Effect of Sagittal Root Position, Angle, and Bone Thickness on Peri-implant Tissue Phenotype and Bone Level in Socket Shield Technique

There were only a few studies investigating the effect of sagittal root position (SRP), sagittal root angle (SRA), and buccal bone thickness (BBT) on peri-implant tissues using the socket shield technique (SST). This retrospective case series aimed to evaluate the SRP, SRA, and BBT in socket shield cases and examine the effect of these anatomical factors on the peri-implant tissue phenotype and bone level. Data from 27 patients (14 women, 13 men) treated with SST in the maxillary esthetic region between July 2019 and September 2021 were included. Clinical indices (modified plaque and bleeding indices, probing depth, keratinized mucosa width, mucosal thickness) and periapical radiographic recordings (marginal bone level) taken immediately after permanent prosthesis placement and one year later were used. Cone beam computed tomography images were used to examine BBT, SRP, and SRA before implant placement and horizontal and vertical bone levels before implant placement and one year after prosthetic rehabilitation. The data were divided into groups based on BBT (<1 and ≥1 mm) and SRA values (<10° and ≥10°). There were no significant differences in 1-year clinical factors between the SRA <10° and SRA ≥10° groups. However, higher vertical bone loss was found in the SRA ≥10° group (p = 0.01, d = 0.53). There were no significant differences in clinical or radiographic factors between the BBT <1 mm and BBT ≥1 mm groups. In conclusion, BBT showed no significant effect on tissue phenotype and bone level, 19 but SRA affected bone level in socket shield cases.

The effect of virtual reality glasses on dental anxiety during scaling and root planing in patients with periodontitis: A randomized controlled clinical trial

OBJECTIVES

This study aimed to evaluate the effect of virtual reality distraction (VRD) on dental anxiety during scaling and root planing (SRP) in periodontitis patients.

MATERIALS AND METHODS

This randomized controlled split-mouth study included 60 patients who scored 9 or above on the dental anxiety scale (DAS) and required SRP in at least two quadrants with at least five teeth and two sites with a probing depth of ≥4 mm. Randomly chosen quadrants were treated using virtual reality glasses, and other quadrants were treated without glasses at the same visit. During VRD, a video of nature scenes was projected onto the screen in front of the patient's eyes. DAS and a visual analogue scale about patient feelings were applied at the end of the procedure.

RESULTS

With VRD, the scale value of pain and discomfort level (VASP) was significantly reduced (p = 0.01, d = 0.57). Starting treatment without glasses significantly decreased VASP in both control and test sides (p = 0.00, d = 0.85; p = 0.00, d = 0.80, respectively) and increased the sensation of immersion and realism (p = 0.03, d = 0.45; p = 0.02, d = 0.46, respectively). Intraoperative and postoperative DAS values were significantly lower in patients who started treatment without VRD (p = 0.04, d = 0.34; p = 0.02, d = 0.44, respectively). Of the patients, 63.3% preferred VRD in the subsequent treatment. While patient preference did not correlate with sex, it correlated with age (r = -0.48, p = 0.01).

CONCLUSIONS

The VRD and initiating SRP procedure with VRD affected the pain and discomfort level in anxious periodontitis patients. In addition, the anxiety level was also affected by starting the procedure with glasses.

Evaluation of the significance of keratinized mucosa on peri-implant tissue health: a prospective clinical trial

BACKGROUND

The effect of keratinized mucosa on peri-implant tissue health is still inconclusive. This study aimed to evaluate the importance of keratinized mucosa and investigate the impact of the free gingival graft procedure on peri-implant health.

METHODS

At prosthesis delivery, the implants were allocated into three groups, based on the width of keratinized mucosa (KM) and patients' agreement on the free gingival graft procedure: KMS (KM ≥2 mm), KMD (KM <2 mm), and FGG (KM <2 mm initially and having surgically increased keratinized mucosa). Modified plaque index (mPI), probing depth (PD), modified bleeding index (mBI), KM, and marginal bone loss (MBL) were assessed at the baseline, 6-, 12-, and 24-month follow-up periods.

