Influence of irrigation and intracanal dressing on the healing process of dogs' teeth with apical periodontitis.

Dogs' teeth with apical periodontitis were treated endodontically, Dakin's solution being used in an experimental group as the irrigation solution, and camphorated paramonochlorophenol as an intracanal dressing. For a second group of teeth, the irrigation solution used was physiologic saline, dry cotton only being placed into the pulpal chamber to take the place of an intracanal dressing. In a second visit, overinstrumentation and a new application of the same kind of dressing were performed, the root canals being then filled with gutta-percha cones and zinc oxide-eugenol cement. Other specimens were treated, in one visit, where physiologic saline or Dakin's solution were the irrigation solutions. The animals were sacrificed 6 months after the obturation of the root canals. Histologic exams showed better results for the experimental group where Dakin's solution and camphorated paramonochlorophenol had been used, with signs of repair characterized by newly formed cementum and bone tissue, as well as a marked reduction in size of the periapical lesions. No differences were seen in the results with physiologic saline or Dakin's solution as irrigants.

Healing and expression of growth factors (TGF-β and PDGF) in canine radial ostectomy gap containing platelet-rich plasma

Objectives: To evaluate bone healing in an experimental radial ostectomy in dogs treated with autologous platelet-rich plasma (PRP), through histological, densitometric, radiographic studies, as well as expression of growth factors in the ostectomy gap. Methods: Twenty-one dogs were randomly divided into either a control or a PRP group. All underwent unilateral ostectomy of the radius to generate a gap of 2.0 mm, that was stabilized with external skeletal fixation. The ostectomy gap was either filled with PRP or left empty as a control. The radiographic and densitometric studies were performed after surgery, then at intervals until 60 days during the post-surgery period. Histological and immunohistochemical evaluations were performed at seven or 60 days post-surgery. Analyses were performed using a statistical analysis system, and the level of significance was set at p <0.05. Results: The median radiographic healing score in the PRP group increased significantly between day 0 and day 60. Furthermore, at 60 days, the median healing score and the proportion of healed ostectomies in the control group (score 1; 1/6 healed) and the PRP group (score 5; 4/5 healed) were significantly different. There were differences between groups in radiographic and densitometric values at days 45 and 60. The histological evaluation showed advanced bone healing at 60 days in the PRP group and signs of delayed union in the control group. Clinical relevance: Platelet-rich plasma can be used as an adjuvant therapy because it may promote better bone healing of a radial ostectomy treated with external skeletal fixation in dogs.

Tratamento conservador de fratura de arco zigomátio: uma visão conservadora

Introduction: The zygomatic maxillary complex is the second most affected area of the face due to injuries, surpassed only by the nasal bones. The zygomatic arch fracture is under the direct action of trauma (punch, head butt), its fragile structure, losing its normal convex curvature in the temporal area. Objective: To report a case, using a reduction technique of zygomatic arch fracture using a hook or Ginestet Barros. Case report: A male patient, 25 years of age, leukoderma, showing zygomatic arch fracture right. The patient underwent closed reduction with the hook adapted to the skin. The patient was instructed to keep care of the region for at least four weeks

Displasia cemento-óssea florida: relato de caso

The florid cemento-osseous dysplasia is an asymptomatic lesion present in the fibro-osseous maxilla and mandible of uncertain etiology. It has higher expression in females, and patients melanoderm, middle-aged to elderly. This dysplasia is an asymptomatic condition that can be discovered when a radiograph is performed. A biopsy is contraindicated to avoid infection difficult to treat. We report the case of a white woman 52 years old, who searched the Clinic of Surgery and Traumatology Bucco-maxillofacial surgery, Faculty of Dentistry of Araçatuba with pain in the posterior portion of left mandible. After radiographic examination was diagnosed with florid cementoosseous dysplasia. Treatment was instituted clinical and radiographic.

