":"Predictors for prolonged and escalated perioperative antibiotic therapy after microvascular head and neck reconstruction: a comprehensive analysis of 446 cases.","authors":"Johannes G Schuderer, Florian Hoferer, Jonas Eichberger, Mathias Fiedler, André Gessner, Florian Hitzenbichler, Maximilian Gottsauner, Michael Maurer, Johannes K Meier, Torsten E Reichert, Tobias Ettl","doi":"10.1186/s13005-024-00463-9","DOIUrl":"https://doi.org/10.1186/s13005-024-00463-9","url":null,"abstract":"<p><p>Literature suggests that intravenous prophylaxis exceeding 48 h offers no additional benefit in preventing surgical site infections (SSI) in patients with microvascular head and neck reconstruction. However, protocols for antibiotic therapy duration post-reconstruction are not standardized. This study identifies factors predicting prolonged intravenous antibiotic use and antibiotic escalation in patients receiving free flap head neck reconstruction. A retrospective analysis of 446 patients receiving free flap reconstruction was conducted, examining predictors for antibiotic therapy > 10 days and postoperative escalation. 111 patients (24.8%) experienced escalation, while 159 patients (35.6%) received prolonged therapy. Multivariate regression analysis revealed predictors for escalation: microvascular bone reconstruction (p = 0.008, OR = 2.0), clinically suspected SSI (p < 0.001, OR = 5.4), culture-positive SSI (p = 0.03, OR = 2.9), extended ICU stay (p = 0.01, OR = 1.1) and hospital-acquired pneumonia (p = 0.01, OR = 5.9). Prolonged therapy was associated with bone reconstruction (p = 0.06, OR = 2.0), preoperative irradiation (p = 0.001, OR = 1.9) and culture-positive SSI (p < 0.001, OR = 3.5). The study concludes that SSIs are a primary factor driving the escalation of perioperative antibiotic use. Clinical suspicion of infection often necessitates escalation, even in the absence of confirmed microbiological evidence. Microvascular bone reconstruction was a significant predictor for both the escalation and extension of antibiotic therapy beyond 10 days. Furthermore, preoperative radiation therapy, hospital-acquired pneumonia, and prolonged ICU stay were associated with an increased likelihood of escalation, resulting in significantly extended antibiotic administration during hospitalization. Antibiotic stewardship programmes must be implemented to reduce postoperative antibiotic administration time.Trial registration The study was registered approved by the local Ethics Committee (Nr: 18-1131-104).</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"58"},"PeriodicalIF":2.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-11DOI: 10.1186/s13005-024-00459-5
Lea C Thiem, Per Rank, Jonas Q Schmid, Yann Janssens, Lara Bettenhäuser-Hartung, Dirk Wiechmann
Background: The aim of the investigation was to evaluate if the inclination of the lower anterior teeth can be controlled reliably after lower premolar extraction for Class III camouflage treatment with completely customized lingual appliances (CCLAs). Treatment outcome was tested against the null hypothesis that lower premolar extractions for non-surgical camouflage treatment of a Class III malocclusion will lead to further compensation by retroclining mandibular incisors during CCLA treatment.
Methods: This retrospective study included 25 patients (f/m 12/13; mean age 20.7 years, SD 9.5 years) with uni- or bilateral Class III molar relationship and a Wits value of ≤ -2 mm. In all consecutively debonded patients, lower premolars were extracted to correct the sagittal relationship with a non-surgical camouflage approach. Lateral head films prior to (T1) and at the end of lingual orthodontic treatment (T2) were used to evaluate skeletal and dentoalveolar effects. A paired t-test with alpha = 5% was used to define differences between the endpoints. The linear correlation between the inclination of the mandibular incisors at T1 and the achieved correction was measured with the Pearson correlation coefficient (PCC). A Schuirmann's TOST equivalence test was used to check if the final lower incisor inclination was within the defined norms.
Results: The null hypothesis was rejected as the mean lower incisor inclination was improved by 1.8° despite lower premolar extractions (T1: 86.8°/ T2: 88.6°). There was a strong correlation (-0.75) between the lower incisor inclination at T1 and the achieved correction indicating a controlled correction towards the norm regardless of the initial incisor position. At T2, the interincisal angle as well as the lower incisor inclination were within the norm.
Conclusion: Lower premolar extractions for non-surgical camouflage treatment of a Class III malocclusion will not lead to undesired retroclining of mandibular incisors during CCLA treatment even in severe cases.