RESULTS

Of the 47 patients, 17 belonged to the KMS group, 17 belonged to the KMD, and the remaining 13 patients belonged to the FGG. KMD demonstrated significantly fewer mPI and higher mBI than KMS and FGG at 6 and 12 months. At 24 months, MBL did not differ between the groups; however, PD was significantly greater in the KMD group.

CONCLUSIONS

Implants with inadequate keratinized mucosa had higher bleeding and pocket depth values despite less plaque accumulation. According to the results, soft tissue grafting should be performed as early as possible. © 2023 Australian Dental Association.

Investigation of the effect of the curcumin component as an alternative to the local treatment of nasal diseases

OBJECTIVE

This study aimed to define the impacts of curcumin on nasal cell viability and proliferation.

MATERIALS AND METHODS

Specimens of healthy primary nasal epithelium were collected and incubated in cell culture during septorhinoplasty from people who signed a consent form. After implementing 2.5 µM curcumin in cultured cells, cell viability was defined via trypan blue assay, and proliferation was defined via the XTT method. The number of total cells, viability, and proliferation was defined. XTT (2,3-bis-(2-methoxy-4-nitro-5-sulphophenyl)-2H-tetrazolium-5-carboxanilide) experiments can be used to evaluate cellular toxicity.

RESULTS

The results revealed no harm to nasal cells after the topical implementation of curcumin. There was no significant change in the proliferation of the cells related to 24 hours of implementation. There was no adverse effect of using curcumin on the cell viability, either.

CONCLUSIONS

No cytotoxic effect on nasal cells has been observed after applying topically implemented curcumin. Curcumin could be used topically for an alternative treatment for allergic rhinitis as it has anti-inflammatory and immune response modulatory effects if clinical trials will confirm experimental data.

Long-term Remission in Schizophrenia and Schizoaffective Disorder: Results from the Risperidone Long-acting Injectable Versus Quetiapine Relapse Prevention Trial (constatre)

Objective:

To report the long-term remission results from the relapse prevention trial (ConstaTRE) in stable patients treated either with risperidone long-acting injectable (RLAI) or the oral atypical antipsychotic quetiapine.

Methods:

Clinically stable adults with schizophrenia or schizoaffective disorder treated with oral risperidone, olanzapine, or oral conventional antipsychotics were randomized to treatment with RLAI or oral quetiapine. Dosing was according to package-insert recommendation. Efficacy and tolerability were recorded for up to 24 months of treatment. Remission was defined as achieving and maintaining mild or less symptoms of schizophrenia over a 6-month period as defined by Andreasen et al, (2005).

Results:

710 patients were randomized (n=355 per group) to either RLAI or quetiapine. Demographics were similar between treatment groups. Relapse occurred in 54 RLAI (16.5%) and 102 quetiapine (31.3%) patients (p< 0.001). Full remission was achieved by 51% RLAI and 39% of quetiapine-treated patients (p=0.003) and was maintained until the end of the trial by 44% of RLAI and 31% of quetiapine patients. Mean duration of full remission was 540.8±181.4 and 508.1±188.0 days for RLAI and quetiapine groups, respectively (p=0.1325). Tolerability was similar between treatment groups. Most adverse events (AEs) were transient. Six RLAI and 10 quetiapine patients discontinued study treatment due to AEs.

Conclusions:

Among stable patients with schizophrenia or schizoaffective disorder, remission was more likely to occur in patients switching to RLAI when compared with quetiapine. both RLAI and quetiapine treatments were well tolerated.

Pre-operative Arterial Embolization of Symptomatic Giant Hemangioma of the Liver

The cavernous hemangiomas of the liver are usually small sized and asymptomatic. Most of them are incidentally diagnosed and a very small portion requires therapy. Giant hemangioma can be symptomatic, and this condition is the indication for treatment. The striking complication of surgical treatment of cavernous hemangiomas is intra-operative bleeding. In this case, we aimed to demonstrate that the risk of intraoperative bleeding can be eliminated with the preoperative percutaneous trans-catheter arterial embolization technique.