Combined effect of anterior malocclusion and inadequate lip coverage on dental trauma in primary teeth

Objectives: The main objective of this study was to investigate whether the interaction of malocclusion (open bite or increased overjet) combined with inadequate lip coverage strengthens its association with traumatic dental injury (TDI) in the primary teeth of preschool children compared to the presence of malocclusion alone. Subjects and methods: A cross-sectional survey was conducted with 376 children aged 3659 months who attended the National Day of Childrens Vaccination. Presence of TDI, tooth discoloration, and sinus tract were evaluated in the children. Variables associated with occlusion were also evaluated. A Poisson regression analysis was performed to verify the association between the explanatory variables and TDI as well as possible interactions among the variables. Then, the prevalence ratio was calculated. Results: The prevalence of TDI was 27.7%. The maxillary central incisor was the most affected tooth, without differences between the right and left sides. Boys had more dental trauma than girls (P = 0.04). The most common TDI was crown fracture restricted to the enamel (58.4%). Children with a combination of anterior open bite or increased overjet and inadequate lip coverage presented a higher prevalence of TDI than when the malocclusions were presented alone (P < 0.05). The same trends were observed when we included, in the final adjusted model, increased overjet instead of open bite. Conclusions: Anterior malocclusions of primary teeth such as increased overjet and anterior open bite are statistically significantly associated with dental trauma only when inadequate lip coverage is also present.

Comparative study of cone beam computed tomography and intraoral periapical radiographs in diagnosis of lingual-simulated external root resorptions

Background: Owing to a lack of symptoms and difficult visualization in routine intraoral radiographs, diagnosis of external root resorptions can be challenging. Aim: The goal of this study was to compare two image acquisition methods, intraoral radiographs and cone beam computed tomography (CBCT), in the diagnosis of external resorption. Material and Methods: Thirty-four maxillary and mandibular bicuspids were divided into three groups. Perforations measuring 0.3 and 0.6 mm in diameter and 0.15 and 0.3 mm in depth, respectively, were made on the lingual root surfaces in thirty teeth, and four were used as controls. Next, teeth were mounted on an apparatus and radiographed at mesial, distal, and orthoradial angulations. CBCT images were also taken. The analysis of the intraoral radiographic and tomographic images was carried out by two experts using standardized scores. Data were then compared statistically. Results: A strong agreement between the examiners was observed in both diagnosis methods, the intraoral radiographic (r = 0.93) and the tomographic analysis (r = 1.0). Tomography had higher statistically significant detection values than intraoral radiography (P < 0.05). In intraoral radiographs, the detection was significantly greater (P < 0.05) in the mandibular bicuspids, compared with their maxillary counterparts. The ability to detect 0.6-mm perforations by intraoral radiography was significantly higher than that of 0.3-mm perforations (P < 0.05). Conclusion: Cone beam computed tomography showed better diagnostic ability compared with intraoral radiography, regardless of the tooth or the dimensions of the resorption evaluated.

Fracture susceptibility of endodontically treated teeth

Aim: To assess the influence of cervical preparation on fracture susceptibility of roots. Material and methods: During root canal instrumentation, the cervical portions were prepared with different taper instruments: I: no cervical preparation; II: #30/.08; III: #30/.10; IV: #70/.12. The specimens were sealed with the following filling materials (n = 8), A: unfilled; B: Endofill/gutta-percha; C: AH Plus/gutta-percha; D: Epiphany SE/Resilon. For the fracture resistance test, a universal testing machine was used at 1 mm per minute. Results: anova demonstrated difference (P < 0.05) between taper instruments with a higher value for group I (205.3 +/- 77.5 N) followed by II (185.2 +/- 70.8 N), III (164.8 +/- 48.9 N), and IV (156.7 +/- 41.4 N). There was no difference (P > 0.05) between filling materials A (189.1 +/- 66.3 N), B (186.3 +/- 61.0 N), C (159.7 +/- 69.9 N), and D (176.9 +/- 55.2 N). Conclusions: Greater cervical wear using a #70/.12 file increased the root fracture susceptibility, and the tested filling materials were not able to restore resistance.

