Clinical and Radiographic Success Rates of Pulpotomies in Primary Molars Treated with Formocresol, BiodentineTM, and Endo Repair: A Randomized Clinical Trial

Objective: To compare the clinical and radiographic success rates of formocresol, BiodentineTM, and Endo Repair agents in primary molars after 12 months. Material and Methods: This randomized double-blind clinical trial was conducted on healthy children referred to the Department of Pediatric Dentistry, Kerman, Iran, in 2018. One hundred twenty children (human primary molar teeth) aged 3-9 years were selected and randomly divided into three interventions (with pulpotomy medicament agents), including formocresol, BiodentineTM, and Endo Repair. All pulpotomized teeth were restored using stainless steel crowns and evaluated clinically and radiographically during a 12-month follow-up. Fisher exact test was used to determine the association of categorical variables and the data were analysed with SPSS 25. Results: All the available teeth in formocresol and BiodentineTM groups obtained clinical success, whereas 62.5% of the Endo Repair group was successful in this regard. Radiographic success rates of the formocresol, BiodentineTM, and Endo Repair groups were 94.7%, 70%, and 28.1% after a 12-month follow-up, respectively. Moreover, pulp canal obliteration was observed in 26.3%, 25%, and 12.5% of the formocresol, BiodentineTM, and Endo Repair groups. Conclusion: This study reported a high rate of clinical success using both BiodentineTM and formocresol pulpotomy techniques. However, the radiographic success rate of formocresol was higher than that of BiodentineTM, and Endo Repair was not considered a suitable pulpotomy medicament agent

Economic Burden of Epidermolysis Bullosa Disease in Iran

Background: Epidermolysis bullosa (EB) is prevalent in Iran and incurs direct and indirect costs on the health care system and the patient.Therefore, this study was conducted to estimate the economic burden of this disease in Iran. Methods: Tins study includes all patients with EB disease who had been referred to the medical centers of Iran in 2019-2020 for treatment of their disease, especially Hazrat Fatimah Hospital and their medical records are available in Iran EB Patients Association (IEBPA). In estimating the economic burden of diseases and costing studies. wre calculated the average direct and indirect costs for a patient and used it to estimate the costs of the patient population. In this study, a prevalence approach was used to calculate the economic burden of this disease. For this purpose, the existing cases of the disease in 2019-2020 were calculated. The data collected from the questionnaires that were completed through interviews with patients as well as the data extracted from the review of their files were entered into Excel software and analyzed. Results: The total direct medical costs of direct non-medical and indirect are equal to 7.319.428.315 & 5.390.440.775 and 45.875.654.514 Rials respectively, and the total economic burden of the disease and the average of each patient is 58.585.514.604 and 155.890.789 respectively. Conclusion: High indirect costs, especially informal care, represent the socio-economic burden of this disease and constitute more than half of the total indirect costs. Therefore, the obvious gap and hidden social costs of this disease are related to health policymakers, especially when they want to study the impact of this disease on different income classes of families

CLEFT LIP AND PALATE. CLINICAL STUDIES REGARDING SPEECH AND FACIAL GROWTH

Cleft lip and palate (CLP), the most common of all craniofacial anomalies, has an incidence about 2 per 1000 births in the Scandinavian countries. The Department of Plastic and Reconstructive Surgery in Malmö has been a regional centre in southern Sweden for the treatment of patients with CLP since 1954 with about 40 new cases of clefts each year. Speech and facial growth are important objectives in the treatment for CLP and these are thought to depend on the primary surgery during infancy. Between 1954 and 1976 we operated on the lip using Millard´s technique and the palate was repaired early according to von Langenbeck’s technique (L-group). From 1976 to 1996, the lip was repaired by a two-stage procedure – the Johansson-Randall concept. Palate repair was postponed to about 18 months of age and performed using Wardill’s technique (W-group). Hence, there was a unique opportunity to study two long periods during which different strategies of primary repair were used according to standardized protocols. Altogether 97 adult patients were investigated for this long term follow-up. The first two studies describe the outcome in patients with unilateral CLP (UCLP) regarding speech (I) and facial growth (II). Only slight speech quality differences were observed between the two groups. The findings possibly favour the L-groups, though at the expense of an increased need for a complementary speech improving operation. The L- and W-groups showed similar results regarding facial growth. Studies III and IV describe similarly the long-term outcome in patients with bilateral CLP (BCLP), respectively. Also in patients with BCLP, only minor differences were noted between groups L and W. However, as in UCLP, the outcome regarding speech possibly favoured the L-group. Concerning facial growth, the results were again compatible. UCLP is generally associated with the better results regarding speech and facial growth, in the long-term perspective. BCLP is associated with the more marked deviation of facial morphology, and the rate of complementary operations, including those intended to improve speech, is more frequent