Use of warm priming solution in open heart surgery: its effects on hemodynamics and acute inflammation

Cardiac surgery causes an acute inflammatory response and organ damage. In this study, for the first time in the literature, we compared the effects of priming solutions at 20°C and 36°C on acute inflammatory markers and hemodynamic parameters. Forty patients were recruited and randomized into two groups, each consisting of 20 participants who underwent elective coronary artery bypass grafting operation. Groups were primed with the same solution at different temperatures. Hemodynamic parameters were recorded. Blood samples were drawn pre-operatively and at the 15th and 60th minutes of aortic cross-clamping and the 24th hour following surgery. Serum pre-albumin, α-1 antitrypsin, and tumor necrosis factor-α levels were determined. The groups were compared statistically. Both of the groups were comparable for mean aortic cross-clamping time and mean time for cardiopulmonary bypass. Mean blood pressure value was significantly lower and the mean amount of ephedrine hydrochloride used was significantly higher in the cold priming group. Spontaneous beating of the heart after removal of aortic cross-clamp significantly was more frequent in the warm priming group. A significant rise was observed in systemic inflammatory markers in the cold priming group. In our study, the lesser amount of ephedrine hydrochloride used and the higher frequency of spontneous beating of the heart in the warm priming group may be considered as improvements in hemodynamic status. Use of warm priming solution also induced a significant improvement in the acute inflammatory markers. We recommend the use of warm priming solution in open heart surgery.

Effect of low dose electrocautery usage during radial artery harvesting on the neurological outcome of the forearm: a neuroelectrophysiological study

BACKGROUND

The present study aimed to investigate whether electrocautery caused any thermal injury to the forearm nerves or not.

METHODS

We compared the neurological outcome of two different radial artery harvesting techniques through neuroelectrophysiological studies. Preoperative values and postoperative conduction changes after one month were compared in two groups of patients. Each of the groups consisted of 20 patients. Radial arteries were harvested using scissors in Group 1 and with a low dose diathermy technique in Group 2.

RESULTS

The mean amplitude of sensory action potentials of radial nerves was significantly reduced postoperatively at the end of the first month in both groups (P = 0.01, P = 0.001). But there were no significant differences between groups with respect to the sensory action potentials of ulnar and median nerves postoperatively. There were no significant differences between groups with respect to radial, ulnar and median nerve motor conduction recordings.

CONCLUSION

Low dose electrocautery does not cause excessive nerve injury compared with the scissors technique in radial artery harvesting. Electrocautery may be used safely for RA harvesting in the forearm.

The effect of oestradiol and neta on immunohistochemical staining of iNOS and eNOS in coronary arteries of ovariectomized rats

AIM

The postmenopausal period is associated with increased risk for coronary atherosclerosis, and the effect of hormone replacement therapy in reducing this risk is controversial. Previous studies reported that nitric oxide synthetase (NOS) level might be important for the development of atherosclerosis, but no study has shown the interaction between hormone replacement therapy and endothelial NOS and inducible NOS intensity on coronary arteries yet. Our goal was to find out the immunostaining intensity of endothelial NOS and inducible NOS in ovariectomized rats which received oestradiol and norethisterone treatment.

METHODS

We performed bilateral ovariectomy in 15, female, 90-day-old Wistar rats with an average weight of 250 grams. After waiting for 4 weeks for the menopausal state, they were divided into 3 groups to receive either placebo, 0.1 mg/day 17-beta-oestradiol (group E2), or 0.1 mg/day 17-beta-oestradiol + 0.1 mg/day norethisterone acetate (group E2-NETA) for 5 weeks. Another group included 5, normal, adult, female intact rats and served as controls. At the end of the treatment, all rats were sacrificed and coronary arteries were stained with inducible NOS and endothelial NOS polyclonal antibodies using streptavidin-biotin technique.

RESULTS

The immunostaining of inducible NOS was prominent in perivascular connective tissue of the ovariectomized group but not in the control group. The inducible NOS immunostaining immunoreactivity was not detected in either treated groups. Immunostaining intensity of endothelial NOS did not differ in any 4 groups with similar staining.

CONCLUSION

The present findings indicate that hormone replacement therapy down-regulates iNOS expression in coronary arteries of ovariectomized rats, and reduced iNOS may likely be involved in estrogen's beneficial effects.