Assessment of nose protector for sport activities: finite element analysis

There has been a significant increase in the number of facial fractures stemming from sport activities in recent years, with the nasal bone one of the most affected structures. Researchers recommend the use of a nose protector, but there is no standardization regarding the material employed. Clinical experience has demonstrated that a combination of a flexible and rigid layer of ethylene vinyl acetate (EVA) offers both comfort and safety to practitioners of sports. The aim of the present study was the investigation into the stresses generated by the impact of a rigid body on the nasal bone on models with and without an EVA protector. For such, finite element analysis was employed. A craniofacial model was constructed from images obtained through computed tomography. The nose protector was modeled with two layers of EVA (1 mm of rigid EVA over 2 mm of flexible EVA), following the geometry of the soft tissue. Finite element analysis was performed using the LS Dyna program. The bone and rigid EVA were represented as elastic linear material, whereas the soft tissues and flexible EVA were represented as hyperelastic material. The impact from a rigid sphere on the frontal region of the face was simulated with a constant velocity of 20 m s-1 for 9.1 mu s. The model without the protector served as the control. The distribution of maximal stress of the facial bones was recorded. The maximal stress on the nasal bone surpassed the breaking limit of 0.130.34 MPa on the model without a protector, while remaining below this limit on the model with the protector. Thus, the nose protector made from both flexible and rigid EVA proved effective at protecting the nasal bones under high-impact conditions.

Isokinetic muscle strength and knee function associated with double femoral pin fixation and fixation with interference screw in anterior cruciate ligament reconstruction

Intensive scheduling in sports requires athletes to resume physical activity shortly after injury. The purpose of this study was to investigate early isokinetic muscle strength and knee function on bone-patellar tendon-bone (BPTB) ACL reconstruction with double femoral pin fixation or interference screw technique. A prospective study was conducted from 2008 to 2009, with 48 athletes who received femoral BPTB fixation with interference screw (n = 26) or double pin (n = 22). Clinical (IKDC objective score and hop test) and isokinetic muscle strength (peak torque (PT), PT/body weight and flexion/extension rate (F/E) in 60 and 240A degrees/s) were analyzed at 6 months of follow-up. Analysis at baseline showed no differences between groups before surgery related to age, gender, associated injury, Tegner or Lysholm score; thus showing that groups were similar. During follow-up, however, there were significant differences between the two groups in some of the isokinetic muscle strength: PT/BW 60A degrees/s (Double Pin = 200% +/- A 13% vs. Interference Screw = 253% +/- A 16%*, *P = 0.01); F/E 60A degrees/s (Double Pin = 89% +/- A 29%* vs. Interference Screw = 74% +/- A 12%, *P = 0.04). No statistical differences between groups were observed on IKDC objective score, hop test and complications. The significant muscle strength outcome of the interference screw group found in this study gives initial evidence that this fixation technique is useful for athletes that may need accelerated rehabilitation. Early return to sports ability signaled by isokinetic muscle strength is of clinical relevance as it is one of the main goals for athletes' rehabilitation. III.

The effect of bone allografts combined with bone marrow stromal cells on the healing of segmental bone defects in a sheep model

Background: The repair of large bone defects is a major orthopedic challenge because autologous bone grafts are not available in large amounts and because harvesting is often associated with donor-site morbidity. Considering that bone marrow stromal cells (BMSC) are responsible for the maintenance of bone turnover throughout life, we investigated bone repair at a site of a critically sized segmental defect in sheep tibia treated with BMSCs loaded onto allografts. The defect was created in the mid-portion of the tibial diaphysis of eight adult sheep, and the sheep were treated with ex-vivo expanded autologous BMSCs isolated from marrow aspirates and loaded onto cortical allografts (n = 4). The treated sheep were compared with control sheep that had been treated with cell-free allografts (n = 4) obtained from donors of the same breed as the receptor sheep. Results: The healing response was monitored by radiographs monthly and by computed tomography and histology at six, ten, fourteen, and eighteen weeks after surgery. For the cell-loaded allografts, union was established more rapidly at the interface between the host bone and the allograft, and the healing process was more conspicuous. Remodeling of the allograft was complete at 18 weeks in the cell-treated animals. Histologically, the marrow cavity was reestablished, with intertrabecular spaces being filled with adipose marrow and with evidence of focal hematopoiesis. Conclusions: Allografts cellularized with AOCs (allografts of osteoprogenitor cells) can generate great clinical outcomes to noncellularized allografts to consolidate, reshape, structurally and morphologically reconstruct bone and bone marrow in a relatively short period of time. These features make this strategy very attractive for clinical use in orthopedic bioengineering

Forensisch-anthropologische und traumatologische Untersuchungen an den menschlichen Skeletten aus der spätmittelalterlichen Schlacht von Dornach (1499 n. Chr.)