Speech results in adult Swedish patients born with bilateral complete cleft lip and palate.

Thirty-six adult patients (26 men and 10 women) who had been operated on for bilateral complete cleft lip and palate (BCLP) were evaluated with regard to long-term follow-up consisting of clinical investigation, perceptual speech analysis, and self-estimation of quality of speech. Twenty-six had had a von Langenbeck repair at the age of 14 months (L-14 group), and 10 a Wardill repair at the age of 18 months (W-18 group). Statistical comparisons between the groups were made by univariate and multiple logistic regression analyses. Both groups had a large percentage of hypernasality despite a high incidence of velopharyngeal flaps in both. There were no significant differences between the groups regarding any of the analysed speech variables. The outcomes of hypernasality, nasal escape, velopharyngeal friction sounds, hyponasality, and general impression indicate, however, a slightly better result for the L-14 group

Tissue expansion 1984-1999: A 15-year review.

We assessed all patients who underwent tissue expansion, excluding breast reconstructions, between 1984 and 1999. A total of 237 patients had 257 expansions, normally for distorted scars, 202 of 257 cases (79%). Their mean age was 27 (range 7- 67) years, most being women, 149 of 237 (63%). The mean duration of expansion was 16 weeks (range 0.4-118). The most common site was the skull (61/257). Prophylactic antibiotics were used in 224 of 257 (86%) at the time of expander insertion and 147 of 257 (56%) at the removal of the expander. Sixty-two patients (24%) had minor complications and 34 (13%) had major complications. Tissue expansion can be used with a currently acceptable failure rate though we continue to strive to lower this further

Speech results in adult Swedish patients born with unilateral complete cleft lip and palate.

Sixty-one adult patients (34 men and 27 women) who were operated on for unilateral complete cleft lip and palate (UCLP) were followed up from 1996-2001 by clinical investigation, perceptual speech analysis, and self-estimation of quality of speech. Thirty-four had had a von Langenbeck repair at the age of 8 months (L-8 group), and 27 a Wardill repair at the age of 18 months (W-18 group). Statistical comparisons were made by univariate and multiple logistic regression analyses. The L-8 group had a slightly better general outcome but at the expense of a greater incidence of velopharyngeal flaps. There was no significant difference in hypernasality, being 7/34 (21%) of the patients in the L-8 group, compared with 9/27 (33%) in the W-18 group. Compared with findings reported previously of patients with isolated cleft palate (CP) who were treated and investigated under the same circumstances, the speech outcome in the group with UCLP was found to be significantly better

von Langenbeck procedures at 14 months or Wardill at 18 months for primary repair of cleft palate in adult Swedish patients with bilateral complete cleft lip and palate: A study of facial growth.