Erectile dysfunction prevalence and sexual function status in patients with chronic obstructive pulmonary disease

PURPOSE

We determined sexual status and erectile dysfunction (ED) in outpatients with chronic obstructive pulmonary disease (COPD).

MATERIALS AND METHODS

Between October 2002 and June 2003 a total of 60 successive outpatients with COPD enrolled in the study with written informed consent. Patients completed International Index of Erectile Function (IIEF) and Duke Activity Status Index questionnaires. They also underwent physical examination including urogenital examination and pulmonary assessment with spirometry, 6-minute walk test and arterial blood sample. COPD severity was determined according to Global Initiative for Chronic Obstructive Lung Disease criteria.

RESULTS

After exclusion criteria 53 patients were assessed for statistical analysis. Mean patient age was 63.4 +/- 7.3 years. COPD severity in these patients was mild in 13.2%, moderate in 34%, severe in 49.1% and very severe in 3.8%. Nearly half of the patients (49%) had no comorbid disease for ED and the most common comorbid disease was hypertension (34%). According to the erectile function domain of IIEF 75.5% of patients were found to have ED with varying degrees (severe 28.3%, moderate 11.3%, mild to moderate 15.1% and mild 20.8%). Mean scores of all IIEF domains except sexual desire decreased with the increasing disease severity. A correlation was determined between severity and physical restrictions of COPD, and ED severity.

CONCLUSIONS

The limitation of physical activity due to COPD also diminishes the sexual function of patients. This point must be kept in mind in the evaluation of patients with COPD.

Bone mineral density in asthmatic patients using low dose inhaled glucocorticosteroids

Inhaled glucocorticosteroids are clearly beneficial in subjects with moderate or severe asthma since they are well tolerated, reduce symptoms, and improve quality of life. Some studies suggest that inhaled glucocorticosteroids can adversely affect bone mineral density. The aim of this study is to determine the effects of inhaled glucocorticosteroid therapy on bone mineral density in female patients. Forty-five asthmatic female patients (36 premenopousal and 9 postmenopausal) and forty-six healthy control subjects were included in the study. Bone mineral density was measured from lumbar spine (L1-4) and femur (neck, trochanter, and Ward's triangle) by dual energy X-Ray absorptiometry. Age, occupation, menopause and smoking status, alcohol consumption, body mass index, previous fractures, family history of fractures, menstrual history, ooferectomy, number of pregnancies, the duration of lactation, physical activity and calcium intake were questioned according to the European Vertebral Osteoporosis Study Group (EVOS) form. Cumulative inhaled glucocorticosteroid dose was calculated. T score of femoral neck and T score and bone mineral density of Ward's triangle were significantly lower in asthmatic patients compared to control group but no statistically significant correlation was found between the disease duration, inhaled steroid treatment duration, cumulative inhaled dose and annual inhaled steroid dose and bone mineral density measurement. These results suggest that in asthmatic patients using low dose inhaled corticosteroids bone mineral density is lower than in healthy controls but it is still unclear if asthma by itself is a risk factor for osteoporosis.

Impaired Tc-99m MIBI uptake in the thyroid and parathyroid glands during early phase imaging in hemodialysis patients

The purpose of this study is to evaluate the possible reasons of an observation of diminished uptake of Tc-99m MIBI in the early phase of parathyroid scintigraphy in the thyroid and parathyroid glands in patients with chronic renal failure who are being evaluated for hyperparathyroidism. Fourteen patients with secondary hyperparathyroidism all on hemodialysis with supplement therapy consisting of mainly vitamin D and calcium carbonate were studied. Neck and mediastinum images obtained at early and late phases were evaluated both visually and semiquantitatively. Patients with high PTH levels on hemodialysis showed diminished accumulation of radioactivity in the thyroid glands in the early phase compared to the soft tissue with a ratio of 1.54 +/- 0.39 (mean +/- std). A control group consisting of 10 patients with osteoporosis and Rickets' disease on vitamin D therapy was taken as control group A, as well as 11 patients with no problems other than cardiac who were not on any medication as control group B and 8 patients on hemodialysis only with normal PTH levels as control group C. Patients in control group A and C showed diminished accumulation of radioactivity in the thyroid glands in the early phase compared to the soft tissue with a ratio of 1.57 +/- 0.43 and 1.34 +/- 0.13, respectively, while patients in control group B showed good uptake 3.18 +/- 0.43. None of the studies showed parathyroid pathology. The results of this study show that patients with chronic renal failure under hemodialysis treatment are prone to show decreased uptake of the radioactivity. Another finding is that vitamin D supplements can cause diminished uptake of Tc-99m MIBI. A possible explanation is mentioned in the literature by an increase in PGP level and multi-drug resistance, so we suggest that it may play a role in impaired Tc-99m MIBI uptake in the thyroid phase and recommend cessation of vitamin D3 metabolites before performing parathyroid scintigraphy.

