Dental Cones: A Novel Stratagem for Dental Drug Delivery

Dental Cones are little pills that are used after tooth extraction to reduce bleeding and halt the formation of germs. They should be made to dissolve or erode during a 20–40-minute period in the presence of a modest volume of serum or fluid. To determine if the local administration into the periodontal pocket could help in boosting medication concentration and reducing systemic adverse effects. d-PTFE membranes, painkillers, mouthwash, sutures, and CT scanners are some of the techniques employed in dental extraction and biomaterial insertion procedures. For this study, 39 Articles in total were included and examined. By having antibacterial, anti-inflammatory, and antioxidant properties, local drug delivery methods can aid in the management of periodontitis

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial

BackgroundAnterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability.MethodsWe did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367.FindingsBetween Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications.InterpretationSurgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management

Malignant eccrine poroma of the vulva: An intriguing case of a rare tumor at an unusual site

Malignant eccrine poroma is a rare malignancy of the eccrine sweat glands, occurring most frequently on the lower extremities. It affects both sexes equally usually in the 6 th to 7 th decade of life. Metastasis to regional lymph nodes may occur in 20% that may be fatal in 60% cases. Its aggressive nature, rarity of occurrence, and unusual presentations make it very important to be evaluated properly by the clinician. We hereby report a case of a 75-year-old female presenting with two exophytic tumors over her vulva with local extension. On histopathological examination, it was diagnosed as malignant eccrine poroma. On magnetic resonance imaging of the pelvic region, metastatic extension in regional lymph nodes was found. She was treated by radical vulvectomy with bilateral inguinal and femoral lymph node dissection followed by radiotherapy

Endoscopic Skull Base Suturing with a Self-Closing U-Clip: A Report of Two Cases and Review of the Literature

Objectives: Self-closing nitinol U-clips (Medtronic, Inc., Minneapolis, MN) have primarily been used by vascular surgeons to facilitate vessel anastomosis. The advantage of this device is that it obviates the need for suturing when manipulation of the tissue or needle is prohibitive. The current report describes a novel use of the U-clip as an aid in endoscopic reconstruction of the skull base. Methods/Participants: Two patients underwent U-clip assisted skull base repair. The first patient underwent transnasal endoscopic repair of an ethmoidal meningoencephalocele requiring primary dural closure and the second underwent odontoidectomy for basilar invagination via an endoscopic transnasal approach requiring primary closure of the soft tissues. Study Design – Case Series Results: The defects were successfully closed using the U-Clip anastomotic device. No cerebrospinal fluid leaks were experienced postoperatively. Intraoperative evaluation combined with postoperative imaging confirmed a satisfactory reconstruction. Conclusions: The U-clip device may be used as an adjunct in select cases to facilitate endoscopic skull base reconstruction. The use of this tool may prevent tissue migration and enhance dural closure. It may be particularly useful in cases where narrow operative corridors make conventional suturing technically difficult

Characteristics of Patients Discontinuing Care

Objectives: Due to lower fees, dental school clinics (DSCs) may provide dental care for vulnerable populations. This study evaluates factors associated with patients deciding to discontinue care at a DSC. Methods: This is a retrospective analysis of a patient transfer form that was implemented to smooth transition of a patient when their student provider graduated. Forms provided deidentified information about characteristics and unmet dental needs. Descriptive and bivariate statistics were used to identify associations between patient characteristics and deciding to continue treatment in the student practice. Results: Of 1894 patients, 73.4% continued care. Financial limitations were most commonly reported as the reason for discontinuing care (30.1%). Patients speaking a language other than English or who had reported financial barriers were significantly less likely to continue care. Conclusions: Dental school patients from vulnerable groups are more likely to discontinue care. Dental schools should implement programs that will assist patients in maintaining a dental home