背景:该研究旨在评估在使用完全定制舌侧矫治器(CCLA)对III类错颌畸形进行伪装治疗时,拔除下前磨牙后能否可靠地控制下前牙的倾斜。治疗结果对照零假设进行了检验,即拔除下前磨牙进行 III 类错牙合畸形的非手术伪装治疗会导致下颌切牙在 CCLA 治疗期间进一步后倾补偿:这项回顾性研究包括25名单侧或双侧III类臼齿关系且Wits值≤-2 mm的患者(男/女12/13;平均年龄20.7岁,SD 9.5岁)。在所有连续脱钩的患者中,通过非手术伪装方法拔除下前磨牙以矫正矢状关系。舌侧正畸治疗前(T1)和治疗结束时(T2)的头部侧位片用于评估骨骼和牙槽骨的影响。采用α=5%的配对t检验来确定终点之间的差异。用皮尔逊相关系数(PCC)测量了 T1 时下颌切牙的倾斜度与达到的矫正效果之间的线性相关。Schuirmann's TOST 等效检验用于检查最终的下切牙倾斜度是否在规定的标准范围内:结果:尽管拔除了下前磨牙,但平均下切牙倾斜度提高了 1.8°(T1:86.8°/ T2:88.6°),因此否定了零假设。T1 时的下切牙倾角与达到的矫正效果之间有很强的相关性(-0.75),这表明无论初始切牙位置如何,矫正效果都在可控范围内。T2时,颊间隙角和下切牙倾角都在标准范围内:结论:对 III 类错颌畸形进行非手术伪装治疗时,拔除下前磨牙不会导致下颌切牙在 CCLA 治疗过程中出现意外后倾,即使在严重病例中也是如此。
{"title":"Favourable dentoalveolar changes after lower premolar extractions for Class III camouflage with completely customized lingual appliances.","authors":"Lea C Thiem, Per Rank, Jonas Q Schmid, Yann Janssens, Lara Bettenhäuser-Hartung, Dirk Wiechmann","doi":"10.1186/s13005-024-00459-5","DOIUrl":"10.1186/s13005-024-00459-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of the investigation was to evaluate if the inclination of the lower anterior teeth can be controlled reliably after lower premolar extraction for Class III camouflage treatment with completely customized lingual appliances (CCLAs). Treatment outcome was tested against the null hypothesis that lower premolar extractions for non-surgical camouflage treatment of a Class III malocclusion will lead to further compensation by retroclining mandibular incisors during CCLA treatment.</p><p><strong>Methods: </strong>This retrospective study included 25 patients (f/m 12/13; mean age 20.7 years, SD 9.5 years) with uni- or bilateral Class III molar relationship and a Wits value of ≤ -2 mm. In all consecutively debonded patients, lower premolars were extracted to correct the sagittal relationship with a non-surgical camouflage approach. Lateral head films prior to (T1) and at the end of lingual orthodontic treatment (T2) were used to evaluate skeletal and dentoalveolar effects. A paired t-test with alpha = 5% was used to define differences between the endpoints. The linear correlation between the inclination of the mandibular incisors at T1 and the achieved correction was measured with the Pearson correlation coefficient (PCC). A Schuirmann's TOST equivalence test was used to check if the final lower incisor inclination was within the defined norms.</p><p><strong>Results: </strong>The null hypothesis was rejected as the mean lower incisor inclination was improved by 1.8° despite lower premolar extractions (T1: 86.8°/ T2: 88.6°). There was a strong correlation (-0.75) between the lower incisor inclination at T1 and the achieved correction indicating a controlled correction towards the norm regardless of the initial incisor position. At T2, the interincisal angle as well as the lower incisor inclination were within the norm.</p><p><strong>Conclusion: </strong>Lower premolar extractions for non-surgical camouflage treatment of a Class III malocclusion will not lead to undesired retroclining of mandibular incisors during CCLA treatment even in severe cases.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"57"},"PeriodicalIF":2.4,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-10DOI: 10.1186/s13005-024-00442-0
Xiaolin Hou, Ru Xiang Xu, Jing Tang, Cheng Yin
Background: Neurovascular compression (NVC) is a primary etiology of trigeminal neuralgia (TN) and hemifacial spasm (HFS). Despite Magnetic Resonance Tomographic Angiography (MRTA) being a useful tool for 3D multimodal fusion imaging (MFI) in microvascular decompression (MVD) surgery planning, it may not visualize smaller arterial vessels and veins effectively. We validate a novel computed tomography angiography and venography (CTA/V) - diffusion tensor tractography (DTT) -3D-MFI to enhance the MVD surgical guidance.
Methods: In this prospective study, 80 patients with unilateral primary TN or HFS who underwent MVD surgery were included. Imaging was conducted using CTA/V-DTT-3D-MFI compared with CT-MRTA-3D-MFI in predicting the responsible vessel and assessing the severity of NVC. Surgical outcomes were subsequently analyzed. Neurosurgery residents were provided with questionnaires to evaluate and compare the two approaches.
Results: CTA/V-DTT-3D-MFI significantly improved accuracy in identifying the responsible vessel (kappa = 0.954) and NVC (kappa = 0.969) compared to CT-MRTA-3D-MFI, aligning well with surgical findings. CTA/V-DTT-3D-MFI also exhibited higher sensitivity in identifying responsible vessels (98.0%) and NVC (98.7%) than CT-MRTA-3D-MFI. Additionally, CTA/V-DTT-3D-MFI showed fewer complications, shorter operation times, and lower recurrence after one year (all p < 0.05). Resident neurosurgeons emphasized that CTA/V-DTT-3D-MFI greatly assisted in formulating precise surgical strategies for more accurate identification and protection of responsible vessels and nerves (all p < 0.001).
Conclusion: CTA/V-DTT-3D-MFI enhances MVD surgery guidance, improving accuracy in identifying responsible vessels and NVC for better outcomes. This advanced imaging plays a crucial role in safer and more effective MVD surgery, as well as in training neurosurgeons.
