Clinical and Experimental Biomechanical Studies Regarding Innovative Implants in Traumatology

Fracture treatment has experienced a fascinating evolution in the last years. The aim of this chapter is to reveal some clinical and biomechanical studies regarding innovative implants. After a short introduction (1), we intend to present our results regarding (2) dynamic condylar screw versus condylar blade plate in complex supracondylar femoral fractures; (3) biomechanical analysis of four types of implants in humeral fractures; (4) clinical and experimental studies for optimal stabilization of trochanteric fractures: the gliding nail; (5) intramedullary XS nail for pilon and ankle fractures: design, biomechanics, and clinical results; (6) the XS nail for the treatment of patella and olecranon fractures; and (7) plates with polyaxial stability for fractures of distal radius and proximal humerus. In conclusion, the authors highlight the advantages of these innovative implants in difficult trauma cases

Nano-Architectonics of Antibiotic-Loaded Polymer Particles as Vehicles for Active Molecules

Recently, nanotechnology research studies have been proven that use of various nanoparticles as drug delivery systems to target and to annihilate pathogenic microorganisms may be a good solution for prevention and treatment of severe infection. In the last few years, antimicrobial drug encapsulation into nano-sized systems has materialized as a promising alternative that increased drug efficacy and minimized adverse effects. Physicochemical properties of erythromycin-loaded polymer nanoparticles were assessed using particle size distribution, HPLC, FTIR, TG/DTA, and SEM characterization techniques. The as-prepared samples exhibited an average particle size of 340 and 270 nm, respectively, with erythromycin content of 99.7% in both samples. From the release profile of erythromycin from PLA/PLGA, a prolonged drug release can be observed from both Ery-PLA and Ery-PLGA nanostructures. Morphology images exhibited spherical, rigid, and ring-shaped nanoparticles. Thermal analytical study in the case of Ery-PLA and Ery-PLGA samples showed that pure drug has an endothermic peak at around 150 °C assigned to a melting point. The antibiotic melting peak disappeared for both antibiotic-loaded PLA and PLGA nanoparticles thermographs, denoting the presence of erythromycin. This indicates that the antibiotic is uniformly dispensed throughout the host polymer matrix at nanometer scale. FTIR spectra of Ery-PLA and Ery-PLGA nano-architectures with almost similar peaks indicated no alteration in chemical structure of drug-loaded polymer nanoparticles

STUDY REGARDING THE CHANGES OF THE PHYSIOLOGICAL PARAMETERS AND ADVERSE EVENTS DURING THE SEDATION PROCEDURES FOR PATIENTS CANDIDATE TO DENTAL IMPLANT

Aim of study: This study assessed the sedation levels, the changes of the physiological parameters and the rates of the adverse events during various procedural sedation techniques in ambulatory patients undergoing pre-implant and implant oral surgical procedures. Methods: 120 patients (aged 20-72 years), undergoing pre-implant (sinus lift, bone grafts) and implant procedures were sedated by inhalosedation, midazolam i.v. or propofol and fentanyl under full monitoring (ECG, blood pressure, SaO2). It were assessed and recorded the sedation levels (Ramsey scores) after induction, at the beginning of surgical procedures and at the end of surgical procedures, the changes of physiological parameters (heart rate, blood pressure, SaO2), as well as the adverse events (hyperexcitability, euphoria, respiratory disorders, vaso-vagal reactions). Results. During the sedation procedures desaturation was absent in inhalosedation procedure and was recorded in sedation with midazolam i.v.(20%) and sedation with propofol and fentanyl (22,5%). Hypertension was recorded for 10% patients under sedation with propofol and fentanyl. Abnormal behaviour (hyperexcitability, euphoria) was recorded for 8,5% patients under sedation with midazolam i.v. Respiratory disorders were recorded for 3,4% patients under sedation with midazolam i.v. or propofol and fentanyl. Conclusion. All sedation procedures used in the dentist office for the patients candidate to dental implant have a moderate rate of adverse events but of minor intensity. Patients can be maintained safe by monitoring of the vital signs and by proper therapy of the physiological parameters changes and adverse events

CAREER OPPORTUNITIES FOR DENTAL STUDENTS THROUGH EUROPEAN PROJECTS

Aim of the study The aim of this study is to emphasize the important role of career counselling in choosing the right career path. The dental students have multiple choices in their future career; the most important thing is to have access at objective tools in order to identify the most suitable trajectory. Material and methods We applied a questionnaire among the dental students from Iasi, the 6th year of study, during a period of 7 years (2011-2017) in order to identify their choices for the future career. The statistical processing was made in SPSS 20.0 and we reported the descriptive and the analytical results. Results It will be structured as shown here. Conclusions The study has shown that targeted career counselling has an important and valuable role in establishing the correct professional trajectory according to the individual skills, competences and aspiration

