A prospective and randomized study comparing ultrasound-guided real time injection to conventional blind injection of botulinum neurotoxin for glabellar wrinkles.

BACKGROUND: Botulinum neurotoxin injections are the most frequently performed cosmetic procedures, but conventional blind injection for glabellar wrinkles remains to have some limitations. AIMS: We intend to directly inject botulinum neurotoxin into the glabella complex guided by real time ultrasound. We aim to propose a more efficient and safer botulinum neurotoxin injection strategy for glabellar wrinkles. METHODS: A total of 40 subjects with moderate to severe glabellar lines were enrolled in this study to receive botulinum neurotoxin injection, either through ultrasound-guided real time injection or conventional blind injection. Facial Wrinkle Scale (ranging from 0 = none to 3 = severe) and inter-brow distance (from 3D scanned face images) were used to evaluate the glabellar wrinkles improvement. Paired t test and two-sample t test were performed to analyze the within-group and between-group differences. RESULTS: The wrinkle score reduction was significant (p < 0.0001) immediately after the injection in ultrasound-guided injection group, but not in blind injection group (p = 0.163). Ultrasound-guided injection also showed a higher performance of wrinkle score reduction and more effective inter-brow distance increase over blind injection at Day 0 (p < 0.0001), Day 1 (p < 0.0001), Day 21 (p < 0.01) and Day 35 (p < 0.01) after initial treatment. CONCLUSIONS: The results of the study confirmed that botulinum neurotoxin injection for glabellar wrinkles under ultrasound guidance achieves quicker onset of action and better final outcomes compared to conventional blind injection.

Bibliometric research on analysis of links between periodontitis and cardiovascular diseases.

Background: Periodontitis (PD) and cardiovascular diseases (CVD) rank among the most prevalent pathologies worldwide, and their correlation has been a subject of prolonged investigation. Numerous studies suggest shared etiological factors; however, a definitive causal connection remains unestablished. The objective of this study was to employ bibliometric and visual analyses in order to comprehensively examine the overarching characteristics, focal areas of research, and prospective trends pertaining to the PD-CVD relationship. Methods: We sourced articles, reviews, and online publications on PD- and CVD- research from the Web of Science Core Collection (WoSCC) spanning from January 1, 1993, to May 15, 2023. A triad of analytical tools (R-Bibliometrix, VOSviewer 1.6.19, and CiteSpace 6.2.R3) were utilized to facilitate collaboration network analysis, co-citation analysis, co-occurrence analysis, and citation burst detection. Results: Out of the 1,116 publications that fulfilled the eligibility criteria in the WoSCC database, the comprehensive characteristics analysis divulged a sustained growth trend in publication frequency. In the cluster analysis of reference co-citation and keyword co-occurrence, prominent themes such as "periodontitis", "cardiovascular diseases", "inflammation", "Porphyromonas gingivalis", and "atherosclerosis" consistently emerged. Contemporary topics such as "peri-implantitis," "COVID-19", "cardiovascular risk factors," and "endocarditis" were pinpointed as burgeoning research hotspots. Conclusion: Based on this bibliometric study, in the field of association studies between PD and CVD, the etiologic mechanisms of both diseases have been intensively studied in the last three decades. Periodontal pathogens might serve as potential initiating factors linking PD and CVD. Inflammation may constitute a significant etiological factor shared by both diseases. Several emerging topics, such as COVID-19 and peri-implantitis, exhibit promising potential. This exhaustive overview casts light on pivotal research arenas, augmenting the field's understanding and stimulating further scholarly investigations.

Scientometric Research on Trend Analysis of Nano-Based Sustained Drug Release Systems for Wound Healing.

Nanomaterials, such as the nanoparticle (NP), nanomicelle, nanoscaffold, and nano-hydrogel, have been researched as nanocarriers for drug delivery more and more recently. Nano-based drug sustained release systems (NDSRSs) have been used in many medical fields, especially wound healing. However, as we know, no scientometric analysis has been seen on applying NDSRSs in wound healing, which could be of great importance to the relevant researchers. This study collected publications from 1999 to 2022 related to NDSRSs in wound healing from the Web of Science Core Collection (WOSCC) database. We employed scientometric methods to comprehensively analyze the dataset from different perspectives using CiteSpace, VOSviewer, and Bibliometrix. The results indicated that China published the most significant number of documents in the last two decades, Islamic Azad Univ was the most productive institution, and Jayakumar, R was the most influential author. Regarding the analysis of keywords, trend topics indicate that "antibacterial", "chitosan (CS)", "scaffold", "hydrogel", "silver nanoparticle", and "growth factors (GFs)" are the hot topics in recent years. We anticipate that our work will provide a comprehensive overview of research in this field and help scholars better understand the research hotspots and frontiers in this area, thus inspiring further explorations in the future.