{"title":"A novel 3D multimodal fusion imaging surgical guidance in microvascular decompression for primary trigeminal neuralgia and hemifacial spasm.","authors":"Xiaolin Hou, Ru Xiang Xu, Jing Tang, Cheng Yin","doi":"10.1186/s13005-024-00442-0","DOIUrl":"10.1186/s13005-024-00442-0","url":null,"abstract":"<p><strong>Background: </strong>Neurovascular compression (NVC) is a primary etiology of trigeminal neuralgia (TN) and hemifacial spasm (HFS). Despite Magnetic Resonance Tomographic Angiography (MRTA) being a useful tool for 3D multimodal fusion imaging (MFI) in microvascular decompression (MVD) surgery planning, it may not visualize smaller arterial vessels and veins effectively. We validate a novel computed tomography angiography and venography (CTA/V) - diffusion tensor tractography (DTT) -3D-MFI to enhance the MVD surgical guidance.</p><p><strong>Methods: </strong>In this prospective study, 80 patients with unilateral primary TN or HFS who underwent MVD surgery were included. Imaging was conducted using CTA/V-DTT-3D-MFI compared with CT-MRTA-3D-MFI in predicting the responsible vessel and assessing the severity of NVC. Surgical outcomes were subsequently analyzed. Neurosurgery residents were provided with questionnaires to evaluate and compare the two approaches.</p><p><strong>Results: </strong>CTA/V-DTT-3D-MFI significantly improved accuracy in identifying the responsible vessel (kappa = 0.954) and NVC (kappa = 0.969) compared to CT-MRTA-3D-MFI, aligning well with surgical findings. CTA/V-DTT-3D-MFI also exhibited higher sensitivity in identifying responsible vessels (98.0%) and NVC (98.7%) than CT-MRTA-3D-MFI. Additionally, CTA/V-DTT-3D-MFI showed fewer complications, shorter operation times, and lower recurrence after one year (all p < 0.05). Resident neurosurgeons emphasized that CTA/V-DTT-3D-MFI greatly assisted in formulating precise surgical strategies for more accurate identification and protection of responsible vessels and nerves (all p < 0.001).</p><p><strong>Conclusion: </strong>CTA/V-DTT-3D-MFI enhances MVD surgery guidance, improving accuracy in identifying responsible vessels and NVC for better outcomes. This advanced imaging plays a crucial role in safer and more effective MVD surgery, as well as in training neurosurgeons.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"56"},"PeriodicalIF":2.4,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-28DOI: 10.1186/s13005-024-00456-8
Kristof Somodi, Andrea Dobos, Ferenc Bartha, Eleonora Solyom, Peter Windisch, Daniel Palkovics, Balint Molnar
Background: Peri-implant soft tissue corrections are often indicated following alveolar ridge augmentation, due to the distortion of the keratinized mucosa at the area of augmentation. The objective of the current study was to evaluate the dimensional soft tissue changes following horizontal guided bone regeneration (GBR) utilizing 3D digital data.
Methods: 8 mandibular surgical sites with horizontal alveolar ridge deficiencies were treated utilizing a resorbable collagen membrane and a split-thickness flap design. Baseline and 6-month follow-up cone-beam computed tomography (CBCT) scans were reconstructed as 3D virtual models and were superimposed with the corresponding intraoral scan. Linear changes of supracrestal vertical- horizontal soft tissue alterations were measured in relation to the alveolar crest at the mesial- middle- and distal aspect of the surgical area. Soft tissue dimensions were measured at baseline and at 6-month follow-up.
Results: Preoperative supracrestal soft tissue height measured midcrestally averaged at 2.37 mm ± 0.68 mm, 2.37 mm ± 0.71 mm and 2.64 mm ± 0.87 mm at the mesial-, middle- and distal planes. Whereas postoperative supracrestal soft tissue height was measured at 2.62 mm ± 0.72 mm, 2.67 mm ± 0.67 mm and 3.69 mm ± 1.02 mm at the mesial, middle and distal planes, respectively. Supracrestal soft tissue width changed from 2.14 mm ± 0.72 mm to 2.47 mm ± 0.46 mm at the mesial, from 1.72 mm ± 0.44 mm to 2.07 mm ± 0.67 mm and from 2.15 mm ± 0.36 mm to 2.36 mm ± 0.59 mm at the mesial, middle and distal planes, respectively. Additionally the buccal horizontal displacement of supracrestal soft tissues could be observed.
Conclusions: The current study did not report significant supracrestal soft tissue reduction following horizontal GBR with a split-thickness flap. Even though there was a slight increase in both vertical and horizontal dimensions, differences are clinically negligible.
Trail registration: The trail was approved by the U.S. National Library of Medicine ( www.