Frequency of skeletal metastases in nasopharyngeal carcinoma after initiation of therapy: should bone scans be used for follow-up?

Previous reports have indicated a relatively high incidence of distant metastases in patients with nasopharyngeal carcinoma (NPC), one of the most common sites being the skeleton. Although bone scintigraphy offers the advantage of whole-body imaging in patients with cancer by providing useful information about disease spread, its value in patients with NPC is not well defined because of cost-effectiveness considerations. In this study, we assessed the value of follow-up bone scintigraphy for the evaluation of skeletal metastases in patients with different stages of NPC. Between 1994 and 2001, 230 patients with histologically proven NPC were admitted to the Department of Radiation Oncology. Out of 230 patients, 171 were examined for skeletal metastases with bone scintigraphy prior to therapy and at 1 year intervals. Bone scintigraphy detected increased uptake in 29 patients, which was reported as suggestive of metastases or equivocal. Twenty-six of these were true-positive, confirmed by radiography or clinical follow-up. Bone pain was present in 67% of these patients and serum lactate dehydrogenase and alkaline phosphatase were elevated in 35% and 37%, respectively. The incidence of bone metastases correlated with the extent of lymph node involvement, which were detected after a median time of 10.5 months following the diagnosis of the primary disease. No correlation was observed between the metastatic status and local T stage, histological differentiation age or gender of the patient. We can therefore recommend that bone scintigraphy be used in determining the presence of bone metastases, but its utilization should be preserved for those with nodal involvement.

The role of Urtica dioica and Nigella sativa in the prevention of carbon tetrachloride-induced hepatotoxicity in rats

The role of Nigella sativa L. (Ranunculaceae) (NS) and Urtica dioica L. was investigated (UD) in the prevention of carbon tetrachloride (CCl4) induced liver fibrosis and cirrhosis. Fifty Sprague-Dawley rats were allocated into fi ve groups (I, IIA and B, IIIA and B) and CCl4 was injected biweekly to all groups. Group I (control, CCl4 only), group IIA and B (NS fixed oil and volatile oil), group IIIA and B (UD fixed oil and UD decoction extract) rats were killed at the end of week 12 and histopathological and immunohistochemical examinations of liver tissues were performed. In the control group, coagulation necrosis and hydropic degeneration were marked in the periacinar regions (zone 3) associated with fibrosis in the periacinar regions and in the portal tracts. In groups IIA-B and IIIA-B (NS and UD), none of the serious histopathological findings were detected except for sparse coagulation necrosis in the periacinar regions. ASMA-positive perisinusoidal cells with myo fibroblastic transformation and lysosomal enzyme activity suggesting fibrogenesis were also significantly more common in the control group than in the NS and UD groups. UD and NS seem to be significantly effective in the prevention of carbon tetrachloride induced hepatotoxicity in rats.

The effects of prednisolone and serum malondialdehyde levels in puppies with experimentally induced meconium aspiration syndrome

The aim of this study was to investigate the effect of different doses of prednisolone in puppies experimentally induced with meconium aspiration syndrome (MAS). Meconium was collected from human babies in the first day of life and was released into the trachea of 11 newborn puppies to induce MAS. Puppies were treated with 2 mg/kg prednisolone (standard dose), 30 mg/kg prednisolone (megadose) or 0.9% saline, all administered intravenously. The study ended 20 h after meconium aspiration and the lungs were then scored for histopathology. Animals not treated with prednisolone deteriorated after 8 h while respiration rate, oxygenation, pH and partial pressure of carbon dioxide values were better in the prednisolone-treated groups. Histopathology scores were better in the treatment groups compared with the control group, with megadose giving the best result. At the end of the study, serum malondialdehyde levels were significantly higher in the megadose prednisolone group compared with the other two groups. In conclusion, we determined that prednisolone reduced physiological and histological changes in puppies with MAS and that a 30 mg/kg dose was more effective than 2 mg/kg.

