Novel Techniques in Dentoalveolar and Implant Surgery

The topics of this chapter can help manage or prevent several common intraoperative problems facing clinicians during dentoalveolar and implant surgery. Three novel techniques are presented: (1) a technique for the stabilization of mucoperiosteal flaps following exposure of an impacted tooth requiring the apical repositioning of the gingival flap to allow for bonding of an orthodontic bracket, (2) a technique for the management of bone loss after tooth extraction and immediate dental implant placement, and (3) a technique to repair maxillary sinus membrane perforations during sinus lifting for implant placement

Local versus radical surgery for early rectal cancer with or without neoadjuvant or adjuvant therapy

Background: Total mesorectal excision is the standard of care for Stage-I rectal cancer. Despite major advances and increasing enthusiasm for modern endoscopic local excision (LE), uncertainty remains regarding its oncologic equivalence and safety relative to radical resection (RR). Methods: We performed a comprehensive search of major electronic databases, trial registries, and grey literature for randomized controlled trials (RCT) comparing LE versus RR with or without use of neo/adjuvant chemoradiotherapy. We used standard Cochrane Collaboration methodological procedures. Oncologic, surgical, and functional outcomes were sought and compared using a generic inverse variance and random-effects models, where appropriate. Results: Of eight potential studies, only three RCTs were complete and included in data synthesis with a combined total of 211 patients. Risk of bias was judged as unclear for oncologic outcomes across studies and high for surgical morbidity outcomes. Disease-free survival was comparable between LE versus RR (hazard ratio (HR) 1.48, (95% confidence interval (CI) 0.54 to 4.02; low-quality evidence, translating into 8.1% vs. 5.6% disease recurrence after LE and RR, respectively). Similarly, there was no difference between LE versus RR in cancer-related survival, local recurrence-free survival, or metastasis-free survival. There were no cases of 30-day mortality after any of the interventions. Risk of major postoperative complications was not significantly lower with LE (risk ratio 0.56, 95%CI 0.21 to 1.51; very low-quality evidence; corresponding to 5.2% for LE vs. 9.3% for RR). Very low-quality evidence suggested a non-significant trend for fewer minor postoperative complications after LE (risk ratio 0.53, 95% CI 0.28 to 1.03; very low-quality evidence; corresponding to 16.2% for LE vs. 30.6% for RR). One study reported 24% rate of definitive stoma only after RR. Data suggested shorter length of stay after LE. No objective data was available regarding sphincter function, quality of life or genitourinary function in any of the studies. Conclusion: Based on limited and low to very low-quality evidence, this review suggests an equal role for LE in terms of oncologic and operative outcomes in patients with early-stage rectal cancer. If further supported by more RCTs, LE has the potential to become the preferred approach in these patients.Medicine, Faculty ofSurgery, Department ofGraduat

The Relation between Serum Vitamin D Levels and Blood Pressure: A Population-Based Study

Vitamin D deficiency has been proposed as an associating factor with increased blood pressure. We studied the relationship between serum vitamin D and blood pressure in a large representative sample of Iranian population. In this cross-sectional study, based on the data of 2508 adults (aged between 20 and 70 years) from the Iran Multicenter Osteoporosis Study (IMOS), the association between serum vitamin D and blood pressure was investigated. There was a significant difference between mean (±SD) vitamin D levels of the individuals with stage I hypertension and that of the three other groups (Normal: 32.9 (±27.5); Prehypertension: 34.4 (±27.2); Stage-I: 38.7 (±29.2); Stage-II: 34.7 (±24.0) ng/ml; P<0.05. In multivariate regression models, the weak positive association of vitamin D and systolic blood pressure values disappeared after age and Body Mass Index (BMI) adjustment. We found a statistically positive but weak association between vitamin D serum concentration and systolic blood pressure. Considering the difference noted between our results and previous studies, further research is needed to assess the potential effect of ethnicity and genetic factors on these findings

Evaluation of cytotoxic effects of Anbarnesa on fibroblast L929: Can it be used as a mouthwash?

Aims: In Iranian traditional medicine Anbarnesa (derived from smoke from burning female donkey′s stool) has been used to treat ulcers and inflammatory conditions like stomatitis and ear infections (otitis). We assess the properties of Anbarnesa as an alternative mouthwash. Materials and Methods: In this experimental study, Anbarnesa smoke was analyzed using aGC-mass device. The smoke collected was dissolved at different densities in propylene glycol and incubated in Dulbecco′s modified Eagle′s medium in direct contact with fibroblast cells. Assessment of cytotoxicity was done at 1, 24 and 72 h. Cell viability was measured by methyl thiazolyl tetrazolium test, and ELISA Reader machine was used to read the results. Data were analyzed using one-way ANOVA test. Results: The findings of this study showed Anbarnesa was nontoxic in 1/64, 1/128 and 1/256 dilutions. In 1/32 dilution, toxicity was seen after 72 h. In dilutions, 1/8 and 1/16 toxicity were seen in the 1 st h. Conclusion: According to the initial results of Anbarnesa may be used as an alternative mouthwash with fewer side-effects for plaque control and prevention of periodontal disease