背景:牙槽嵴增高术后,由于增高区域的角质化粘膜变形,通常需要进行种植体周围软组织修正。本研究的目的是利用三维数字数据评估水平引导骨再生(GBR)后软组织的尺寸变化。方法:利用可吸收胶原膜和分层厚度皮瓣设计治疗了 8 个下颌手术部位的水平牙槽嵴缺损。基线和 6 个月的随访锥束计算机断层扫描(CBCT)扫描结果被重建为三维虚拟模型,并与相应的口内扫描结果叠加。在手术区域的中-中-远端,测量牙槽嵴上垂直-水平软组织改变的线性变化。在基线和 6 个月随访时测量软组织尺寸:结果:术前测量的牙槽嵴顶上软组织高度平均为 2.37 mm ± 0.68 mm、2.37 mm ± 0.71 mm 和 2.64 mm ± 0.87 mm。而术后测量的嵴上软组织高度在中线、中线和远端平面分别为 2.62 mm ± 0.72 mm、2.67 mm ± 0.67 mm 和 3.69 mm ± 1.02 mm。中、中、远端平面的上颌软组织宽度分别从 2.14 mm ± 0.72 mm 变为 2.47 mm ± 0.46 mm,从 1.72 mm ± 0.44 mm 变为 2.07 mm ± 0.67 mm,从 2.15 mm ± 0.36 mm 变为 2.36 mm ± 0.59 mm。此外,还可以观察到上颌软组织的颊水平位移:结论:本研究并未发现使用劈开厚度皮瓣进行水平 GBR 后上嵴软组织明显缩小的情况。尽管垂直和水平方向的尺寸都略有增加,但临床上的差异可以忽略不计:该试验获得了美国国家医学图书馆(www.Clinicaltrials: gov)的批准;试验注册号:NCT05538715;试验时间:2011 年 12 月:NCT05538715;注册日期:2022 年 9 月 9 日。
{"title":"Changes in soft tissue dimensions following horizontal guided bone regeneration with a split-thickness flap design - evaluation of 8 cases with a digital method.","authors":"Kristof Somodi, Andrea Dobos, Ferenc Bartha, Eleonora Solyom, Peter Windisch, Daniel Palkovics, Balint Molnar","doi":"10.1186/s13005-024-00456-8","DOIUrl":"https://doi.org/10.1186/s13005-024-00456-8","url":null,"abstract":"<p><strong>Background: </strong>Peri-implant soft tissue corrections are often indicated following alveolar ridge augmentation, due to the distortion of the keratinized mucosa at the area of augmentation. The objective of the current study was to evaluate the dimensional soft tissue changes following horizontal guided bone regeneration (GBR) utilizing 3D digital data.</p><p><strong>Methods: </strong>8 mandibular surgical sites with horizontal alveolar ridge deficiencies were treated utilizing a resorbable collagen membrane and a split-thickness flap design. Baseline and 6-month follow-up cone-beam computed tomography (CBCT) scans were reconstructed as 3D virtual models and were superimposed with the corresponding intraoral scan. Linear changes of supracrestal vertical- horizontal soft tissue alterations were measured in relation to the alveolar crest at the mesial- middle- and distal aspect of the surgical area. Soft tissue dimensions were measured at baseline and at 6-month follow-up.</p><p><strong>Results: </strong>Preoperative supracrestal soft tissue height measured midcrestally averaged at 2.37 mm ± 0.68 mm, 2.37 mm ± 0.71 mm and 2.64 mm ± 0.87 mm at the mesial-, middle- and distal planes. Whereas postoperative supracrestal soft tissue height was measured at 2.62 mm ± 0.72 mm, 2.67 mm ± 0.67 mm and 3.69 mm ± 1.02 mm at the mesial, middle and distal planes, respectively. Supracrestal soft tissue width changed from 2.14 mm ± 0.72 mm to 2.47 mm ± 0.46 mm at the mesial, from 1.72 mm ± 0.44 mm to 2.07 mm ± 0.67 mm and from 2.15 mm ± 0.36 mm to 2.36 mm ± 0.59 mm at the mesial, middle and distal planes, respectively. Additionally the buccal horizontal displacement of supracrestal soft tissues could be observed.</p><p><strong>Conclusions: </strong>The current study did not report significant supracrestal soft tissue reduction following horizontal GBR with a split-thickness flap. Even though there was a slight increase in both vertical and horizontal dimensions, differences are clinically negligible.</p><p><strong>Trail registration: </strong>The trail was approved by the U.S. National Library of Medicine ( www.</p><p><strong>Clinicaltrials: </strong>gov ); trial registration number: NCT05538715; registration date: 09/09/2022.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"53"},"PeriodicalIF":2.4,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: The duration of response to treatment is a significant prognostic indicator, with early recurrence (ER) often predicting poorer survival outcomes in nasopharyngeal carcinoma (NPC) survivors. This study seeks to elucidate the factors contributing to the onset of ER following radiotherapy in NPC survivors.
Methods: This investigation encompassed 2,789 newly diagnosed NPC patients who underwent radical intensity-modulated radiotherapy. Ordinal logistic regression analysis was employed to evaluate the independent predictors of earlier recurrence. A machine learning-based prediction model of NPC recurrence patterns was developed. Tumorous RNA-sequencing (in-house cohort: N = 192) and biological tipping point analysis were utilized to infer potential molecular mechanisms associated with ER.
Results: Our results demonstrated that ER within 24 months post-initial treatment was the optimal time frame for identifying early malignant progression in NPC survivors. The ER cohort (150 of 2,789, 5.38%) exhibited a notably short median overall survival of 48.6 months. Multivariate analyses revealed that male gender, T4 stage, local or regional residual disease, detectable pre- and post-radiotherapy EBV DNA, and the absence of induction chemotherapy were significant predictors of earlier recurrence. The machine learning-based predictive model further underscored the importance of tumor-related factors in NPC recurrence. Moreover, ER emerged as a pivotal stage in NPC progression, with 15 critical transition signals identified potentially associated with the negative modulation of the immune response.
Conclusions: Our comprehensive analysis of NPC recurrence patterns has unveiled insights into the key factors driving ER and provided novel insights into potential early warning biomarkers and the mechanisms underlying NPC progression.