Der Forschungsgegenstand der vorliegenden Arbeit war die Identifikation und Interpretation von Traumata an menschlichen Skeletten. Neben einer umfassenden Darstellung des aktuellen Kenntnisstandes unter verschiedenen Gesichtspunkten wurden menschliche Überreste aus der Schlacht von Dornach 1499 n. Chr. untersucht. Ergänzend wurde eine Versuchsreihe mit Replika mittelalterlicher Waffen an Kunstköpfen durchgeführt. Für die Ansprache und Kategorisierung von Traumata an Skelettfunden existiert kein einheitliches und allgemein gebräuchliches System. Die verschiedenen Herangehensweisen und ihre Vor- und Nachteile wurden benannt und diskutiert. Nachfolgend wurden die Erscheinungsformen prä-, peri- und postmortaler Traumata bzw. Defekte sowie von Verletzungen durch stumpfe und scharfe Gewalt, Schussverletzungen und anderen Verletzungsarten dargestellt. Weitere besprochene Aspekte waren die Abgrenzung von Traumata gegen pathologische Veränderungen und anatomische Varianten sowie eine Diskussion der Methodik und Problematik der Erfassung von Verletzungsfrequenzen. Neben der Bestimmung von Geschlecht, Sterbealter und Körperhöhe wurden an den zur Untersuchung zur Verfügung stehenden Schädeln (N=106) und Femora (N=33) aus der Schlacht von Dornach 1499 n. Chr. pathologische und postmortale Veränderungen sowie als Schwerpunkt prä- und perimortale Traumata identifiziert und beschrieben. Die anthropologischen Befunde zeichneten das Bild einer in Hinsicht auf Sterbealter und Körperhöhe heterogenen Gruppe von Männern mit wenigen pathologischen Veränderungen. Die Ergebnisse wurden vor dem Hintergrund des spätmittelalterlichen Söldnerwesens diskutiert. An den Schädeln wurden insgesamt 417 perimortale Traumata identifiziert, wobei Hiebverletzungen stark überwogen. Die Entstehungsweise charakteristischer Merkmale von Hiebverletzungen konnte experimentell nachvollzogen werden. Weiter stellte sich heraus, dass Hiebverletzungen durch Schwerter und Hellebarden nur in Ausnahmefällen voneinander unterschieden werden können. Verletzungen durch punktuelle Einwirkungen und stumpfe Gewalt sowie Schussverletzungen wurden in weitaus geringerer Häufigkeit festgestellt. Experimentell konnte gezeigt werden, dass die Verletzungen durch punktuelle Einwirkungen mit einer Beibringung durch Langspiesse, Stossspitzen und Reisshaken von Hellebarden sowie Armbrustbolzen vereinbar sind, wobei beträchtliche Limitationen einer genaueren Waffenzuordnung offenkundig wurden. Die Verletzungen konnten als wohl typisch für die damalige Zeit bezeichnet werden, da sie das zeitgenössische Waffenspektrum deutlich widerspiegeln. Die Lokalisation der perimortalen Traumata am Schädel liess kein Muster erkennen, mit Ausnahme der Feststellung, dass grössere Schädelknochen mehr Verletzungen aufwiesen als kleinere. Diese regellose Verteilung wurde als Hinweis darauf verstanden, dass die Kampfweise keine „ritterliche“ gewesen sein dürfte, was in Einklang mit den damals geltenden Kriegsordnungen steht. Postmortale Veränderungen unterschiedlicher Art liessen vermuten, dass die untersuchten Individuen nicht bestattet wurden und dass die vom Schlachtfeld aufgesammelten Gebeine in Beinhäusern aufbewahrt wurden. Die Resultate bestätigten damit Angaben aus Schriftquellen und erlaubten die Zuordnung der Skelettreste zu Gefallenen des Reichsheeres. Beim Vergleich der Dornacher Stichprobe mit anderen mittelalterlichen Schlachtfeldserien traten sowohl hinsichtlich der anthropologischen Befunde als auch im Hinblick auf die Verletzungen und Verletzungsmuster deutliche Ähnlichkeiten zutage. Diese ergänzten nicht nur das lückenhafte Bild spätmittelalterlicher Heere und ihrer Kampfweise, sondern beleuchteten auch Unterschiede zwischen mittelalterlicher und neuzeitlicher Kriegsführung.