[Application of local skin flaps in adjustment of reconstructed nasal alars at second stage].

Objective: To investigate the effectiveness of local skin flaps such as V-Y advancement flap (V-Y plasty) and transposition flap (Z plasty) in the adjustment of reconstructed nasal alars at second stage. Methods: Between June 2012 and January 2017, 14 cases of reconstructed nasal alars by nasolabial flap or expanded forehead flap were recruited. There were 9 males and 5 females with an average age of 34.8 years (range, 18-52 years). The interval time between one- and two-stage operations was 1-12 months (mean, 3 months). The type of local skin flap was decided according to the flaws of reconstructed nasal alars. V-Y plasty was used in 5 cases, Z plasty in 2 cases, and V-Y plasty combined with Z plasty in 7 cases. Results: All operations were successfully completed. The flaps in 3 cases suffered from epidermal necrosis at the far end and healed by dressing change. The other wounds healed by first intention. All 14 cases were followed up 6-40 months (mean, 12 months). The nasal alars had verisimilar shape and symmetrical appearance. The color and texture of reconstructed nasal alar were closed to peripheral tissues. Conclusion: Applying local skin flaps such as V-Y plasty and Z plasty can acquire a better shape in the adjustment of reconstructed nasal alars.

Enhanced Repairing of Critical-Sized Calvarial Bone Defects by Mussel-Inspired Calcium Phosphate Cement.

The goal of this study is to investigate the biological response of mussel-inspired calcium phosphate cement (CPC) in vivo. Polydopamine (PDA), which is analogous to that of mussel adhesive proteins, was added in CPC. PDA-CPC was implanted into the femur, muscle, and critical-sized calvarial bone defects of rabbits. Histomorphometry of the sequential fluorescence sections showed that PDA-CPC was capable of forming more newborn bone than the control-CPC. More new bone, bone marrow cavity, and blood vessel were observed in PDA-CPC than in the control-CPC in decalcified and undecalcified histological sections. Necrosis bone was not observed in PDA-CPC, whereas it appeared in the control-CPC after 2 weeks. The histological sections in muscle witnessed that there was more ingrowth of collagen in PDA-CPC than that in the control-CPC. There were no significantly difference in the number of leukocyte between PDA-CPC and the control-CPC in blood. It was confirmed that the addition of PDA enhanced the bone repairing ability and biocompatibility of PDA-CPC. Push-out testing indicated that PDA increased the bonding strength between PDA-CPC and host bone in the early stage. These present results indicated that PDA-CPC might be one potential bone graft with gratifying biocompatibility and enhanced bone repairing.

[EFFECTIVENESS OF DEEP INFERIOR EPIGASTRIC ARTERY PERFORATOR FLAP FOR REPAIR OF PERINEAL AND PERIANAL CICATRICIAL CONTRACTURE].

OBJECTIVE: To discuss the effectiveness of deep inferior epigastric artery perforator flap to repair perineal and perianal cicatricial contracture. METHODS: Between March 2007 and December 2013, 23 patients with perineal and perianal cicatricial contracture were treated with deep inferior epigastric artery perforator flap. There were 15 males and 8 females, aged from 21 to 62 years (mean, 42 years). Burn depth was III degree. The burning scars involved in the fascia, even deeper, which was rated as peripheral type (mild stenosis of the anal region and perianal cicatricial contracture) in 13 cases and as central type (severe stenosis of the anal region and anal canal with shift or defect of external genitalia) in 10 cases. All patients had limited hip abduction and squatting. Repair operation was performed at 3 months to 2 years (mean, 6 months) after wound healing. The size of soft tissue defects ranged from 10 cmx6 cm to 28 cm x 13 cm after scar excision and release. The size of flaps ranged from 12 cmx7 cm to 30 cmx15 cm. The donor site was sutured directly in 16 cases and repaired by autograft of skin in 7 cases. RESULTS: The flap had distal necrosis, distal cyanosis, and spotted necrosis in 1 case, 2 cases, and 1 case respectively, which were cured after symptomatic treatment; the other flaps survived and wound healed primarily. Twenty-one patients were followed up 6 months to 2 years (mean, 1 year). Nineteen patients had good appearance of the perinea and position of external genitalia, normal function of defecation function; stenosis of the anal region was relived, and the flaps had good texture and elasticity. Linear scar contracture was observed at the edge of flap in 2 cases, and the appearance of the perineum was restored after Z plasty. The hip abduction reached 30-40°. No abdominal hernia was found at donor site. CONCLUSION: Deep inferior epigastric artery perforator flap has stable blood supply and flexible design, which is similar to the perianal and perineal tissues. The good effectiveness can be obtained to use this flap for repair of perineal and perianal cicatricial contracture.