目的:治疗反应持续时间是一个重要的预后指标,早期复发(ER)往往预示着鼻咽癌(NPC)幸存者较差的生存结果。本研究旨在阐明导致鼻咽癌幸存者放疗后出现早期复发的因素:这项调查涵盖了2789名接受根治性调强放疗的新确诊鼻咽癌患者。采用正态逻辑回归分析评估早期复发的独立预测因素。研究开发了基于机器学习的鼻咽癌复发模式预测模型。利用肿瘤 RNA 序列分析(内部队列:N = 192)和生物临界点分析来推断与 ER 相关的潜在分子机制:结果:我们的研究结果表明,首次治疗后 24 个月内发生 ER 是确定鼻咽癌幸存者早期恶性进展的最佳时间框架。ER组群(2789人中有150人,占5.38%)的中位总生存期明显较短,仅为48.6个月。多变量分析表明,男性性别、T4分期、局部或区域残留疾病、放疗前后可检测到的EBV DNA以及未接受诱导化疗是较早复发的重要预测因素。基于机器学习的预测模型进一步强调了肿瘤相关因素在鼻咽癌复发中的重要性。此外,ER是鼻咽癌进展的关键阶段,已发现的15个关键转换信号可能与免疫反应的负调控有关:我们对鼻咽癌复发模式的全面分析揭示了驱动ER的关键因素,并为潜在的早期预警生物标志物和鼻咽癌进展的内在机制提供了新的见解。
{"title":"Early recurrence as a pivotal event in nasopharyngeal carcinoma: identifying predictors and key molecular signals for survivors.","authors":"Ying Li, Zongwei Huang, Ximing Zeng, Yuhui Pan, Lishui Wu, Jing Wang, Ronghui Chen, Yingjie Xie, Jinghua Lai, Duanyu Lin, Sufang Qiu","doi":"10.1186/s13005-024-00457-7","DOIUrl":"https://doi.org/10.1186/s13005-024-00457-7","url":null,"abstract":"<p><strong>Purpose: </strong>The duration of response to treatment is a significant prognostic indicator, with early recurrence (ER) often predicting poorer survival outcomes in nasopharyngeal carcinoma (NPC) survivors. This study seeks to elucidate the factors contributing to the onset of ER following radiotherapy in NPC survivors.</p><p><strong>Methods: </strong>This investigation encompassed 2,789 newly diagnosed NPC patients who underwent radical intensity-modulated radiotherapy. Ordinal logistic regression analysis was employed to evaluate the independent predictors of earlier recurrence. A machine learning-based prediction model of NPC recurrence patterns was developed. Tumorous RNA-sequencing (in-house cohort: N = 192) and biological tipping point analysis were utilized to infer potential molecular mechanisms associated with ER.</p><p><strong>Results: </strong>Our results demonstrated that ER within 24 months post-initial treatment was the optimal time frame for identifying early malignant progression in NPC survivors. The ER cohort (150 of 2,789, 5.38%) exhibited a notably short median overall survival of 48.6 months. Multivariate analyses revealed that male gender, T4 stage, local or regional residual disease, detectable pre- and post-radiotherapy EBV DNA, and the absence of induction chemotherapy were significant predictors of earlier recurrence. The machine learning-based predictive model further underscored the importance of tumor-related factors in NPC recurrence. Moreover, ER emerged as a pivotal stage in NPC progression, with 15 critical transition signals identified potentially associated with the negative modulation of the immune response.</p><p><strong>Conclusions: </strong>Our comprehensive analysis of NPC recurrence patterns has unveiled insights into the key factors driving ER and provided novel insights into potential early warning biomarkers and the mechanisms underlying NPC progression.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"55"},"PeriodicalIF":2.4,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The incisive foramen width was a traditional imaging criterion for diagnosing nasopalatine duct (NPD) cysts. Recent CBCT studies demonstrated significant dimensional variations of the nasopalatine canal, which raised questions about the accuracy of this criterion. This study investigated whether nasopalatine canal diameters assessed on CBCT images can accurately differentiate NPD cysts from normal nasopalatine canals.
Methods: The study included 19 patients with NPD cysts (12 (63.2%) males, 7 (36.8%) females, mean age 44.7 ± 13.3), and a control group of 164 patients (72 (43.9%) males, 92 (56.1%) females, mean age 47.25 ± 17.74). CBCT images were retrospectively evaluated. The following nasopalatine canal diameters were measured on reference sagittal, coronal, and axial reformation images: nasal opening anteroposterior (AP) and mediolateral (ML) diameter, oral opening AP (APOO) and ML (MLOO) diameter, nasopalatine canal length, minimum ML (minML) diameter, anterior wall expansion (AWE), nasopalatine canal angle, and the mid-level AP diameter (midAP). All parameters were compared between groups. Discriminant functional analysis (DFA) was applied to detect CBCT parameters that best differentiate the NPD cyst from the normal canal.
Results: Patients with NPD cyst had significantly greater values of APOO (7.06 ± 2.09 vs. 5.61 ± 1.70), MLOO (6.89 ± 2.95 vs. 3.48 ± 1.24), minML (2.88 ± 1.53 vs. 2.25 ± 1.09), AWE (2.15 ± 0.65 vs. 0.41 ± 0.67), and midAP (4.58 ± 1.61 vs. 2.48 ± 0.96). DFA showed MLOO, AWE, and midAP as the most accurate in distinguishing NPD cyst from the normal canal. When combined in the discriminant function equation X = 0.390·MLOO + 1.010·AWE + 0.288·midAP (cut score 1.669), the differentiation can be performed with a sensitivity and specificity of 98.8% and 76.9%, respectively.
Conclusion: NPD cysts can be accurately distinguished from the normal nasopalatine canal by measuring MLOO, AWE, and midAP diameter on CBCT images.