Percutaneous cement augmentation for the treatment of depression fractures of the tibial plateau

The management of insufficiency fractures of the tibial plateau in osteoporotic patients can be very challenging, since it is difficult to achieve a stable fixation, an essential condition for the patients' early mobilization. We present a minimally invasive technique for the treatment of proximal tibial plateau fractures, "tibiaplasty", using percutaneous polymethylmethacrylate augmentation. Five osteoporotic patients (7 fractures) with a non-traumatic insufficiency tibial plateau fracture were treated with this technique at the authors' institution from 2006 to 2008. The patients' median age was 79 (range 62-88) years. The intervention was performed percutaneously under general or spinal anesthesia; after the intervention, immediate full weight bearing was allowed. The technique was feasible in all patients and no complications related to the intervention were observed. All patients reported a relevant reduction in pain, were able to mobilize with full weight bearing and would undergo the operation again. No secondary loss of reduction or progression of arthrosis was observed in radiological controls; no revision surgery was required. Our initial results indicate that tibiaplasty is a good treatment option for the management of insufficiency in tibial plateau fractures in osteoporotic patients. The technique is minimally invasive, safe and allows immediate mobilization without restrictions. In our group of patients, we found excellent early to mid-term results.

Anterior knee pain after total knee arthroplasty: does it correlate with patellar blood flow?

Total knee arthroplasty (TKA) disturbs patellar blood flow, an unintended accompaniment to TKA that may be a cause of postoperative anterior knee pain. We examine whether disrupted patellar blood flow correlates with anterior knee pain following TKA.

Use of a 1.5 mm butterfly locking plate for stabilization of atlantoaxial pathology in three toy breed dogs

The objective of this study was to describe the use of a titanium 1.5 mm locking plate in the stabilization of atlantoaxial pathology in three toy breed dogs. Two dogs with atlantoaxial subluxation and another dog with an axial fracture, confirmed by diagnostic imaging, were stabilized via a ventral approach with a 1.5 mm titanium 5-hole locking butterfly-plate. Surgical reduction and stabilization were assessed by computed tomography and radiography after surgery. Follow-up evaluation for resolution of neurological signs and possible complications was performed in all three dogs. For long-term assessment, a telephone follow-up was performed. A considerable improvement of neurological signs occurred within two to four weeks after surgery. An excellent clinical outcome was identified in all three patients. Adequate stabilization and resolution of neurological signs in all three dogs was achieved. The stabilization of atlantoaxial surgical conditions in toy breeds with the 1.5 mm titanium 5-hole butterfly locking plate appears to be an effective means of surgical treatment.

Ground reaction force profiles after partial and pancarpal arthrodesis in dogs

OBJECTIVES: To evaluate and compare long-term functional outcome after partial carpal arthrodesis and pancarpal arthrodesis in dogs using kinetic gait analysis. METHODS: Fourteen dogs with 19 partial carpal or pancarpal arthrodeses were retrospectively examined and underwent force-plate gait analysis. Mean times since surgery were 29.4 and 24.4 months for pancarpal and partial carpal arthrodesis respectively. Vertical and braking-propulsive ground reaction force profiles were compared between treatment groups, and to those of normal dogs (control group) using Kruskal-Wallis one-way analysis of variance. RESULTS: With the exception of time to vertical peak that occurred earlier in dogs with pancarpal than in dogs with partial carpal arthrodesis (p <0.01), there was no difference between the two treatment groups. Several parameters differed significantly between operated and healthy dogs (p <0.01): vertical impulses were significantly lower in both treatment groups, braking forces and impulses were also reduced after both techniques. Propulsive forces and impulses were only reduced in dogs with pancarpal arthrodesis. When comparing gait parameters of sound limbs of unilateral operated dogs to those of control dogs, braking forces and impulses (p <0.01; p <0.05) were significantly higher in the sound legs of unilateral operated dogs. CLINICAL SIGNIFICANCE: Long-term outcome after partial carpal and pancarpal arthrodesis is good and comparable to each other. Propulsive action may be altered more in dogs with pancarpal arthrodesis.