Dental Implants and Trauma

Implant dentistry treatment target to avoid any kind of edentulous state including tooth loss due to trauma. In the literature there are numerous case reports and few clinical studies documenting treatment options of post-trauma patients by dental implants. Principally there are some limitations of dental implant application related to the age and available bone volume of patients. Implant candidate should complete bone growth as the metallic implants do not follow bony development phases. Most often traumatic dental injuries occur in childhood and implant treatment should postponed. In this aspect the major problem associated with dental implant placement is the lack of adequate bone volumes at the future time of surgery as such cases receives traumatic dental injury in the early years and disuse atrophy occurs during waiting period. Future trends and strategies in dental traumatology in general and with special attention to dental implant applications are based on the education of population in terms of emergency treatments and urgent transport of patients to the clinics

Oral Mucosal Trauma and Injuries

Trauma-related oral lesions are common in clinical practice of dentistry and they can impair patients’ normal oral function and cause pain in patients’ eating, chewing, and talking. An injury to the oral mucosa can result from physical, chemical, or thermal trauma. Such injuries can result from accidental tooth bite, hard food, sharp edges of the teeth, hot food, or excessive tooth brushing. Some injuries can also be caused by iatrogenic damage during dental treatment or other procedures related to oral cavity. In this chapter, oral mucosal trauma and injuries will be examined in four subclasses: physical and mechanical traumas of oral mucosa; chemical injuries of the oral mucosa; radiation injuries; and electrical, thermal burns

Platelet-Rich Plasma in Trauma Patients

Platelet-rich plasma (PRP) was mixed with thrombin and excess calcium resulting in activated platelets trapped within the fibrin network; within the matrix, platelets secrete bioactive substances that diffuse into the surroundings tissues. PRP is prepared from the patient’s own blood, a variety of manufacturing techniques in vastly different cell counts, and growth factor concentrations. The clinical use of PRP is treatment of soft tissue diseases and injuries, treatment of burns, hard-to-heal wounds, tissue engineering, and implantology in dentistry. An essential criterion for PRP is for it to be autologous, for the donor of the blood, and the recipient of the PRP to the same person. Most of the literatures suggest that PRP does not appreciably impact bone healing or induce bone formation. PRP might augment recruitment of osteoblast progenitors to injection sites or in sites expected to experience delayed healing. In this capacity, PRP might be utilized to initiate repair of an otherwise poorly healing bony lesion. PRP stimulates bone repair in fractures. Early through late healing process is compromised with fractures, including reduced cell proliferation, delayed chondrogenesis, and decreased biomechanical properties. In this chapter, the importance of the PRP in oral and maxillofacial surgery in trauma patients is studie

Biomaterial Used in Trauma Patients

The development of bone tissue engineering and bone regeneration is always of interest to improve methods to reduce costs of trauma patient. Ability to use autogenous bone forming cells attached to bone morphogenetic proteins would be ideal. There are many clinical reasons to develop bone tissue engineering alternatives, for use in the reconstruction of large defects and implants. The traditional methods of bone defect management include autografting and allografting cancellous bone, vascularized grafts, and other bone transport techniques. However, these are the standard treatments. Since bone grafts are avascular and dependent on the size of the defect, the viability can limit their application. In large defects, the grafts can be resorbed by the body before osteogenesis is complete; tissue loss develops in the living organism due to infection, trauma, congenital, and physiological reasons. Placing tissue defects in the dentist and maxillofacial surgery and accelerating wound healing are an important issue. From an old Egypt, material used in treatment of different doctors with various causes. Oral surgery, periodontology, and implantology, which are surgical branches of the dentistry, need to increase bone formation in the treatment of bone defects, congenital defects, and defects around the implant. Many years of work have been done to obtain ideal biomaterials, and many materials have been used. We have prepared detailed information on biomaterials used in dentistry, oral, and maxillofacial surgeries in this book to help dentists and dental students

Fast MRI evaluation of pulmonary progressive massive fibrosis with VIBE and HASTE sequences: comparison with CT