Clomiphene citrate does not adversely affect endometrial leukemia inhibitory factor levels

The aim of this study was to compare endometrial leukemia inhibitory factor (LIF) levels in spontaneous and clomiphene citrate (CC)-induced cycles of patients with unexplained infertility. The patients were followed in two consecutive cycles. Endometrial samples were obtained 7 days after ultrasonographic evidence that ovulation has occurred during the spontaneous cycle, then the patients were induced with CC from day 5 to day 9 during the subsequent cycle with 50 mg/day, and ovulation monitoring and endometrial biopsy were performed in the same manner. The samples were obtained using a Pipelle biopsy device without using local anesthesia, and kept in formaldehyde solution until the day of measurement. Then they were homogenized in phosphate buffered distilled water, and LIF levels were detected in the homogenized fluid by ELISA method. Endometrial LIF levels were 470 +/- 52 and 501 +/- 45 pg/1 gram wet tissue in spontaneous and CC-induced cycles respectively, revealing no significant difference. Ovulation induction with CC did not adversely affect endometrial LIF levels.

Clomiphene citrate does not affect the secretion of alpha3, alphaV and beta1 integrin molecules during the implantation window in patients with unexplained infertility

BACKGROUND

The expression of integrin molecules on the endometrium suggests that certain integrins may participate in the cascade of molecular events leading to successful implantation. A prospective, controlled study was carried out to investigate the effect of clomiphene citrate (CC) on secretions of beta1, alpha3 and alphaV integrin molecules in the endometrium of patients with unexplained infertility during the implantation window.

METHODS

A total of 40 endometrial samples was evaluated in both spontaneous (n = 13) and ensuing clomiphene-treated cycles (100 mg on days 5-9) and also from fertile women serving as controls (n = 14) during postovulatory 7th or 8th day of menstrual cycle. A semiquantitative grading system (H-score) was used to compare the immunohistochemical staining intensities. Endometrial thickness and serum oestradiol and progesterone concentrations were also measured on the day of sampling.

RESULTS

Staining of alpha(v) but not beta1 and alpha3 integrins was significantly less intense in infertile cases than fertile control cases (1.42 +/- 0.12 versus 2.21 +/- 0.13 respectively, P = 0.012) and this was not restored to normal concentrations with treatment.

CONCLUSIONS

Our study indicated that cc treatment significantly decreased the endometrial thickness and increased oestradiol and progesterone concentrations. However, secretion of alpha(v), beta1 and alpha3 integrin molecules, which might play a role in implantation, was not affected.

Water-pipe smoking and pulmonary functions

Water-pipe smoking is a type of smoking habit, widely encountered in Turkey and Arabic and Middle East countries. However there is limited data about the effects of water-pipe smoking. The aim of this study is to investigate this habit with regard to the duration and amount of smoking and to analyse its characteristics and effects on pulmonary function by the correlation of the results with those of cigarette smokers and non-smokers. All cafés in Izmir city were visited for this purpose. A total of 397 males were studied in four groups: water-pipe smokers, water-pipe smokers who used to smoke cigarettes, active cigarette smokers and non-smokers. After recording a detailed history of smoking, pulmonary function tests on each person were performed. There were statistically significant differences between cigarette smokers and non-smokers within most of the parameters. The results of recent study have shown that the detrimental effects on pulmonary function of water-pipe smoking are not as great as cigarette smoking (FEV1, FEV1/FVC parameters were higher in water-pipe smokers), especially on the parameters for small airways (FEF50, MMEF parameters were higher in water-pipe smokers) (P < 0.05). It is difficult to explain the reasons exactly without estimating possible mechanisms in detail, but the most likely mechanisms arise from the smoking technique itself which involves a water filter and a long spout through which the smoke passes before reaching the lungs.