背景:切孔宽度是诊断鼻腭管(NPD)囊肿的传统成像标准。最近的 CBCT 研究表明,鼻腭管的尺寸变化很大,这就对这一标准的准确性提出了质疑。本研究探讨了 CBCT 图像上评估的鼻腭管直径能否准确区分 NPD 囊肿和正常鼻腭管:研究对象包括19例NPD囊肿患者(男性12例(63.2%),女性7例(36.8%),平均年龄(44.7 ± 13.3)岁)和164例对照组患者(男性72例(43.9%),女性92例(56.1%),平均年龄(47.25 ± 17.74)岁)。对 CBCT 图像进行了回顾性评估。在参考矢状面、冠状面和轴向重塑图像上测量了以下鼻腭管直径:鼻腔开口前胸(AP)和内外侧(ML)直径、口腔开口AP(APO)和ML(MLOO)直径、鼻腭管长度、最小ML(minML)直径、前壁扩张(AWE)、鼻腭管角度和中层AP直径(midAP)。所有参数均在组间进行比较。应用判别功能分析(DFA)检测最能区分鼻腭管囊肿和正常鼻腭管的 CBCT 参数:结果:NPD 囊肿患者的 APOO(7.06±2.09 vs. 5.61±1.70)、MLOO(6.89±2.95 vs. 3.48±1.24)、minML(2.88±1.53 vs. 2.25±1.09)、AWE(2.15±0.65 vs. 0.41±0.67)和 midAP(4.58±1.61 vs. 2.48±0.96)值明显更高。DFA 显示 MLOO、AWE 和 midAP 在区分 NPD 囊肿和正常管腔方面最为准确。如果将其合并到判别函数方程 X = 0.390-MLOO + 1.010-AWE + 0.288-midAP(切分分值 1.669)中,区分的灵敏度和特异度分别为 98.8%和 76.9%:结论:通过测量 CBCT 图像上的 MLOO、AWE 和 midAP 直径,可将鼻腭管囊肿与正常鼻腭管准确区分开来。
{"title":"Morphological CBCT parameters for an accurate differentiation between nasopalatine duct cyst and the normal nasopalatine canal.","authors":"Aleksa Janovic, Djurdja Bracanovic, Svetlana Antic, Biljana Markovic-Vasiljkovic","doi":"10.1186/s13005-024-00458-6","DOIUrl":"https://doi.org/10.1186/s13005-024-00458-6","url":null,"abstract":"<p><strong>Background: </strong>The incisive foramen width was a traditional imaging criterion for diagnosing nasopalatine duct (NPD) cysts. Recent CBCT studies demonstrated significant dimensional variations of the nasopalatine canal, which raised questions about the accuracy of this criterion. This study investigated whether nasopalatine canal diameters assessed on CBCT images can accurately differentiate NPD cysts from normal nasopalatine canals.</p><p><strong>Methods: </strong>The study included 19 patients with NPD cysts (12 (63.2%) males, 7 (36.8%) females, mean age 44.7 ± 13.3), and a control group of 164 patients (72 (43.9%) males, 92 (56.1%) females, mean age 47.25 ± 17.74). CBCT images were retrospectively evaluated. The following nasopalatine canal diameters were measured on reference sagittal, coronal, and axial reformation images: nasal opening anteroposterior (AP) and mediolateral (ML) diameter, oral opening AP (APOO) and ML (MLOO) diameter, nasopalatine canal length, minimum ML (minML) diameter, anterior wall expansion (AWE), nasopalatine canal angle, and the mid-level AP diameter (midAP). All parameters were compared between groups. Discriminant functional analysis (DFA) was applied to detect CBCT parameters that best differentiate the NPD cyst from the normal canal.</p><p><strong>Results: </strong>Patients with NPD cyst had significantly greater values of APOO (7.06 ± 2.09 vs. 5.61 ± 1.70), MLOO (6.89 ± 2.95 vs. 3.48 ± 1.24), minML (2.88 ± 1.53 vs. 2.25 ± 1.09), AWE (2.15 ± 0.65 vs. 0.41 ± 0.67), and midAP (4.58 ± 1.61 vs. 2.48 ± 0.96). DFA showed MLOO, AWE, and midAP as the most accurate in distinguishing NPD cyst from the normal canal. When combined in the discriminant function equation X = 0.390·MLOO + 1.010·AWE + 0.288·midAP (cut score 1.669), the differentiation can be performed with a sensitivity and specificity of 98.8% and 76.9%, respectively.</p><p><strong>Conclusion: </strong>NPD cysts can be accurately distinguished from the normal nasopalatine canal by measuring MLOO, AWE, and midAP diameter on CBCT images.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"54"},"PeriodicalIF":2.4,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-21DOI: 10.1186/s13005-024-00445-x
Kai Liu, Siyi Chen, Xudong Wang, Zhihui Ma, Steve G F Shen
Background: Successfully restoring facial contours continues to pose a significant challenge for surgeons. This study aims to utilize head-mounted display-based augmented reality (AR) navigation technology for facial soft tissue defect reconstruction and to evaluate its accuracy and effectiveness, exploring its feasibility in craniofacial surgery.
Methods: Hololens 2 was utilized to construct the AR guidance system for facial fat grafting. Twenty artificial cases with facial soft tissue defects were randomly assigned to Group A and Group B, undergoing filling surgeries with the AR guidance system and conventional methods, respectively. All postoperative three-dimensional models were superimposed onto virtual plans to evaluate the accuracy of the system versus conventional filling methods. Additionally, procedure completion time was recorded to assess system efficiency relative to conventional methods.