We compared facial growth in patients with bilateral complete cleft lip and palate (BCLP) in whom the palate had been repaired by the von Langenbeck procedure at the age of 14 months (L-14), or by the Wardill procedure at 18 months (W-18). A total of 151 unaffected subjects were used as a reference group. Thirty-six adult patients, 26 in the L-14 group, and 10 in the W-18 group, were investigated clinically and with lateral skull radiography, and they also filled out a questionnaire about their dental condition. Multiple linear regression was used to analyse the effect of surgical strategy, sex, and the presence of a velopharyngeal flap on several dependent variables indicating sagittal and vertical jaw relations, and inclination of incisors. The BCLP group was characterised by a pre-normal basal relation (ss-n-sm), retroclined upper (ILs/NL) and lower (ILi/ML) incisors, maxillary retrognathism (s-n-ss) in men, larger maxillary plane angle (NSL/NL) in women, larger mandibular plane (NSL/ML) and intermaxillary vertical relation (NL/ML) in men, and smaller anterior facial height (n-gn) and upper anterior facial height (n-sp). In the BCLP group, differences in outcomes could be explained only by sex. The sagittal jaw base relation (ss-n-sm) was significantly smaller in men than in women, whereas the total anterior facial height (n-gn) was greater in men. Lateral crossbite was found in about 75% of patients. About 70% were satisfied with their dental condition. The choice of surgical strategy had no significant influence on the variables measured on facial morphology

von Langenbeck procedures at 8 months or Wardill at 18 months for primary repair of cleft palate in adult Swedish patients with unilateral complete cleft lip and palate: A study of facial growth.

The purpose of this study was to compare facial growth in patients with unilateral complete cleft lip and palate (UCLP) in whom the palate was repaired with the von Langenbeck procedure at 8 months (L-8), or the Wardill procedure at 18 months (W-18). A total of 151 unaffected subjects were used as a reference series. Sixty-one adult patients, 34 in the L-8 group and 27 in the W-18 group, were investigated clinically and with lateral skull radiography and also filled out a questionnaire about their dental condition. Multiple linear regression was used to analyse the effects of the surgical strategy, sex, and the presence of a velopharyngeal flap on several dependent variables indicating sagittal jaw relations, vertical jaw relations, and inclination of incisors. The UCLP group was characterised by a short (n-sp) and retrusive maxilla (s-n-ss) and a retrusive mandible for women (s-n-sm), larger maxillary inclination (NSL/NL), more retroclined lower incisors (IL(I)/ML), shorter upper facial heights (n-sp) and normal total face height (n-gn) than the reference group. In the UCLP group there were significant differences between men and women in mandibular prognathism (s-n-sm), maxillary/mandibular relations (ss-n-sm), maxillary inclination (NSL/NL), total anterior facial height (n-gn), and upper anterior facial height (n-sp). Lateral crossbite was found in 20% of the UCLP group. The prevalence was similar in the L-8 and W-18 groups. Almost 80% of the patients in the UCLP group considered that their dental condition was good. The choice of surgical strategy had no significant influence on the variables measured on facial morphology

Ionic Liquid Modified SPION@Chitosan as a Novel and Reusable Superparamagnetic Catalyst for Green One-Pot Synthesis of Pyrido[2,3-<i>d</i>]pyrimidine-dione Derivatives in Water

In this paper, the chitosan-functionalized ionic liquid is modified with superparamagnetic iron oxide nanoparticles to form a novel and reusable catalyst (SPION@CS-IL), which was carried out using an ultrasonic promoted approach. Transmission electron microscopy (TEM), vibrating-sample magnetometer (VSM), energy-dispersive X-ray spectroscopy (EDX), Fourier transform infrared spectroscopy (FT-IR), X-ray powder diffraction (XRD), energy-dispersive X-ray spectroscopy (EDX), and thermogravimetric analysis (TGA) are some of the techniques that are used to fully characterize SPION@CS-IL. The created nanoparticles were discovered to be a reusable heterogeneous superparamagnetic catalyst for the environmentally friendly one-pot synthesis of pyrido[2,3-d]pyrimidine derivatives using a simple three-component reaction approach involving thiobarbituric acid, 4-hydroxy coumarin, and various aromatic aldehydes. The method is studied by performing the reaction under ultrasonic irradiation, while the approach is a “green” method, it uses water as the solvent. The isolated yields of the synthesized products are very advantageous. The catalyst has outstanding reusability and is easily removed from the products via filtration (5 runs). Short reaction times, low catalyst loadings, the nanocatalyst’s capacity to be recycled five times, and the absence of harmful chemical reagents are all significant benefits of this environmentally benign process