THE PREVENTION OF MEDICAL EMERGENCY IN DENTAL PRACTICE

The diagnosis and management of medical emergencies represents a current issue for dental practitioners, considering the high prevalence of medical disorders, patients receiving polypharmacy as well as the preoperative fear and anxiety among patients receiving dental care. In-depth knowledge of the factors that regulate the chronically disease processes, and pharmacodynamics of drug action, complete medical history and physical examination, as well as stress reduction protocols are requested for effective prevention of medical emergencies in dental office

THE REHABILITATION OF ANTHROPOLOGICAL PARAMETERS THROUGH BONE REGENERATION MATERIALS AND TECHNIQUES

Bone regeneration materials and techniques aid in restoring bone structure and function, consequently improving mobility and alleviating discomfort or disability in individuals suffering from bone defects or injuries. This restoration contributes significantly to an improved quality of life for affected individuals. Continuous research and innovation in bone regeneration materials have led to the development of more sophisticated and effective techniques. These advancements are pivotal in the evolution of medical technology and its potential to address various bone-related conditions. Traditional methods, such as autografts, are associated with limitations like donor site morbidity and limited supply. Emerging bone regeneration materials and techniques offer alternatives that mitigate these issues, potentially reducing reliance on traditional approaches. In conclusion, the utilization of bone regeneration materials and techniques holds substantial promise in rehabilitating anthropological parameters, improving patient outcomes, advancing medical technology, and contributing to a more comprehensive and ethical approach to healthcare

OPTIMIZING ORTHOPEDIC OUTCOMES: THE CRUCIAL ROLE OF PREOPERATIVE DENTAL ASSESSMENT IN HIP AND KNEE ARTHROPLASTY – NARRATIVE REVIEW

Introduction: In the context of orthopedic surgery, particularly knee and hip replacements, the role of dental health often goes unnoticed. This literature review explores the significance of dental clearance prior to knee and hip arthroplasty, highlighting the role of preoperative dental evaluation in reducing the risk of Periprosthetic Joint Infections (PJI). Materials and Methods: The review involved a comprehensive examination of various studies and reports discussing the prevalence of dental pathology in patients requiring joint arthroplasty and the risk factors for PJIs. Additionally, it included the development of a patient selection algorithm and a questionnaire designed to identify individuals at higher risk of dental-related complications. Results and Discussions: This section would discuss the findings of the literature review, particularly focusing on the effectiveness of preoperative dental clearance in mitigating the risks of PJIs. It would also analyze the results obtained from the application of the patient selection algorithm and questionnaire, emphasizing their role in streamlining the preoperative evaluation process. Conclusions: The review concludes by emphasizing the necessity of comprehensive oral health evaluations for patients undergoing hip and knee arthroplasty, especially for those with multiple comorbidities or at higher risk of dental infections. The importance of integrating dental assessments into the perioperative management of joint arthroplasty patients is also highlighted

DENTAL ANTIBIOTIC PROPHYLAXIS IN TOTAL JOINT REPLACEMENT: AN UPDATED REVIEW OF GUIDELINES AND CLINICAL STUDIES

Aim of the study: This review evaluates the necessity and effectiveness of antibiotic prophylaxis in preventing prosthetic joint infections (PJI) following dental procedures in patients with joint implants.Material and methods: An extensive literature review was conducted, focusing on studies evaluating the link between dental care and PJI. Sources included PubMed and other databases, using terms such as dental care, joint prosthesis, and antibiotic prophylaxis. The review spanned papers from 2003 to 2023, with a focus on hip and knee joint replacements and dental procedure-related prophylaxis guidelines.Results: The review found that the prevalence of dental pathology in patients with total hip arthroplasty (THA) or total knee arthroplasty (TKA) varied significantly. Studies indicated no significant benefit of antibiotic prophylaxis in reducing PJI risk post-dental procedures. Furthermore, the incidence of PJI was not significantly different in patients receiving antibiotic prophylaxis compared to those who did not. It was observed that routine activities, such as chewing and brushing, contribute more to bacteremia and potential joint infection than dental procedures themselves.Conclusions: The evidence suggests that antibiotic prophylaxis for dental procedures in patients with joint prostheses is not universally beneficial and should not be routinely recommended. Emphasis on individual risk assessment, maintenance of good oral hygiene, and adherence to evidence-based guidelines is paramount. The study advocates for personalized approaches to PJI prevention, aligning with the goals of antibiotic stewardship and patient safety