Results: The error in facial soft tissue defect reconstruction assisted by the system in Group A was 2.09 ± 0.56 mm, significantly lower than the 3.23 ± 1.15 mm observed with conventional methods in Group B (p < 0.05). Additionally, the time required for facial defect filling reconstruction using the system in Group A was 25.45 ± 2.58 min, markedly shorter than the 37.05 ± 3.34 min needed with conventional methods in Group B (p < 0.05).
Conclusion: The visual navigation offered by the fat grafting AR guidance system presents obvious advantages in facial soft tissue defect reconstruction, facilitating enhanced precision and efficiency in these filling procedures.
背景:成功恢复面部轮廓仍然是外科医生面临的重大挑战。本研究旨在利用基于头戴式显示器的增强现实(AR)导航技术进行面部软组织缺损重建,并评估其准确性和有效性,探索其在颅面外科手术中的可行性。将 20 例面部软组织缺损的人工病例随机分为 A 组和 B 组,分别使用 AR 引导系统和传统方法进行填充手术。所有术后三维模型都被叠加到虚拟平面图上,以评估该系统与传统填充方法的准确性。此外,还记录了手术完成时间,以评估系统相对于传统方法的效率:结果:在 A 组中,该系统辅助面部软组织缺损重建的误差为 2.09 ± 0.56 毫米,明显低于在 B 组中使用传统方法所观察到的 3.23 ± 1.15 毫米的误差(p 结论:该系统提供的可视化导航功能可以帮助患者在最短的时间内完成手术:脂肪移植 AR 引导系统提供的可视化导航在面部软组织缺损重建中具有明显优势,有助于提高填充手术的精确度和效率。
{"title":"Utilization of facial fat grafting augmented reality guidance system in facial soft tissue defect reconstruction.","authors":"Kai Liu, Siyi Chen, Xudong Wang, Zhihui Ma, Steve G F Shen","doi":"10.1186/s13005-024-00445-x","DOIUrl":"10.1186/s13005-024-00445-x","url":null,"abstract":"<p><strong>Background: </strong>Successfully restoring facial contours continues to pose a significant challenge for surgeons. This study aims to utilize head-mounted display-based augmented reality (AR) navigation technology for facial soft tissue defect reconstruction and to evaluate its accuracy and effectiveness, exploring its feasibility in craniofacial surgery.</p><p><strong>Methods: </strong>Hololens 2 was utilized to construct the AR guidance system for facial fat grafting. Twenty artificial cases with facial soft tissue defects were randomly assigned to Group A and Group B, undergoing filling surgeries with the AR guidance system and conventional methods, respectively. All postoperative three-dimensional models were superimposed onto virtual plans to evaluate the accuracy of the system versus conventional filling methods. Additionally, procedure completion time was recorded to assess system efficiency relative to conventional methods.</p><p><strong>Results: </strong>The error in facial soft tissue defect reconstruction assisted by the system in Group A was 2.09 ± 0.56 mm, significantly lower than the 3.23 ± 1.15 mm observed with conventional methods in Group B (p < 0.05). Additionally, the time required for facial defect filling reconstruction using the system in Group A was 25.45 ± 2.58 min, markedly shorter than the 37.05 ± 3.34 min needed with conventional methods in Group B (p < 0.05).</p><p><strong>Conclusion: </strong>The visual navigation offered by the fat grafting AR guidance system presents obvious advantages in facial soft tissue defect reconstruction, facilitating enhanced precision and efficiency in these filling procedures.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"51"},"PeriodicalIF":2.4,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11415977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-21DOI: 10.1186/s13005-024-00453-x
Asmaa Fathelrahman Mohamed, Heba Ahmed El-Asfouri, Suzan Abdul Wanees Amin
Background: The aim of this trial was to evaluate the effect of a preoperative, single dose sublingual fast-dissolving piroxicam (20 mg) compared to placebo on postoperative pain at rest (POP), on biting (POPB) and on percussion (POPer) after single-visit endodontic treatment of asymptomatic mandibular molars with non-vital pulp.
Methods: Seventy patients randomly received either piroxicam or placebo 1 h before treatment (n = 35). Patients recorded their pain (POP and POPB) level 6 h, 12 h, 24 h, 48 h, 72 h and 7 days postoperatively using an 11-point numerical rating scale; POPer was assessed after 7 days. Resuce-analgesic intake (RAI) and flare-up incidence (FUI) were recorded. Data were statistically analyzed.
Results: Both groups had similar baseline characteristics (P > 0.05). Piroxicam showed less POP intensity and incidence than placebo at 6, 12 and 24 h, less POPB intensity and incidence at all timepoints, less POPer intensity and incidence and less RAI (p > 0.05), but similar FUI (P > 0.05). A significant rise in pain compared to baseline occurred with placebo from 6 to 72 h for POP and to 7 days with POPB (p > 0.05); such rise was not detected with piroxicam. POPB showed higher pain intensity than POP at all time points (p < 0.05). No swelling or adverse effects occured.
Conclusions: A preoperative single dose of sublingual fast-dissolving piroxicam can be effective in reducing spontaneous pain up to 24 h, stimulated pain up to 7 days, and RAI incidence in asymptomatic mandibular molars with non-vital pulp; it can prevent rise in POP and POPB postoperatively. Stimulated postoperative pain can be more severe and longer lasting than spontaneous pain.