Effect of polydopamine on the biomimetic mineralization of mussel-inspired calcium phosphate cement in vitro.

Inspired by the excellent adhesive property of mussel adhesive protein, we added polydopamine (PDA) to calcium phosphate cement (PDA-CPC) to enhance its compressive strength previously. The mineralization and mechanism on PDA-CPC were investigated by soaking it in simulated body fluid in this study. The results indicated that PDA promoted the conversion of dicalcium phosphate dihydrate and α-tricalcium phosphate to hydroxyapatite (HA) in the early stage but inhibited this conversion subsequently. PDA promoted the rapid mineralization on PDA-CPC to form a layer of nanoscale calcium phosphate (CaP) whereas there was no CaP formation on the control-CPC after 1d of soaking. This layer of nanoscale CaP was similar to that of natural bone, which was always observed during soaking. X-ray photoelectron spectroscopy showed that the peak of CO of PDA existed in the newly formed CaP on PDA-CPC, indicating the co-precipitation of CaP with PDA. Furthermore, the newly formed CaP on PDA-CPC was HA confirmed by transmission electron microscopy, which the newly formed HA was in association with PDA. Therefore, PDA increased the capacity of mineralization of CPC and induced the formation of nanoscale bone-like apatite on PDA-CPC. Thus, this provides the feasible route for surface modification on CPC.

New horizontal v-shaped osteotomy for correction of protrusion of the zygoma and the zygomatic arch in East Asians: indication and results.

Protrusion of the zygoma is commonly considered undesirable and unattractive among East-Asians, and many try to achieve a harmonious oval midface by having various cosmetic operations. However, effective contouring for a severe protruding zygoma has rarely been reported .The objectives of this study therefore were to investigate the feasibility and effectiveness of a horizontal V-shaped ostectomy for correction of protrusion of the zygoma and zygomatic arch, and to discuss its indications. From January 2008 to December 2011 we treated 27 patients by contouring of the zygoma with a horizontal V-shaped ostectomy through intraoral and preauricular incisions. The effectiveness was then evaluated with cephalometric radiographs, 3-dimensional computed tomography, and standard facial photographs taken before and after operation. The postoperative appearance of all 27 patients showed that the protrusion had been effectively reduced with no serious complications, and the facial contour had improved. The final aesthetic outcomes were satisfactory for both surgeons and patients. The horizontal V-shaped osteotomy is a good technique for the reduction of protrusion of the zygoma and zygomatic arch, and it has the advantages of more convenient multishifting, better results, and fewer complications. It also ensures the integrity of the structure of the malar complex.

High conversion self-curing sealer based on a novel injectable polyurethane system for root canal filling.

Low monomer-polymer conversion is the key factor leading to cytotoxicity for resin-containing restorative materials. This paper provides a new root canal filling system based on self-curing injectable polyurethane which can achieve high conversion in a short time. Traced FTIR spectra show more than 90% NCO group participated in the curing reaction after 4h, and only about 5% remained after 24h. The calculated data also testified the curing process supports a third-order reaction, and this efficient and sufficient reaction is postulated to weaken the toxic stimulation. By culturing with L929 murine fibroblasts, the PU sealer is shown to be favorable for cell attachment and proliferation. Then physicochemical properties of the injectable PU-based sealer were evaluated according to the Standard [ISO 6876:2001 (E)] for clinical application. A series of physicochemical properties of PU sealer have been tested comparing with AH Plus and Apexit Plus. And the results present that the self-curing PU sealer could not only match the clinic requirements, but even has better properties than the other two commercial sealers. We expect the high conversion PU sealer has a tremendous potential in the field of root canal filling after further biological evaluation.

Preliminary evaluation of a novel strong/osteoinductive calcium phosphate cement.

We developed a novel calcium phosphate cement (CPC) by combining the silk fibroin and osteogenic supplements (ß-glycerophosphate, ascorbic acid, and dexamethasone) with α-tricalcium phosphate cement. Mesenchymal stem cells (MSCs) were cultured on the novel CPC scaffold. Results showed that the novel CPC scaffold was biocompatible and favorable for the adhesion, spreading, and proliferation of MSCs. Osteogenic differentiation of MSCs was confirmed by high osteocalcin content and elevated gene expressions of bone markers, such as alkaline phosphatase, collagen type I, and osteocalcin. Therefore, the novel CPC scaffold may be potentially useful for implant fixation and more rapid new bone formation in moderate load-bearing applications.