PURPOSE The aim of this prospective study was to evaluate the diagnostic utility of volumetric interpolated breath-hold examination (VIBE) and half-Fourier-acquisition single-shot turbo spin-echo (HASTE) fast magnetic resonance imaging (MRI) sequences in the evaluation of pulmonary progressive massive fibrosis (PMF) in comparison with computed tomography (CT) imaging. If fast MRI is proven to be diagnostically significant, this modality can be used for diagnosis and follow-up studies of PMF patients. MATERIALS AND METHODS Twenty-two PMF lesions from 20 coal workers were evaluated. After CT imaging, patients underwent pre-contrast VIBE, contrast-enhanced VIBE, and HASTE MRI studies for detection and evaluation of the PMF lesions. Measurements of the three groups were evaluated with intra-class coefficients. Correlation levels between sizes, image quality, and artifact were evaluated with linear Pearson correlation analysis. RESULTS There was almost perfect agreement among radiologists for lesion detection with kappa analysis. There was significant agreement between three MRI study groups and gold standard CT images. We found the best agreement values with contrast- enhanced VIBE images for lesion detection and image quality in comparison with CT imaging. Presence of artifact was also lowest with this protocol. CONCLUSION With fast MRI sequences in pulmonary imaging, image quality has significantly improved being very close to that of CT studies. In this study, contrast-enhanced VIBE protocol provided the best depiction of PMF lesions. This protocol may be an alternative choice for CT, avoiding the use of iodinated contrast material and minimizing exposure to ionizing radiation for follow-up studies

Preparation, Characterization and İnvestigation of Swelling Behavior of HEMA-Based Amphiphilic Semi-IPN Cryogels Containing Polymeric Linoleic Acid

In this study, it was aimed to synthesize and characterize a new polymeric cryogel system to be formed with polymeric linoleic acid (PLina), a vegetable oil-based polymeric fatty acid, and the widely preferred 2-hydroxyethyl methacrylate (HEMA) monomer. cryogels. For this purpose, firstly, autoxidation and hydroxylation reactions were carried out for polymeric lineloic acid, respectively. Hydroxylated polymeric lineloic acid (PLina-OH) and HEMA monomer were subjected to a cryogenic gelation reaction in the presence of N,N′-methylene bisacrylamide (MBAA) as crosslinking agent. The obtained new cryogel was characterized by FTIR, SEM, BET, TGA analyses. The swelling behavior of the synthesized PLinaOH-HEMA cryogels in water was concluded with kinetic studies. In the other hands, some of polar and non-polar other solvents was used for investigation of all cryogels to see their potentials for solvent uptake

Radioguided occult lesion localization versus wire-guided localization for non-palpable breast lesions: randomized controlled trial

AIM: This prospective randomized clinical study was conducted to compare radioguided occult lesion localization (ROLL) with wire-guided localization to evaluate optimum localization techniques for non-palpable breast lesions. METHODS: A total of 108 patients who were undergoing an excisional biopsy for non-palpable breast lesions requiring pathologic diagnosis were randomly assigned to the ROLL group (n = 56) and wire-guided localization group (n = 52). In the study, patients' characteristics, radiological abnormalities, radiological technique of localization, localization time, operation time, weight of the excised specimen, clearance margins, pathological diagnosis and perioperative complications were assessed. RESULTS: There were no differences between the two groups in terms of age, radiological abnormalities and localization technique (p = non-significant for all). ROLL techniques resulted in 100% retrieval of the lesions; for the wire-guided localization technique, 98%. Both localization time and operation time were significantly reduced with the ROLL technique (p = significant for all). The weight of the specimen was significantly lower in the ROLL group than in the wire-guided localization group (p = significant). The overall complication rate and pathological diagnosis were similar for both groups (p = non-significant for all). Clear margins were achieved in 91% of ROLL patients and in 53% of wire-guided localization patients, and the difference was significant. CONCLUSIONS: The present study indicated that the ROLL technique is as effective as wire-guided localization for the excision of non-palpable breast lesions. In addition, ROLL improved the outcomes by reducing localization and operation time, preventing healthy tissue excision and achieving clearer margins

The Role of Oxygen Free Radicals in Acute Renal Failure Complicating Obstructive Jaundice: An Experimental Study

