Orthodontic Extrusion as an Aid for Restoring Extensively Destroyed Teeth and Preserving Implant Site Creation: A Case Series

Razan Abu Alqasem Bosly,1 Mushyirah Yahya Sabyei,2 Abdulaziz Mohammed Zailai,2 Nada Yousef Fageehi,2 Sara M Madkhali,3 Ahmad Abdulraheem Ageel,4 Mohammed M Al Moaleem5 1Saudi Board in Restorative Dentistry, Jazan Dental Center, Jazan, Saudi Arabia; 2Ministry of Health, Consultant in Restorative Dentistry Department, Jazan Specialist Dental Center, Jazan, Saudi Arabia; 3Senior Registrar in Orthodontics Dentistry Department, Ministry of Health, Jazan Specialist Dental Center, Jazan, Saudi Arabia; 4Consultant in Restorative Dentistry, Jazan Specialized Dental Center, Ministry of Health, Jazan, Saudi Arabia; 5Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, 45142, Saudi ArabiaCorrespondence: Mohammed M Al Moaleem, Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, 45142, Saudi Arabia, Email [email protected]: Preserving questionable maxillary teeth for aesthetics is challenging for many practitioners. This report presents the clinical and radiographic results of an orthodontic extrusion technique for clinical crown lengthening of female patients’ maxillary teeth to increase the restorability of teeth. Splinting was carried out by using specially designed hucks cast with custom-made post joined with orthodontic brackets with adjusting teeth. Teeth were carefully extruded to the desired level without harming the marginal bone areas or root apices. Clinical follow-up evaluations were performed for 3 months before construction of the final prosthesis. Intra-oral radiographs showed normal periodontal contour consistent with new bone formation in the periapical area of all cases, with no evidence of root or crestal bone resorption or endodontic problems. This technique is highly recommended in the aesthetic area of the maxillary arch.Keywords: aesthetic, biologic width, crown lengthening, orthodontic extrusion, tooth restorabilit

Neurological manifestations of COVID-19 in adults and children

Different neurological manifestations of coronavirus disease 2019 (COVID-19) in adults and children and their impact have not been well characterized. We aimed to determine the prevalence of neurological manifestations and in-hospital complications among hospitalized COVID-19 patients and ascertain differences between adults and children. We conducted a prospective multicentre observational study using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) cohort across 1507 sites worldwide from 30 January 2020 to 25 May 2021. Analyses of neurological manifestations and neurological complications considered unadjusted prevalence estimates for predefined patient subgroups, and adjusted estimates as a function of patient age and time of hospitalization using generalized linear models. Overall, 161 239 patients (158 267 adults; 2972 children) hospitalized with COVID-19 and assessed for neurological manifestations and complications were included. In adults and children, the most frequent neurological manifestations at admission were fatigue (adults: 37.4%; children: 20.4%), altered consciousness (20.9%; 6.8%), myalgia (16.9%; 7.6%), dysgeusia (7.4%; 1.9%), anosmia (6.0%; 2.2%) and seizure (1.1%; 5.2%). In adults, the most frequent in-hospital neurological complications were stroke (1.5%), seizure (1%) and CNS infection (0.2%). Each occurred more frequently in intensive care unit (ICU) than in non-ICU patients. In children, seizure was the only neurological complication to occur more frequently in ICU versus non-ICU (7.1% versus 2.3%, P < 0.001). Stroke prevalence increased with increasing age, while CNS infection and seizure steadily decreased with age. There was a dramatic decrease in stroke over time during the pandemic. Hypertension, chronic neurological disease and the use of extracorporeal membrane oxygenation were associated with increased risk of stroke. Altered consciousness was associated with CNS infection, seizure and stroke. All in-hospital neurological complications were associated with increased odds of death. The likelihood of death rose with increasing age, especially after 25 years of age. In conclusion, adults and children have different neurological manifestations and in-hospital complications associated with COVID-19. Stroke risk increased with increasing age, while CNS infection and seizure risk decreased with age.</p

The value of open-source clinical science in pandemic response: lessons from ISARIC

International audienc