Operating Room Use of Hypertonic Solutions: A Clinical Review

Hyperosmotic-hyperoncotic solutions have been widely used during prehospital care of trauma patients and have shown positive hemodynamic effects. Recently, there has been a growing interest in intra-operative use of hypertonic solutions. We reviewed 30 clinical studies on the use of hypertonic saline solutions during surgeries, with the majority being cardiac surgeries. Reduced positive fluid balance, increased cardiac index, and decreased systemic vascular resistance were the main beneficial effects of using hypertonic solutions in this population. Well-designed clinical trials are highly needed, particularly in aortic aneurysm repair surgeries, where hypertonic solutions have shown many beneficial effects. Examining the immunomodulatory effects of hypertonic solutions should also be a priority in future studies

Early Osseointegration Events on Neoss (R) ProActive and Bimodal Implants : A Comparison of Different Surfaces in an Animal Model

Background: Cell interactions, adherence, and osseointegration at the bone-implant interface can be directly influenced by the surface properties of the titanium implant. Purpose: To characterize osseointegration of Neoss (R) implants with conventional (control group) and hydrophilic (test group) surface treatments. Materials and Methods: Six Labrador dogs received Neoss implants with conventional and hydrophilic surfaces. The bone-implant interfaces were evaluated 1 and 4 weeks after implantation, and osseointegration was evaluated using histological, histomorphometric, fluorescence, and resonance frequency analyses. The surfaces were also subjected to topographic and hydrophilicity analyses. Results: The topographic analyses revealed increased surface roughness in the test group compared with the control group (surface area roughness 0.42 and 0.78 mu m, respectively, for control and test group surfaces; p <= .05). The wettability values were higher in the test group (contact angles 67.2 degrees and 27.2 degrees for the control and test group surfaces, respectively; p <= .05). Implants in the test group also exhibited better stability, more bone-implant contact, and increased bone area compared with implants in the control group. Conclusion: Neoss implants in the test group improved bone formation in the early stages of osseointegration compared with implants in the control group

Guided Surgery in Unusual Palatal Torus

Palatine torus is a benign congenital outgrowth of bone that affects the hard palate and palatine processes, resulting from the "overworking" of osteoblasts and bone deposition along the line of the palatine fusion. Surgical excision is the only treatment for torus, and such patients are susceptible to intraoperative and postoperative complications of a traumatic, functional, or infectious nature. This article describes an atypical case of torus palatinus measuring 20.31 x 27.25 x 59.20 mm, which is the largest size ever described in the literature. This case required the use of a surgical guide in the intraoperative phase, with viable use in the postoperative phase as well. This guide proved versatile in reducing the risk of undercorrection and complications, offering greater patient comfort