Oxydant injury is considered to be an important mechanism in the pathophysiology of acute renal failure. It has been thought that decrease in extracellular and intracellular fluid and endotoxemia seen in obstructive jaundice may cause an increase in production of oxygen free radicals and impairment in antioxydant defense mechanism. This study is designed to investigate the possible role of oxydant injury in renal failure seen in jaundiced patients. In this study, 28 rats were divided into four groups: Control(C) (N=7); Renal ischemia (RI) (N=7); Obstructive jaundice+renal ischemia (OJ+RI) (N=7); Obstructive jaundice (OJ) (N=7). All groups were compared with each other according to renal failure findings and enzyme activities, such as Xanthine oxidase (XOD), Superoxide Dismutase (SOD) and Catalase in renal cortex and Glutathione Peroxidase (GSH-Px), in blood at 3rd day after ischemia and reperfusion. Renal failure findings monitored by blood urea and creatinine levels, seemed more evident in OJ+RI than RI group (p <0.05). When compared with RI, in OJ+RI group, increase in XOD activity at 3rd day was statistically significant [0.259 ±0.01 U/g (tissue) and 0.362±0.03 U/g (tissue) respectively] (p <0.05). SOD and GSH-Px activities of each ischemic group at 3rd day were decreased compared to non-ischemic groups. This fall was significant (p <0.05). But there was no statistical difference between jaundiced and non-jaundiced groups. Alterations in catalase activities also had no statistical significance

Electrostimulation of the lingual nerve by an intraoral device may lead to salivary gland regeneration : a case series study

Salivary gland function is controlled by the salivary reflex, whose efferent arm is composed by the parasympathetic and the sympathetic divisions of the autonomic nervous system. Parenchymal injury is the main salivary gland involvement of Sjögren?s syndrome and head and neck radiotherapy, but neural damage has been reported as well. Recently an intraoral device for electrostimulation of the lingual nerve in vicinity to the lower third molar has been introduced. At this point this nerve carries efferent fibers for the innervation of the submandibular, sublingual and several minor salivary glands and afferent fibers of the salivary reflex. Therefore, excitation of these fibers potentially leads to increased secretion of all salivary glands. Thus, the study objective was to assess whether comprehensive neural activation by electrostimulation of the lingual nerve carries the potential to induce the regeneration of damaged salivary glands. The device was tested on three patients with no collectable resting and stimulated secretion of saliva during a double blind, sham controlled period of two months and nine open-label months. All three subjects developed the capacity to spit saliva, not only in direct response to the electrostimulation but also after free intervals without electrostimulation. In addition, their symptoms of dry mouth severity and frequency improved. This recovery is probably due to the combined effect of increase in secretory functional gland mass and regain of nervous control of the secretory elements and blood vessels. Both are phenomena that would contribute to gland regeneration

Clinical features and molecular genetic analysis in a Turkish family with oral white sponge nevus

Oral white sponge nevus (WSN) is a rare autosomal dominant benign condition, characterized by asymptomatic spongy white plaques. Mutations in Keratin 4 (KRT4) and 13 (KRT13) have been shown to cause WSN. Familial cases are uncommon due to irregular penetrance. Thus, the aim of the study was: a) to demonstrate the clinical and histopathological features of a three-generation Turkish family with oral WSN b) to determine whether KRT4 or KRT13 gene mutation was the molecular basis of WSN. Out of twenty members of the family ten were available for assessment. Venous blood samples from six affected and five unaffected members and 48 healthy controls were obtained for genetic mutational analysis. Polymerase chain reaction was used to amplify all exons within KRT4 and KRT13 genes. These products were sequenced and the data was examined for mutations and polymorphisms. Varying presentation and severity of clinical features were observed. Analysis of the KRT13 gene revealed the sequence variant Y118D as the disease-causing mutation. One patient revealed several previously unreported polymorphisms including a novel mutation in exon 1 of the KRT13 gene and a heterozygous deletion in exon 1 of KRT4. This deletion in the KRT4 gene was found to be a common polymorphism reflecting a high allele frequency of 31.25% in the Turkish population. Oral WSN may manifest variable clinical features. The novel mutation found in the KRT13 gene is believed to add evidence for a mutational hotspot in the mucosal keratins. Molecular genetic analysis is required to establish correct diagnosis and appropriate genetic consultation