{"title":"Effect of sublingual fast-dissolving piroxicam premedication on postoperative pain experience in mandibular molars with non-vital pulp: a randomized double-blind controlled trial.","authors":"Asmaa Fathelrahman Mohamed, Heba Ahmed El-Asfouri, Suzan Abdul Wanees Amin","doi":"10.1186/s13005-024-00453-x","DOIUrl":"10.1186/s13005-024-00453-x","url":null,"abstract":"<p><strong>Background: </strong>The aim of this trial was to evaluate the effect of a preoperative, single dose sublingual fast-dissolving piroxicam (20 mg) compared to placebo on postoperative pain at rest (POP), on biting (POPB) and on percussion (POPer) after single-visit endodontic treatment of asymptomatic mandibular molars with non-vital pulp.</p><p><strong>Methods: </strong>Seventy patients randomly received either piroxicam or placebo 1 h before treatment (n = 35). Patients recorded their pain (POP and POPB) level 6 h, 12 h, 24 h, 48 h, 72 h and 7 days postoperatively using an 11-point numerical rating scale; POPer was assessed after 7 days. Resuce-analgesic intake (RAI) and flare-up incidence (FUI) were recorded. Data were statistically analyzed.</p><p><strong>Results: </strong>Both groups had similar baseline characteristics (P > 0.05). Piroxicam showed less POP intensity and incidence than placebo at 6, 12 and 24 h, less POPB intensity and incidence at all timepoints, less POPer intensity and incidence and less RAI (p > 0.05), but similar FUI (P > 0.05). A significant rise in pain compared to baseline occurred with placebo from 6 to 72 h for POP and to 7 days with POPB (p > 0.05); such rise was not detected with piroxicam. POPB showed higher pain intensity than POP at all time points (p < 0.05). No swelling or adverse effects occured.</p><p><strong>Conclusions: </strong>A preoperative single dose of sublingual fast-dissolving piroxicam can be effective in reducing spontaneous pain up to 24 h, stimulated pain up to 7 days, and RAI incidence in asymptomatic mandibular molars with non-vital pulp; it can prevent rise in POP and POPB postoperatively. Stimulated postoperative pain can be more severe and longer lasting than spontaneous pain.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov ID: NCT03998826 (2019).</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"52"},"PeriodicalIF":2.4,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-16DOI: 10.1186/s13005-024-00455-9
Xu Liu, Dan Wang, Yue-Lin Hsieh, Suming Shi, Wuqing Wang
This study aimed to investigate the relationship between the features of endolymphatic hydrops and hearing loss in patients with Bilateral Meniere's Disease. A retrospective analysis was conducted on 77 patients diagnosed with Bilateral Meniere's Disease. The features of endolymphatic hydrops in the affected ear were evaluated through gadolinium-enhanced inner ear Magnetic resonance imaging. The Spearman correlation coefficient, paired t-tests, and Wilcoxon signed-rank tests were employed for data analysis. The analysis revealed a significant correlation between the degree of endolymphatic hydrops and hearing loss across all frequencies(0.125–8 kHz), including the cochlear, vestibular, and overall degree of endolymphatic hydrops. The strongest correlation between the overall degree of endolymphatic hydrops and hearing loss was observed at low frequencies (r = 0.571, p < 0.05), followed by mid-frequencies (r = 0.508, p < 0.05), and high-frequencies (r = 0.351, p < 0.05), with a correlation of r = 0.463, p < 0.05 for the staging of Meniere's disease. Affected Ears with endolymphatic hydrops both in the cochlea and vestibule exhibited more severe hearing loss and Meniere's disease staging compared to those with isolated endolymphatic hydrops within the same patient. The features of endolymphatic hydrops in patients with Bilateral Meniere's Disease were found to correlate with the severity of hearing loss and the staging of Meniere's disease.
{"title":"The relationship between endolymphatic hydrops features and hearing loss in Bilateral Meniere's disease","authors":"Xu Liu, Dan Wang, Yue-Lin Hsieh, Suming Shi, Wuqing Wang","doi":"10.1186/s13005-024-00455-9","DOIUrl":"https://doi.org/10.1186/s13005-024-00455-9","url":null,"abstract":"This study aimed to investigate the relationship between the features of endolymphatic hydrops and hearing loss in patients with Bilateral Meniere's Disease. A retrospective analysis was conducted on 77 patients diagnosed with Bilateral Meniere's Disease. The features of endolymphatic hydrops in the affected ear were evaluated through gadolinium-enhanced inner ear Magnetic resonance imaging. The Spearman correlation coefficient, paired t-tests, and Wilcoxon signed-rank tests were employed for data analysis. The analysis revealed a significant correlation between the degree of endolymphatic hydrops and hearing loss across all frequencies(0.125–8 kHz), including the cochlear, vestibular, and overall degree of endolymphatic hydrops. The strongest correlation between the overall degree of endolymphatic hydrops and hearing loss was observed at low frequencies (r = 0.571, p < 0.05), followed by mid-frequencies (r = 0.508, p < 0.05), and high-frequencies (r = 0.351, p < 0.05), with a correlation of r = 0.463, p < 0.05 for the staging of Meniere's disease. Affected Ears with endolymphatic hydrops both in the cochlea and vestibule exhibited more severe hearing loss and Meniere's disease staging compared to those with isolated endolymphatic hydrops within the same patient. The features of endolymphatic hydrops in patients with Bilateral Meniere's Disease were found to correlate with the severity of hearing loss and the staging of Meniere's disease.","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"66 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}